Exploratory Mixed Methods Study Research Articles

Preschool Teachers’ Perceptions and Use of Naturalistic Developmental Behavioral Intervention Strategies: An Explanatory Sequential Mixed Methods Investigation

Preschool classrooms serve children of varying abilities, including those who may benefit from social communication intervention. Research supports the use of naturalistic developmental behavioral interventions (NDBI) to effectively increase the social communication skills of young children. Yet, little is known about preschool teachers’ perspectives on and use of NDBI strategies. The purpose of this explanatory sequential mixed methods study was to integrate data from classroom observation, teacher self-report, and qualitative interviews to understand training and support needs for increasing implementation of NDBIs in a preschool classroom context. Eight preschool teachers provided a recording of an intervention session, self-reported their use of NDBI strategies, and participated in an interview to discuss their experiences. Results indicate preschool teacher participants perceive NDBI strategies favorably although they may need targeted support understanding and using NDBI strategies. We discuss implications for practice that may support increased use of NDBIs by preschool teachers.

The effect of case-based teaching method on professional competence and clinical decision-making levels of public health nursing students: A sequential explanatory mixed-methods study.

To evaluate the effect of case-based teaching method applied to fourth year nursing students on their professional competence and clinical decision-making levels. A quasi-experimental design study with a sequential-exploratory mixed-method approach. 64 nursing students enrolled in the Public Health Nursing course. A case-based teaching program was applied to the students that cover the topics of the Public Health Nursing course. Quantitative phase data were collected with the Clinical Decision Making in Nursing Scale and Nursing Students' Competence Scale. For the qualitative part, focus group interviews were conducted with a Structured Interview Form. It was determined that the total and subscale posttest scores of the students increased significantly compared to their pretest scores (p<.001). A moderate positive correlation was found between the total scores received from the scale and a significant positive correlation was found between researching information and adopting new information impartially and all sub-dimensions except care (p<.05). Three main themes emerged from the focus group interviews conducted after the case-based teaching method experience: usefulness, limitations, and improvement. Case-based teaching method is effective on students' professional competence and clinical decision-making scores. Students' professional competence levels positively affect their clinical decision-making levels.

Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study

ABSTRACT Background Wider healthcare-strengthening interventions are recommended in cholera hotspots and could benefit other types of diarrhoeal diseases which contribute to greater mortality than cholera. Objective Describe facility capacity and provider knowledge for case management of diarrhoea and cholera surveillance in cholera hotspots in the Democratic Republic of Congo (DRC) among health facilities, drug shops, and traditional health practitioners. Methods We conducted a sequential exploratory mixed-method study, using focus group discussions, facility audits, and provider knowledge questionnaires during September and October 2022 in North Kivu and Tanganyika provinces, Eastern DRC. Content analysis was used for qualitative data. Quantitative data were summarised by facility level and healthcare provider type. Audit and knowledge scores (range 0–100) were generated. Multivariable linear regression estimated association between scores and explanatory factors. Qualitative and quantitative data were triangulated during interpretation. Results Overall, 244 facilities and 308 providers were included. The mean audit score for health facilities was 51/100 (SD: 17). Private facilities had an −11.6 (95% CI, −16.7 to −6.6) lower adjusted mean score compared to public. Mean knowledge score was 59/100 (95% CI, 57 to 60) for health facility personnel, 46/100 (95% CI, 43 to 48) for drug shop vendors and 37/100 (95% CI, 34 to 39) for traditional health practitioners. Providers had particularly low knowledge concerning when to check for low blood sugar, use of nasogastric tubes, and dosing schedules. Knowledge about case definitions for cholera was similar between groups (range 41–58%) except for traditional health practitioners for the definition during an outbreak 15/73 (21%). Conclusions Increasing awareness of cholera case definitions in this context could help improve cholera surveillance and control. Increased support and supervision, especially for private providers, could help ensure facilities are equipped to provide safe care. More nuanced aspects of case management should be emphasised in provider training.

East Asian American cultural essentialism

East Asian American cultural essentialism

The Pandemic Experiences of Special Education Teachers in Georgia: A Mixed Methods Study

A sequential explanatory mixed methods study was conducted to determine Georgia special education teachers’ (SETs) pandemic experiences. We distributed a survey, held focus groups, and analyzed both data for complementarity. We found that SETs experienced challenges, benefits, and concerns when they returned to their classrooms. Although they reported feeling professionally supported during remote learning, they described difficulties and worries about meeting the individualized needs of students with disabilities. Special educators’ increased workload and stress likely impacted attrition and student learning outcomes. Based on these pandemic-related experiences, we provided five recommendations for researchers, administrators, and policymakers to address the SET shortage and prepare for future school closures.

Treatment burden and regimen fatigue among patients with HIV and diabetes attending clinics of Tikur Anbessa specialized hospital

Nascent studies showed that patients with chronic medical illnesses such as diabetes mellitus (DM) and HIV/AIDS are highly vulnerable to face both treatment burden and regimen fatigue. However, an attempt made so far in this sphere in sub-Saharan African health care context is dearth. Thus, this study aimed to determine the level of treatment burden and regimen fatigue of diabetic and HIV patients attending adult diabetic and ART clinics of TASH and explore patients’ and health care workers’ propositions to reduce treatment burden and regimen fatigue. An explanatory sequential mixed methods study was conducted at the adult HIV and DM clinics of TASH, Addis Ababa, Ethiopia from February 01-March 30, 2022. Simple random and purposive sampling techniques were employed to select participants for quantitative and qualitative studies, respectively. Descriptive analysis was done to summarize the quantitative data. Logistic and linear regression analyses were performed to identify predictors of treatment burden and regimen fatigue, respectively. P value < 0.05 was considered statistically significant. Qualitative data was analyzed by using a thematic analysis. A total of 300 patients (200 diabetes and 100 HIV) were included in the quantitative study. For the qualitative study, 14 patients and 10 health care workers (six nurses and four medical doctors) were included. Participants' mean global Treatment Burden Questionnaire (TBQ) and Treatment Regimen Fatigue Scale (TRFS) score were 28.86 ± 22.13 and − 42.82 ± 17.45, respectively. Roughly, 12% of patients experienced a high treatment burden. The presence of two or more comorbidities (adjusted odds ratio [AOR] = 7.95, 95% confidence interval [CI] 1.59–39.08), daily ingestion of more than five types of prescribed medications (AOR = 6.81, 95%CI 1.59–29.14), and good knowledge about DM and/or HIV (AOR = 0.33, 95%CI 0.12–0.92) were predictors of treatment burden. Poor availability of medications (β = 0.951, p < 0.001) was the only predictor of regimen fatigue. Patients and health care workers primarily proposed to foster self-care efficacy, advance administrative services of the clinic and hospital, and improve healthcare system provision. The findings of this study unveiled that a considerable proportion of patients experienced low levels of treatment burden and regimen fatigue. This study showed that boosting the patients’ self-care efficacy, upgrading administrative services of the clinic and hospital, and promoting the healthcare system provision had enormous significance in reducing treatment burden and regimen fatigue. Therefore, when designing patient-specific healthcare interventions for both HIV and diabetic patients’ various factors affecting both treatment burden and regimen fatigue should be considered to achieve the desired goals of therapy.

Role of predictors in acceptance of post-exposure prophylaxis with single-dose rifampicin among contacts of leprosy in rural area of Bankura: An explanatory mixed-method study

Background: India achieved the elimination of leprosy two decades ago although its sustenance continues to be threatened by ongoing active transmission in few remaining pockets. There is a paucity of data regarding the acceptance of single-dose rifampicin (SDR) prophylaxis among healthy contacts. Aims and Objectives: The aims and objectives of the study are to assess the factors influencing the acceptability of SDR among contacts. Materials and Methods: A community-based, sequential, explanatory mixed-method study was conducted over 6 months from September 2022 to February 2023 among 168 contacts of leprosy patients from two blocks in Bankura district, West Bengal. Quantitative analysis was done for SDR acceptance and its predictors among contacts using the Chi-square test, Mann–Whitney U test, and Logistic regression. This was followed by qualitative assessment using focus group discussions and in-depth interviews among contacts to explain the findings through a thematic approach. Results: Household contacts (aOR=13.72, 95% CI=2.09–90.19), increasing knowledge score of contacts (aOR=3.18, 95% CI=1.88–5.38), counseling by health workers (aOR=11.98, 95% CI=2.20–65.15), trust in health workers (aOR=152.96, 95% CI=13.17–1776.09), and not taking other medicines for comorbidity (aOR=35.82, 95% CI=2.94–436.02) were associated with increased SDR uptake among leprosy contacts. Barriers and facilitators of post-exposure prophylaxis (PEP)-SDR were categorized as contact, health workers, and program-related factors. Conclusion: SDR acceptability among contacts was 77.4%. Facilitators of SDR-PEP were awareness of side-effects, follow-up, prompt support by health workers, IEC, belief in National programs, etc. Lack of knowledge of PEP-SDR and contraindications, ineffective counseling by health workers, stigma of the disease, the increased workload of health workers, etc., were the barriers to SDR-PEP implementation.

Using timeliness metrics for household contact tracing and TB preventive therapy in the private sector, India.

<sec id="st1"><title>BACKGROUND</title>Although screening of household contacts (HHCs) of TB patients and provision of TB preventive therapy (TPT) is a key intervention to end the TB epidemic, their implementation globally is dismal. We assessed whether introducing a '7-1-7' timeliness metric was workable for implementing HHC screening among index patients with pulmonary TB diagnosed by private providers in Chennai, India, between November 2022 and March 2023.</sec><sec id="st2"><title>METHODS</title>This was an explanatory mixed-methods study (quantitative-cohort and qualitative-descriptive).</sec><sec id="st3"><title>RESULTS</title>There were 263 index patients with 556 HHCs. In 90% of index patients, HHCs were line-listed within 7 days of anti-TB treatment initiation. Screening outcomes were ascertained in 48% of HHCs within 1 day of line-listing. Start of anti-TB treatment, TPT or a decision to receive neither was achieved in 57% of HHC within 7 days of screening. Overall, 24% of screened HHCs in the '7-1-7' period started TPT compared with 16% in a historical control (P < 0.01). Barriers to achieving '7-1-7' included HHC reluctance for evaluation or TPT, refusal of private providers to prescribe TPT and reliance on facility-based screening of HHCs instead of home visits by health workers for screening.</sec><sec id="st4"><title>CONCLUSIONS</title>Introduction of a timeliness metric is a workable intervention that adds structure to HHC screening and timely management.</sec>.

Evaluating the impact of movement tracking feedback on engagement with home exercise programmes of children with cerebral palsy using a new therapy app: a protocol for a mixed-methods single-case experimental design with alternating treatments

IntroductionChildren with cerebral palsy (CP) are prescribed home exercise programmes (HEPs) to increase the frequency of movement practice, yet adherence to HEPs can be low. This paper outlines the protocol...

Family skill development for attention deficit hyperactivity disorder behavior problem alleviation model in at-risk preschool children: a mixed methods study

Introduction: Attention Deficit Hyperactivity Disorder is the most prevalent childhood mental health problem. This study examined families caring for children with ADHD and created a model to alleviate behavior problems in at-risk preschoolers. Methods: This exploratory sequential mixed-methods study comprised two phases. Phase 1 included a qualitative retrospective survey that examined family experiences in caring for ADHD children. This involved in-depth interviews with 14 family caregivers (FCGs) and utilized thematic content analysis. Phase 2 involved creating, implementing, and evaluating a family skill development model using a quasi-experimental design. Thirty FCG- ADHD at-risk preschool child dyads, utilizing services at two Child Development Clinics, were paired and equally divided into experimental and control groups. Data analysis used repeated measures ANOVA and covariances (ANCOVA). Results: The study FCGs reported that family-child interactions and positive parenting alleviated the ADHD at-risk preschool child’s behavior problems. The Family Skill Development for ADHD Behavior Problem Alleviation Model was constructed and validated. Results from within-group comparisons showed significant improvements in the experimental group, with reduced behavior problems (p&lt;0.05, ηp2=0.28) in ADHD at-risk children, improved caregiver behaviors to alleviate the child’s behavior problems (p&lt;0.01, ηp2=0.37), and enhanced family functions (p&lt; 0.001, ηp2=0.42). Conclusions: The model significantly aids families in alleviating behavior problems in ADHD at-risk children, improving family functions and caregivers’ efforts to address the children’s behavioral issues. It is a promising parental intervention model for fostering healthy families and reducing behavior problems in ADHD-at-risk preschool children in northeastern Thailand and similar contexts.

Operational Differences between Product Development Partnership, Pharmaceutical Industry, and Investigator Initiated Clinical Trials.

Medicine development is a lengthy endeavour. Increasing regulatory stringency and trial complexity might lead to reduced efficiency, dwindled output, and elevated costs. However, alternative models are possible. We compared the operational differences between pharmaceutical industry sponsored trials, product development partnership trials, and investigator-initiated trials to identify key drivers of inefficiency in clinical research. We conducted an exploratory mixed-methods study with stakeholders, including clinical trial sponsors, contract research organisations, and investigators. The qualitative component included 40 semi-structured interviews, document reviews of 12 studies and observations through work shadowing in research institutions in Burkina Faso, Mali, and Switzerland. The findings were triangulated with an online survey polling clinical research professionals. The operational differences were grouped under five categories: (i) trial start-up differences including governance and management structure; (ii) study complexity; (iii) site structural and organisational differences; (iv) study conduct, quality approaches, and standard operating procedures; and (v) site capacity strengthening and collaboration. Early involvement of sites in the planning and tailored quality approaches were considered critical for clinical operations performance. Differences between the types of trials reviewed pertained to planning, operational complexities, quality approaches, and support to the sites. Integration of quality-by-design components has the potential to alleviate unnecessary process burden.

Barriers to the accessibility of health insurance in elderly patients attending NCD clinic in a tertiary care hospital Trichy, Tamil Nadu: a mixed-method study

Background: Health insurance schemes launched by governments have been inadequate to provide health coverage to the vulnerable elderly population. This research aimed to study the prevalence, preference, and pattern of health insurance coverage among the study participants and barriers to its accessibility. Methods: It was a facility-based Sequential explanatory mixed-method study where patients above 60yrs attending the non-communicable disease OPD were recruited by systematic random sampling and enquired using a semi-structured questionnaire for the prevalence, preference, and pattern of health insurance. Focussed Group discussions (FGD) were later conducted to explore the barriers faced by participants in accessing health insurance. Results: Health Insurance coverage among the study participants was 74.5%. Of the participants who had any type of health insurance, 86.7% had public health insurance. About three fourth (73.8%) of those who had health insurance were covered under the CMCHIS. Mean health insurance coverage provided was significantly higher by private health insurance (INR170897.4) as compared to both the LIC and CMCHIS (p&lt;0.01) while premium charged was significantly higher for LIC (INR 10003.3/yr.) as compared to others (p&lt;0.01). Institutional issues, lack of awareness, and economic dependence on children were considered as barriers to the accessibility of health insurance among elderly. Conclusions: A dedicated universal Health Insurance Programme with higher monetary coverage and low premium involving all elderly populations may provide necessary financial risk protection and reduce out-of-pocket health expenditure.

Global Perspectives on Innovations in Emergency Care during the COVID-19 Pandemic: A Mixed Methods Study.

In mid-2020, the Emergency Medicine Education and Research by Global Experts (EMERGE) network surveyed the emergency response to the COVID-19 pandemic. We demonstrated that innovative measures were being generated at unprecedented rates. Our aim was to build on these findings to develop the first theoretical model with utility in assessing and developing emergency innovations. Phase 1 of a two-phase, explanatory sequential mixed methods study was a secondary analysis of the original EMERGE survey. Phase 2 involved follow-up interviews of a purposeful sample of 15 of the original survey respondents, representing 12 countries and all 6 World Health Organization regions. Thematic analysis was performed by three members of the research team. Innovation is a nonlinear process in which ideas are developed, implemented, refined, and spread. Ideas grew from departmental needs or the spread of successful innovations from other sites. Development was highly localized, influenced by institutional and regional factors. Obtaining buy-in from relevant stakeholders and addressing various barriers were essential to implementation. The majority of innovations then underwent a process of evolution before some were spread to other institutions through a largely unidirectional flow of information. This study proposes the first model for emergency innovation processes and highlights multiple areas for improvement. Understanding how to prioritize departmental needs and the barriers may streamline development and implementation. Furthermore, the apparent unidirectional flow of information demonstrated by our participants suggests both an opportunity and a need for improved information systems. We present a framework for further research and an outline for innovation management.

Bioelectrical impedance vector analysis as an indicator of malnutrition in children under five years with and without pneumonia in Mchinji District, Malawi: An exploratory mixed-methods analysis

Background Bioelectrical impedance vector analysis (BIVA) is a non-invasive approach to assessing body composition and cellular health, which may improve the assessment of nutritional status in sick children. We explored the reliability, clinical utility, and acceptability of BIVA, as an indicator of nutritional status for children under five years with and without pneumonia, in Malawi. Methods We conducted a parallel convergent mixed-methods exploratory study in Mchinji District Hospital, Malawi, in 2017. We recruited a convenience sample of children aged 0–59 months with clinical pneumonia, and without an acute illness. Children had duplicate anthropometric and BIVA measurements taken. BIVA measurements of phase angle were taken of the whole body, and trunk and arm segments. Reliability was assessed by comparing the variability in the two measures, and clinical utility by estimating the association between anthropometry and phase angle using linear regression. Focus group discussions with healthcare workers who had not previously used BIVA instrumentation were conducted to explore acceptability. Results A total of 52 children (24 with pneumonia and 28 healthy) were analysed. The reliability of sequential phase angle measurements was lower than anthropometric measurements, but trunk and arm segments performed better. The largest associations with phase angle were a negative relationship with weight-for-age z-score (WAZ) in children with pneumonia in the trunk segment, and a positive association with WAZ in the full body measurement in healthy children. Healthcare workers in focus group discussions expressed trust in BIVA technology and that it would enable more accurate diagnosis of malnutrition; however, they raised concerns about the sustainability and necessary resources to implement BIVA. Conclusions While healthcare workers were positive towards BIVA as a novel technology, implementation challenges should be expected. The differential direction of association between anthropometry and phase angle for children with pneumonia warrants further investigation.

Urinary incontinence in health workers as a predisposing factor for presenteeism in Chile: A mixed-methods exploratory study.

Urinary incontinence negatively impacts the quality of life and can harm work activities, causing presenteeism in health professionals and decreasing the quality of care and patient safety. The objective of this study is to explore the self-perception of health workers who suffer from urinary incontinence as a predisposing factor for presenteeism. Mixed study of an exploratory-descriptive nature. The sample was selected in a non-probabilistic and intentional way by criterion and convenience with a size of 14 volunteers, considering the saturation of the information. Reliability criteria defined by Guba for the process and analysis of thematic data were considered. The sample had a mean age of 38.9 + 7.1 years and a mean SPS-6 score of 15.8 + 3.5 points, showing alteration in the dimension of avoiding deconcentration. The narratives in the case study provide relevant information on how urinary incontinence affects the work performance of health workers through the interruption in their day, decreases the quality of clinical care, and increases their anxiety regarding their environment. Urinary incontinence and presenteeism are subjective, and multidimensional experiences affect work performance. Therefore, further studies are recommended to identify predictor variables and the economic losses associated with this condition to establish improvements in the work environment and the self-care of female employees seeking greater benefits and better levels of efficiency in the organization.

Fathers’ perceived role, self-efficacy and support needs in promoting positive nutrition and physical activity in the first 2000 days of life: a mixed methods study

BackgroundThe first 2000 days of life are a crucial and opportunistic time to promote positive dietary and physical activity behaviours that can continue throughout life. The bulk of research on the impact of parents promoting positive dietary and physical activity behaviours has been on mothers, with the impact of fathers rarely investigated. The aim of this study is to investigate fathers’ perceived role, self-efficacy and support needs in promoting positive dietary and physical activity behaviours in early childhood.MethodsA sequential explanatory mixed methods study design consisted of a cross sectional survey of Australian fathers (n = 200) from a convenience sample, followed by semi-structured qualitative interviews (n = 21) with a purposeful sample of Australian fathers.ResultsQuantitative survey data revealed that more than 90.0% of fathers agreed that it is important to role model healthy eating and participating in physical activity with their babies, toddlers and children. A majority of fathers were confident in getting their child to eat fruit/ vegetables (90%) and playing with their child (80%). When searching for information about nutrition and physical activity, the highest proportion of fathers nominated online sources (52%) as their preferred source in survey data. Qualitative interview data revealed that while fathers exhibited high self-efficacy in their abilities, this was susceptible to deterioration due to feelings of isolation, pressures of fatherhood, a lack of information and resources that are father specific, and difficulties navigating the different types of information/resources to find what is right for them.ConclusionsAlthough possessing self-efficacy, being committed and seeking knowledge, many fathers found that useful information was hard to find and understand. Appropriate resources are therefore required to support the specific needs of fathers to promote positive dietary and physical activity behaviours in their infants and young children.

The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study.

Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing. This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences. Results indicate that total spiritual well-being was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan. This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.

Technology-Enabled Collaborative Care for Type-2 Diabetes and Mental Health (TECC-D): Findings From a Mixed Methods Feasibility Trial of a Responsive Co-Designed Virtual Health Coaching Intervention.

Type-2 diabetes (T2D) is a complex chronic condition associated with a lower quality of life due to disease specific distress. While there is growing support for personalized diabetes programs, care for mental health challenges is often fragmented and limited by access to psychiatry, and integration of care. The use of communication technology to improve team based collaborative care to bridge these gaps is promising but untested. We conducted an explanatory sequential mixed methods study to assess the feasibility and acceptability of the co-designed Technology-Enabled Collaborative Care for Diabetes and Mental Health (TECC-D) program. Participants included adults aged ≥18 years who had a clinical diagnosis of T2D, and self-reported mental health concerns. 31 participants completed the 8-week virtual TECC-D program. Findings indicate that the program is feasible and acceptable and indicate that there is a role for virtual diabetes and mental health care. The TECC-D program, designed through an iterative co-design process and supported by innovative, responsive adaptations led to good uptake and satisfaction. The TECC-D model is a feasible and scalable care solution that empowers individuals living with T2D and mental health concerns to take an active role in their care.

Preservice teachers’ cultural competence factors in teacher preparation programs: an explanatory sequential mixed methods study

ABSTRACT Cultural competence is a framework that develops preservice teachers’ self-awareness to confront their attitudes, beliefs, biases, and values, to learn and understand culturally diverse groups’ needs, and to translate such knowledge into culturally responsive professional practices and skills. Previous studies investigating teacher preparation programmes through the lens of cultural competence examined its application in early childhood and elementary undergraduate programmes, in an ESOL course, in a study abroad programme, and in a literacy method course. However, questions were left unanswered concerning the factors affecting preservice teachers’ perceptions of being culturally competent to teach culturally and linguistically diverse (CLD) students. The purpose of this study is to examine the factors that affect preservice teachers’ cultural competence development to teach CLD students using an explanatory sequential mixed-method design. The goal is to provide a holistic understanding of preservice teachers’ experiences with cultural competence in their teacher preparation programmes by integrating quantitative and qualitative data. The findings from this study highlight the need to implement intentional efforts to prepare preservice teachers to attend to the increasing demand for offering high-quality education to CLD students.

Does language teachers’ intercultural competence influence oral participation in EFL classrooms?: unveiling learner perspectives through a mixed methods inquiry

ABSTRACT The present two-phased sequential explanatory mixed methods study investigates the potential association between foreign language teachers’ (FLTs) intercultural competence and Japanese students’ oral participation through the perspectives of students. In Study 1, a survey questionnaire was administered to second-year advanced-level students at two Japanese universities (N = 115). The participants were asked about their learning styles and FLTs’ teaching practices that promoted and hindered their oral participation based on their prior language learning experiences. The results confirmed the associations between FLTs’ host language proficiency, host cultural understanding, and students’ oral participation. In Study 2, qualitative data were obtained from 21 students to explain and build upon the quantitative results. The findings showed that demonstrating intercultural competence by emphasizing group work, showing tolerance for silence, and using Japanese gestures, personal anecdotes, and stories from Japanese culture could create avenues to students’ own worlds and give them psychological safety to express themselves. The study concludes that FLTs’ intercultural competence needs to be further emphasized in teacher training manuals and school curricula in Japanese EFL settings.