Five Focus Group Discussions Research Articles

Challenges and coping strategies among caregivers of children with cancer receiving care at a national referral hospital in Kenya

BackgroundThe number of children diagnosed with cancer is expected to increase by 2050. The caring aspect of these children is usually left to members of the family, more so the mothers. Caregivers are usually faced with various challenges, such as financial issues, social stigma, and emotional and psychological issues. Caregivers use various coping strategies to manage the challenges they experience in the caring process, which can be positive or negative coping strategies.ObjectiveTo explore the challenges and coping strategies of caregivers of children with cancer receiving care at a national referral hospital in Kenya.MethodsThis study employed a descriptive phenomenological approach to explore the challenges and coping strategies of caregivers of children with cancer receiving treatment at a national referral hospital in Kenya. Purposive and snowball sampling techniques were used to select 44 participants for five focus group discussions (FGDs) conducted between October and December 2023. The data were analysed via inductive thematic analysis.ResultsFour themes arose from the challenges experienced, which included psychological, financial, treatment-related, and social/family-related issues. These eleven subthemes included stress, depression, lack of transport, lack of food, loss of employment, treatment delays, and marital issues, among others. Two themes related to coping strategies were positive adaptation and denial, which were highlighted as negative coping strategies. Positive coping included praying, crying, talking to people, and seeking help.ConclusionCaregivers of children with cancer undergo various challenges and apply various coping strategies to try and adapt to their new normal. Reinforcing positive coping strategies and helping caregivers utilize other coping strategies, such as the use of support groups, could help them better care for their children.

"ARVs is for HIV and cream is for HPV or precancer:" Women's Perceptions and Perceived Acceptability of Self-Administered Topical Therapies for Cervical Precancer Treatment: A Qualitative Study from Kenya.

Women in low- and middle-income countries (LMICs) bear a disproportionate burden of global incidence and deaths from cervical cancer, despite being a preventable disease. Prevention efforts in LMICs are hindered in part by lack of access to cervical precancer treatment, due to weak health infrastructure and a lack of adequate human resources to deliver current provider-administered precancer treatments. Innovative strategies are urgently needed to close the cervical precancer treatment gap in LMICs, including the use of self-administered topical therapies for which efficacy evidence is available from high-income settings. We investigated African women's perceptions and perceived acceptability of these therapies for cervical precancer treatment. Between November 2022 and April 2023, we conducted five focus group discussions (FGDs) with women ages 25-65 years undergoing cervical cancer screening or precancer treatment in Kisumu, Kenya. The FGDs explored women's experiences with screening and precancer treatment, their acceptability of topical therapies for precancer treatment, and perceived barriers and facilitators to uptake. The FGDs were moderated by local qualitative research assistants, conducted in local languages, transcribed, coded, and analyzed using qualitative description using NVIVO software. Twenty-nine women participated, with a mean age of 35.4 years (SD 6.5). All had undergone cervical cancer screening, and 25 (83%) had a history of precancer treatment with ablation or excision. Multiple themes were identified related to women's perceptions of topical therapies. Participants were highly receptive of topical treatments, with many favoring the option of self-administration compared to provider-administration of such therapies. Self-administration of topical therapies was felt to help address challenges associated with current treatment methods, including difficulty in access, pain with procedures, cost, and lack of privacy with pelvic exams. Participants had a preference for topical therapies that are used less frequently compared to those used daily. Among Kenyan women with a history of cervical precancer treatment, self-administered topical therapies for precancer are acceptable and have the potential to address barriers, including access, privacy, and cost, that hinder precancer treatment in LMICs. If supported by efficacy studies in LMICs, self-administered topical therapies offer a scalable approach to closing the precancer treatment gap in LMICs. Not applicable.

Forest Encroachment and Agriculture Land Abandonment in the Context of Land Cover Change in Kailali

Land use land cover (LULC) area has been changing for many decades in the Kailali district but has little been researched. The study aims to examine the spatial and temporal changes of LULC from 1978 to 2021, carrying out major driving factors of forest cover change regarding forest encroachment and abandonment. The researcher employed a mixed-method approach to accomplish this study. Field observation, household survey with 45 participants, Key Informant Interviews (KII) with three participants, and five Focus Group Discussions (FGD) were used as research tools to collect the data. Moreover, the researcher used books, journal articles, official reports, and related previous empirical studies as secondary data [Land Resource Mapping Project (LRMP) data were used to screen LULC status of 1978 and 1990, and digitization on Google Earth Pro to prepare LULC data for 2000 and 2021]. The findings of the study revealed that the forest cover area of the Kailali district was in a decreasing trend [ for instance in 1978 the area of forest cover was 75.38%, in 1990 it was 66.51% in 2000, and was 65% in 2021]. In contrast to forest cover, the agricultural [settlements and infrastructures] land area was on an increasing trend which was followed by 21.77%, 30.28%, 31.75%, and 32.25% in each period. The study also found that the changing rate of forest cover and the agricultural land have been decreasing. Further, the research found the major drivers of forest cover change were encroachment and agricultural land abandonment. In addition, population growth, migration, poverty, development activities, natural hazards, resettlement, public utilities, weak implications of policy, and illegal activities were also the major causes of forest cover change. The research implies that both forest encroachment and land abandonment should be controlled, and are to be considered by the stakeholders.

Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study

BackgroundNonadherence to national standards for malaria diagnosis and treatment has been reported in Sudan. In this study, qualitative research examined the clinical domains of nonadherence, factors influencing nonadherent practices and health workers’ views on how to improve adherence.MethodsIn September 2023, five Focus Group Discussions (FGDs) were undertaken with 104 health workers from 42 health facilities in Sudan’s Northern State. The participants included medical assistants, doctors, nurses, laboratory personnel, pharmacists and public health officers. The FGDs followed a semi-structured guide reflecting the national malaria case management protocol. Qualitative thematic analysis was performed.ResultsNonadherent practices included disregarding parasitological test results, suboptimal paediatric artemether–lumefantrine (AL) dosing, lack of counselling, use of prohibited artemether injections for uncomplicated and severe malaria, artesunate dose approximations and suboptimal preparations, lack of AL follow on treatment for severe malaria; and rare use of primaquine for radical Plasmodium vivax treatment and dihydroartemisinin-piperaquine as the second-line treatment for uncomplicated malaria. Factors influencing nonadherence included stock-outs of anti-malarials and RDTs; staff shortages; lack of training, job aids and supervision; malpractice by specialists; distrust of malaria microscopy and RDTs; and patient pressure for diagnosis and treatment. Health workers recommended strengthening the supply chain; hiring personnel; providing in-service protocol training including specialists; establishing external quality assurance for malaria diagnosis; and providing onsite supportive supervision and public health campaigns.ConclusionsThis study revealed a broad spectrum of behavioural and systemic challenges in malaria management among frontline health workers in Northern Sudan, including nonadherence to protocols due to resource shortages, training gaps, a lack of supportive supervision and patient pressure. These insights, including health workers’ views about improvements, will inform evidence-based interventions by Sudan’s National Malaria Control Programme to improve health systems readiness and the quality of malaria case management.

"I'll take them another day": A qualitative study exploring the socio-behavioral complexities of childhood vaccination in urban poor settlements.

Despite improvement over recent decades, childhood vaccination uptake remains a concern across countries. The World Health Organization observed that over 25 million children missed out on one or more vaccines in 2021, with urban poor and other marginalized groups being the most affected. Given the higher risk of disease transmission and vaccine-preventable diseases (VPD) outbreaks across densely populated urban slums, identifying effective interventions to improve childhood vaccination in this vulnerable population is crucial. This study explored the behavioral and social factors influencing childhood vaccination uptake in urban informal settlements in Nairobi, Kenya. A grounded theory approach was employed to develop a theoretical account of the socio-behavioral determinants of childhood vaccination. Five focus group discussions (FGDs) were conducted with purposively sampled caregivers of children under five years of age residing in informal settlements. The Theory of Planned Behavior guided the structuring of the FGD questions. An iterative process was used to analyze and identify emerging themes. Thirty-nine caregivers (median age 29 years) participated in the FGDs. From the analysis, four main thematic categories were derived. These included attitude factors such as perceived vaccine benefits, cultural beliefs, and emotional factors including parental love. Additionally, subjective norms, like fear of social judgment, and perceived behavioral control factors, such as self-control and gender-based influences, were identified. Furthermore, a number of practical factors, including the cost of vaccines and healthcare providers attitude, also affected the uptake of vaccination. Various social, behavioral, cultural, and contextual factors influence caregiver vaccination decisions in urban poor settings. Community-derived and context-specific approaches that address the complex interaction between socio-behavioral and other contextual factors need to be tested and applied to improve the timely uptake of childhood vaccinations among marginalized populations.

Educational Introspections of Medical Students Post Disability Competencies Training: A Qualitative Study

Background: Despite the substantial presence of persons with disabilities (PWD) in the population, they face many barriers in healthcare. Competency-Based Medical Education (CBME) is increasingly used to address these gaps. Aims and Objective: This study assesses the impact of disability competencies training on medical students' attitudes towards PWD. It aims to explore new perspectives, identify attitudinal shifts, evaluate training effectiveness, and promote solution-oriented learning. Materials and Methods: Five Focus Group Discussions (FGD) with 8 participants each, a series of themes related to the understanding of disability and empathy were explored. The participants, who had undergone training in disability competencies. The FGDs were facilitated by trained moderators and analysed employing thematic analysis and generating tree maps. Results: Key themes evolved from the students' new perspectives towards PWD, which included Inclusion and Responsibility, Empathy and Understanding, Managing patients with disabilities, Equity and rights, and Acceptance. Themes also emerged regarding the impact of training, revealing an Attitudinal Shift, Engagement and Interaction, Personal Impact, and Solution-Oriented Learning. Conclusion: Disability competency training significantly transforms medical students' attitudes, fostering a more inclusive, empathetic approach in healthcare. This shift is crucial for integrating disability competencies into medical education, especially in developing countries

Assessing Factors Influencing the Failure of Constituency Development Fund (CDF) Projects in Education and Health Sectors in Zambia: A Critical Analysis

This study critically evaluates factors leading to the failure of Constituency Development Fund (CDF) projects within Zambia's education and health sectors, aiming to recommend effective strategies for improving project success rates. Utilizing a sequential mixed-method approach, the research examines the effectiveness of existing management strategies, identifies key factors contributing to project failures, and explores challenges faced by project committees. Data was collected through semi-structured interviews, a literature review, and five focus group discussions (FGDs) with 46 respondents from Chongwe Constituency. Purposive sampling was employed to gather both primary and secondary data. Quantitative data were analyzed using the mean t-test to determine factors significantly impacting community engagement and project outcomes. Qualitative data underwent thematic analysis to explore themes from interviews, literature, and FGDs, enhancing the triangulation of findings. Findings reveal that despite the alignment of management practices with best practices, factors such as failure to use CDF, funding delays, lack of transparency and accountability, weak monitoring and evaluation, limited community involvement, and limited community knowledge of CDF, contractor incompetence, Key challenges faced by implementors included, volunteer status of WDCs which was unsustainable and challenging, lack of capacity building contribute to project failures. The study advocates for improved project management practices, enhanced stakeholder engagement and education about CDF to communities and robust monitoring to increase project success.

Barriers and Facilitators of Implementing a Healthy Lifestyle Intervention at Workplaces in South Africa.

Current evidence indicates that workplace health and wellness programmes provide numerous benefits concerning altering cardiovascular risk factor profiles. Implementing health programmes at workplaces provide an opportunity to engage adults towards positive and sustainable lifestyle choices. The first step in designing lifestyle interventions for the workplace is understanding the barriers and facilitators to implementing interventions in these settings. The barriers and facilitators to implementing lifestyle interventions in the workplace environment was qualitatively explored at two multinational consumer goods companies among seven workplaces in South Africa. Semi-structured in-depth interviews (IDIs) were conducted with ten workplace managers. Five focus group discussions (FGDs) were conducted among workplace employees. The IDI findings revealed that the main facilitators for participation in a lifestyle intervention programme were incentives and rewards, educational tools, workplace support, and engaging lessons. In contrast, the main facilitator of the FGDs was health and longevity. The main barriers from the IDIs included scheduling time for lifestyle interventions within production schedules at manufacturing sites, whereas time limitations, a lack of willpower and self-discipline were the main barriers identified from the FGDs. The findings of this study add to literature on the barriers and facilitators of implementing healthy lifestyle interventions at workplaces and suggest that there is a potential for successfully implementing intervention programmes to improve health outcomes, provided that such efforts are informed and guided through the engagement of workplace stakeholders, an assessment of the physical and food environment, and the availability of workplace resources.

Enablers and barriers to rotavirus vaccine coverage in Assam, India- A qualitative study

BackgroundEstimates suggest that 78,000 children died due to rotavirus gastroenteritis annually between 2011 and 2013 in India. The north eastern state of Assam reported 38.4% pediatric diarrheal admissions testing positive for rotavirus. Rotavirus vaccine (RVV) was introduced in Assam in 2017 following which the National Family Health Survey-5 (NFHS-5) (2019) revealed low RVV coverage in Assam with wide variation between the districts. the current study was conceptualized and undertaken to capture the enablers and barriers to RVV coverage in Assam. MethodsQualitative study conducted in 5 randomly selected districts in Assam. Participants (key informants) were recruited by purposive sampling at each level of the health system including healthcare officials, service providers and caregivers based on availability. Thirty-five in-depth interviews (IDIs) and five focus group discussions (FGDs) were conducted. Interviews were tape recorded and transcribed. Data was coded and analyzed using the thematic framework approach. ResultsFindings from the qualitative data collection were collated and analyzed under 7 identified themes. Difficult terrain, limited service provider availability and no catch-up training for new recruits were some of the barriers to RVV coverage. In contrast, Information, Education & Communication (IEC) in vernacular language, RVV safety profile, development partner support and adequate RVV supply were identified as some of the enablers of RVV coverage. ConclusionFew broad recommendations to overcome identified barriers include comprehensive inter-sectoral coordination, regular monitoring and frequent refresher training sessions. There is a need for a future study utilizing existing coverage data and larger sample size to triangulate the findings of this study.

A qualitative study of mentors’ perceptions and experiences of a near-peer mentoring program for medical students

IntroductionDuring their academic studies, medical students may encounter a variety of challenging situations. It is no wonder that they have a higher prevalence of poor mental health than the general population. Mentoring programs have proven useful in promoting mental health in medical education. The study aimed to explore the perceptions and experiences of medical students as mentors in a near-peer mentoring program.MethodsA qualitative study was carried out between March and April 2022 at Semmelweis University in Budapest, Hungary. Five focus group discussions (FGDs) included 26 medical students who were enrolled as mentors in the mentoring program. The recordings were transcribed verbatim and anonymized. An deductive and semantic approach was adopted, and the data were analyzed with thematic analysis.ResultsThree major themes were identified: professional and personal growth and reflections on the mentoring experience. Mentors reported growth in social and practical problem-solving skills, self-confidence, psychosocial benefits, and both personal and professional development. The program had a great impact on students’ sense of self-efficacy, self-awareness, perception of their competencies, and adherence to their boundaries.DiscussionIn conclusion, the mentors strongly emphasized the professional and psychosocial benefits they perceived while participating in the mentoring program. Therefore, the experiences obtained during the mentoring are important milestones. Mentoring programs could greatly improve students both personally and professionally so that later, they will be the best possible professionals in the field of health care.

"There is nothing that can prevent me from supporting her:" men's perspectives on their involvement and support of women's use of topical therapy for cervical precancer treatment in Kenya.

Cervical cancer disproportionately impacts women in low- and middle-income countries (LMICs). The World Health Organization's (WHO) 90/70/90 strategy aims to eliminate cervical cancer by 2030 by increasing HPV vaccination coverage to 90%, screening 70% of eligible women, and effectively treating 90% of those with abnormal results by 2030, potentially preventing 62 million deaths in LMICs. LMICs, however, struggle with limited access to cervical precancer treatment, in part due to a lack of trained professionals and weak health systems. Effective non-surgical, self-administered, which have demonstrated efficacy in high-income countries, could bridge the treatment gap in LMICs and may be more scalable and cost-effective than provider-administered therapies. To inform feasibility studies in LMICs, data are needed on the role of male partners in influencing the acceptability and uptake of self-administered topical therapies, including their support of recommended abstinence and contraception guidelines associated with these therapies. Between November 2022 and April 2023, we conducted five focus group discussions (FGDs) with men aged 25 to 65 years in Kenya to explore their perspective and perceived support regarding their female partners using topical self-administered therapies for cervical precancer treatment. The FGDs were moderated by local qualitative research assistants and conducted in local languages, transcribed, coded, and analyzed using qualitative description. Thirty-nine male participants meeting the eligibility criteria participated in five FGDs. The mean age of participants was 42.5 years. Most participants, 79.5%, had a female partner with a history of cervical precancer treatment, 5.1% did not, and 15.4% were unsure of their female partner's prior precancer treatment history. The study aimed to assess men's support of their female partners' use of topical therapies for treating cervical precancer. We find that male participants strongly express acceptance and willingness to support their wives or partners in using such therapies, if available. Reported supportive behavior included permitting the use of the therapies and support of maintaining abstinence during the recommended times. Additionally, participants desired male involvement in clinic and community-based education about topical therapies to facilitate widespread support. The use of self-administered topical therapies for cervical precancer treatment, if supported by efficacy studies in LMICs, may support achieving the WHO's 2030 goal of 90% treatment access. We find that with adequate education, men express overwhelming support of their female partner's use of topical therapies, including adherence to abstinence and contraception guidelines.

Experiences of Private Sector Employees on Transfer of Soft Skills Trainings

The issue of low training transfer remains prevalent despite private organizations' efforts in conducting soft skills training programs for its employees. Varying experiences of training transfer process are also reported. In this context, the purpose of this study aimed to explore the experiences of participants of private organizations of Nepal during soft skills training (reaction level), and their experiences while applying the knowledge and skills back to their workplace. The research design was qualitative and a total of 34 employees from four private companies of Nepal participated in this study who had attended a soft-skills training. Data was collected using five focus group discussions (FGDs) and thematic analysis used in which three overarching themes were generated with 25 categories and 210 codes. The study found that the participants had perceived soft skill training as the means for refreshments and socialization. In the post-training phase, they experienced changes in their mindset and improvement in interpersonal relationship with others in their workplace. Besides, irrespective of whether they participated in indoor or outdoor based programs, the duration and content of the program and their perspective towards whether they took it as an actual training or just a means of refreshment also affected their training transfer intentions. They experienced that for training transfer to occur, their own willingness to transfer guided by training content’s job relevance, micro-sessions based training designs, and importantly the post training interventions and support from employers or HR/line managers were necessary. Practical and research implications have been discussed in the paper.

Development of a Culturally Appropriate Text Messaging Platform for Improving Breast Cancer Screening Uptake Among Ghanaian Women in Metropolitan Areas.

Objective: Early detection through screening could improve breast cancer (BC) outcomes in sub-Saharan Africa (SSA). We explored women's preferences for BC-related mobile health text messaging, described the development of a mobile-health text messaging platform, and examined the enablers and barriers to BC screening. Methods: A concurrent mixed-method study of women aged 40-59 years was conducted. Four essential actions were carried out: (i) a baseline survey of 130 women, (ii) five focus group discussions (FGDs), (iii) a stakeholder meeting with BC research and clinical treatment specialists, and (iv) text message pretesting. The survey and FGD findings were used to create a culturally appropriate SMS platform for BC screening. Results: Thirty-five text messages were developed and evaluated with the following communication goals in mind: 15 addressed BC awareness, six emphasized the importance of early detection, five alleviated anxieties as a barrier to BC screening, seven encouraged women to prioritize their health, and three indicated screening locations and costs. The majority (92.6%) of survey respondents who had heard of mammography (54/130) said screening was necessary. Fear of the screening procedure, receiving a positive diagnosis, and other testing-related worries (40.7%) were identified as potential barriers to BC screening, along with low income (18.5%), a lack of BC-related indicators (9.3%), insufficient breast awareness education (9.3%), and time restrictions (7.4%). The presence of BC-related symptoms (27.8%), breast awareness education (24.1%), and doctor's advice (16.7%) were all potential facilitators of BC screening uptake. The majority of FGD participants favored brief texts, with 42.3% preferring one text message per day. Conclusion: Several factors limit women from accessing BC screening services; nevertheless, specific barriers such as a lack of BC education, time constraints, and disease fears can be successfully targeted through SMS messaging interventions to encourage women to use BC screening programs.

"We always felt psychologically unstable": A qualitative study of midwives' experiences in providing maternity care during the COVID-19 pandemic in Tanzania.

We explored midwives' experiences and challenges in providing maternity care during the period of the first surge of the COVID-19 pandemic in Dodoma. Phenomenological study design was used to explore midwives' experiences and challenges in providing maternity care during the COVID-19 pandemic in Tanzania. We conducted interviews with a total of 23 midwives, using semi-structured interviews and an audio recorder. Five focus group discussions (FGDs) were conducted. To analyse the data, we used interpretive phenomenological thematic data analysis with NVivo software. To analyse templates, we followed a step-by-step process, starting with familiarizing ourselves with the data, followed by preliminary coding, organizing themes, developing an initial coding template, using the initial template, refining the template and finally applying it to the entire dataset. It was found that three themes and eight subthemes merged in the current study. The main themes were ① mental health distress, ② work environment challenges and ③ isolation of midwives by different groups. Reducing risk and protecting midwives from infectious diseases will improve the workforce, reduce the number of hospital stays, reduce the cost of hospital services, improve birth outcomes and indirectly improve family, community and national economies. Due to the system's failure to provide psychological support, protective environment and isolation rooms for confirmed or suspected cases put midwives at a higher risk of contracting the virus and had to work in a stressful environment. In addition to having the right tools, midwives must also receive emotional and psychological support in order to be at their best. The system must ensure that midwives are ready for uncertain times, such as pandemic infectious disease outbreaks, by providing protective work place environment such as personal protective equipment, psychological support and isolation room for confirmed COVID-19 cases.

Designing effective U = U communication strategies considering the needs of PLHIV, their partners, and healthcare worker constraints in South African clinics.

We sought to understand the Undetectable = Untransmittable (U = U) communication needs of persons living with HIV (PLHIV) and barriers to U = U communication among healthcare providers (HCPs) in South Africa. We conducted five focus group discussions (FGDs) with HCPs (N = 42) including nurses and counsellors from primary healthcare clinics (PHCs) in the Gauteng and Free State Provinces of South Africa, three FGDs (N = 27) with PLHIV recruited by snowball sampling from civil society organizations, and 27 in-depth interviews (IDIs) with recently diagnosed PLHIV in Johannesburg. IDIs and FGDs were audio recorded, transcribed, translated to English, and analysed thematically. PLHIV were largely unaware and sceptical of U = U as the message appeared to contradict the mainstream HIV prevention clinical guidance. The low viral load (VL) knowledge further reduced confidence in U = U. PLHIV need support and guidance on the best approaches for sharing U = U information and disclosing their VL status to their partners, highlighting the central role of community understanding of U = U and VL to mediate the desired stigma reduction, social acceptance and emotional benefits of U = U for PLHIV. HCPs were uneasy about sharing U = U due to concerns about risk compensation and ART non-adherence and worried about enabling any ensuing HIV transmission. HCPs also need a simple, unambiguous, and consistent narrative for U = U, integrated with other HIV prevention messages. PLHIV and HCPs alike recommended a patient-centred approach to communicating U = U, focusing primarily on attaining viral suppression and emphasizing that condomless sex is only safe during periods of ART adherence. These data highlight the need for simple U = U communication support targeting both HCP and PLHIV. Culturally appropriate communication materials, with training and ongoing mentorship of the clinic staff, are essential to improve patient-centred U = U communication in clinics.

Exploring enablers and barriers to breast self-examination among women in the North Shewa Zone, Oromia, Ethiopia: a qualitative study

Breast cancer (BC) is the leading cause of cancer death worldwide and the second most common cancer overall. Breast self-examination (BSE) is one of the cheapest methods used for the early detection of BC in asymptomatic women. More than 90% of cases of BC can be detected by women themselves. This reality stresses the importance of BSE as the key BC detection mechanism. However, in Ethiopia, most of the BE studies were not conducted among women in the general population. Therefore, this study aimed to explore enablers and barriers to breast self-examination among women in the North Shewa Zone, Oromia. A descriptive qualitative study design was conducted from August 1, 2022, to September 30, 2022. Five focus group discussions (FGDs) were conducted with 46 women from one selected district in the North Shewa Zone, Oromia. A Purposive sampling technique was used to select participants for FGD. The audio-recorded data were transcribed verbatim to “Afan Oromo”. Transcribed data were translated into English. The data were manually coded into themes and analyzed manually by using inductive thematic analysis. The findings of the study were discussed under five themes of enablers and three themes of barriers. The five themes of enablers were knowledge about BC, knowledge about BSE, experience of BSE practice, perceived susceptibility, and perceived benefit of BSE practice. The four themes of barriers were low knowledge of BSE practice, misconceptions about BSE practice, and fear of detecting BC. These findings suggest that targeted health education programs, collaboration between healthcare providers and local stakeholders, and the availability of support services can play a crucial role in overcoming barriers and encouraging BSE practice for early detection of breast abnormalities.

Bullying Experiences of South Asian Immigrants in Australia: a Mixed-Method Study.

Bullying is a pervasive problem faced by immigrants that negatively impacts their health and well-being. Understanding the factors that contribute to bullying and the prevalence of bullying victimisation may help to develop strategies to prevent bullying. Using a mixed-method approach, this study explored the perceptions and prevalence of bullying of South Asian immigrants living in Australia. Five focus group discussions (FGDs) were conducted to explore bullying experiences and to inform an online survey. The online survey included the California Bullying Victimisation Scale-Retrospective (CBVS-R) to measure prevalence, types, and places of bullying victimisation. Data collected from FGDs were thematically analysed while survey data were examined to identify factors associated with bullying. The main contributing factors reported by participants during FGDs were ethnic attire (clothing), religion, accent, workplace achievement, skin colour, and body shape. The online survey collected responses from 313 participants that included females (44%) and males (56%) with a mean age of 41.0 (SD ± 10.3) years. Almost 31% of participants surveyed experienced multiple bullying incidents per month with no differences observed between gender (32% in males, 31% in females). Males were mostly bullied (63%) in their workplaces while females were mostly bullied (56%) at bus or train stations. Country of birth, employment status, educational qualification, and English proficiency significantly associated with bullying experience (p < 0.001). These findings show that bullying affects male and female immigrants in different forms and settings; therefore, a large national assessment is needed to evaluate the magnitude of bullying and its consequences on immigrant health and well-being.

A Qualitative Study on Factors Associated with Low Academic Performance among Medical Students

Introduction: To ensure optimal quality of health care for the community, it is important to produce an efficientprimary care provider. In order to attain this quality we must ensure that all students achieve the requiredstandards. In spite of pre-set prescribed standards, the academic performance varies among medical students.Objectives: 1. Describe the factors affecting the learning of medical students. 2. Explore the possible solutions toimprove their academic performance.Materials and Methods: A total of 18 students and 12 faculties participated in the study. Among them, five FocusGroup Discussions (FGD) were carried out (three FGDs with students and two FGDs with faculties). The discussionwas guided by a facilitator and audio-recorded. Information from the audio was transcribed.Results: Factors affecting learning include content of the class, class schedule, attention span, assessment pattern,audio-visual aids, level of integration of classes, ability of the teacher and teaching learning methods used.Solutions include field visits, hands-on training, appropriate use of audio-visual aids, integration of classes, activeparticipation in research, communication with peers, strict maintenance of attendance and motivation of thestudents, etc,.Conclusion: Addressing all the factors hindering the learning process by incorporating solutions suggested byfaculties and students may help the learners to improve their academic performance. It is important to teach thetopics with its practical application with an appropriate assessment pattern.

Construction and Validation of Organizational Conflict Types and Conflict Management Styles Inventories

Conflicts occupy a pertinent role in every aspect of human life and organizational settings are not an exception. In the absence of indigenous, comprehensive and latest assessment measures for organizational conflict types and management styles, the present study aimed to develop and validate inventories for both constructs by converging on the sociocultural context. Ensuing an exploratory sequential design, the investigation started with a qualitative study in which five focus group discussions (FGDs) were conducted with 30 professionals (including teachers, bankers, engineers, managers and doctors) who shared their experiences of organizational conflicts by highlighting types and management styles. From an initial pool of 137 items (65 &amp; 72 items respectively), the subject matter experts finalized 55 items each for organizational conflict types and management style inventories. In study II, exploratory factor analysis was administered on a sample of 400 adult professionals resulting in a six-factor Qayyum-Younas Organizational Conflict Types Inventory (QY-OCTI) with 40 items. It was later confirmed by running a Confirmatory Factor Analysis on another sample of 400 professionals. In study III, EFA was conducted on a sample of 310 participants that revealed a six-factor model of the Qayyum-Younas Organizational Conflict Management Styles Inventory (QY-OCMSI) with 48 items and this model was later confirmed by running CFA on a sample of 490 participants. These scales have significant research, academic and organizational setting-based implications.

University Health Risk Behaviour (UniHRB) Inventory (Sinhala): a tool to assess common health risk behaviours among undergraduates in Sri Lanka

Introduction: The degree of health risk behaviour (HRB) among undergraduates has not been researched extensively in Sri Lanka and there is no tool available to assess common HRBs in a university setting. Objectives: To develop, translate and validate a tool to measure common HRBs in Sinhalese second-year undergraduates in Sri Lanka Methods: The UniHRB-Inventory (Sinhala) was developed using a seven-step design process for tool development. An extensive literature review, nine key informant interviews (KII), and five focus group discussions (FGD) were carried out. A combination of deductive and inductive methods was used to define the domain and identify the questions to assess. Content and consensual validity was assessed using the modified Delphi process. A validation study was conducted among 666 second-year undergraduates at the University of Kelaniya selected using stratified-cluster sampling. Construct-validity of UniHRB-Inventory-Sinhala was assessed using Principal Component Analysis (PCA) (n=333), Confirmatory Factor Analysis (CFA) (n=333), multi-trait scaling analysis and convergent validity assessment (n=80). Internal consistency and test-retest reliability was assessed in a sub-sample (n=25). Results: There has been a deficit of choices for adapting an HRB tool for undergraduates in Sri Lanka. Violence and injuries, sexual risk behaviours, addictions to mobile phones and the internet are common among undergraduates. Students’ dismissive attitude towards violence and neglecting health behaviours, such as sleep deprivation and poor hygienic practice, were highlighted as important aspects of HRBs. The UniHRB-Inventory (Sinhala) with 70 items showed good face, content and consensual validity. A seven-factor model was identified through PCA, which was confirmed through CFA. UniHRB-Inventory domains and sensation seeking scale (SSS) total score showed correlations between 0.39-0.67. Cronbach’s alpha coefficient of 0.77 and test-retest reliability coefficients of seven domains ranging between 0.74-0.82 indicated high reliability. Conclusions &amp; Recommendations: The newly developed UniHRB -Inventory (Sinhala) is a valid and reliable tool to assess common HRBs among undergraduates in Sri Lanka.