Exploratory Focus Groups Research Articles

The Power of Documentary Theatre to Promote Cross-National Understanding: Personal Impact of Performing With Their Voices Raised by Japanese and American Youth Actors.

The purpose of this article is to share descriptions of the personal impact for cross-national youth actors (Japanese, American) who performed With Their Voices Raised (Voices), a documentary theater script that shares the stories of Pearl Harbor and Hiroshima survivors who lived through the bombings of December 7, 1941, and August 6, 1945, respectively. This was a descriptive exploratory focus group study conducted immediately after student-actors from Funairi High School in Hiroshima (n = 15) and Farrington High School in Oahu, Hawaii (n = 8), performed Voices. Data were content analyzed by a cross-national research team to address the question "What was the personal impact of performing Voices for Japanese and American youth actors?" There were three themes that crossed national boundaries: sense of power of the message from real-life people, new cross-national awareness, and moving beyond familiar history to engage and learn. The fourth theme distinguished the youth groups: for Japanese youth, performing Voices inspired an awareness of their local focus; for American youth, it enlivened youth-to-youth engagement as a learning approach. Documentary theater script is a creative, holistic approach with the potential to bridge divisiveness and promote cross-national understanding.

Dissemination strategies and the adoption of improved agricultural technologies: The case of improved cassava varieties in Ghana

Cassava (Manihot esculanta Crantz) is an important tropical root crop for food security and national economies in Africa. In Ghana, it is the most important staple food also used in breweries, bakery and confectionery industries. Several high-yielding and disease resistant improved cassava varieties (ICVs) have been released and are being promoted through diverse dissemination channels. Past studies investigate the role of information in the adoption of agricultural technologies without accounting for the diversity in the dissemination strategies. The paper explores the diversity of dissemination strategies in examining the adoption of improved cassava varieties using a sequential mixed-method approach which combines exploratory interviews and focus group discussions with a questionnaire-based quantitative survey and the Cragg's two-part model. The paper uses data collected from 608 farmers randomly selected from major cassava producing communities in the Ashanti and Brong-Ahafo regions in Ghana, West Africa. The results show statistically significant and identical impact of information through demonstrations, distribution of planting materials, farmer-to-farmer and media on the probability of ICV adoption. Other drivers of adoption are the membership of farmers based organizations (FBO), planting of two or more varieties and having large livestock size. However, ICV adoption and intensity was hampered by household size, distances to the nearest tarred road and market, and grey-skin color. These attributes need to be integral of dissemination campaigns for cassava variety adoption.

"Chasing hope": Parents' perspectives on complementary and alternative interventions for children with autism in Kazakhstan.

The article reports the findings of a qualitative research study on how and why parents of autistic children in Kazakhstan utilize complementary and alternative medicine. We found that parents turn to complementary and alternative medicine because of the lack of professional care options available to them and in pursuit for hope and opportunities for their children with ASD.

Primary care providers' use of and attitudes towards placebos: An exploratory focus group study with US physicians.

To examine how primary care physicians define placebo concepts, use placebos in clinical practice, and view open-label placebos (OLPs). Semi-structured focus groups that were audio-recorded and content-coded. Two focus groups with a total of 15 primary care physicians occurred at medical centres in the New England region of the United States. Prior experience using placebo treatments and attitudes towards open-label placebos were explored. Themes were analysed using an inductive data-driven approach. Physicians displayed a nuanced understanding of placebos and placebo effects in clinical contexts which sometimes focused on relational factors. Some respondents reported that they prescribed treatments with no known pharmacological effect for certain conditions and symptoms ('impure placebos') and that such prescriptions were more common for pain disorders, functional disorders, and medically unexplained symptoms. Opinions about OLP were mixed: Some viewed OLPs favourably or considered them 'harmless'; however, others strongly rejected OLPs as disrespectful to patients. Other issues in relation to OLPs included the following: lack of guidelines, legal and reputational concerns, and the notion that such treatments would run counter to customary medical practice. A number of physicians reported prescribing impure placebos in clinical care. Although some primary care physicians were resistant to the possibility of recommending OLPs, others regarded OLPs more favourably, viewing them as potential treatments, albeit with restricted potential. Statement of contribution What is already known? Many physicians report prescribing drugs for the purposes of eliciting a placebo effect. Initial evidence for the efficacy of open-label placebos is promising. What does this study add? A more nuanced description of the circumstances under which primary care physicians report placebo prescribing. A qualitative account of physician attitudes about using open-label placebos in clinical practice.

Does a student's ethnicity affect their understanding of cultural competency?

Cultural competency has been described as the ability to provide care to patients with various behaviours, beliefs, and values. In essence, creating a working culture and practices that recognise, respect, value and harness differences for the benefit of the organisation and individuals (Nayar, 2013). However, this is just one of the many definitions present; there is currently no widely accepted definition of cultural competency used for the healthcare sector. This lack of a clear explanation is both a reason and a contributing factor to the increasing research into cultural competency.The research method used in this study was an explorative semi-structured focus-group. It involved pharmacy students studying at the University of Huddersfield. Students were interviewed in a focus group style setting and data was transcribed and then coded into themes, which were then further coded into sub-themes utilising a system of semantic thematic analysis. Students showed a holistic understanding of cultural competency and could define it in-line with standard definitions. However, findings showed there was still a gap as to how to apply it in practice especially when dealing with patients of a different ethnicity. The results highlight the positive and negative attributes of student and patient ethnicity towards patient care. The majority of students showed confidence when serving patients of the same ethnicity as them. When dealing with some patients of different ethnicities, students indicated that they knew little about other cultures and therefore struggled to overcome cultural barriers.

Organizational characteristics explaining participation in sustainable business models in the sharing economy: Evidence from the fashion industry using conjoint analysis

AbstractEnvironmental and social challenges require new sustainable business models, like sharing platforms. However, sharing platforms differ widely in their contribution to a more sustainable society. Whereas idealistic sharing platforms have dominant social goals, other sharing platforms are, or became, commercial. We explore the attractiveness of the typical organizational characteristics of idealistic sharing platforms in the fashion industry context, an industry with negative environmental and social impacts. Based on a literature review and exploratory focus groups, we conduct an online survey using conjoint analysis, completed by 1,512 respondents. Our results reveal that potential users prefer clothes sharing platforms to be small, to not partner with large clothing retailers, to have the possibility to participate in decision‐making, but to not require shareholding.

General Practitioners' Perspectives on General and Specialized Palliative Home Care in North Rhine, Germany: An Explorative Focus Group Study.

General practitioners (GPs) are important providers and coordinators of palliative home care (PHC). Through this double role, their perspectives and their treatment decisions influence PHC fundamentally. This study aims to gain deeper insights into GPs' perspectives regarding PHC in North Rhine, Germany. An explorative, semistructured focus group was conducted with 7 doctors. The researchers performed content analysis. Main topics were GPs' role definition in PHC and GPs' medical activities in PHC. Participating GPs describe their role in PHC, based on high motivation and positive attitudes toward PHC as a hybrid role: coordinator, provider (mostly in general PHC), and referrer (gateway to palliative care [PC] specialists). According to GPs' medical activity, participants describe moderate expertise, demanding tasks, and elaborate PHC provision for GPs. Participants stressed the importance of PC in GPs' work. But also PC is a small field in general practice. GPs' PHC benefits from the deep trust resulting from the often close and long-term GP-patient relationship. Complexity and bureaucracy of PHC structures as well as the lack of resources and multidisciplinary cooperation are named as barriers for providing PHC. The highest level of care is reached in specialized PHC, which only very few, severely impaired patients need. Participating GPs see themselves as important PHC providers as well as referrers and coordinators. Complexity and discontinuity in PC arrangements create challenges for their provision. Therefore, they long for reduced bureaucratic burdens.

British South Asian Patients' Perspectives on the Relevance and Acceptability of Mobile Health Text Messaging to Support Medication Adherence for Type 2 Diabetes: Qualitative Study.

BackgroundThe prevalence of type 2 diabetes (T2D) is greater in South Asian populations and health outcomes are poorer compared with other ethnic groups. British South Asians are up to six times more likely to have T2D than the general population, to develop the condition at a younger age, and to experience diabetes-related complications. Interventions to support people in managing their condition can potentially reduce debilitating complications. Evidence to support the use of digital devices in T2D management, including mobile phones, has shown positive impacts on glycemic control. There is increasing recognition that health interventions that are culturally adapted to the needs of specific groups are more likely to be relevant and acceptable, but evidence to support the effectiveness of adapted interventions is limited and inconclusive.ObjectiveThis formative study aimed to explore the perceptions and views of British South Asian patients with T2D on mobile health SMS text messaging to support medication adherence, aimed at the general UK population.MethodsEight exploratory focus groups were conducted in Leicester, the United Kingdom, between September 2017 and March 2018. A diverse sample of 67 adults took part.ResultsBritish South Asian people with T2D who use digital devices, including mobile phones, felt that short messages to support medication adherence would be acceptable and relevant, but they also wanted messages that would support other aspects of self-management too. Participants were particularly interested in content that met their information needs, including information about South Asian foods, commonly used herbs and spices, natural and herbal approaches used in the United Kingdom and in South Asia, and religious fasting. Short messages delivered in English were perceived to be acceptable, often because family members could translate for those unable to read or understand the messages. Suggestions to support patients unable to understand short messages in English included having them available in different formats, and disseminated in face-to-face groups for those who did not use digital devices.ConclusionsExploring the views of British South Asian patients about SMS text messaging aimed at the general UK population is important in maximizing the potential of such an intervention. For such a digital system to meet the needs of UK South Asian populations, it may also have to include culturally relevant messages sent to those who opt to receive them. It is equally important to consider how to disseminate message content to patients who do not use digital devices to help reduce health inequalities.

On the Right Track: Comfort and Confusion in Indoor Environments

Indoor navigation systems are not well adapted to the needs of their users. The route planning algorithms implemented in these systems are usually limited to shortest path calculations or derivatives, minimalizing Euclidian distance. Guiding people along routes that adhere better to their cognitive processes could ease wayfinding in indoor environments. This paper examines comfort and confusion perception during wayfinding by applying a mixed-method approach. The aforementioned method combined an exploratory focus group and a video-based online survey. From the discussions in the focus group, it could be concluded that indoor wayfinding must be considered at different levels: the local level and the global level. In the online survey, the focus was limited to the local level, i.e., local environmental characteristics. In this online study, the comfort and confusion ratings of multiple indoor navigation situations were analyzed. In general, the results indicate that open spaces and stairs need to be taken into account in the development of a more cognitively-sounding route planning algorithm. Implementing the results in a route planning algorithm could be a valuable improvement of indoor navigation support.

An exploration of taught master’s student perceptions of UK dissertation supervision

This paper presents the results of an investigation into taught master’s students’ expectations and experience of being supervised during their final project. It does so using exploratory survey and focus group data from one UK institution with a high proportion of international students. The paper adds to the limited literature on master’s students’ experience, and makes two further main contributions. It finds that students both expect supervisor engagement and respond well to it, and argues that focusing on key elements of the dyadic supervision process can disproportionately improve student’s overall learning and satisfaction. In addition to furthering knowledge in this area, the research suggests numerous practical implications and lines of potential future inquiry.

Norwegian children’s perceptions of effectiveness of social media companies’ cyberbullying policies: an exploratory study

ABSTRACTThere is a paucity of research that examines the effectiveness of social media companies’ anti-bullying tools from the children’s perspective. This article relies on two datasets from Norway: A small-scale exploratory survey and focus groups with children at one school in Norway; and the EU Kids Online survey with a nationally representative sample of Norwegian Internet-using children, to examine whether children and young people aged 9–19 are aware of and whether they use social media companies’ mechanisms against cyberbullying (e.g., various types of reporting, blocking, and companies’ safety and help centers). We also examine the extent to which children find these tools to be helpful and the underlying reasons for such perceptions of the effectiveness of social media companies’ mechanisms. The study further inquires into children’s perceptions of company responsibility for providing assistance in bullying incidents. While the majority of children in both samples know how to use basic tools such as reporting, the levels of awareness of various companies’ advanced tools as well as the use of these, are relatively low. Children also have mixed perceptions as to whether companies are able to assist. Results are discussed from the framework of children’s rights, offering policy recommendations.

Public opinion on crime, punishment and the death penalty in Barbados

The bulk of extant research on public opinion on crime and punishment is focused on Global North nations. This article contributes a new perspective to the literature on punitivism by examining public opinion on crime, punishment and the death penalty in Barbados. The article presents insights from exploratory focus group research conducted in Barbados in 2017. These findings are particularly relevant as Barbadian lawmakers navigate reform of the nation’s death penalty law. While the focus groups reveal anxieties that echo those identified in other jurisdictions, related to nostalgia for the past and concern regarding social order for instance, they also demonstrate the specific relevance of time and place. Using approaches from Caribbean Criminology and drawing on post-colonial perspectives, the article examines the context of views on punishment in Barbados, including perceptions of ‘neo-colonial’ interference and concerns about what can be lost in the process of ‘progress’.

Consumer Response to Mechanically Tenderized Beef (MTB) and MTB Labels: An Exploratory Focus Group Study

In May 2016, labeling of certain nonintact mechanically tenderized beef (MTB) products was mandated in the United States. MTB products should be handled differently by the consumer because pathogens can be transferred from the exterior to the interior of the meat during the tenderization process. Without labeling, it is difficult to visually distinguish between some intact beef and MTB products, which is a concern because MTB products require higher internal cooking temperatures for safety. An exploratory study was conducted to understand consumer understanding of MTB products and consumer responses to the new label. Thirteen focus groups were convened in rural and urban settings across Virginia and North Carolina between December 2015 and May 2016. Sessions were audiorecorded, transcribed verbatim, and analyzed through constant-comparison thematic analysis. Although MTB products were commonly bought, prepared, and consumed, consumer awareness of MTB products and the MTB process was limited. Generally, the label confused participants, and they did not understand the message. Specifically, terminology such as "blade tenderized" and "mechanically tenderized" were preferred over the term "needle tenderized" on labels. Once explained, many individuals wanted more information and better messaging. Through a multiprong approach, other messaging methods (e.g., in stores, through technology, and with certifications) were highly valued by consumers and may result in increased message clarity. Ultimately, the intrinsic and extrinsic properties of the beef rather than the MTB product continued to be the primary guide for purchasing and preparation. This study is the first to be conducted regarding American perceptions of MTB products. An understanding of consumer awareness of MTB products and labels is needed to develop targeted risk messaging communication tools.

The development of a cognitive indoor route planning algorithm: which aspects to include?

Abstract. Wayfinding in the indoor environment is challenging and people often get lost indoors. Navigation systems guide people in these environments, however, the existing systems are not well adapted to their users. The focus of our research is on the route planning aspect of navigation systems. By adapting the routes that people are guided along in the environment, our goal is to substantially improve the wayfinding experience for the users of those systems. Guiding people along routes that adhere better to their cognitive processes could ease the wayfinder in the indoor environment.To select the aspects that should be implemented in a routing algorithm that calculates such routes, a mixed method approach was applied. In this approach, the results of an exploratory focus group and a complementary online survey were combined. To validate these results, a real-life experiment is being developed at the time of writing.Our first study, the exploratory focus group, comprised academic researchers and experts with different background (i.e. Psychology, Geography and Architectural Design). The discussions were guided by a rotating wheel according to the GPS-method which was developed by the Flanders District of Creativity. These discussions provided a broad overview of the elements to be regarded when studying wayfinding. Moreover, results indicate that route complexity has to be considered at different levels: local level (i.e. at decision points) and global level (i.e. legibility of the building). Based on the results of the focus group, multiple situations with specific local characteristics likely inducing confusion and discomfort (e.g. specific intersections, different stair cases, different door types) were selected to elaborate more deeply in the complementary online survey. In this survey, videos of these situations were shown to the participants, as if they were navigating through the building. They were asked to rank their comfort and confusion level about the recorded situation on a 5-point Likert-scale. The results show that visibility, visual clutter and geometric simplicity are of substantial importance when evaluating comfort and confusion levels, and thus the complexity of indoor navigation situations.Since body-movement and the real-world perceptions, which have a substantial impact on information processing and spatial decision making [1], are excluded in these well-controlled lab environments of the previous studies, a real-life experiment will be executed to validate previous findings. The developed study design is in line with the experiment design of previous wayfinding studies [2], [3]. Eye tracking data of participants guided through different complex buildings along different paths (i.e. shortest path and fewest turn path) will be recorded. Performance measures (e.g. duration, stops, errors), eye tracking measures (e.g. fixation number, fixating duration) and annotations of the accompanying researcher, which are all measures indicating complexity and cognitive load, will be compared across the different paths and its decision points. This analysis will allow us to determine complex routes and to identify the environmental characteristics increasing the perceived complexity. Moreover, it will lead to an understanding how and in which occasions people make wayfinding errors.In a subsequent phase of our research project, these results will be incorporated in a cognitively-sounding route planning algorithm which could be a valuable improvement of indoor navigation support. Focus will be on the theoretical interpretation of the underlying spatial concepts. Adjusting the route planning support of indoor navigation systems to human wayfinding behavior could be a substantial contribution in this area.

Giving primacy to the voices of people affected by cancer (PABC) in shaping educational innovations—An exploratory qualitative study

AbstractBackgroundThe number of adults diagnosed with cancer is increasing. Life beyond cancer poses many challenges for individuals and their families; many of those challenges are characterised by health uncertainties both physical and emotional. Evidence suggests that appropriate education improves care and patient outcomes specifically reducing the long‐term adverse effects of cancer and its treatments and increasing adjustment. Less evidence exists as to how meeting holistic rehabilitation needs, monitoring those surviving cancer long‐term, and supporting self‐management are enabled by health care professional (HCP) education.AimsThe aims of this study were to explore the experiences of people affected by cancer (PABC) as a long‐term condition and to use the themes emerging from their experiences to develop online bespoke educational resources/tools.Methods and ResultsA project team of professionals and PABC worked together on a qualitative study to explore the challenges and consequences of life beyond cancer. This paper presents the data from the exploratory focus group, analysed using thematic analysis to identify both common and unique perspectives in PABC experiences. Four themes were identified: the meaning of “survivorship”; the impact of cancer; long‐term needs/expectations; and the role of HCPs and education in meeting needs. These themes were compared with existing literature to enable understanding and “sense making” of the participants' life beyond cancer and to inform the development of the educational resources based on a fictitious patient story to be presented in a future publication.ConclusionsDerived from the PABC stories, a scripted story digitally recorded has been embedded with information and resources. Consultation with additional patient, professional, and public groups helped develop the work into an educational module for nurses and allied health care professionals.

Exploring millennial psychological contract expectations across talent segments

PurposeThe purpose of this paper is to identify talent segments within the millennial generation based on performance and intention to stay and differentiate them in terms of their expectations. Based on results, the paper proposes a customized approach to talent management.Design/methodology/approachThe paper uses a mixed methodology, including 11 exploratory focus group discussions, followed by a survey involving 1,065 employees from nine information technology and business process management companies.FindingsThe paper creates a framework of talent segments (performing loyals, performing movers, developing loyals and developing movers) that have different values for the organization. Significant differences are observed in their PC expectations from the manager, PC expectations related to career growth and development and PC expectations related to job and work environment.Research limitations/implicationsResearchers faced constraints in obtaining actual performance data from the organizations; therefore, a self-perception report of performance was used.Practical implicationsOrganizations’ talent-management strategy must acknowledge and understand the differences in PC expectations of talent segments and offer tailored TM programs for maximum impact.Social implicationsThe paper challenges the old assumption of a uniform psychological contract (PC) that has guided the talent management strategy. Every talent segment has value and must be viewed on continuum rather than a binary construct of “Talent or no talent.”Originality/valueThis is one of the few studies which explores how the perception of PC expectations differs between talent segments. It contributes to literature on talent segments, PC and the millennial generation.

Perceptions of Vanuatu seasonal workers on conducting oral health promotion in their community

Video link: https://www.youtube.com/watch?v=FlJd_Mv2ApU
 Introduction: Poor oral health is a significant public health problem in Vanuatu, and in Melanesia more generally. It has a negative impact on overall health and well-being and is linked to heart disease and diabetes. Determinants of health such as poverty, poor diet, geographical remoteness, and limited oral health care are some of the contributing factors of poor oral health in Vanuatu. Vanuatu seasonal workers visit Aotearoa New Zealand annually under the Recognised Seasonal Employer (RSE) Scheme, for the purposes of fruit processing. Fruit of the Pacific (FOP), a charitable trust, has collaborated with Oral Health at Auckland University of Technology (AUT) to provide oral health care to seasonal workers since 2010. Emerging from these relationships, a community-led initiative was undertaken by returning workers to Vanuatu in collaboration with FOP involving good oral health, especially tooth-brushing.
 Method: In 2016, a small-scale study was undertaken of the perceptions of Vanuatu seasonal workers’ of oral health promotion in their community. An exploratory focus group discussion with seasonal workers and a contextual review of sources was undertaken. This paper discusses oral health in Vanuatu and presents the findings of the study.
 Results/Discussion: The seasonal workers are well aware of the poor oral health of their communities, describing important gains from community-led sharing of oral health messages, including cultural knowledge, empathy, and appropriate forms of communication. They noted that stakeholders and funders are needed on an ongoing basis to support such mechanisms. 
 Conclusion: The study presents and discusses a positive case of Pacific community leaders from migrant diaspora taking action on oral health. This can inform similar actions in Vanuatu, Melanesia, and other Pacific island communities. Further research would be valuable to explore community oral health messaging in Vanuatu and in other settings. Given the potential of the ‘digital dividend’ for greater access to the internet in future, ehealth promotion tools alongside appropriate community programming, might provide a low cost and sustainable model of Pacific oral health promotion.

Effect of a Trauma-Awareness Course on Teachers’ Perceptions of Conflict With Preschool-Aged Children From Low-Income Urban Households

Adverse childhood experiences are common and are associated with changes in early development and learning, but training early childhood educators in trauma-informed approaches to care has not been evaluated with randomized clinical trials. To determine whether a 6-session (12-week) professional development course, "Enhancing Trauma Awareness," improved the quality of teachers' relationships with the children in their classrooms. This cluster randomized clinical trial conducted from September 2017 to May 2018 allocated classrooms by a computer-generated random sequence to intervention (attend Enhancing Trauma Awareness course) and control (no course) groups. Outcomes were reported by participants via survey and analyzed by group allocation. Classrooms under the auspice of the School District of Philadelphia, Pennsylvania, serving 3- and 4-year-old children living in low-income households were invited to participate. Lead and/or assistant teachers from 63 of 348 eligible classrooms (18.1%) agreed to participate, and none were excluded. Of 96 enrolled teachers, 93 (96.9%) were assessed at follow-up (61 of 63 classrooms [96.8%]). In September 2017, 32 classrooms (48 teachers) were assigned to receive a professional development course that taught about the effects of trauma using a group-based relational process, and 31 classrooms (48 teachers) received no intervention. Teachers completed online surveys immediately before and after the course. Exploratory focus groups with intervention teachers (n = 15) were conducted 5 months after the course ended. The primary outcome was teacher-children relationship quality, with a hypothesized decrease in teacher-children conflict scores. Secondary outcomes included relational capacities (eg, empathy, emotion regulation, and dispositional mindfulness). Focus group themes described teachers' experience of the course. Of 96 teachers enrolled, 93 (96.9%) were women, and 58 (60.4%) were 40 years and older. Follow-up surveys were completed by 46 teachers (95.8%) in the control group and 47 (97.9%) in the intervention group, of whom 38 (79.2%) attended 4 or more course sessions. Adjusting for baseline values, mean (SE) conflict scores after the course were not significantly different between course participants (15.8 [0.6]) and controls (15.0 [0.6]) (effect size = 0.16; 95% CI, -0.19 to 0.52). There were no significant between-group differences in secondary outcomes. However, in focus groups, the teachers reported improvements in teacher-children relationship quality and several related relational capacities. A course to enhance trauma awareness among preschool teachers did not reduce teacher-children conflict scores, yet qualitative assessments suggested the potential for improved teacher-children relationship quality. ClinicalTrials.gov identifier: NCT03303482.

Patient acceptance of a telemedicine service for rehabilitation care: A focus group study

Background and purposeDespite positive outcomes, widespread implementation of telemedicine services in rehabilitation care is lacking. This could, for a large part, be attributed to a lack of end-user acceptance. The aim of this article is to look beyond the common theoretical approaches towards end-user acceptance (like the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology), and to explore the factors that contribute to or hinder the acceptance of a telemedicine service for rehabilitation care by patients with a chronic disease. MethodsA qualitative, exploratory focus group approach was applied. We involved 188 patients in 22 focus groups. A guide was developed to provoke a discussion among participants of a rehabilitation clinic on the topic of using an online portal with a wide range of telemedicine features (e.g., an exercise module and a teleconference module). Three coders, using thematic analysis, coded the focus group transcripts simultaneously. ResultsThe focus groups resulted in a wide range of factors that drive or hinder patient acceptance. Facilitators included the possibility to exercise from the comfort of home, the ability to work on one’s recovery, irrespective of the time schedule of care professionals, and improved quality of exercise instruction, due to the provision of exercise videos on the portal. Barriers included a lack of intrinsically motivation, experiencing portal-mediated communication with care professionals as ‘impersonal’, and the lack of physical space and rest to properly exercise at home. Generally speaking, participants were enthusiastic about the idea to provide the telemedicine service as a follow-up treatment as they liked to be in contact with their therapist and to continue training. ConclusionAcceptance of telemedicine services depends on many factors that are not part of well-established theories that explain technology acceptance. These factors are more specific than general determinants, such as ease of use and usefulness, and focus mainly on contextual factors, such as a fit between the service configuration and daily life, personal motivation and the associated psychological burden.

Discussing modern poultry farming systems—insights into citizen's lay theories

A growing public concern, especially about animal welfare problems in poultry farming systems in the EU, has been addressed by numerous (mostly quantitative) studies. However, in-depth research about the underlying reasons for the lack of acceptance concerning modern poultry farming is rare. Debates on animal welfare are often polarized. Thus, this study involved 8 exploratory focus group discussions in 4 German cities. To understand the different positions and to simulate controversial debates on animal welfare, the study includes vegetarians/vegans (as a critical and involved group) and meat eaters. The actual level of knowledge about modern poultry production among participants was heterogeneous, varying between detailed specialized knowledge and misinformation. It was found that improvements for poultry animal welfare that have already been achieved, such as the ban of conventional cages for laying hens in the EU, were not yet recognized by the wider public. A central finding was that participants mostly use lay theories and conclude that the actual poultry husbandry systems make a high use of antibiotics necessary, which has a negative influence on the meat products and, thus, endangers consumer health. The results also indicate that an industrialized agri-food system (rather than farmers) is held primarily responsible for the perceived problems in the poultry value chain. Furthermore, participants are aware of their responsibility and also blame their buying behavior.