Results Of Focus Groups Research Articles

Development and validation of a short version of the Female Sexual Function Index in the Spanish population

BackgroundThe Female Sexual Function Index (FSFI) is a commonly used scale for the assessment of female sexual function. Our aim was to develop and validate a Spanish short version of the FSFI.MethodsA parallel exploratory, sequential mixed-methods approach was used, involving 2 sites. The process consisted of 2 steps: (1) cognitive and content validation of the previously translated FSFI in the Spanish population, both through a focus group; and item selection based on the difficulty and discrimination parameters using item response theory (IRT), thereby obtaining a short version of the scale (sFSFI-sv); (2) assessment of test–retest reliability (intraclass correlation coefficient, ICC) of the sFSFI-sv. The presence or absence of a sexual disorder variable based on clinical interview was used on the Receiver Operating Characteristic (ROC) to establish the cut off point whose Area Under the Curve (AUC) based on sensibility and specificity was maximum.ResultsSpecific modifications of the FSFI were made according to the focus group results. 114 women were included for IRT analysis. The initial IRT model pointed to the exclusion of items 1, 2, 5, 11, 18, and 19 (S-χ2 p < 0.001). Items 3, 9, 11, and 14 showed the best discrimination and difficulty parameters. On the basis of the IRT and focus group results, items 1, 3, 9, 12, 16, and 17 were included in the final sFSFI-sv. sFSFI-sv showed good reliability (ICC 0.91) in a group of 93 women. A total score ≤ 18 could indicate a higher risk of sexual disorder (sensitivity: 81.0%, specificity: 73.3%).ConclusionA focus group and the IRT analysis allowed the development of a 6-item Spanish version of the FSFI, which showed good reliability in a group of Spanish women.

Using a Mechanical Lift at Home.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.

Spirituality as Strategies for Coping With Tropical Spastic Paraparesis: Results of Focus Group.

In the logic of integrality in health, one of the aspects less addressed by assistance services is the question of spirituality. This study utilized qualitative analysis from focus groups to identify whether spirituality can contribute to coping with problems arising from the HTLV-1 myelopathy associated or tropical spastic paraparesis (HAM/TSP). The testimonies were recorded and then transcribed. The information was then systematized by the analysis of thematic-categorical content. When giving voice to people who suffer from HAM/TSP, there is clear evidence that spirituality, understood broadly and not restricted to institutionalized religious practices, is expressed in narratives of feeling for others and trust in God. Through spiritual solutions, people with HAM/TSP find the strength to face their disability and pain.

Cross cultural and global uses of a digital mental health app: results of focus groups with clinicians, patients and family members in India and the United States.

Despite significant advancements in healthcare technology, digital health solutions - especially those for serious mental illnesses - continue to fall short of their potential across both clinical practice and efficacy. The utility and impact of medicine, including digital medicine, hinges on relationships, trust, and engagement, particularly in the field of mental health. This paper details results from Phase 1 of a two-part study that seeks to engage people with schizophrenia, their family members, and clinicians in co-designing a digital mental health platform for use across different cultures and contexts in the United States and India. Each site interviewed a mix of clinicians, patients, and their family members in focus groups (n = 20) of two to six participants. Open-ended questions and discussions inquired about their own smartphone use and, after a demonstration of the mindLAMP platform, specific feedback on the app's utility, design, and functionality. Our results based on thematic analysis indicate three common themes: increased use and interest in technology during coronavirus disease 2019 (COVID-19), concerns over how data are used and shared, and a desire for concurrent human interaction to support app engagement. People with schizophrenia, their family members, and clinicians are open to integrating technology into treatment to better understand their condition and help inform treatment. However, app engagement is dependent on technology that is complementary - not substitutive - of therapeutic care from a clinician.

Preventing Home Dialysis Complications.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.

ПЛАТФОРМА PROСИБИРЬ: ПЕРВЫЙ ГОД РАБОТЫ И ПЕРСПЕКТИВЫ РАЗВИТИЯ

The article aims to review the experience of creating and launching the ProSiberia platform, and to discuss the prospects for its further development. Based on the aggregation of digital sources of Siberian origin, the ProSiberia project aims to create a research platform that will bring together scholars, content curators (libraries, museums, archives) and society in order to study Siberia and position the region in the global information space. Work on the platform began in 2020 within the framework of the Program for Increasing the Competitiveness of National Research Tomsk State Unversity by the staff of the Tomsk State University Research Library. Now the platform has implemented opportunities both for humanitarian researchers and for civic science representatives (volunteers). For researchers, access to digital copies of texts about Siberia with detailed description and full-text search is organized; it is possible to create one’s own collections of texts; there are some text collaboration tools. It is also possible to find researchers with similar interests and exchange views. A volunteer can edit texts, operate a blog, participate in challenges. The platform is also being filled with new texts. Prospects for the development of the project are considered; they were formulated based on the results of surveys and focus groups. The main directions of development include: work on improving the quality of texts (attracting volunteers for their correct recognition); aggregation of digital tools for the humanities in one place for effective work with texts; attraction of partners; integration into the educational process. The most difficult issue is the aggregation of digital tools. The article lists their most interesting groups: tools for creating and working with digital facsimiles, textometric tools, and a number of tools for working with digitized manuscripts. Thus, at the moment, the initial version of the ProSiberia platform has been created. It allows implementing remotely the basic functions characteristic for any research in the field of humanities. However, most probably, the most important and difficult will be the next stage of the work, which includes, among other things, the aggregation of digital tools for working with the text of interest for the researcher. Therefore, it is extremely important to have a broad discussion in the professional community of both the work already done within the ProSiberia project and the further prospects for its development.

Цифровые волонтерские платформы: готовность россиян и потенциал применения

В статье рассматривается потенциал использования цифровых волонтерских платформ в России на основе данных количественного и качественного исследований, проведенных в период самоизоляции в связи с распространением новой коронавирусной инфекции (апрель — май 2020 г.) Центром исследований гражданского общества и некоммерческого сектора НИУ «Высшая школа экономики» в рамах проекта «Самоорганизация и взаимопомощь в условиях противодействия распространению коронавирусной инфекции». На основе данных всероссийского опроса населения (N = 2012) выявлено, что уровень готовности зарегистрироваться на специализированном сайте, позволяющем добровольцам узнавать о том, где и когда они могли бы оказать помощь нуждающимся, подобрать себе подходящую волонтерскую работу, достаточно высок. Ключевыми факторами, влияющими на готовность к использованию подобных сайтов, являются половозрастные параметры, уровень образования, род занятий, а также вовлеченность в добровольческую деятельность. Результаты онлайн-фокус-групп (с обычными гражданами и с волонтерами) также демонстрируют востребованность волонтерских онлайн-платформ. Определены основные желаемые характеристики сайта-агрегатора, такие как возможность выбирать из большого числа разнообразных волонтерских активностей, доступность, безопасность и прозрачность. Благодарность. Исследование выполнено при поддержке Программы фундаментальных исследований НИУ «Высшая школа экономики».

Evaluation of the online teaching of architectural design and basic design courses case study: College of Architecture at JUST, Jordan

Due to COVID-19, universities in Jordan put all classes on-hold and switched to online learning. This study evaluates the online teaching of architecture design at the Department of Architecture- Jordan University of Science and Technology, second semester 2019/2020. The study started with organizing a focus group meeting of ten expert participants. Based on the focus group results, a questionnaire survey was prepared. The survey sample included the faculty members and a randomly selected sample of students in design courses and basic design courses. A simple statistical analysis was conducted. The results showed that online teaching during pandemic had been performed regularly in synchronous meetings format. Both faculty and students were satisfied with online teaching in theoretical courses. However, both groups were less satisfied with the design and basic design courses. While students reported technical difficulties, faculty members suffered from a lack of privacy and the extended working hours.

Managing Home Infusion Therapy.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.

People with disabilities’ perceptions of autonomous vehicles as a viable transportation option to improve mobility: An exploratory study using mixed methods

Autonomous vehicles (AVs) are expected to bring significant changes to the mobility of people, especially those with disabilities. Despite the strong potential of AVs to impact the lives of people with disabilities, little attention has been paid to understand their perspectives on this technology. This study aims to fill the gap, by exploring the mobility challenges experienced by people with disabilities and the overall perceptions of autonomous vehicle transportation (AVT) services among people with disabilities. The specific focus is on individuals with physical disabilities and individuals with visual impairments. This study used a three-phase exploratory sequential mixed-methods design. We began by conducting focus groups and analyzing the collected data. From the focus group results, we developed a survey instrument in the second phase. In the third phase, we collected and analyzed the survey data to verify the initial focus group findings. Additionally, the survey included stated preference choice experiments to assess the AV acceptance level of people with disabilities. The results revealed that people with disabilities’ mobility issues with current public transit services and neighborhood built environments may influence their positive attitudes toward AVT services. Despite several concerns raised about AVs regarding accessibility, safety, and reliability, most participants showed a high acceptance level of AVT. The findings provide industry and policy-makers with insights into the expectations, concerns, and needs regarding AVT from the perspectives of people with disabilities.

Home Oxygen Therapy.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.

Perceptions and experiences of promotoras and pharmacists in an academic-community partnership providing telephonic MTM services to a Spanish-speaking, rural population: a focus group study.

BACKGROUND: The literature is limited concerning the collaboration between pharmacists and promotoras in the delivery of medication therapy management (MTM) services. Yet, this information could help address a practice gap while improving MTM collaborative care approaches. OBJECTIVE: To identify the knowledge, attitudes, and barriers of clinical call center health professionals (pharmacists, nurses, pharmacy interns) and promotoras towards MTM collaborative care in implementing the Rural Arizona Medication Therapy Management (RAzMTM) program. METHODS: A descriptive, qualitative study using semistructured focus groups was conducted with call center health professionals and promotoras who participated in the RAzMTM program to improve pharmaceutical care for patients with diabetes and/or hypertension in rural Arizona. Recruitment and consent letters, a demographic questionnaire, and a focus group guide were designed specifically for this project. Three facilitators participated in each focus group-one guided the discussion while the others took notes. Focus groups were audio recorded to verify all responses and transcribed verbatim with omission of participant identifiers. Thematic analysis was conducted by 2 independent researchers who reviewed the transcripts to identify codes, seek consensus, and agree on themes, with negotiation from a third independent researcher. RESULTS: Nine participants took part in 2 focus groups. Participants were predominantly female (89%), college graduates and/or had postgraduate/professional degrees (78%), and were Hispanic or Latino (89%). Five themes were identified: (1) roles and responsibilities of RAzMTM participants; (2) benefits unique to the RAzMTM program; (3) interprofessional experience of RAzMTM participants; (4) professional growth for RAzMTM participants; and (5) opportunities for future improvement. Perceptions of the participants in the RAzMTM program were consistent-experiences of health professionals and promotoras were positive; they recognized the benefit of each other's involvement in the program; and they learned how to work together to improve patient care. Future recommended program improvements include improving ease of scheduling (e.g., extending pharmacist availability to provide MTM services). CONCLUSIONS: These focus group results suggest that provision of telephonic MTM services, using an academic-community partnership, was positively received by participating pharmacists and promotoras. However, future work is needed for continued improvement of strategies to enhance interprofessional relationships in patient chronic disease management. DISCLOSURES: This project was supported by the Grant or Cooperative Agreement Number DP004793, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. This work also was supported, in part, by SinfoniaRx. Axon, Taylor, and Warholak received funding from SinfoniaRx. Axon reports grants from Tabula Rasa Op-Co, Merck & Co, Pharmacy Quality Alliance, Arizona Department of Health, and American Association of Colleges of Pharmacy, outside the submitted work. Warholak and Taylor received funding from Arizona Department of Health Services as part of a contract, outside the submitted work. Vaffis reports funding from Merck and Pharmacy Quality Alliance. This study was presented as a poster at the American Society of Health-System Pharmacists Summer Meetings & Exhibition (June 10-12, 2019, Boston, MA) and as a podium presentation at the Arizona Pharmacy Association Southwestern States Residency Conference (June 14, 2019, Phoenix, AZ).

Consumer perception of the sustainability of dairy products and plant-based dairy alternatives

Plant-based dairy alternative beverage sales have increased in recent years. Plant-based dairy alternatives often advertise on a platform of sustainability and environmental commitment. To successfully position and market dairy products in this competitive environment, dairy companies must understand the consumer definition of and importance placed on sustainability, as well as communicate sustainability information effectively. The objective of this study was to characterize consumer perception of the sustainability of milk and dried dairy ingredients and their respective plant-based alternatives. Focus groups and 2 online surveys were conducted. In the first survey, maximum difference scaling was used to rank the importance of specific dairy product attributes to sustainability, along with an exercise in which respondents selected whether a fluid milk or protein powder product was sustainable. A follow-up survey included 2 exercises in which respondents selected whether generic dairy products or dried dairy ingredients were sustainable, natural, healthy, trustworthy, or ethical. Over half of dairy product consumers reported that they looked for sustainability-related information. Consumers who purchased both plant-based dairy alternative and dairy products placed a higher self-reported importance on sustainability than those who purchased dairy products only. Focus group and survey maximum difference scaling results identified 5 key attributes for sustainability: minimal carbon footprint/greenhouse gas emissions, few/no preservatives, animal happiness and welfare, and simple/minimal ingredients. Plant-based dairy alternatives followed by fluid milk and protein powders were considered more sustainable than dairy products, but package type and organic status also played a role in consumer sustainability perception. Product labels were the most common source of sustainability information, although consumers also sought information on websites affiliated and unaffiliated with dairy companies. There was cognitive overlap among the terms sustainable, natural, healthy, ethical, and trustworthy as they relate to dairy products, but consumers used the terms distinctly. Consumers perceived differences in these terms between general categories of dairy as well as among products in a specific dairy category. Dairy companies may be able to differentiate themselves by helping consumers make these choices by simplifying sustainability-related messaging and by maintaining open, transparent communication regarding sustainability.

If school walls could talk: A mixed-method study of physical space marking in promoting multiculturalism

Combining two qualitative and a quantitative method, we explored whether school’s physical environment promotes multicultural values or reflects intergroup climate in two multiethnic communities in Croatia. Croatia offers unique context for this study because minority youth from two ethnic groups use their right on minority language education and hence attend separate minority schools. Results show that the representation of ethnic symbols in schools is a reflection of inter-ethnic relations in the specific intergroup context. Specifically, ethnic symbols are overrepresented in the post-conflict context compared to the more harmonious multi-ethnic community. In harmonious intergroup context, multiculturality is promoted by emphasizing common identity, and by giving space to symbols of both minority and majority group. However, in the conflicted intergroup setting we found overrepresentation of symbols emphasizing intergroup differences. Results of focus groups as well as of the quantitative survey confirm that schools physical environment reflects intergroup relations in each community.

A mixed-method comparison of physician-reported beliefs about and barriers to treatment with medications for opioid use disorder

BackgroundEvidence demonstrates that medications for treating opioid use disorder (MOUD) —namely buprenorphine, methadone, and extended-release naltrexone—are effective at treating opioid use disorder (OUD) and reducing associated harms. However, MOUDs are heavily underutilized, largely due to the under-supply of providers trained and willing to prescribe the medications.MethodsTo understand comparative beliefs about MOUD and barriers to MOUD, we conducted a mixed-methods study that involved focus group interviews and an online survey disseminated to a random group of licensed U.S. physicians, which oversampled physicians with a preexisting waiver to prescribe buprenorphine. Focus group results were analyzed using thematic analysis. Survey results were analyzed using descriptive and inferential statistical methods.ResultsStudy findings suggest that physicians have higher perceptions of efficacy for methadone and buprenorphine than for extended-release naltrexone, including for patients with co-occurring mental health disorders. Insurance obstacles, such as prior authorization requirements, were the most commonly cited barrier to prescribing buprenorphine and extended-release naltrexone. Regulatory barriers, such as the training required to obtain a federal waiver to prescribe buprenorphine, were not considered significant barriers by many physicians to prescribing buprenorphine and naltrexone in office-based settings. Nor did physicians perceive diversion to be a prominent barrier to prescribing buprenorphine. In focus groups, physicians identified financial, logistical, and workforce barriers—such as a lack of addiction treatment specialists—as additional barriers to prescribing medications to treat OUD.ConclusionsAdditional education is needed for physicians regarding the comparative efficacy of different OUD medications. Governmental policies should mandate full insurance coverage of and prohibit prior authorization requirements for OUD medications.

AppRaiseVR – An Evaluation Framework for Immersive Experiences

Abstract Objective. VR is evolving into everyday technology. For all diverse application areas, it is essential to understand the user’s condition to ensure a safe, pleasant, and meaningful VR experience. However, VR experience evaluation is still in its infancy. The present paper takes up this research desideratum by conflating diverse expertise and learnings about experience evaluation in general and VR experiences in particular into a systematic evaluation framework (appRaiseVR). Method. To capture diverse expertise, we conducted two focus groups (bottom-up approach) with experts working in different fields of experience evaluation (e. g., Movie Experience, Theatre Experiences). First, we clustered the results of both focus groups. Then, we conflated those results and the learnings about experience evaluation stemming from the field of user experience into the final framework (top-down approach). Results. The framework includes five steps providing high-level guidance through the VR evaluation process. The first three steps support the definition of the experience and evaluation conditions (setting, level, plausibility). The last two steps guide the selection to find an appropriate time course and tools of measure. Conclusion. appRaiseVR offers high-level guidance for evaluators with different expertise and contexts. Finally, establishing similar evaluation procedures might contribute to safe, pleasant, and meaningful VR experiences.

Best Practices in Letters of Recommendation for General Surgery Residency: Results of Expert Stakeholder Focus Groups

Performance inflation is rampant in applications to general surgery residency. The medical student performance evaluation, transcript, and letters of recommendation (LOR) have all been shown significantly biased in the applicants' favor. This study sought to determine best practices for LOR to improve transparency and alignment of applicant and program characteristics. Two 1-hour focus groups were conducted using semi-structured interviews. Participants were asked to discuss the value and role of LOR characteristics, including standardized LOR, and provide recommendations for best practices. The transcribed discussions were coded by two educators using grounded theory and an inductive approach utilizing NVivo 12. Codes were then reviewed and revised to achieve consensus and recommendations. Focus groups were held during the annual Surgical Education Week meeting in April 2019. General Surgery Program Directors from 10 institutions and Surgery Clerkship Directors from 11 other medical schools participated, with each group meeting independently from the other. Individually, 18 codes were identified by the authors, with consensus agreed on ten. These were grouped into 4 themes: author factors, letter content, bias, and standardized letters. Overall, a checkbox and short-answer standardized LOR was not recommended, favoring a template of items to include and exclude. Ideal letter writers were felt to be surgeons who best know the applicant, and the Chair's letter, when they have no working knowledge of the applicant, was perceived to add little value. Use of specific examples to demonstrate applicant characteristics were favored, and descriptors for coded language should be included to aid in interpretation. The focus groups identified best practices to guide writing LOR in support of applicants to general surgery residency. A template of content is provided to improve the efficiency, transparency, and accuracy of these letters for the benefit of students, medical schools, and residency programs.

Increasing Engagement of African American Patients with Glaucoma during Medical Encounters: Creation of a Pre-visit Video.

The developed video can be accessed by African American patients with glaucoma from across the United States on YouTube to learn why it is important to ask eye care providers any questions they might have about glaucoma and/or its treatment. Our objective was to develop an educational video for African Americans with glaucoma to watch before their ophthalmology office visits to help motivate them to be actively involved in their care. The Social Cognitive Theory guided the development of the video. We conducted three focus groups with African American patients with glaucoma and three focus groups with providers who care for African American patients with glaucoma. The research team reviewed the transcripts of the focus groups and then developed a plan for video production. The themes that both patients and providers felt should be covered in the video to motivate patient question-asking included the following: what is glaucoma, glaucoma treatment, glaucoma testing, and treatment adherence. Based on focus group results, the resulting video had one male African American physician and four African American patients covering the themes that emerged. Ophthalmologists and African Americans with glaucoma gave us excellent insight into developing videos to increase patient involvement during their visits.

P60 The Effectiveness of Nutrition Education: Comparing Registered Dietitian Educators and Dietetic Interns

<h3>Background</h3> The Marshall University Nutrition Education Program (MUNEP) delivers nutrition education to needy elementary schools (grades K-2) in rural West Virginia. This dissertation research reviewed pre-/post-tests and teacher focus group findings comparing effectiveness of RDN educators and dietetic intern (DI) educators in program delivery. DI educators have no formal educational training or pedagogical practice compared to RDNs, yet they play a significant role in program implementation. <h3>Objective</h3> To examine differences in knowledge/behavior change based on pre-/post-scores after an intervention of nutrition education lessons by RDN educators/DI educators; and to compare the effectiveness of RDN educators/DI educators through teacher focus group findings. <h3>Study Design, Setting, Participants</h3> A mixed-methods, retrospective study of (15) knowledge/behavior-change questions on student pre-/post-tests (n = 1160) comparing RDN/DI educators; and results of teacher focus groups (n = 4), with teachers (n = 30) examining the effectiveness of RDN/DI educators in program implementation. <h3>Measurable Outcome/Analysis</h3> Quantitative analysis included independent t-tests comparing pre-/post-test scores for overall knowledge/behavior change; independent t-tests examining post-test scores for overall behavior/overall knowledge and comparing RDN/DI educators; post-hoc Bonferroni ANOVA analysis comparing post-test scores to free/reduced-priced (FR) meals in needy schools. Qualitative inquiry included thematic analysis to compare effectiveness of RDN/DI educators. <h3>Results</h3> Overall knowledge change from pre- to post-test was statistically significant (<i>P</i> = .000); no significant difference in overall behavior change from pre- to post-test (<i>P</i> = .710), or comparison between RDN/DI educators (<i>P</i> = .175 for knowledge change; <i>P</i> = .479 for behavior change) were found. Statistical significance existed for post hoc review of students' post-tests and socio-economic status based on percentage of FR school meals for students in the 50%-59% FR meal category vs students in the 90%-100% FR meal category (<i>P</i> = .017). Focus groups showed that RDN educators were empowered in the classroom and had better management than DI educators; taste-testing is a critical component for both RDN/DI educators. <h3>Conclusions</h3> This study adds to limited data comparing effectiveness of RDN/DI educators in nutrition education. Results will be used to inform DI training, improve MUNEP participant experience related to knowledge and behavior change, and to improve MUNEP experience in needy schools. <h3>Funding</h3> Supplemental Nutrition Assistance Program - Education.

User-relevant factors determining prosthesis choice in persons with major unilateral upper limb defects: A meta-synthesis of qualitative literature and focus group results.

ObjectiveConsidering the high rejection rates of upper limb prostheses, it is important to determine which prosthesis fits best the needs of each user. The introduction of the multi-grip prostheses hands (MHP), which have functional advantages but are also more expensive, has made prosthesis selection even harder. Therefore, we aimed to identify user opinions on factors determining prosthesis choice of persons with major unilateral upper limb defects in order to facilitate a more optimal fit between user and prosthesis.MethodsA qualitative meta-synthesis using a ‘best-fit framework’ approach was performed by searching five databases (PROSPERO registration number: CRD42019126973). Studies were considered eligible if they contained qualitative content about adults with major unilateral upper limb defects experienced in using commercially available upper limb prostheses and focused on upper limb prosthesis users’ opinions. Results of the meta-synthesis were validated with end-users (n = 11) in a focus group.ResultsOut of 6247 articles, 19 studies were included. An overview of six main themes (‘physical’, ‘activities and participation’, ‘mental’, ‘social’, ‘rehabilitation, cost and prosthetist services’ and ‘prosthesis related factors’) containing 86 subthemes that could affect prosthesis choice was created. Of these subthemes, 19 were added by the focus group. Important subthemes were ‘work/school’, ‘functionality’ and ‘reactions from public’. Opinions of MHP-users were scarce. MHPs were experienced as more dexterous and life-like but also as less robust and difficult to control.ConclusionThe huge number of factors that could determine upper limb prosthesis choice explains that preferences vary greatly. The created overview can be of great value to identify preferences and facilitate user-involvement in the selection process. Ultimately, this may contribute to a more successful match between user and prosthesis, resulting in a decrease of abandonment and increase of cost-effectiveness.