Relatives play a crucial role when palliative care is provided at home. More advanced care at home places higher demands on relatives, taking great responsibility, facing challenges, and often lacking adequate knowledge and skills to provide care. Therefore, relatives need support from healthcare professionals, yet do not receive the needed support. This study aimed to elucidate relatives' experiences of support from healthcare professionals before and after a patient's death when general palliative care is provided at home. A phenomenological hermeneutical method was used. The inclusion criteria were relatives of people who had died, involved in general palliative care at home. The sample consisted of 14 adult relatives involved in general palliative care at home between one week and 12 months. Data were collected through individual interviews between January and May 2025. Relatives needed to be seen as they felt left out; they felt an overwhelming responsibility; they needed to feel safe at home through guidance from and access to healthcare professionals; they felt the need to know what was happening and what to expect; and they needed help in processing the grief both before and after the patient's death. These themes formed the main theme: Standing next to but not being part of. The findings of this study showed a lack of support for relatives before and after the patient's death but offer insights into what support relatives need from HCPs when general PC is provided at home. Relatives need to feel seen, informed and prepared, to feel safe when care is provided at home, and not feel overwhelmed by the responsibility of the situation. As research continuously reveals that relatives have unmet support needs, this highlights the need for tailored interventions and the targeting of available support actions for improved support. Since relatives play a crucial role in palliative care at home, continued work with education and training for relatives should be prioritised to support them in feeling prepared, obtaining necessary caregiving knowledge and skills, enabling them to cope with the situation at home.

BackgroundIndonesia has made significant progress in malaria control, however hotspots such as Sumba Island continue to experience high rates of malaria transmission, driven by multiple Anopheles mosquito species. The Sumba Livestock Ivermectin for Malaria (SLIM) trial was conducted to assess the efficacy of ivermectin treatment in livestock as a vector control strategy. This accompanying social science study aimed to explore community perceptions of ivermectin-based malaria interventions, including ivermectin livestock treatment (ITL) and potential mass drug administration (MDA) in humans.MethodsA social science study was conducted alongside the SLIM trial between November 2022 and September 2023 across four villages in Southwest Sumba. Qualitative and participatory approaches were used to explore community perceptions. 75 individuals (>18 years old) from the SLIM study village sites were included in four focus group discussions (59 individuals) and 16 individual in-depth interviews. We also held four feedback meetings for all members of each study village. Community engagement activities, such as puppet shows and interactive sessions on malaria transmission, were also implemented. Data were transcribed, coded, and thematically analysed using Nvivo software.ResultsA total of 75 individuals participated in qualitative data collection, and approximately 650 individuals engaged in community events. Malaria was ranked as the most pressing health concern by study participants. Initial skepticism about ivermectin treatment of livestock was mitigated through trust-building efforts such as village meetings and respectful communication. Community members actively contributed to the trial, demonstrating acceptance of ivermectin treatment of livestock and expressing interest in future research participation. While there was openness to mass drug administration for humans, concerns about safety, particularly for children, were raised. Local authority approval was deemed essential for intervention acceptance. In one village, low social cohesion posed barriers to research participation, highlighting the importance of engagement before the trial started.ConclusionsCommunity perceptions of ivermectin-based malaria control strategies were shaped by trust, engagement, and cultural considerations. In this case there were multiple engagement activities built into the study – before, during and after the research, with stakeholders in local government and village leaders as well as with animal owners, other community members and children. The findings of this social research underscore the need for, and benefits of, sustained, respectful communication, partnership with local leaders and inclusive stakeholder engagement in malaria research. Future malaria control interventions should also account for local social dynamics, ensuring informed community participation to enhance trial feasibility and acceptance.

ABSTRACTBackgroundBackyard, or hobby, poultry ownership is increasingly popular in the United States, driven, in part, by a desire for food security and personal connection with animals. However, backyard poultry ownership can impose public health and biosecurity risks. Backyard poultry‐associated Salmonella outbreaks are on the rise. Qualitative studies are needed to obtain updated information on husbandry and biosecurity practices, motivations for ownership, and engagement with available resources. This knowledge can inform contemporary interventions that reduce zoonotic disease risks in backyard poultry settings.ObjectivesTo qualitatively assess practices, management, and resource preferences of backyard poultry owners in central North Carolina, a large commercial poultry‐producing state, regarding flock management and health and resource preferences.MethodsDuring January 2024 to June 2024, we conducted focus groups and individual interviews with 18 North Carolina backyard poultry owners recruited through an online interest group. Discussion topics included flock purpose, management, health, and biosecurity and owners’ knowledge base and resource preferences regarding flock management and health. We analysed transcripts using thematic analysis.ResultsParticipants reported owning small mixed‐breed flocks, primarily for egg production and companionship, and maintaining basic biosecurity measures (e.g., handwashing, yard boots). Among the major themes identified, participants considered their poultry as pets, though flocks were managed with a focus on overall herd health. Participants reported independence in treating poultry health conditions at home without veterinary specialist guidance. Online communities of backyard poultry owners and homesteaders were the preferred sources of information and advice.ConclusionA public health approach that frames biosecurity in backyard poultry settings around the pet‐owner mindset warrants further exploration as a strategic communication tactic. The potential impact of this approach on educational outcomes, however, remains to be established. Additional resources are needed to successfully bridge the veterinary care gap that exists for some backyard flocks. Future research should investigate cost‐effective, owner‐friendly interventions related to these efforts.

ABSTRACT This article examines the planning of music education and the enactment of teacher autonomy in primary schools with Slovene as the language of instruction in Italy. Applying a qualitative methodology – including individual semi-structured interviews with fourteen teachers and an analysis of personal annual teaching plans and school-level curricula for music education – the study finds that national curricular guidelines serve primarily as a broadly framed orientation document. The autonomy afforded by these guidelines is realised in practice in a situational and individualised manner, predominantly through the three core musical activities (performing, listening, and creating), interdisciplinary connections, and the integration of local Slovene musical traditions. The principal obstacles to effective planning and implementation include time constraints, insufficient material and spatial conditions, and the lack of updated teaching materials in Slovene. Document analysis confirms alignment with the overarching aims of the guidelines but reveals variation in the scope, sequencing, and complexity of planned content. Effective enactment of autonomy is associated with clear personal or school-level curricula (curricolo di istituto), professional collaboration, and targeted professional development. The findings contribute to understanding how the open curricular goals of the Italian guidelines are transformed into high-quality and culturally responsive pedagogical practice within a minority education setting.

ABSTRACT This article explicates key ethical and methodological considerations in qualitative research on sexism in academia. We draw on a longitudinal qualitative study that combined focus groups, diaries and repeated individual interviews with 15 female PhD students. First, we outline prospective considerations in the design phase. Previous studies document how sexism and gender biases may be hard for individuals to recognize; we explicate how we took this research into account in our methodological design. Second, we examine the cognitive, emotional and social impacts that participants experienced, such as an increased awareness of sexism. Instead of treating research participation impact as an unexpected and potentially harmful by-product of the research process, we actively engaged with the possibility of ‘ethical change’ and embraced a process-oriented conception of validity. We outline the limitations, risks, and potentials of various methodological tools, discussing them in relation to qualitative research on other oppressive practices reflecting structural injustices.

ABSTRACT Smartphones are being acquired at increasingly younger ages in the United States. Although existing research suggests that the age of acquisition is not strongly associated with adolescent outcomes, there are growing calls to delay smartphone ownership. Delaying smartphone use can be seen as a form of family media resistance, or the intentional choice to limit or avoid specific technologies. However, little is known about the lived experiences of adolescents and parents who make this choice. This study explored the experiences of 13 parent – adolescent dyads (n = 26 individuals) through in-depth, individual interviews. Using qualitative dyadic analysis, four themes emerged: (1) Navigating the promise and peril of smartphones, (2) Relational benefits and developmental trade-offs of not having a smartphone, (3) Defining and deciding readiness for smartphone ownership, and (4) Gradual exposure through alternatives. Both parents and adolescents reported minimal drawbacks and highlighted several benefits to delaying smartphones, including increased engagement in offline activities and strengthened family connections.

This study explores how school nurses in Norway plan and conduct health dialogues with first graders and their caregivers. Using an exploratory qualitative design, data were generated through six focus group discussions and 10 individual interviews with school nurses from diverse contexts, including rural and urban areas, small and large communities, and varying socioeconomic and cultural backgrounds. Reflexive thematic analysis by Braun and Clarke constructed three intersecting themes: strategies for trust-based relationships, conflict between quality and quantity, and striving for consistency and professional autonomy. Results highlight the complexities of translating National Guidelines into real-world practice, emphasizing the demanding nature of school nurses' work. The study underscores the need for clearer guidelines to support school nurses in delivering meaningful, health-promoting dialogues tailored to the diverse needs of children and their caregivers.

Generation Z nursing students, accustomed to text and video communication, face challenges in direct interaction, relationship building, and clinical adaptation. This study aims to investigate the effects of handover training using video-based debriefings on nursing students' teamwork attitudes. This mixed-methods study employed a sequential exploratory design. The study was conducted from March to October 2024. Handover training using video-based debriefings was administered to 37 fourth-year nursing students. Pre-test and post-test surveys assessing teamwork attitudes were conducted, and 15 participants engaged in individual interviews. Teamwork attitudes were analyzed using a paired t-test, and the qualitative data were analyzed using content analysis. Teamwork attitudes significantly improved from 4.28 to 4.58 out of 5. Three themes emerged: (1) recognizing handover-related challenges that hinder patient care provision; (2) learning the power of collaboration to support continuity of care; and (3) achieving patient-centered care through effective teamwork. Handover training using video-based debriefings effectively enhances communication, collaboration, and nursing students' understanding of teamwork by fostering both self-reflection and peer reflection. These improvements are anticipated to ultimately support the delivery of safer, high-quality, and patient-centered care.

Linking European colonialism to current racial inequality may pose identity challenges to White European people. Through mixed methods, we examined how White people in the Netherlands manage their advantaged ethno‐racial identity in relation to linking colonialism to current racial inequality. In Study 1, using individual interviews (N = 24), we found that participants exhibited identity strategies described in previous theorising: prideful (strong identification), distancing (weak identification) and power‐cognisant (critical identification). In Studies 2a and 2b, using surveys (N = 591), we built on Study 1's results and found using latent profile analysis that participants blended strategies, resulting in four profiles: prideful‐distancing (or prideful‐ambivalent), distancing, distancing‐cognisant and power‐cognisant. Identity profiles distinguished whether participants linked colonialism to current racial inequality and their ideological outlook. Those exhibiting prideful‐distancing and distancing profiles unlinked colonialism, asserted existing racial equality and downplayed the role of ethno‐racial categories in shaping people's lives. Those exhibiting distancing‐cognisant and power‐cognisant profiles linked colonialism to and acknowledged current racial inequality. Those exhibiting a power‐cognisant profile uniquely recognised the importance of ethno‐racial categories, displaying thus a markedly pro‐egalitarian outlook. We conclude by discussing the implications of how White people's identity management relates to linking colonialism to current racial inequality and its legitimacy.

Limited financial and human resources and infrastructure can affect the implementation of Good Clinical Practice (GCP), which can have a detrimental impact on data quality and the robustness and application of clinical trial outcomes. Monitoring frameworks are designed to ensure good data quality and help to guide adaptations of trial procedures over time. However, these frameworks tend to be based on datacentric approaches, which often neglect vital aspects of trials, such as social responsibility, capacity strengthening, and contextual influence. Therefore, this study analyses barriers and facilitators of the implementation of GCP in resource-limited settings to inform the establishment of adapted frameworks for trial management and monitoring. In this multi-method analysis of the freeBILy trial, conducted in Madagascar from 2019-2022, a random subset of trial participants (n = 500) and informed consents (n = 500) was analyzed for protocol deviations through descriptive statistics and trend analysis. Framework analysis of focus group discussions and individual semi-structures interviews provided a sociological viewpoint of the study context. Findings were subsequently triangulated, merging the viewpoints on the influences towards GCP in resource-limited settings. A decreasing trend in incorrect database entries was found (z = -6.968, Mann-Kendall Test, p < 0.001) over the course of the study, with an overall rate of 1.8% incorrect data entries. Triangulation showed three key areas of GCP implementation in resource-limited settings, which extend previous frameworks: a) Context adaptation towards infra-, team- and social structures as promoting factors, b) External influences, such as external threats, study personnel attitudes and perception towards the trial require recurrent assessment, and c) Promote GCP-compliant data collection subject to regular documentation and training cycles to facilitate capacity strenghtning and data ownership. This study shows the limitations of datacentric clinical trial management to assess GCP performances in the frame of clinical trials in resource-limited settings. We highlight the importance of well-trained and integrated study staff, as well as thorough preparation, budgeting and context appropriate monitoring. This achieves high quality, patient centered and compliant research, implemented through alternative frameworks for monitoring and evaluation.

IntroductionLimited financial and human resources and infrastructure can affect the implementation of Good Clinical Practice (GCP), which can have a detrimental impact on data quality and the robustness and application of clinical trial outcomes. Monitoring frameworks are designed to ensure good data quality and help to guide adaptations of trial procedures over time. However, these frameworks tend to be based on datacentric approaches, which often neglect vital aspects of trials, such as social responsibility, capacity strengthening, and contextual influence. Therefore, this study analyses barriers and facilitators of the implementation of GCP in resource-limited settings to inform the establishment of adapted frameworks for trial management and monitoring.MethodsIn this multi-method analysis of the freeBILy trial, conducted in Madagascar from 2019-2022, a random subset of trial participants (n = 500) and informed consents (n = 500) was analyzed for protocol deviations through descriptive statistics and trend analysis. Framework analysis of focus group discussions and individual semi-structures interviews provided a sociological viewpoint of the study context. Findings were subsequently triangulated, merging the viewpoints on the influences towards GCP in resource-limited settings.ResultsA decreasing trend in incorrect database entries was found (z = -6.968, Mann-Kendall Test, p < 0.001) over the course of the study, with an overall rate of 1.8% incorrect data entries. Triangulation showed three key areas of GCP implementation in resource-limited settings, which extend previous frameworks: a) Context adaptation towards infra-, team- and social structures as promoting factors, b) External influences, such as external threats, study personnel attitudes and perception towards the trial require recurrent assessment, and c) Promote GCP-compliant data collection subject to regular documentation and training cycles to facilitate capacity strenghtning and data ownership.ConclusionThis study shows the limitations of datacentric clinical trial management to assess GCP performances in the frame of clinical trials in resource-limited settings. We highlight the importance of well-trained and integrated study staff, as well as thorough preparation, budgeting and context appropriate monitoring. This achieves high quality, patient centered and compliant research, implemented through alternative frameworks for monitoring and evaluation.

SYNOPSIS Objective. This study extends current knowledge on coparenting, that is how parents work as a parenting team, by comparing patterns of prospective coparenting (i.e. expectations and worries related to forthcoming coparenting) among expectant parents in three countries varying in their sociocultural contexts. Design. During the third trimester of pregnancy, 30 Finnish, Japanese, and Portuguese heterosexual couples (N = 180) expecting their first child participated in individual semi-structured interviews on their prospective coparenting. A structured coding frame was developed in an iterative process between and within country teams. Results. Both country-general and country-specific patterns in prospective coparenting among Finnish, Japanese and Portuguese expectant couples emerged. Five themes of prospective coparenting across the three countries were identified, providing support for coparenting as a multidimensional construct but also revising knowledge on the relevance of these dimensions among expectant parents. Sociocultural context was reflected in couples’ expectations about the division of parenting responsibilities and in their expectations related to mutual support and agreement on childrearing. Country differences were also identified in how the expectant parents justified their decisions and saw the relative primacy of mothers and fathers in forthcoming coparenting. Conclusions. Parental cooperation in terms of mutual support, team spirit, sharing, and agreeing on childrearing were recognized among prospective parents in the three countries. However, the availability of institutional support, gender and the care regime, and the associated set of values as well as existing work and parenting cultures shaped expectant parents’ future visions of their coparenting.

ABSTRACT Principals are positioned at the heart of professional development in schools as their engagement has significant consequences for the ways in which professional development is enacted. However, little is known about how principals engage with professional development generally, and action research more specifically, in physical education. Therefore, in this study, we explore how five principals reflect on their engagement in a two-year action research project using individual semi-structured interviews. Through a thematic analysis we develop three themes highlighting various patterns across the principals’ reflections. In the first theme, ‘Reflecting on their engagement from and with different positions’, we showcase how principals engage in action research in different ways and to varying degrees. In the second theme, ‘Reflecting on action research from a tension between trust and the need for visible change’, we present what we found to be a tension among principals between the need for documentable changes and their wish to trust in action research processes that do not necessarily lead to observable change. In our third theme, ‘Reflecting on their engagement in action research as “business as usual”, we elaborate on how principals’ reflect on how schools are always in development mode, but also how action research makes these processes more explicit and visible. Overall, our findings contribute to a deeper understanding of principals’ engagement, an area that has been under-explored in the action research literature in physical education.

Demographic changes have increased the number of older adults with chronic diseases, leading to more emergency visits and poorer outcomes. In response, Sweden's "Close care" initiative promotes patient-centered care through models such as mobile care units, which provide hospital care in patients' homes during office hours. To support their integration, this study explored patients' experiences of receiving care from mobile care units in Sweden. A qualitative interview design was used. Data were collected through individual interviews with 17 patients receiving care from mobile care units in different regions of Sweden between June 2021 and May 2025. Interviews were transcribed verbatim and analyzed using manifest conventional content analysis. The findings emerged into two main categories with six subcategories: "The home as a care setting" and "Comprehensive patient-centered care". Patients valued mobile care for its comfort, reduced stress, and decreased need for hospital visits, preferring it for mild conditions while favoring hospital care for acute illness. Patients appreciated the person-centered, home-based care, which reduced logistical challenges and supported daily routines and independence. However, some questioned its suitability for severe conditions, preferring hospital care for its advanced resources and 24/7 availability.

Few studies on teleconsultation (TC) have focused on comparing the points of view of general practitioners (GPs) and patients. To explore bio-psycho-social situations suitable for TC according to GPs and patients. A qualitative study, with thematic analysis, was conducted. Data were collected through individual, semi-directed face-to-face or remote interviews with GPs and patients. The interview guide was validated by a steering committee that included patients. Maximum variation sampling of established GPs and patients was based on diversification criteria. Thirteen patients and eleven physicians were included in this study. The main condition for TC was a pre-established relationship of trust. It was used on an Ad hoc basis as an alternative to face-to-face consultations. Patients and GPs identified that the use of TC should be the result of a shared decision. Participants agreed on the situations in which the use of TC could be justified: to respond to one-off, specific requests, for benign reasons or reasons not requiring a physical examination. Patients considered their health experience and level of health literacy to be strong determinants of TC use. Participants noted the risk of TC widening certain inequalities in access to care. Patients and doctors have identified the same suitable situations and the need to respect certain prerequisites. TC seems appropriate when its use is the result of a prior shared decision between patient and GP.

Pedagogical content knowledge (PCK) refers to educators' understanding of subject matter integrated with teaching approaches that ensure teaching effectively supports learners' needs. Anatomy demonstrators are temporary or sessional early career educators responsible for facilitating the full spectrum of anatomical learning, yet their understanding and application of PCK are poorly understood. Given the educational value of PCK, this study sought to explore demonstrators' understanding of PCK and identify factors influencing their PCK development. The 11 study participants were current and former anatomy demonstrators at an Australian medical school. Data were collected through seven semi-structured group and individual interviews and analyzed through reflexive thematic analysis using PCK components as the conceptual framework. Three themes were developed: (1) PCK Familiarity, (2) PCK in practice, and (3) Factors influencing PCK development. While demonstrators had limited explicit familiarity with the PCK concept, multiple PCK elements were implicit within descriptions of their educational practice, such as how their knowledge of content, students and context influenced their specific approach. Factors influencing demonstrator PCK development included educational experience, peer collaboration, reflective practice, embodying feedback and development time. Despite anatomy demonstrators having limited teaching experience, this study highlights the application of several components of PCK within their teaching practices. However, there is a considerable opportunity to further develop this group's PCK and thereby the support of learners. Key implications for demonstrators' supervisors and mentors include supporting professional development opportunities such as educational fellowships, encouraging and facilitating reflective practice, and including PCK in role performance standards.

Purpose This study evaluates the effectiveness of African Career Networks (ACN) disability inclusion efforts by examining barriers and facilitators experienced by youth with disabilities participating in employment transition programmes, assessing the role of reasonable accommodations and analysing stakeholder attitudes that influence employer and university engagement. Design/methodology/approach A mixed-methods study employed an online survey (n = 92), focus group discussions and individual interviews with youth with disabilities who were current students and alumni of African Leadership Academy or Mastercard Foundation Scholars programme. Data analysis utilised a critical occupational perspective informed by the International Classification of Functioning, Disability and Health framework. Quantitative data were analysed descriptively, while qualitative data underwent thematic analysis across environmental factors that influence participation. Findings Results revealed diverse participation patterns among youth with disabilities, with mobility (40%) and visual impairments (31%) representing the largest demographics. Key barriers included inaccessible technology platforms, physical infrastructure limitations, negative stakeholder attitudes and inadequate communication systems. Facilitators included assistive technology, disability-sensitised staff, supportive peer networks and understanding employers providing reasonable accommodations. Participants emphasised the need for universal design principles, mentorship opportunities and comprehensive disability awareness training for employers rather than focusing solely on training persons with disabilities. Research limitations/implications The study's findings are limited by the relatively small sample size of 92 survey participants and the total population of 12 youth who participated in ACN's customised Career Readiness Curriculum, which may restrict the generalisability of results across the broader population of African youth with disabilities. Qualitative methods of research, however, emphasises the transferability of findings to similar contexts over statistical generalisability. The reliance on online data collection methods through MS Teams and Zoom platforms may have inadvertently excluded youth with disabilities who lack reliable Internet access or appropriate assistive technology, potentially underrepresenting the experiences of those facing the most significant digital barriers to participation. Originality/value This research provides contemporary empirical evidence from an African context on employment transitions for youth with disabilities, addressing a knowledge gap in disability employment research from African scholars. The study contributes novel insights into the effectiveness of targeted inclusion strategies and offers evidence-based recommendations for improving equitable access in graduate employment transition programmes across Africa. The findings inform policy implications for programme design of youth with disabilities' transitional efforts that challenge standardised approaches to support of this marginalised group.

Medical professionalism is a core component of medical education, yet it remains conceptually ambiguous and inconsistently articulated across institutions, cultures and training contexts. Although students are expected to demonstrate professionalism as part of professional identity formation, the meanings and expectations associated with professionalism are often implicit, variable and shaped by both formal curricula and the hidden curriculum. This qualitative study examined how medical students articulate and make sense of professionalism during undergraduate medical training using a discourse-informed analytical approach. All students (M1-M4) at a single US medical school were invited to participate, and recruitment concluded after 44 students volunteered. Data were collected through 20 individual semistructured interviews and four focus groups, and transcripts were analysed inductively to identify recurring ways professionalism was articulated in students' accounts. Analysis revealed three recurring ways professionalism circulated in student discourse: (1) definable and actionable, in which professionalism was described through observable behaviours such as punctuality, dress and communication; (2) inherently subjective, where professionalism was framed as situational, relational and shaped by cultural or interpersonal expectations; and (3) uncertain and confusing, characterised by difficulty articulating a coherent understanding and by the expansion of professionalism into broader expectations of self-presentation and image management. Across these accounts, students most often articulated professionalism in physician-centred terms, emphasising self-regulation, appearance, composure and evaluability, reflecting the institutional and assessment contexts of early medical training. This study demonstrates that medical students encounter professionalism through multiple coexisting ways of understanding that circulate within medical education and are variably taken up as students navigate professional expectations. By shifting analytical attention away from defining what professionalism should be and toward examining how professionalism is articulated and taken up in practice, a discourse-informed approach offers a productive framework for understanding professional identity formation in contemporary medical education.

Research has highlighted the important role that communities of kink play in the social and sexual lives of kinksters. Existing literature has not examined the experience of community for rural and remote-living kink-identified individuals, where access to communities, networks of playmates, and spaces for kink may be limited by virtue of social and geographic isolation. The aim of this study was to explore the lived experience of community among self-identified cisgender gay men who engage in fist-fucking and live in rural areas. A qualitative study was conducted with a multi-national sample of 40 fist-fuckers, each of whom participated in an online semi-structured individual interview. Guided by a interpretative phenomenological analysis of the data, six themes were developed: (1) the experience of isolation in the formative journey of self-discovery; (2) geographic, logistical, and financial burdens in accessing community; (3) feelings of (dis)connection from the community and the struggle for kink identity; (4) the absence of community networks and resources in supporting healthcare needs; (5) the opportunities and challenges of online communities and connections; and (6) the lack of communal spaces and local networks of partners in fostering sexual satisfaction. The findings revealed that participants shared lived experiences of personal isolation, sexual frustration, and social exclusion from urban-based fisting communities. For some fist-fuckers, their rural-living circumstances produced not only social and sexual dislocations from their communities but, also, a disconnectedness from their kink identity. For others, the remoteness of their living contexts forged new modes of online community building, strategies for sexual and erotic resilience, and experiences of community.

Abstract Objective This study examined the impact of quality time spent with family in modifying the relationship between various negative home and social consequences of the pandemic and subsequent social and behavioral outcomes. Background Adverse consequences related to economic, health, and social factors were brought about by the COVID‐19 pandemic. In other contexts, family protective factors and resiliency have been found to mitigate similar adverse circumstances. Method This mixed‐method study included participants across five states ( N = 67). Quantitative methods included survey data on individual and family experiences related to work and education, home and social circumstances, and physical and emotional health. Qualitative measures included individual interviews to better understand familial experiences during the pandemic. Results Relationships between negative home life experiences and consequences of the pandemic and subsequent negative outcomes were found to be altered as levels of quality time spent with family and children increased. These results were replicated through robust qualitative data, which told the stories of families using quality time to support positive outcomes. Conclusion Findings suggest that quality time spent with family can be a point of emphasis for mitigating adverse social and health outcomes. Implications Quality time may serve as a low‐cost, accessible relational strategy that can be intentionally emphasized in prevention, intervention, and public health messaging to strengthen family resilience during periods of prolonged adversity.