Inductive Approach Research Articles

Mothers’ perspectives on the use and acceptability of 3d printed prosthesis by their children with congenital upper limb difference in India: a qualitative study

Purpose Children with congenital upper limb difference (CULD) in India have limited access to treatment with conventional prostheses. 3D printed prosthetic devices (3DPP) can function as transitional prostheses for growing children with congenital transverse deficiency. They are low-cost and the designs are easily customized. However, functional outcomes, access, and acceptability are still unexplored in many clinical settings. This qualitative study sought perspectives from Indian mothers of children with CULD using 3DPP for the first time. The objective was to enhance understanding of 3DPP acceptability and to explore how their children utilized these devices. Method Semi-structured interviews were conducted with seven mothers of children aged 3 to 11 years with varying levels of CULD who had been fitted with a 3DPP for at least 1 month prior. The interviews aimed to gather insights into the children’s daily experiences with the devices and the mothers’ perceptions of 3DPP. Thematic analysis was carried out using an inductive approach. Results Four major themes were identified through thematic analysis. They were: 1. Design and functionality of 3DPP, 2. Adaptation patterns, 3. Social attitudes and perceptions, and 4. Access to the Center for congenital hand differences: location and its services. Conclusion Our study explores the early-stage use and acceptance of 3DPP in India. Mothers reported several reasons for prosthesis abandonment including functional limitations, pain, and unmet expectations. The acceptability of 3DPP was moderate among close family, but social stigmatization was still a barrier to continued use. Addressing these issues and offering tailored solutions could be important to achieve successful 3DPP adaptation.

'A potentially ticking time bomb' - barriers for prevention, diagnosis, and treatment of cardiovascular disease in people with intellectual disabilities.

Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities. We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data. We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability overshadows other possible diagnoses. This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group.

Breastfeeding Experiences of Mothers Staying in Temporary Shelter Areas in Disaster-Affected Provinces in the 2023 Türkiye Earthquake.

While the basic needs of breastfeeding women are similar to those of the general population, there are some specificities that must be taken into account when responding to an emergency. This study examines the breastfeeding barriers faced during a large earthquake in Türkiye and aims to investigate how infant feeding practices of breastfeeding mothers staying in temporary shelters after the earthquake were affected. This study follows a qualitative descriptive design with an inductive approach. It included participants who were older than 18 years of age, had babies no older than 1 year, and were breastfeeding mothers when the earthquake struck. Five main themes were identified through a content analysis of the interviews: (1) breastfeeding environment after the earthquake, (2) emotional impact, (3) change in social relationships, (4) physiological needs and problems, (5) specialized maternal and baby health services. Factors affecting mothers' infant feeding practices were crowded breastfeeding environments, stress and fear caused by the earthquake, decreased breastfeeding support due to changes in social relationships, difficulty in reaching basic physiological needs, and lack of professional health workers in the earthquake region. The most important factor affecting breastfeeding was the lack of suitable environments in which to breastfeed. There should be local, regional, and federal policies to support the privacy needs of displaced breastfeeding mothers.

Grief Responses During the COVID-19 Pandemic: A Qualitative Study in Spain

IntroductionThe recent COVID-19 pandemic led to a rise in the number of people bereaved by the death of a loved one. There are many pandemic-related stressors that may have further complicated grief in these people. The aim of this research was to conduct an in-depth the experience of illness and death during the pandemic, as well as obstacles to and factors facilitating grief in people who had lost a loved one during this period, whether due to COVID-19 or to natural or sudden causes. MethodThe sample consisted of 42 participants who had lost loved ones to COVID-19 or other causes (both natural and sudden). An inductive approach using grounded theory with open, axial and selective coding was used to analyse the semi-structured open-ended interviews. ResultsThe resulting theory was structured around a central category: “Processes of Loss and Grief in Pandemics”. The other relevant and related categories were: disease processes during the pandemic, emotional responses to the loss, factors facilitating the grieving process and obstacles to the grieving process. The various analytical categories were then further classified with reference to the Dual Process Model. ConclusionThis study highlights the main features of grief during the pandemic, including the impact of restrictive measures on disease processes; the funeral rituals performed and subsequent coping; responses such as intense shock, anger, fear or loneliness; and the way in which factors facilitating the grief process were adapted to the circumstances.

Identifying critical elements in using Question Prompt Lists at the pharmacy counter to induce patient activation—using principles of conversation analysis

BackgroundThe incorporation of Question Prompt Lists (QPLs) into pharmacy interactions has been tested as an innovative strategy aimed at enhancing patient engagement and addressing personal information needs. However, there is a gap in understanding regarding how QPLs induce or reduce patient activation and contribute to improved medical treatment. The specific aim of the study was therefore to qualitatively describe how pharmacy encounters in which QPL are introduced unfold, in order to identify and discuss relevant interactional mechanisms that induce or reduce patient activation. MethodsThe QPL, which includes questions about usage, interaction, side effects, and follow-up, was introduced to patients during pharmacy encounters. Employing a qualitative inductive approach based on principles from conversation analysis (CA), audio-recordings from 56 QPL encounters in community pharmacies were transcribed and thematically analysed. ResultsMost meetings began with along initiation phase focused on determining which medications to take home. This was followed by an introduction to the QPL and a natural break where the pharmacist left to get the medicines, giving the patient an opportunity to contemplate their needs, as prompted by the QPL. While the QPL itself was not explicitly explained or discussed, the majority of patients asked questions and shared personal information. Even those who were disinterested felt compelled to justify their stance, demonstrating the influence of the norm of reciprocity. However, instances of unsolicited information provision by the pharmacist, were still identified. ConclusionThis study demonstrates that Question Prompt Lists (QPLs) can enhance patient activation in pharmacy encounters, even without detailed explanations, but their impact is not straightforward. The presence of the QPL encouraged patients to engage, share personal information, and ask questions. These findings suggest that QPLs can create opportunities for patient involvement, even in brief pharmacy interactions.

Mental Health Experiences Among Undergraduate Nursing Students in a New Zealand Tertiary Institution: A Time for Change.

Nursing students in undergraduate programmes exhibit comparable, sometimes higher, levels of poor mental health and substance use compared to the general population; however, this area remains under-researched in New Zealand. The study involved 172 nursing students enrolled in the Bachelor of Nursing programme at one tertiary institution in Auckland, New Zealand. Employing a mixed-methodology approach, a 29-question survey comprising both open and closed questions was administered to explore the students' experiences with mental health and substance use, as well as their access to support services. Quantitative data were analysed using SPSS version 29 descriptive statistics, while a general inductive approach guided the qualitative analysis. A significant proportion of participants (75%) reported experiencing emotional distress during their studies, with anxiety being the most prevalent (78.5%). A smaller percentage disclosed substance use (8.1%) including excessive alcohol use, cannabis use, nicotine use, vaping cannabis and some refusal to reveal substance use. Surprisingly, less than 1% (n = 0.6) utilised institutional support services. Three qualitative themes were identified including emotional distress and associated effects, emotional and psychological impacts on nursing students' academic journey and tertiary support systems. The findings highlight the urgent need to address the mental health and addiction challenges experienced by nursing students, given their potential adverse effects on academic success and overall well-being. Urgent action is needed to integrate mental health training into the curriculum and provide faculty support. In this study, the underutilisation and inadequacy of institutional support services signal a need for institutional reforms to provide access and personalised mental health support to nursing students. Providing essential skills and support for student success contributes to the overall well-being of the nursing workforce.

The Development of Contingency Theory in Public Sector: An Overview

The purpose of this study is to provide an overview of contingency theory research, particularly in the public sector. The inductive approach of a series of studies with the goal of theoretical development in the field of investigation served as the foundation for the research methodology and design. We focus on the publication in journals indexed on the Scopus database. A quantitative bibliometric analysis is carried out. 159 articles on the topic were located. We also identified the authors, journals, nations/regions, and the number of citations that contributed most to the growth of the investigation in this research topic by encouraging the analysis of strict bibliometric tools. To better understand the evaluation of the research topic, we use the VOSviewer software. As a result, despite a very slow start in 1979, this field of study has significantly expanded in recent years. There was a total of 13 documents published in 2019 and 2022, and so far in 2024, 9 documents have been published. With 44 documents published, the United States is the country or territory that has conducted most of this research; Indonesia is in sixth place with 9 documents.

Application of an implementation premortem: A novel qualitative approach leveraging prospective hindsight to enhance barbershop health interventions for Black men.

Barbershop-based efforts to promote health among Black men have been uniquely successful. Despite the success of these efforts, the emphasis on outcomes as opposed to how these outcomes can be achieved has created a gap in the literature. The present study addresses this gap by describing implementation-related program priorities that Black men identify for barbershop-based interventions. Twenty-three Black men participated in implementation premortem activities. Participants were: (i) given details about a barbershop-based health promotion effort, (ii) told that the effort had failed, and (iii) were asked to identify potential sources of program failure and strategies to overcome those challenges. The frequency of program priorities was calculated based on the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework, and focus group data were analyzed using an inductive thematic qualitative data analytic approach. Data analyses occurred in three phases: (i) excerpts were grouped by Phase, Domain, and Construct of the EPIS Framework; (ii) themes within each excerpt were then identified using an inductive approach; and (iii) themes were organized into conceptually similar and parsimonious categories. Participants suggested that the biggest source of program failure was that more attention needed to be paid to Program Fit during the Implementation Phase. Participants reported concerns with the accessibility and convenience of the effort. Additional participant concerns included economic issues, community ownership, climate, staffing processes, cultural sensitivity, engagement, and trust. The implementation of health promotion programs for Black men should pay particular attention to how the intervention fits the needs, lives, and contexts of potential participants.

Development and Validation of Spiritual Well-Being Scale in India: A Yogic Niyama Perspective.

This study developed and validated the niyama-based spiritual well-being scale (NSWBS) using a mixed-method approach. Niyama is one of the eight limbs of ancient Indian Ashtanga yoga philosophy. There are five niyamas: soucha (internal and external cleanliness and hygiene), santosha (happiness and contentment), tapas (austerity and discipline), swadhyaya (self-study, observation and self-introspection) and ishvara-pranidhana (believe and surrender to the God and cosmic power). Both deductive (using existing spiritual well-being scales) and inductive (focus group discussions) approaches were used to generate items. These statements were first subjected to content validity testing and pre-testing, which resulted in seventeen statements. The psychometric properties of generated items were analyzed with the help of three independent studies that utilized various statistical tests like exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's alpha, McDonald Omega, Average variance explained, and Fornell and Larcker criterion. The first study examined the factorial structure of the proposed scale. EFA yielded five factors: Internal and external health and purity, Self-discipline and rigour, Self-introspection and observation, Contentment and gratitude, and Belief in God and higher cosmic power. They explained 62.35% of the total variance. The CFA validated the five factorial structure of the scale. The second study established the proposed scale's internal consistency reliability, convergent, divergent, and predictive validities. Lastly, the third study evaluated and concluded the test-retest reliability of the scale. Overall, the niyama-based spiritual well-being scale depicted appreciable psychometric properties.

Mathematics Teachers’ Experiences of Using Online Teaching Resources for Professional Learning in a Context of Disadvantage

This interpretative phenomenological study adopted the Community of Inquiry framework to explore 30 South African teachers’ experiences of the effectiveness of Grade 9 online mathematics teaching resources. A survey questionnaire with open-ended questions and a semi-structured interview guide were used to obtain data on the teachers' experiences. Data were analysed using an inductive thematic coding approach. The findings were that the teachers positively experienced the efficacy of online teaching materials for their professional development in terms of cognitive, social, teaching and learning presences. Using WhatsApp groups to share and discuss the online materials enhanced a common identity (social presence), deep engagement with the mathematical and pedagogical content knowledge of the materials (cognitive presence), (peer) teaching and (peer) learning from one another via WhatsApp (social media) chat groups (teaching and cognitive presences) that collectively eased curriculum implementation and enhanced student learning. However, limited facilitator teaching presence and limited internet access for both teachers and learners constrained the platform's benefits. Participating teachers reported spending at least three hours per week searching for online teaching resources, sometimes fruitlessly, indicating a need for more digital literacy training. The study makes a valuable contribution to our understanding of the potential benefits of online resources for teaching complex mathematics topics such as fractions and familiarity with the obstacles that need to be overcome. The more teachers and students turn to online resources, the more the findings of this study can inform the development of such resources to improve mathematics learning outcomes for schools in contexts of disadvantage.

Reasons for contraceptive discontinuation among women of reproductive age in Kano, Nigeria: A qualitative study

Women’s attempts to achieve their desired levels of fertility are hindered when they stop using contraceptives, which could lead to unwanted pregnancies. This study aimed to assess reasons for contraceptive discontinuation among women of reproductive age in urban and rural areas of Kano State, Nigeria. Qualitative data were collected in urban and rural communities of Kano State in February to May, 2022 from women of reproductive age group, their male partners, family planning service providers, and community and religious leaders. Focus group discussions (FGD), and key informant interviews (KII), using multi-stage sampling methods explored previous experience with contraceptive use, fertility consequences and reasons for contraceptive discontinuation. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Study reported the high discontinuation rates and identified side effects as the primary reason for discontinuation, with injectable contraceptives being the most commonly discontinued method. Other reported reasons for contraceptive discontinuation by respondents in both urban and rural groups were: method failure, intention to get pregnant, health concerns, husband disapproval, methods not available, inconvenience to use and interference with body structure or functions. The high contraceptive discontinuation poses significant risks of unintended pregnancies and unsafe abortions, thereby increasing maternal morbidity and mortality rates in Kano State. These consequences emphasize the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help gather support for contraception, rather than focusing exclusively on women.

Financing immunisation in Kenya: examining bottlenecks in health sector planning and budgeting at the decentralised level

BackgroundDecentralisation has increasingly been adopted by countries as an important health sector reform aimed at increasing community participation in decision making while enhancing swift response at decentralised levels, to accelerate the attainment of health system goals. Kenya adopted a devolved system of government where health services delivery became a function of the 47 semi-autonomous county governments with planning and budgeting functions practised at both levels of government. This study sought to explore challenges facing health sector planning and budgeting and how they affect immunisation service delivery at the county level.MethodsData were collected through 77 in-depth interviews of senior county department of health officials across 15 counties in Kenya. We applied an inductive thematic approach in analysing the qualitative data using NVIVO software.FindingsThe study found a lack of alignment between planning and budgeting processes, with planning being more inclusive compared to budgeting. Inadequate capacity in conducting planning and budgeting and political interference were reported to hinder the processes. Limited budget allocations and delayed and untimely disbursement of funds were reported to affect execution of health and immunisation budgets. Low prioritisation of preventive health interventions like immunisation due to their perceived intangibility influenced resource allocation to the programs.ConclusionThe findings highlight the need for effective strategies to align planning and budgeting processes, increased technical support to counties to enhance the requisite capacity, and efforts to improve budget execution to improve budget credibility. Counties should plan to increase their funding commitment toward immunisation to ensure sustainability of the program as Kenya transitions from GAVI support.

The relationship between feeding practices and stunting among children under two years in Tanzania mainland: a mixed-method approach

BackgroundProper infant and young child feeding practices have gained attention over the years as one of the interventions to reduce childhood stunting. However, there is still a gap in research to determine these relationships in children under two years and the reasons for improper feeding.ObjectiveThis study aimed to assess the relationship between feeding practices, stunting and barriers among children under two years.MethodologyUtilizing a mixed-method approach, the study involved secondary analysis of 1806 records of children aged 6–23 month, from the Next Generation Nutrition Program conducted in Tanzania (2015–2019). Both quantitative and qualitative data analyses were employed. Frequency distribution tables were utilized to describe study participants stratified by their stunting status. Subsequently, modified Poisson regression models identified predictors of stunting. Qualitative analysis encompassed deductive and inductive approaches, to extract themes that address the behaviors contributing to inappropriate feeding practices.ResultsStunting prevalence was 28.8% among children aged 6–23 months, with the majority (65%) of stunted children aged 1 year or older. Dietary diversity was low: 88.3% and 86.3% of stunted and non-stunted children, respectively, consumed less than 5 food groups. Surprisingly, early initiation of breastfeeding, time of stopping breastfeeding, and minimum dietary diversification were not significantly associated with child stunting (p-value > 0.05). Barriers to proper feeding practices identified were inadequate knowledge of feeding, maternal condition, economic hardship, cultural issues, and seasonality.ConclusionEarly breastfeeding and minimum dietary diversity were not significant predictors of stunting. However, the mother’s age and height > 150 cm reduced stunting risk while child sex, age, birth weight, marital status, and place of delivery also influenced stunting risk. It is crucial for initiatives to emphasize good feeding practices while addressing the complex factors that may hinder optimal feeding practices in this age group to reduce childhood stunting effectively.

دراسة تطبيقية عن دور إدارة المخاطر في تعزيز الأمن السيبراني للمؤسسات الصغيرة والمتوسطة في المملكة العربية السعودية

This study aimed to evaluate and improve cyber risk management in small and medium enterprises in the Kingdom of Saudi Arabia. The study relied on the descriptive, analytical and inductive approach, using data collection tools such as questionnaires, interviews and case studies. The most prominent results were weak level of use of information technology among 50% of employees. Shipping and delivery procedures policy is the most used at 33%. Antivirus software is the most used security technology at 40%. Fake audio and video attacks represent the biggest obstacle to cyber risk management at 30%. 50% of employees are aware of cyber risks. There is a strong correlation (89%) between employee awareness and cyber risk management. Key recommendations include raising awareness, developing comprehensive policies, conducting periodic risk assessments, investing in modern technologies, building a strong security culture, and providing qualified human resources.

Development of an air quality communication strategy with underserved groups

Abstract Air quality is the greatest environmental health threat. Effective communication can support individuals to take actions to protect themselves, however, we know some groups are less likely to engage with exposure reducing behaviours than others. We aimed to explore what information individuals want to receive about raised air pollution levels, when, where and how they would like to receive it. In this qualitative study individuals participated in either semi-structured interviews (n = 6) or focus groups (n = 8) in North East England between Oct23-Feb24. We used purposive sampling underpinned by extensive community-based engagement to ensure inclusion of those who were underserved and/ or at risk of digital exclusion. The Capability Opportunity Motivation-Behaviour model was used to help guide discussions and the data thematically analysed using an inductive approach. Fifty individuals participated, many of whom were of non-white ethnicity (n = 23, 46%), spoke English as an additional language (n = 12, 24%), and had lower educational attainment levels (i.e., no-qualifications n = 7, 14%). Participants discussed four aspects that they deemed important to include in air quality communication: (1) the risk and harms of air pollution should be stated, and be tailored because “what’s a dangerous level for one person isn’t a dangerous level for another”(P41) (2) Participants felt detail about the pollutants should be included such as: “what is causing the air pollution?”(P15) to “avoid the exposure to this source”(P21). (3) Messages should also include actionable recommendations about how to protect oneself and, (4) various ways to communicate these messages (text-message-based approaches being the most popular) were suggested. Our findings indicated using a combined communication strategy including text messages and community-based approaches. This work can inform the development of inclusive future air quality information communication Key messages • Effective communication can support individuals to take actions to protect themselves from air pollution. • A combined communication strategy including text messages and community-based approaches were suggested as being effective communication strategies.

Exploring the health challenges of affected people in the 2023 Khoy earthquake: a content analysis

BackgroundAn earthquake has significant effects on health and livelihood of people. It is important to identify health needs and challenges of earthquake victims and use them to prepare for other possible earthquakes. Therefore, the purpose of this study is to explain the challenges and health needs of earthquake victims in Iran.MethodsThis was a qualitative study with 25 participation who were affected by the earthquake in Khoy City, and were selected using purposive sampling by snowball method technique in 2023. The study data was collected through open and semi-structured interviews. To analyze the data, the conventional content analysis with an inductive approach was used.ResultsThe results show two main categories. The main categories “Management as a missing link in unexpected events” includes 9 subcategories: “The challenge of access to emergency resources and health facilities”, “Feeling of abandonment in medical personnel”, “Weakness in the structural safety and infrastructure of the health system”, “Logistical challenges”, “Risk management training”, “Crisis response management challenges”, “Weakness in the intelligent relief system”, “Management of secondary incidents”, and “Need to provide medical services and disease prevention”. Also, the main categories “Emotional actions of people in crisis” consist of 5 subcategories: “Overexcitement”, “Psychological vulnerability of children”, “Physical complaints caused by stress”, “Confusion caused by the lack of reliable information sources” and “Negative effects of living together with several families”.ConclusionTo help deal with threats and other challenges in the earthquake crisis, countries should try to improve their capacity to manage natural disasters.

Experiences of treating people with persisting symptoms after COVID-19: a focus group study

Abstract Background A proportion of people who had COVID-19 infection continue to suffer with persistent symptoms. The long-term effects of COVID-19 are recognised as heterogeneous and complex, challenging health services. This study aims to explore the experiences of healthcare professionals dealing with patients suffering from persisting symptoms following COVID-19 infection and their views on the healthcare services response. Methods We held 4 focus groups (n = 19) with healthcare professionals by video-call. Healthcare professionals were recruited using a snowball strategy, taking level of care, healthcare area, and nature of function as diversification criteria. Participants were invited to tell their experiences regarding the following topics: experiences and challenges in providing care to patients with persisting symptoms following COVID-19 infection; usual care pathways; models of care. Data were recorded, transcribed, and anonymized. The qualitative data were submitted to thematic analysis following an inductive approach. A computer-assisted qualitative data analysis software (MaxQDA) was used. Results Based on thematic analysis, 4 core themes emerged: uncertainty; new condition, usual challenges; variable standards implementation; personalized and multilevel care. This new condition challenged health services and health professionals to keep adjusting and updating responses in a context of uncertainty, but at the same time revealed the usual challenges and needs for providing timely and integrated care. Health services burden challenges the implementation of care standards. This heterogeneous condition demands a multi-level response, including general information and advice, enabling self-management, and providing rehabilitation. Conclusions Healthcare professionals envision an heterogenous condition, bringing uncertainty to healthcare services. More research, training, and information to the population is required for an appropriate response. Key messages • Persisting symptoms following COVID-19 challenged an already overwhelmed health system, bringing barriers to healthcare standards implementation. • The heterogeneous nature of the condition and the healthcare services burden may leave some people to chance, demanding a diverse set of care.

Impact of organisational injustice on health and wellbeing of female police: A meta-ethnography

Abstract Background Female police officers face more bias, discriminatory treatment, and insufficient support compared to male officers, resulting in poorer health outcomes. This meta-ethnographic review investigates beyond individual responsibilities to explore the dimensions of policing, and their effects on the health and well-being of female police officers. Methods The study reviewed qualitative and mixed-method studies (2000-2022) on the health and well-being of female police officers. Ten databases were searched using keywords related to health, well-being, women, police, and qualitative study. Twenty-one papers were synthesised, analysed, and interpreted using a seven-phase inductive and interpretative meta-ethnographic approach. Results The data analysis unveiled a distinct outcome, indicating a strong correlation and significant impact of organisational injustice on the health and well-being of women in law enforcement. Our research findings imply that organisational injustice, including procedural, relational, distributive, and gendered injustice, notably affects the health and well-being of female officers, with mental health being frequently cited, followed by effects on social, workplace, and physical health. Furthermore, the consequences of these four types of organisational injustice, alongside related cultural, systemic, and structural risk factors, reach beyond the immediate health and well-being of individual female officers. They also hinder various aspects of their professional lives, such as career advancement and maintaining a healthy work-life balance, potentially exacerbating long-term health and well-being issues. Conclusions This review emphasizes addressing organisational injustice and related cultural, systemic, and structural determinants in policing for healthier work environments for female officers. Policy makers must scrutinize gender-neutral policies affecting women, enabling transformative action for safer, supportive, and healthier workplaces. Key messages • Organisational injustice in various forms, significantly impact health and wellbeing of female police officers, necessitating policy reforms. • Addressing organisational injustice embedded in seemingly gender-neutral policies and practices, is vital for ensuring equitable treatment and health promotion of female police officers.

Needs and perceptions regarding healthy eating among people at risk of food insecurity in the Netherlands

Abstract Background Healthy eating behaviour is an essential determinant of overall health. This behaviour is generally poor among people at risk of experiencing food insecurity, which may be caused by many factors including perceived higher costs of healthy foods, financial stress, inadequate nutritional knowledge, and inadequate skills required for healthy food preparation. Few studies have examined how these factors influence eating behaviour among people at risk of experiencing food insecurity. We therefore aimed to gain a better understanding of the needs and perceptions regarding healthy eating in this target group. Methods We conducted a qualitative exploration with 10 participants at risk of experiencing food insecurity in the Netherlands. Results and conclusions The analysis using an inductive approach identified four core factors influencing eating behaviour: Health related topics; Social and cultural influences; Influences by the physical environment; and Financial influences. Overall, participants showed adequate nutrition knowledge. However, eating behaviour was strongly influenced by social factors and physical environmental factors. Perceived barriers for healthy eating behaviour included poor mental health, financial stress, and high food prices. Participants had a generally conscious attitude towards their financial situation, reflected in their strategies to cope with a limited budget. Participants were familiar with several existing resources to reduce food-related financial strain and generally had a positive attitude towards these resources. An exception was the Food Bank, of which the food parcel content was not well appreciated. Proposed interventions to reduce food-related financial strain included facilitating social contacts, increasing healthy food supply in the neighbourhood, and lowering prices of healthy foods. The insights from this study increase understanding of factors influencing eating behaviour of people at risk of food insecurity.

Taxing animal-based food products: A qualitative framing analysis of the media debate in Germany

Abstract Background In most high-income countries, consumption of animal-based food products exceeds levels recommended for health and environmental reasons. Although taxes can reduce the consumption of animal-based products, they are politically controversial. In recent years, various tax models and motivations for these have been discussed. Our study seeks to identify key arguments and policy actors in the German media debate on the taxation of animal-based products, shedding light on emerging narrative frames surrounding tax models and motivations. Methods We conducted a qualitative analysis of German media coverage on taxes and levies influencing the price of animal-based foods. We analyzed 488 articles from 10 national newspapers and eight trade press journals published between February 2019 and July 2023. Employing an inductive approach, we identified the actors involved in the debate and common frames and arguments around various tax proposals. Results We found broad consensus on a need for change due to inadequate animal welfare conditions, while environmental and health arguments are more contested. Significant debate surrounds the suitability of taxation as the preferred policy instrument. Furthermore, doubts are raised about a tax’s effectiveness and appropriate revenue allocation. Framing of the tax often emphasizes potential negative impacts on domestic production and product affordability. Additionally, concerns about various unintended consequences and the overall unpopularity of taxation emerge as prominent themes. Conclusions The taxation of animal-based products for health and environmental reasons is still highly contested in the media debate in Germany. Many, but not all arguments commonly raised against such taxes may be considered spurious from an evidence-based public health perspective. Proponents of such taxes may seek to address existing concerns through appropriate policy design and communication strategies. Key messages • Taxation of animal-based foods may help to align consumption with levels recommended for health and environmental reasons, but adoption and implementation is hindered by political controversy. • Objections common in the public debate on such taxes could be addressed with appropriate policy design alleviating justified concerns, and with communication strategies countering spurious arguments.