Focus Group Interviews Research Articles

Developing a Digital Tool to Calculate Protein Quality in Plant-Based Meals of Older Adults: User Engagement Design Approach With End Users

Background The global shift toward plant-based diets has been increasing, with more people making the transition for various reasons. In vulnerable subgroups such as older adults, the transition to plant-based diets deserves attention due to the potentially detrimental consequences of lower protein quantity and quality. Objective We aimed to develop a digital tool that ensures adequate protein quality in plant-based meals for older adults experiencing low protein intake through an interdisciplinary collaboration and user engagement with potential end users. Methods Three focus group interviews of Dutch and Danish dietitians and older adults as potential end users were conducted to identify their needs, preferences, and deal-breakers. Focus group interviews were based on a user-task-environment analysis, the Walt Disney method, the brainwriting method, and a cognitive walkthrough. The interview transcripts were analyzed with a thematic analysis. The front end and backend development of a potential tool took place in parallel and was well-synced to the focus group interviews. Results Both dietitians and older adults from Dutch and Danish sites expressed high interest in a tool that provides feedback and background information on protein quality, sustainability, and nutrients or micronutrients. The user-task-environment analysis delivered input among others that dietitians and older adults are good potential users, the tool should be functional as an app as well as a website and the tool should provide preprogrammed meals or recipes. The Walt Disney method delivered usable and realistic solutions to the 4 challenges presented. Thirty-two percent of the solutions on all themes presented with the brainwriting method appeared to be highly feasible and relevant, having the potential to be implemented in a tool. The cognitive walkthrough identified certain screens as unclear, necessitating revisions for improved understandability, for example, the need for explanation in selecting food item filters is shown in screenshot 2, with an overall usability score of 59%. Conclusions Our user engagement design approach resulted in a prototype that ensured end users’ wishes and needs, with a finetuned output tested in focus groups. We conclude that our user engagement design approach was a suitable and meaningful stepwise approach to ensure the relevance of the tool and identify potential barriers. The focus group results indicate that dietitians have a clear understanding and need for a tool to aid in meal planning for enhanced protein quality, highlighting its absence in their current resources despite increasing demands arising from the protein transition. Conversely, for older adults, the introduction of a digital tool appears less appropriate; instead, there is a necessity for foundational education on protein quality before such a tool can be effectively used. Future studies are needed to further implement the prototype into practice.

How practising social workers benefit from teaching social work students in university classrooms

ABSTRACT This paper explores the impact on practising social workers who engage in teaching social work students in a university classroom setting. Using a narrative inquiry approach, focus group interviews were conducted with social workers from three London local authorities to understand how teaching opportunities influence their professional development and practice. The findings reveal that classroom interactions, characterized by dialogical engagement and student curiosity, prompt social workers to reflect on and reconsider established social work knowledge and practices. Teaching in a university environment invites practitioners to develop a revised understanding of their professional identity by enhancing self-reflexive opportunities and by freeing up new ways to think about social work. These insights, often cultivated by students asking unanticipated questions, are taken back to the practitioners’ workplace, potentially leading to shifts in their practice with colleagues and service users. The paper concludes that teaching not only benefits students, but also offers practising social workers unique opportunities for continuous professional development, as university classrooms can foster a dynamic, social constructivist approach to learning.

Modeling the determinants of circular procurement adoption for sustainable construction: a fuzzy logic-based evaluation approach

PurposeTraditional procurement approaches are no longer sufficient amidst dire environmental challenges caused by the construction sector. Yet, it is unclear from existing studies what factors could encourage alternatives such as circular procurement (CP). Thus, this study aims to investigate the determinants of CP adoption in the global construction industry.Design/methodology/approachThe study employs a mixed-method approach involving focus group interviews with circular experts and engaging 194 international construction professionals using a questionnaire survey. Multiple statistical techniques, including exploratory factor analysis and fuzzy synthetic modelling, were employed to analyze the data.FindingsThe study identified fourteen key benefits that drive the adoption of CP practices in construction, with “Waste management throughout the construction lifecycle,” “Integration of supply chains” and “Opportunities from new business models” as the three most significant. However, a deeper analysis of the interconnections between these drivers revealed four clusters of principal benefit drivers (PBDs). The four principal groups were “lifecycle cost optimization,” “climate impact mitigation,” “circular capability and waste reduction” and “supply chain collaboration.” Through fuzzy synthetic modeling, it was predicted that three out of four PBDs exerted high levels of influence and should be prioritized for developed economies, while all four PBDs had significant levels of influence in developing regions.Practical implicationsThe findings provide a useful reference point for policymakers, practitioners and researchers in formulating strategies to accelerate the adoption and implementation of CP practices in different construction industries.Originality/valueThe study provides a novel perspective on CP adoption through understanding and promotion of its benefits. This offers a valuable framework for decision-making in two regional contexts.

Tailored Multifaceted Strategy for Implementing Fundamental Evidence-Based Nursing Care: An Evaluation Study

Background/Objectives: Extensive research has emphasised the persistent challenges and failures in providing hospitalised patients with fundamental evidence-based nursing care, often resulting in grave consequences for patient safety. Recommendations from implementation research indicate that a tailored theory- and research-based implementation strategy targeting contextual determinants can optimise the implementation of evidence-based clinical practice for the benefit of patients. This study evaluated the feasibility of an implementation strategy designed to improve the quality of nursing care by targeting behavioural and environmental barriers in a hospital setting. Methods: Proctor’s conceptual model for implementation was applied to evaluate the strategy based on eight outcomes: adoption, acceptability, appropriateness, fidelity, feasibility, penetration, sustainability, and costs. Data collection methods included field observations, informal and focus group interviews, registrations, and audits of electronic patient records. Results: The strategy was adoptive, acceptable, appropriate, and feasible in targeting complex environmental and behavioural determinants (at the individual, team, and management level), enabling successful implementation of fundamental evidence-based nursing care. However, fidelity, feasibility, and sustainability were challenged by competing organisational demands and time constraints. Conclusions: The tailored, multifaceted strategy proved effective in addressing complex environmental and behavioural determinants across multiple levels, facilitating the implementation of fundamental evidence-based nursing care in a clinical practice. Further testing and larger-scale studies is needed to assess the strategy’s transferability and its impact on nursing-sensitive patient outcomes in different clinical settings.

The Role of Social Media in Marital Relationships: A Symbolic Interactionist Perspective

As part of the digital transformation of modern societies, social media has become a space where individuals express their identities, display their social roles, and make their relationships visible. This study adopts a symbolic interactionist framework to explore how social media reflects meaning, identity, and role processes within marital relationships. The research was conducted using a qualitative methodology. In the first phase, semi-structured interviews were conducted with 30 participants, and two focus group interviews with six people each were then used to deepen the findings. The data were analyzed thematically under the guidance of symbolic interactionist theory, and three main themes emerged: "new forms of communication in marriage," "representation of marriage on social media," and "definition of relationship roles." The findings show that social media serves as a tool for creating new meanings, identities, and roles in marriage. Within the framework of symbolic interactionism, social media symbols contribute significantly to strengthening emotional bonds, building trust, mitigating conflict, and raising awareness of gender roles in marital relationships. In addition, demographic factors such as age, years of marriage, and gender, as well as individual preferences and relationship dynamics, were found to influence meanings, identities, and roles within these interactions.

On the move: understanding home care workers’ experiences of using various modes of transportation at work in an occupational health perspective

BackgroundThe demand for home care workers (HCWs) is increasing, but home care services face challenges in recruiting and retaining skilled workers, partly due to hazards in the work environment. Transportation to client visits is an important part of HCWs' working conditions, with various modes (e.g., walking, cycling, driving) being utilized. However, these modes are often implemented without considering HCWs' perceptions of their use. Therefore, our study aimed to understand HCWs’ perceptions and experiences of using different transportation modes at work, and how they may influence health.MethodsFourteen HCWs from a home care unit in Trondheim (Norway) participated in focus group interviews. The interviews were analyzed using a reflexive thematic analysis approach including reflexive journaling. The analytical process was guided by a biopsychosocial understanding of health.ResultsThe analysis showed that when different transportation modes were assigned, predictability of the assignment was important for the HCWs. Both walking and driving were regarded to have both positive and negative health impacts. When walking, informants thought that getting fresh air outdoors and doing physical activity was health-promoting, while bad weather conditions and too much walking could be negative for their health. When driving a car, informants talked about privacy and getting physical rest as positive for their health, while traffic and parking conditions could be stressful. Individual factors such as age, physical health, and strong preferences were highlighted as important to consider when planning HCWs’ transportation modes in an occupational health perspective.ConclusionsWalking now and then between client visits was generally believed by the HCWs to lead to positive health effects compared to only driving a car. Introducing planning of various transportation modes in advance, so that they are predictable, seems important to reduce stress among HCWs. In addition, some individual factors should be considered in the planning, and it should be realized that the planning likely represents a trade-off between promoting the psychosocial work environment when driving a car and potentially enhancing long-term physical health when using active transportation. Thus, biopsychosocial aspects of health should be considered when planning the mode of transport between client visits for HCWs.

Participants' Experience with Gamification Elements of a School-Based Health Promotion Intervention in Italy: A Mixed Methods Study.

Gamified interventions consist of a combination of game elements designed to motivate and engage users, thus addressing issues of participant low participation and enthusiasm in interventions. Gamification does not work well in all situations and its success depends on the context and target users. However, there is a lack of research on analog health interventions. Qualitative and quantitative data were collected in parallel to examine participants' experiences with Food Game, an analog gamified intervention designed to promote healthier and more sustainable food choices among high school students. Teams of students compete to complete peer-led thematic challenges. Sixty-four students from the 2022/23 edition participated in focus group interviews (N = 11), and 119 completed a survey (56.1% response rate) with indicators of responsiveness and perceived motivational impact of the program's five game elements. Results indicate a relatively high level of engagement with the program. Students valued Food Game because it gave them the opportunity to demonstrate their sense of agency and autonomy and to work in a group with their peers, thus addressing basic needs for competence, relatedness, and autonomy as described by Self-Determination Theory and providing an empowering experience. The least motivating game element in the Food Game was the leaderboard and inter-team competition. Focus group data confirmed students' ambivalence about the competition embedded in the program and pointed to potential unintended consequences, including inter-team conflict, stress, and reduced intrinsic motivation to play. The strengths and weaknesses of Food Game approach to gamification are discussed, along with implications for prevention research and practice.

Personalized Learning Policy and Student Voice: A Statewide Case Study

This qualitative study examines the experiences of student leaders working in partnership with teacher leaders to implement Vermont’s Act 77, a state mandated personalized learning policy. Drawing on a theoretical framework that connects the zones of mediation and knowledge brokering research, this study explores the question: How do youth and adults experience youth leadership around the implementation of Vermont’s Act 77? Drawing on focus group data, interviews, and observations of youth leadership of personalized learning policy implementation across 18 high schools between 2014 and 2018, the study identifies the opportunities challenges of youth acting as knowledge brokers around state education policy in their schools. It concludes with implications for educational leaders and policymakers.

Inclusion in the Classroom: Student Teachers’ Views on Affirming Gender and Sexual Diversity

Research shows that gender and sexually diverse learners face discrimination in schools; however, there is little evidence of affirming gender and sexual diversity in Namibian classrooms. This qualitative case-study investigated student teachers’ views on affirming gender and sexual diversity in the classroom. The researchers purposively selected 90 student teachers. Semistructured focus group interviews revealed that gender and sexuality were not considered as a form of diversity in the classroom. However, participants understood the importance of affirming gender and sexual diversity in the classroom. The study demonstrated a need for intense gender and sexual diversity content in the pre-service teacher curriculum.

Deriving the Importance of Defects in Multi-Unit Residential Buildings Using the Analytic Hierarchy Process Method

Defects in apartment buildings significantly impact the convenience and safety of residents, and their prevalence has been steadily increasing. This study prioritizes the key defects in apartment buildings to enhance quality management. The primary causes of defects were identified by focusing on frequently occurring issues such as tile installation, flooring, wallpaper, PL windows, and kitchen furniture. A literature review was conducted to analyze the main types of defects, and expert focus group interviews were held to investigate the causes of defects and potential countermeasures. Following this, the analytic hierarchy process was employed to assess the relative importance of these defects and establish their prioritization. The findings indicated that structural issues and material-related factors, particularly flooring and window installation, were the primary causes. Based on these insights, this study proposes a strategic approach to improving quality management in apartment buildings. This research serves as a valuable reference for developers, contractors, and policymakers in defect prevention and management.

Challenges in Academic Writing for Undergraduate Students in Bangladesh

This study examines the challenges faced by undergraduate students in academic writing at a government college in Bangladesh, focusing on linguistic barriers, critical thinking, organizational skills, and academic integrity. Using a qualitative approach, data were collected through focus group interviews with students, individual teacher interviews, participant observations, and document analysis. Findings reveal key difficulties, including limited vocabulary, grammar issues, weak critical thinking, poor organizational skills, and plagiarism concerns. To address these challenges, the study recommends interventions such as structured vocabulary lessons, grammar instruction, critical thinking exercises, and promoting academic integrity. The research emphasizes the importance of collaboration between educators and students to enhance writing skills and improve academic outcomes. Additionally, it identifies areas for future research, such as the impact of socioeconomic status and language background on writing proficiency, offering valuable insights for educators and policymakers.

Special Education Teacher Candidate Identity Development: A Descriptive Study

Professional identity is an area of significant research in engineering and health care but research in special education teacher identity is limited. Using the framework of Identity Theory, this study examined the evolving professional identity standard of seven preservice teacher candidates using concept maps across three points in time during their preparation program. An analysis of course syllabi provided context for the knowledge and skills learned during the program. A focus group interview with the candidates at the completion of their program targeted the factors they felt influenced their development. Findings indicate that participants’ identity standard evolved throughout the program, particularly related to special education teacher role, with significant consolidation and integration occurring during the internship experience. Implications of these findings are discussed.

Nurse Educators’ Perspectives on LGBTI Nursing Students in a Nursing Education Institution in Gauteng, South Africa

Aim: The study explored nurse educators’ perceptions of lesbian, gay, bisexual, transgender, and intersex (LGBTI) nursing students in a nursing education institution in Gauteng, South Africa. Background: More young students with “fluid” views on sexuality and gender are joining nursing colleges, largely influenced by digital communication. This has made LGBTI students more visible, and nurse educators need to understand their views. Methods: An interpretive phenomenological inquiry employing focus group interviews (FGI) with eight nurse educators and three student counsellors who were purposively selected was conducted between February and August 2021. A Heideggerian hermeneutic approach formed the basis for data analysis. Findings: Five themes emerged about LGBTI-oriented nursing students: (1) being in strained relationships; (2) nurse educators are not involved in students’ sexual orientation; (3) religious and cultural views about LGBTI orientation; (4) a process of discovering identity—identity crisis; (5) inheritance, family background, and relationships with family and community. Conclusion: The findings suggest that acceptance of an LGBTI identity is still a challenge to nurse educators, particularly those with strong religious and cultural beliefs and convictions; however, they were aware of professional standards, human rights, and their support role towards the students. In general, the findings indicate a need for increasing awareness of the LGBTI community and consideration of policies that promote social inclusion and respect for human rights, dignity, and difference.

The internet of things deployed for occupational health and safety purposes: A qualitative study of opportunities and ethical issues.

The deployment of the Internet of Things (IoT) technology (connected devices enabling algorithmic analysis of behaviour and individualized feedback) has been growing increasingly over the last decades, including in the workplace where they can serve occupational safety and health (OSH) purposes. However, although the IoT is deployed for good aims, the use of these devices raises numerous ethical issues which have had little literature specifically dedicated to them. To fill this gap, we have investigated the ethical views of key stakeholders on the deployment of IoT for OSH. We conducted a focus group and semi-structured interviews including 24 stakeholders and analysed transcripts with an open coding method. Participants were favourably disposed towards the use of some versions of IoT (posture-tracker chair, step-tracker watch), but rejected other devices (sound-tracker on computer). They highlighted an important number of ethical issues which could be grouped into five overarching categories: goal relevance, adverse side effects, role of employees, data process, and vagueness. Their inputs were remarkably coherent with the issues highlighted in the academic literature. They also felt quite disenchanted and shed a stark light on the lack of information at the disposal of stakeholders in the front line to assess such technology. Our results provide important ground material on which to base necessary and still-awaited guidelines and regulation instruments.

Health and social care professionals’ perspective on the interprofessional competencies required in palliative care

ABSTRACT Competent professionals are essential when delivering patient-centered and individual palliative care to patients and their families. However, interprofessional competencies for health and social care professionals in specialized palliative care have not been defined. The purpose of this study was to describe the competencies required for good interprofessional teamwork in specialized palliative care from the perspective of health and social care professionals. A qualitative descriptive study design was chosen to undertake the face-to-face individual and focus-group interviews. Fifty participants working in specialized palliative care units were recruited through a purposive sampling technique. The data were analyzed using abductive content analysis. The required interprofessional competencies in specialized palliative care were identified as values and ethics for interprofessional practice, roles and responsibilities, interprofessional communication, and teams and teamwork. Professionals should be interprofessionally competent to meet patients’ care needs holistically and individually. Meeting patients and relatives with respect is vital, but respectful behavior and communication among professionals are also highlighted in palliative care. Certain professional qualities, such as patience, humility, and flexibility, were emphasized in interprofessional palliative care. It is important to note that the nature of palliative care affects even experienced professionals, who should be able to face death as a team in everyday work.

Development and validation of a broadly applicable instrument to measure patients' health promotion and empowerment process in chronic disease.

This study aimed to develop and validate a generic, non-disease-specific, self-assessment measure that recognizes patients' health capacities and their empowering process of health promotion in chronic illness by using Bodyknowledging as the theoretical frame. Item generation and expert content validity analysis were the first steps in instrument development. Potential items were then validated in focus group interviews with six patients diagnosed with various chronic diseases. The research team reviewed the resulting items and undertook item reduction. A sample of adults (n = 357) with chronic disease surveyed the instrument items. Exploratory factor analysis with Oblimin rotation was conducted. A 3-factor solution was identified: nine items on the regaining health and wellness subscale, seven items on the uncertainty and bereavement subscale, and eight items on the loss of control and distancing subscale. Cronbach alpha for the scale was .92. The final 24-item instrument is non-disease-specific and broadly applicable for use in health promotion within the context of chronic disease. The instrument demonstrates high internal consistency reliability with initial face and construct validity. The new instrument has the potential for measuring patients' empowering process of health promotion in chronic disease and the outcomes of person-centered interventions and may guide clinicians in tailoring individual support.

Exploring how Parents can Promote Gender Diversity in South African High Schools

By examining the voices of parents regarding the extent to which South African high schools maintain a cisnormative culture, this paper aims to explore how parents' understanding of gender can play a role in promoting gender diversity. Drawing on a qualitative study conducted in the Free State Province of South Africa and framed by both Queer Theory and the African philosophy of Ubuntu. A focus group interview was employed to interview nine parents. Consistent with many international studies on the experiences of parents regarding gender diversity in high schools, this paper found that most of the parents’ views were influenced by cultural and religious backgrounds. The results reveal that parents' understanding of gender can play a role in promoting gender diversity in South African high schools. Results further reveal an emerging understanding that gender diversity is real, not mythical. This paper calls for more research to examine how parents can help others to embrace gender diversity through various school platforms to accelerate parental support of trans learners. Lastly, the Department of Basic Education can formulate a policy that will assist schools in engaging parents to support schools in promoting gender diversity.

Designing recovery-oriented care: a qualitative study to inform service design at Kyrie Therapeutic Farm in Ireland.

Recovery-oriented approaches are gaining increased attention in the mental health sector, including from the World Health Organization and the United Nations, for their potential to support people in recovering and building meaningful lives through strengths-based, person-centered principles. Kyrie Therapeutic Farm (KTF) is a new initiative in Ireland that seeks to develop recovery-oriented model of adult mental health care. The aim of this study was to explore the barriers and facilitators of recovery-oriented models of practice in a small number of therapeutic farm settings across the world in order to inform service design at KTF whilst also addressing a gap in research on this topic. Three semi-structured focus-group interviews were conducted online via MS Teams with ten staff members in different roles and years of experience from three existing therapeutic community farms. reflexive thematic analysis was employed for data analysis. Four themes emerged that illustrate how therapeutic farm communities operate in general and specifically in relation to recovery: 1. common humanity, 2. freedom and responsibility, 3. interdependence and community living, and 4. learning organisations. This study demonstrates the viability of recovery-oriented practices in community therapeutic farms, including KTF, thereby contributing to the broader trend toward more person-centered mental health services. The values inherent in the recovery-oriented approach - such as community, empowerment, and close, equitable, non-hierarchical relationships - act as facilitators. However, embedding these values in practice can generate tensions for staff which warrant attention. Implications for the integration into service design of KTF and further research are offered.

“Breaking a vicious cycle”: the reproduction of ableism in higher education and its impact on students with disabilities

IntroductionDespite the widespread promotion of inclusive learning environments, students with disabilities have to exert time and effort in gaining accommodations and proving themselves as competent individuals. In following up a factorial survey experiment that found that students with disabilities are considered less likely to achieve their educational goals compared to students without, this study explored how understandings of inclusive education and disability are constructed within Norwegian higher education institutions.MethodNineteen employees across 10 universities participated in focus group interviews. Transcripts were analyzed using thematic analysis.ResultsThree themes were generated: (1) determining the role of the educator, (2) knowing how, when, and why to grant accommodations, (3) calling for action from the university.DiscussionOverall, the findings suggest that understandings of inclusion are ambiguous and characterized by juxtaposing ideals. The participants’ accounts illustrate how they are tasked with promoting inclusion while simultaneously protecting their respective professions. Thus, despite being considered a resource based on their diversity, students with disabilities are still expected to fit into an environment designed for mainstream learners. In discussing these findings in light of ableist theory, we argue that more action is needed on a systemic level to restructure how inclusive education is understood and practiced.

Acculturating Pathway to Practice: A Conceptual Framework of Factors Influencing Foreign-Educated Physicians (FEPs) Transitioning to Nursing as a Second Career.

Introduction: Many foreign-educated physicians (FEPs) are transitioning to licensed registered nurses (RNs) in the United States, a process that helps decrease the nursing shortage. There is a gap in knowledge regarding how they transform from medical to nursing professionals. This information could assist FEPs to effectively transition into the nursing role. Method: The purpose of this grounded theory study was to discover a substantive theory explaining the process of FEPs experience as they transition from their original role as physicians in their country of origin to their new role as registered nurses in the United States. A total of 22 FEPs were recruited for the study and participated in individual and focus group interviews. Results: The basic social process identified in this study was the: acculturating pathway to practice, which provided an in-depth description of the dynamic process of FEPs and their integration, socialization, and transition into nursing as a second career. The three categories that explained this process were practicing, transitioning, and reconciling. Conclusion: The substantive theory allows for an understanding of the factors that influence this group of nursing professionals. This is an essential component of retention, patient care, and improvements in academic and healthcare institutions.