Inductive Approach Research Articles

Unraveling attrition and retention: A qualitative study with rehabilitation professionals.

Health human resources are scarce worldwide. In occupational therapy (OT), physical therapy (PT), and speech-language pathology (S-LP), attrition and retention issues amplify this situation and contribute to the precarity of health systems. To investigate the phenomena of attrition and retention with OTs, PTs and S-LPs who stayed in, or left their profession. Cultural-historical activity theory provided the theoretical scaffolding for this interpretive description study. We used purposeful sampling (maximum variation approach) to recruit OTs, PTs, and S-LPs from Quebec, Canada. Individual interviews were conducted with 51 OTs, PTs, and S-LPs from Quebec, Canada, in English or French (2019-2020). Inductive and deductive approaches, and constant comparative techniques were used for data analysis. Six themes were developed: 1) characteristics of work that made it meaningful; 2) aspects of work that practitioners appreciate; 3) factors of daily work that weigh on a practitioner; 4) factors that contribute to managing work; 5) relationships with different stakeholders that shape daily work; and 6) perceptions of the profession. Meaningfulness was tied to participants' sense that their values were reflected in their work. Factors outside work shaped participants' work experiences. Recurrent negative experiences led some to leave their profession. Findings underscore a critical need to address contributing factors to attrition and retention which are essential to ensuring the availability of OTs, PTs and SLPs for present and future rehabilitation needs.

The Educational Context In The Literature Of Ibn Al-Muqaffa Through His Book Al-Adab Al-Saghir/ السياق التربوي في أدب ابْنِ الْمُقَفَّع من خلال كتابه الْأدب الصغير

The purpose of this study is to analyze the contents of the book "Al-Adab Al-Shaghir" by the author Abdullah Ibn Al-Muqaffa, and identify the educational context of the texts of this book. This study uses an inductive approach to extrapolate Arabic texts and extract research materials and descriptive-analytical (content analysis) To analyze. The author focuses on social behavior and discusses topics including the importance of self-discipline and self-control and the importance of friendship and positive social relationships. It also emphasizes ethical behavior and the importance of moral values, personal relationships, and social responsibility. He discusses educational issues with reason, wisdom, and literature, which increases the influence of his philosophy on readers and contributes to establishing educational values in society. The study results also show that the content and values of education, the most prominent of which are the love of knowledge, choosing good friends, Honesty and integrity, and their role in encouraging personal and social growth, Self-awareness, and self-control. This book contains many rhetorical methods with the educational implication that a wise person must be at odds with himself and judge himself. Among the most prominent educational means in Ibn al-Muqaffa's texts are education by example, the need for ethics and discipline (education) and its role in the context of watering the mind, and developing society to benefit from these contents in raising children in the current era, and it is recommended that these values need to be included in educational books so that pre-university students can contribute to instilling values and purifying the minds of the younger generation.

Global language geography and language history: challenges and opportunities

As the several thousand languages spoken by people all around the world became more and more systematically assessed and catalogued in the 20th century, it became clear that linguistic diversity is unevently distributed across the globe. Up to the present day, the reasons for that are poorly understood. Linguists are thus in the embarassing situation that they do not understand significant regularities in the way the objects of their study –languages– pattern; human sciences at large are faced with the fact that the way humans produce that key cultural product which is often seen as defining the essence of what makes them humans –language–remains in the dark. In this essay, I explore three interrelated strands of thought associated with the problem of explaining patterns in global language diversity to create a perspective that is different from those explored so far. First, I suggest that instead of looking at present-day levels of diversity and find parameters of variation between the regions in which they are spoken, we should take a process-based approach that looks into how these distributions were generated. Related to this point and in contradistinction to extant work, second, I advocate an inductive approach that departs from qualitative case studies which inform theory-building. Third, I ponder that, in contrast to the traditional focus of historical linguistics on language diversification and expansion, understanding how the ranges of languages are reduced might be the key missing piece of evidence in a global theory of language diversity and its genesis.

Core Mechanisms in Mediating eHealth Implementation and Uptake: A Case Study of Eastern Uganda

Researchers agree that, globally, in both developing and developed countries, healthcare management is faced with acute challenges: expanding areas of health needs, operationalizing health management, constrained budget allocations, as well as resource limitations. Hence, there is an imminent drive to find solutions to stimulate health system transformation through health system innovation. Therefore, effective national operational strategies to minimize resource wastage and contain the costs of health service delivery are critical. The study adopted a methodology that incorporated different research approaches and strategies. Deductive and inductive approaches were used; the strategies were surveys and case studies. A sample of 178 health professionals and administrators in three Health care facilities in Eastern Uganda, were determined and surveyed. Eligible respondents were stratified and selected through simple random sampling. Self-administered questionnaires and interview guides were used to gather the data. The captured data was analysed using Stata version 17. Regression analysis was used to determine the impact of eHealth Implementation core mechanisms on Quality Health Service Delivery. From the results of regression analysis, the core mechanisms variable had a p-value of 0.049 which was significant. For eHealth Implementation Core Mechanisms, the respondents have less control over them since they are dependent on several environmental factors, such as government funding or grants, Government regulations, and policies among others.

Consumers’ quest for justice: a multi-actor analysis of formal legal complaints

ABSTRACT Third-party consumer complaints are relatively under-studied despite being the most effortful variant of consumer complaining behavior (CCB). We address this gap by performing a qualitative thematic analysis on adjudicated legal claims selected through multiphase sampling. Through a mix of the inductive and deductive approaches, under-emphasized themes of the phenomenon are extracted from the perspectives of the disputants, adjudicator(s), and the system at the macro level and then summarized into an actionable grievance continuum. We contribute to theory, practice, and policy by linking the hitherto separate domains of market-shaping and consumer complaints and delineating systemic challenges in managing consumer claims.

Vaping to quit smoking: Qualitative study of people receiving opioid agonist treatment.

Most patients receiving opioid agonist treatment (OAT) smoke tobacco. Approved cessation interventions are less effective in this group than the wider population. We investigated how people on OAT experience nicotine vaping to quit smoking. Patients on OAT randomised to the vaping arm of a smoking cessation trial were invited to participate in structured interviews incorporating broad pre-determined themes. A qualitative descriptive approach employing template analysis was used. Four authors coded transcripts, discussed discrepancies, modified the template using both inductive and deductive approaches. Authors made explicit their starting orientations and independent authors sought disconfirmatory data in a subsequent round of analysis. Four women and eight men (median age 44 years) participated, including four who identified as Aboriginal. Participants reported vaping as cheaper, more acceptable and less stigmatising than smoking but expressed concerns about ongoing accessibility due to the Australian prescription access model. Some found it technically challenging at first, but not more so than standard nicotine replacement therapies. Participants gave accounts of craving and withdrawal experiences, including supplementary use of nicotine patches, and compulsions to vape frequently and intensely, potentially indicating need for higher nicotine dosage. Participants generally reported that vaping helped them quit smoking, though some worried about swapping nicotine addictions. Others were glad to be using a lower-risk alternative. This group reported varied experiences of nicotine vaping but were mainly optimistic that it could help them and others quit smoking. This was despite initial nicotine cravings and concerns about remaining addicted long-term.

Strategies and sacrifices of family caregiving in the Somali-American community: a qualitative study

BackgroundAmong the many pressing concerns of the Somali-American community, and other similar immigrant and refugee communities as they grow in the United States, is the provision of care for older adults and adults with disabilities. The implications of effective caregiving range from the facilitation of community building and place-making to the delivery and management of healthcare on a systemic level. However, little is currently known about Somali-American family caregivers, including their duties and responsibilities, primary concerns, and the impacts of surrounding influences on their ability to fulfill their role.MethodsSemi-structured interviews were conducted with 10 Somali-American family caregivers in Somali language. The resulting transcripts were translated into English by a professional interpreter and analyzed using an inductive thematic analysis approach. A key informant from the community was additionally consulted for insights regarding cultural nuances and interpretations of idiomatic expressions and concepts.ResultsThematic analysis of the reports revealed the principal themes of visitation, patient accompaniment, and self-sacrifice through acceptance and God-consciousness as pervasive and salient concerns across participants. Furthermore, the heightened stresses of the COVID-19 pandemic revealed just how severe the consequences can be when access to culturally habituated navigational tools and coping mechanisms are restricted.ConclusionsIn light of our findings, the growing concern for discrimination and sociocultural discord in the Somali-American community presents a particularly prescient threat to the well-being and sustainability of family caregivers. Their experiences must be understood and used to promote education and partnership between the healthcare system and the community in order to build trust and ensure a healthy future for this indispensable population.

Responding to fluctuations in public and community trust and health seeking behaviour during the COVID-19 pandemic: a qualitative study of national decision-makers’ perspectives in Guinea and Sierra Leone

BackgroundThe level of trust in health systems is often in flux during public health emergencies and presents challenges in providing adequate health services and preventing the spread of disease. Experiences during previous epidemics has shown that lack of trust can impact the continuity of essential health services and response efforts. Guinea and Sierra Leone were greatly challenged by a lack of trust in the system during the Ebola epidemic. We thus sought to investigate what was perceived to influence public and community trust in the health system during the COVID-19 pandemic, and what strategies were employed by national level stakeholders in order to maintain or restore trust in the health system in Guinea and Sierra Leone.MethodsThis qualitative study was conducted through a document review and key informant interviews with actors involved in COVID-19 and/or in malaria control efforts in Guinea and Sierra Leone. Key informants were selected based on their role and level of engagement in the national level response. Thirty Six semi-structured interviews (16 in Guinea, 20 in Sierra Leone) were recorded, transcribed, and analyzed using an inductive and deductive framework approach to thematic analysis.ResultsKey informants described three overarching themes related to changes in trust and health seeking behavior due to COVID-19: (1) reignited fear and uncertainty among the population, (2) adaptations to sensitization and community engagement efforts, and (3) building on the legacy of Ebola as a continuous process. Communication, community engagement, and on-going support to health workers were reiterated as crucial factors for maintaining trust in the health system.ConclusionLessons from the Ebola epidemic enabled response actors to consider maintaining and rebuilding trust as a core aim of the pandemic response which helped to ensure continuity of care and mitigate secondary impacts of the pandemic. Monitoring and maintaining trust in health systems is a key consideration for health systems resilience during public health emergencies.

Evaluating Spatial Interpolation Maps of the Age Structure of the Population of Thi Qar Governorate Using Geographic Information Systems (GIS) Technologies

The research aims to harness spatial interpolation techniques to produce maps with a high level of perceptual accuracy in representing the population data of the study area. This is achieved after exploring the statistical and spatial nature of the databases used, analyzing them, and determining their distribution using a variety of spatial data exploration tools available within the GIS (Geographic Information Systems) environment. These tools contribute to evaluating the characteristics, distribution, and analysis of data, including testing data distribution, identifying its direction, and uncovering its spatial correlations. This highlights the importance of the study and understanding the distribution pattern of the population data in the study area, thereby facilitating the preparation of future that serve spatial organization by building spatial models for the numerical distribution of the data for age groups: young, middle-aged, and elderly, at the level of administrative units of the study area by relying on the inductive approach and the quantitative analysis approach. This is done using Geostatistical Analysis methods within the concept of spatial interpolation in GIS. The research also seeks to predict the population maps for Thi Qar Governorate by comparing spatial interpolation methods, namely Inverse Distance Weighting (IDW) and Simple Kriging (SK). The study concluded, after verifying the accuracy of the results using the Cross-Validation curve, that the Simple Kriging (SK) method is the most accurate model in spatial prediction of population data for representing the data of the young age group in the study area, as it had the lowest Root Mean Square Error (RMSE) of 10.012. It was followed by the Inverse Distance Weighting (IDW) method for representing the data of the elderly age group with an RMSE of 350.48. This indicates that the use of statistical criteria improves the accuracy of spatial interpolation and that the spatial prediction of the population data for the study area using the Simple Kriging (SK) method was more accurate than the Inverse Distance Weighting (IDW) method based on statistical indicators.

Capturing sources of health system legitimacy in fragmented conflict zones under different governance models: a case study of northwest Syria

IntroductionLegitimacy and trust are crucial for resilient health systems in fragmented conflict zones. This study evaluates the legitimacy of health systems in northwest Syria under different governance models.MethodsUsing a deductive and inductive mixed-methods approach, the research team developed a framework with an index, 4 sub-indices and 18 indicators to assess the legitimacy of health systems using different governance models – top-down, bottom-up, and hybrid – in the context of the response to the earthquake that hit Syria in February 2023. The study includes surveys, workshops, stakeholder consultations, and an expert panel conducted in northwest Syria and online.ResultsThe findings indicate that bottom-up health governance model is perceived as the most legitimate, followed by the mixed model, while top-down model is perceived as the least legitimate. This preference is measured across all legitimacy source sub-indices, including legality, justification, consent and performance and across the overall Health System Legitimacy Index (HSLI). However, the hybrid governance approach showed limited superiority at two indicator levels regarding long-term health system response.ConclusionThis study highlights the importance of considering the legitimacy of the health system in fragmented conflict zones. It helps explain the effectiveness of the bottom-up approach and community-based governance in enhancing trust, cooperative behaviour, health interventions and achieving sustainability. Additionally, the study highlighted the role of legitimate health systems in practising civic virtue and promoting social justice, thus contributing to peace-building efforts. These insights are crucial for policymakers and development donors to strengthen health systems in challenging contexts.

Harmonizing Maqasid al-Shari’ah with sustainable waste management practices: a conceptual framework for principles and implementation

Purpose This paper aims to investigate the principles guiding sustainable waste management practices within the framework of Maqasid al-Shari’ah. The purpose is to address the environmental challenges arising from economic expansion, population growth and resource consumption, which often lead to unsustainable waste management practices and hinder economic growth. The focus is on aligning waste management principles with the ethical objectives outlined in Shari’ah. Design/methodology/approach Adopting a qualitative content analysis method and an inductive approach to outline the constituent elements that formulate the framework, this study investigates the objectives of Maqasid al-Shari’ah to identify underlying elements crucial for sustainable waste management. Findings The study reveals how the principles embedded in Maqasid al-Shari’ah provide a foundation for effective waste management practices. The findings emphasize the importance of integrating these principles into human behavior to ensure that waste management aligns with the Shari’ah viewpoint. The insights shed light on the role of Maqasid al-Shari’ah in managing waste sustainably and contributing to environmental conservation efforts. Originality/value This research contributes to the field by offering a unique perspective on waste management practices through the lens of Maqasid al-Shari’ah. The study’s originality lies in its exploration of how Islamic ethical objectives can guide sustainable waste management, providing a framework that goes beyond conventional approaches. The incorporation of a comprehensive literature review enhances the authenticity and novelty of the proposed waste management framework.

The double-edged sword of shame: hindrance and catalyst for immigrant teachers’ career development

ABSTRACT This international study offers a groundbreaking examination of the role of shame in the career development of immigrant teachers. Despite existing research on the challenges immigrant teachers face, such as language barriers and accreditation, limited focus has been placed on understanding the emotional aspects of their career progression. Utilizing the Social Cognitive Career Theory (SCCT) in exploring the interplay between self-efficacy, outcome expectations and performance outcomes, the study delves into the complexities of shame experienced by 45 immigrant teachers from Australia, Hong Kong, and South Korea, and how it impacts their career decisions and actions. The researchers have conducted three semi-structured one-on-one interviews and one focus group discussion with each immigrant teacher. Using the general inductive approach, the findings demonstrate that shame serves as a dual-faced influencer, acting as both a hindrance and a catalyst for career development. Moreover, the study raises concerns about the effects of emotional well-being on immigrant teacher retention and offers insights for policy and practice aimed at fostering emotional resilience among immigrant teachers. Though limited by its qualitative nature, the study represents a significant step towards a nuanced understanding of immigrant teachers’ emotional experiences, inviting further exploration into the field.

Detection and Characterization of Online Substance Use Discussions Among Gamers: Qualitative Retrospective Analysis of Reddit r/StopGaming Data.

Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ≥1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD was identified in 66.8% (191/286) posts. More than half, 62.9% (180/286) of the posts, discussed a health issue, with the majority (n=144) cited mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a significant association between IGD and substance use (P<.001; chi-square test), and there were significantly increased odds of IGD among those who self-reported substance use (odds ratio 2.29, P<.001) and those who discussed mental health (odds ratio 1.64, P<.03). As gaming increasingly becomes highly prevalent among various age groups and demographics, a better understanding of the interplay and convergence among disordered gaming, substance use, and negative health impacts can inform the development of interventions to mitigate risks and promote healthier gaming habits.

Leadership in small business environments: from the heroic model to distributed approach

Purpose This study explores the process of interactions experienced by leaders during the evolution of the small firm. Three key propositions are conceptualized into a model with the main aim of supporting leaders of small organizations in understanding better the leadership phenomena. Design/methodology/approach This qualitative research project investigates the dynamics of leadership in small businesses through an inductive and abductive approach, inherent to grounded theory. This enabled the development of propositions directly from data. Field research involved responsive interviews with 12 established small enterprise leaders. Selective and theoretical sampling coupled with ongoing data comparison and analysis were applied to uncover and refine emerging leadership concepts. Findings Intellectual assets of leaders in small firms propel the recognition and sensitivity to the process of organizational evolution which requires a continuous adaptation of the leadership paradigm. Research limitations/implications The researchers’ philosophical stance to construct reality based on the participants own experiences, cannot produce generalized findings on the subject area. Practical implications Enhanced Decision-Making and Strategic Planning: Small business leaders can leverage their academic and industry backgrounds to make more informed and strategic decisions. Facilitating Organizational Change: By understanding the necessity of continuous change, small business leaders can implement frameworks that encourage flexibility and adaptability within their organizations. Adopting Distributed Leadership: Encouraging small business owners to move away from centralized control towards a more distributed leadership model can lead to better organizational outcomes. Originality/value A considerable amount of research has been devoted to leadership in the past decades. There is very little evidence on behavioral patterns of leaders, grounded in data within the context of the Small Firm aimed at the practitioner. This work is contribution towards this shortfall.

The Impact Of Using Blockchain Technology On Financial Statements To Reducing Of Fraud

This study aimed to investigate the impact of using blockchain technology on financial statements to reducing of fraud in Saudi Arabia. The researchers have used a quantitative and inductive approach for theoretically analyzing the data collected in the study. The study sample included 67 participants of accounting professors and doctors in Saudi Arabia universities. The result showed that there isa positive response to the using blockchain technology on financial statements as a strategic tool for reducing fraud in Saudi Arabia. and the using blockchain technology on financial statements in Saudi Arabia can reduce fraud by about 18%.

Bladder Health Knowledge, Attitudes, and Beliefs among US Adolescent Women

Lower urinary tract symptoms (LUTS) can have a pronounced impact on adolescent women's overall health and quality of life, both during adolescence and across the life course. Little research has examined adolescent women's knowledge, attitudes, and beliefs about bladder health and preventing LUTS. This study combines data from two large multi-site focus group studies of individuals born female who identified as women conducted by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. The first study included data from 8 focus groups conducted in 2018 with 44 adolescents aged 11 through 17 years. The second consisted of data from 20 focus groups conducted in 2020 with 123 adolescents aged 13 through 17 years. We used directed content analysis, including deductive and inductive approaches, to explore textual data and identify emergent insights. We present themes that emerged from analyzing coded data related to knowledge, attitudes, and beliefs. Themes included: (1) lack of information about bladder function, leading to limited knowledge, (2) hydration as a healthy behavior, (3) distinguishing healthy versus unhealthy voiding, (4) social and environmental barriers to voiding, and (5) shame and stigma of bladder related behaviors. Our data suggests that adolescent women are aware of healthy and unhealthy behaviors related to bladder health, despite little exposure to formal education about the bladder. Social and environmental factors, including stigma, appear to be primary drivers of adolescents' behaviors around bladder health, suggesting that multi-level socio-ecological prevention interventions are needed to prevent LUTS in this population.

Understanding e-Cigarette Addictiveness: Triangulation of Focus Group and Netnographic Data.

Numerous studies have shown that e-cigarettes are addictive. For example, we previously showed that users of e-cigarette online forums discuss experiences of addiction in a netnographic analysis. However, it is unclear what makes e-cigarettes addictive apart from nicotine. In a focus group analysis, we recently identified 3 unique features of e-cigarettes that users linked to experiences of addiction: the pleasant taste, unobtrusiveness, and unlimited usability of e-cigarettes. This study aimed to validate the previously identified features of e-cigarette addictive potential by triangulating data from the netnographic analysis and focus group discussions. Drawing on a netnographic analysis of 3 popular, German-language e-cigarette forums, we studied whether experiences of addiction were linked to specific e-cigarette features. We included 451 threads in the analysis that had been coded for addictive experiences in a previous study by our team. First, we conducted a deductive analysis with preregistered codes to determine whether the features of pleasant taste, unobtrusiveness, and unlimited usability were mentioned in relation to the addictive potential of e-cigarettes in the online forums. Second, an inductive approach was chosen to identify further possible addictive features of e-cigarettes. Our deductive analysis confirmed that the features highlighted in our previous focus group study (pleasant taste, unobtrusiveness, and unlimited usability) were also frequently discussed in online forums in connection to addictive symptoms. In addition, our inductive analysis identified nicotine dosage as a significant feature linked to addiction. Users reported varying their nicotine doses for different reasons, leading to the identification of four distinct user types based on dosing patterns: (1) high doses for intermittent, (2) high doses for constant use, (3) low doses for constant use, and (4) switching between high and low doses depending on the situation. Our comprehensive analysis of online forum threads revealed that users' experiences of addiction are linked to 4 specific features unique to e-cigarettes: pleasant taste, unobtrusiveness, unlimited usability, and nicotine dosage. Recognizing these addictive features of e-cigarettes is crucial for designing cessation programs and informing public health policies to reduce the addictiveness of e-cigarettes.

An ICT-enabled community oriented primary care intervention in mining communities during COVID-19 (2019–2022): perceived changes in the role and place of community health workers

BackgroundThis is a study of service provider perceptions of the place, role and practices of CHWs in a four-year, large-scale private sector funded, public service ICT-enabled COPC intervention with rural and remote mining communities. Like all South African communities, apart from large mining house employees and some contractors, most people use available public healthcare services and private traditional as well as limited allopathic private sector providers. In addition to the limitations of facility centred primary healthcare and a fragmented health care system, the many negative health effects of mining on the communities, go unattended.MethodsThis is a rapid, qualitative pragmatic study. Using site and participation convenience sampling, 37 semi-structured individual or group interviews were conducted with 57 stakeholders from 38 of the 135 intervention PHC facilities. Using a data driven, inductive approach, the results were analysed thematically in terms of perceived changes in the role and place of CHWs.ResultsCHWs registered 42 490 households and captured the demographic and social profiles as well as the health status of over 154 910 individuals using AitaHealth™. These data provided healthcare professionals and managers with knowledge about community demographics, at-risk groups and vulnerable individuals. The intervention changed the locational focus of CHW practice and expanded their scope of work and competencies in household comprehensive health education, advice and care. It led to a growth in community and professional confidence in CHWs as trusted members of mining community PHC teams and to more focused and efficient clinic work.ConclusionThis ICT-enabled COPC intervention adopted a comprehensive approach to healthcare delivery that started by including CHWs in PHC teams and locating them in communities. Inclusive and systematic continuous learning, clinically-led CHW service support and ICT-enabled information technology engendered trust in CHWs as competent PHC members, and grew community confidence in them and the PHC system as a whole. Although health, care and other professionals and workers valued the changes the intervention brought to their work as well as people’s lives in underserved and vulnerable mining communities, its sustainability is contingent on the vagaries of political will and financial commitment.

What do we know about the role of neoadjuvant targeted therapy in early-stage EGFR-mutant and ALK-fused non-small cell lung cancer?-a narrative review of the current literature.

The standard first-line treatment for patients with advanced non-small cell lung cancer (NSCLC) harbouring epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) fusions is targeted therapy using tyrosine kinase inhibitors (TKIs). However, data are still lacking on the use of TKIs as a neoadjuvant or induction approach. Therefore, this narrative review aims to summarize the current knowledge on resectable EGFR-mutant and ALK-fused NSCLC regarding available perioperative treatment regimens and off-label neoadjuvant use of targeted therapy. The relevant literature was identified by using PubMed and ClinicalTrials.gov (last search phase June 2024) and was restricted to English language. Peer-reviewed manuscripts but also conference abstracts that did not undergo peer-review were included. Patients with EGFR-mutations and ALK-fusions have typically been excluded from available phase III perioperative immunotherapy trials due to lower efficacy and higher toxicity of immunotherapy in those patients. In the adjuvant setting, recent evidence from the phase III ALINA and ADAURA trials demonstrated efficacy and safety of targeted therapy in resected ALK-fused and EGFR-mutant NSCLC. However, to date there is no approval for the use of TKIs as neoadjuvant or induction therapy in those patients. We have therefore identified a number of case series and phase II trials using targeted therapy in resectable EGFR-mutant and ALK-fused NSCLC. Current evidence suggests that targeted therapies might be effective in patients with resectable EGFR-mutant and ALK-positive NSCLC, but ongoing trials will need to provide further evidence on the safety and efficacy of perioperative TKI therapy.

Enhancing minority participation in cancer clinical trials: Insights from a mixed methods study.

70 Background: The urgency to enhance cancer clinical trial enrollment among racial and ethnic minority patients is underscored by the rise in novel therapies. This study examines referral mechanisms from a community-based oncology care clinic to an academic medical center, evaluates the clinical trial knowledge of minority groups, and explores perceptions and attitudes toward trials. Methods: Using a sequential explanatory mixed methods research design, Clinical Trial Knowledge Survey was administered to patients seen at the Hem/Onc clinic in a community-medical center. Descriptive statistics were calculated and multivariate analysis were used to examine associations between variables using STATA 18. Qualitative data from 10 semi-structured interviews were analyzed by two independent investigators using NVivo 14. Themes were identified through a combination of deductive and inductive approaches. Results: Of the 502 mailers sent, 97 individuals responded (response rate of 9.56%). Average age of participants was 54 years, predominantly single and African American. Majority of the of respondents (62%) agreed that patient participation is crucial for generating new and effective treatments. 65% believed that clinical trials are typically conducted on drugs presumed to be effective. However, 32.99% of the respondents perceived participation in clinical trials as a frightening experience. Four qualitative themes emerged: (i) Engagement with one’s health varied between participants. (ii) While clinical trial awareness was limited, willingness to participate was strongly endorsed. (iii) Clinical trial decision-making is a complex process heavily influenced by awareness of and attitudes toward clinical trials. (iv) There is a need to tailor educational strategies to increase awareness of and participation in clinical trials. Conclusions: Our findings emphasize the critical role of awareness and tailored, culturally congruent educational strategies that are crucial to bridge the knowledge gap, alleviate hesitations, and enhance cancer clinical trial participation rates among racial and ethnic minorities.