Participant Interviews Research Articles

Exploring secondary school staff views of potential interventions in the school food and drink environment: a qualitative study

BackgroundInterventions in the secondary school food environment have potential to improve pupils’ dietary behaviours by modifying how food options are presented to enhance the convenience and appeal of healthier food options. Co-designing an intervention with pupils and input from school staff may lead to more acceptable and feasible interventions. Prior to this study, pupils suggested and prioritised interventions, and identified examples from the literature. This study aimed to explore the perceived acceptability, feasibility, and sustainability of the pupils interventions with a range of school staff. MethodsThree schools in North East England were recruited. School staff participated in a one-hour face-to-face interview. They reviewed the interventions suggested, prioritised and identified from the literature by pupils in their school. Interview participants (n=12) included catering staff, catering managers, teachers, and senior leadership team (SLT) members. Ethics approval was granted by Newcastle University Faculty of Medical Sciences Research Ethics Committee. Staff provided informed written consent. Interviews were either audio recorded and transcribed or documented using handwritten comprehensive notes. We analysed data using framework analysis, using NVivo to assist. FindingsPreliminary results showed that canteen staff perceived the current school food environment as adequate given cost and time restrictions in schools. As such, they were less receptive to the interventions. The SLT members were more willing to implement feasible, acceptable, and sustainable interventions. Teachers and support staff viewed interventions as acceptable; however, input into the feasibility and sustainability of interventions was limited as they viewed their position as more peripheral to the school food environment. InterpretationFindings were limited to the three schools involved and, therefore, had limited generalisability. The development of school-based interventions may benefit from school staff's views into how interventions may work within their school. Further work should consider the interventions and the impact on pupils’ food choices. FundingThis project was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NIHR200173). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Analysing influential factors in e-learning technology acceptance for digital learning effectiveness enhancement

This study aims to discover the factors that influence the acceptance of electronic learning media and its effect on the effectiveness of digital instruction. The study involved a learning management system and online tutorials using management system (MS) teams from various faculties at the Universitas Terbuka. These include the Faculty of Economics and Business, the Faculty of Teacher Training and Education, the Faculty of Science and Technology, and the Faculty of Law, Social Sciences, and Political Sciences. also conducted in three regional offices in Ambon, Gorontalo and Makassar, which were selected through purposive sampling. Primary data sources include participant questionnaires and interviews. Analytical methods include correlation and multiple regression analysis, with descriptive statistics used to summarize the dataset. Variable selection involves reliability and validity tests and classical assumption tests like multicollinearity. The F-test demonstrates a statistically significant and beneficial influence of utilizing e-learning media and individual ability, training, and intention to use it for digital learning success. The results of ttests and regression models provide empirical evidence supporting the significant effect of e-learning media and intention to use on the effectiveness of digital learning. However, variables related to training and ability do not show any significant influence.

Exploring social preferences for health and wellbeing across the digital divide. A qualitative investigation based on tasks taken from an online discrete choice experiment

Increasingly, discrete choice experiments (DCEs) are conducted online, with little consideration of the digitally-excluded, who are unable to participate. Policymakers or others considering online research data need clarity about how views might differ across this 'digital divide'. We took tasks from an existing online DCE designed to elicit social preferences for health and wellbeing outcomes. We aimed to explore: i) How telephone interview participants answered a series of choice tasks taken from an online DCE; and ii) Whether and how decision-making for these tasks differed between digitally-excluded and non-excluded participants. Semi-structured telephone interviews with members of the public (n=27), recruited via an existing social research panel. Data were analysed thematically to identify key approaches to decision making. Twelve participants were classed as 'digitally-excluded', and 15 as 'digitally non-excluded'. Responses were similar between the two samples for the majority of choice tasks. We identified three approaches used to reach decisions: (1) simplifying; (2) creating explanatory narratives; and (3) personalising. Whilst these approaches were common across both samples, understanding the exercise appeared more challenging for the digitally- excluded sample. This novel study provides some assurance that the participants' views over the choice tasks used are similar across the digital divide. The challenges we identify with understanding highlight the need to be careful examining the views held by the digitally-excluded. If online data are to inform policy-making, it is essential to explore the views of those who cannot participate in online DCEs.

Integrating community health workers into HIV care clinics: a qualitative study with health system leaders and clinicians in the Southern United States

BackgroundCommunity health workers (CHWs) can support patient engagement in care for a variety of health conditions, including HIV. This paper reports on the experiences of HIV clinics and health departments that integrated CHWs into their health systems as part of a capacity-building initiative to address HIV-related disparities in the United States.MethodsSemi-structured interviews were conducted with key informants (n = 14) in two Ryan White HIV/AIDS program jurisdictions: Mississippi (jurisdiction covers the entire state) and the city of New Orleans, Louisiana. This work was part of a larger evaluation of an initiative that used a Learning Collaborative model to facilitate the implementation of evidence-informed interventions to address HIV care continuum gaps in four jurisdictions. The two jurisdictions that focused on integrating CHWs into HIV care clinics and support service agencies were selected for this sub-analysis. Interview participants included HIV clinic leaders and staff, health department leaders, and other Learning Collaborative leaders. Interview transcripts were coded and analyzed for themes related to the acceptability, feasibility, and perceived impact of CHW integration.ResultsOverall, participants expressed interest in having support from CHWs at HIV clinics and service agencies to assist with patient retention and engagement efforts. However, there were challenges integrating CHWs into existing systems (e.g., gaining access to electronic health records, changing policies to conduct home visits, and clarifying roles and scope of work). Negotiating contracts and accessing funding for CHW positions presented major challenges that often contributed to turnover and conflicts around scope of practice. When health departments leveraged existing funding streams to support CHW positions, the clinics and agencies where the CHWs worked had limited flexibility over the hiring process.ConclusionsOur findings reinforce the value and acceptability of CHWs as part of the workforce in HIV clinical and support service settings; however, integrating CHWs into clinics and service agencies required effort. Training the CHWs was not sufficient; other staff and clinicians had to understand the role of CHWs to facilitate their integration into health systems. Resources are needed to support organizations in incorporating CHWs effectively, and long-term, flexible sources of funding are necessary for these positions.

Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers

Cancer patients, who face increased foodborne illness susceptibility and severity, are often placed on neutropenic diets (NDs), which eliminate the consumption of fresh produce, among other foods perceived as high-risk. Such diets are clinically disputed because they have never been proven effective in reducing foodborne illness, leading to unstandardized dietary guideline content, format, and delivery methods. To inform a strategic communication approach, this study explored the produce safety handling behavior, barriers, motivators, and beliefs of pediatric cancer patient caretakers using a mixed methods convergent parallel design. A quantitative survey revealed high frequencies (>60%) for generally recommended produce safety behaviors, such as rinsing produce and washing cutting boards, and more mixed responses for restrictive produce safety behaviors, such as peeling produce and avoiding precut, self-serve, and school cafeteria produce. Total produce safety frequency scores were not significantly affected by demographic factors or Child Vulnerability Scale (CVS) scores. Qualitative interviews established a wide domain of caretaker produce safety experiences and beliefs, finding that eight of seventeen interview participants from different hospitals received produce restrictions typical of the ND. Ultimately, five caretaker archetypes were identified, with common motivators and barriers linked to materials received, child’s health and perceived susceptibility, and self-efficacy beliefs. Finally, response-driven communication strategy improvements were recommended. Although sample sizes in this work were small, and further validation is advised, this work highlights the inconsistent use of the restrictive ND, advances understanding of the drivers of produce safety behaviors in cancer patient caretakers, and supports future endeavors to streamline communication strategy interventions.

Identifying the facilitators and barriers to implementation of renal tumour biopsy in the diagnostic pathway for small renal masses.

To understand the facilitators and barriers to the implementation of renal tumour biopsy (RTB) in the diagnostic pathway for renal tumours in England. Participants consisted of patients who had a renal tumour diagnosed and/or treated at one of five tertiary centres in England, healthcare professionals involved in the direct care of patients diagnosed with renal tumours, and clinical service managers and commissioners. The study employed a mixed-methods research methodology consisting of individual interviews and an on-line survey that explored the types of facilitators and barriers individuals perceived and experienced and the frequency in which these were reported. A public dissemination event took place following the completion of data collection; to facilitate discussion of potential solutions to implementing RTB. There were 50 participant interviews (23 patients, 22 clinicians, and five health service commissioners/operations managers). The patient on-line survey received 52 responses, and the clinician survey received 22 responses. Patients most frequently reported influences in choosing whether to undergo RTB pertained to wanting to know the diagnosis of their kidney mass (40%), the advice or information provided by healthcare professionals (40%), and not wishing to delay treatment (23%). Clinicians most frequently reported barriers to recommending RTB related to their uncertainty of diagnostic accuracy (56%), availability of appointments or hospital beds (52%), concerns of risk of bleeding (44%), risk of seeding (41%), and delays in meeting national cancer pathway targets (41%). The dissemination event was attended by 18 participants (seven patients and 11 clinicians). Suggestions to improve implementation included reducing variation and promotion of standardisation of practice by a consensus statement, increasing the evidence base (clinicians) and improved communication by developing better patient aids such as videos and diagrams (patients and clinicians). Implementation of RTB may be dependent on the quality of information provided, its format and perceived reliability of the information. Increased utilisation of RTB may be improved by development of a consensus statement on the role of biopsy, with patients expressing a preference for alternative information aids such as patient videos.

The role of primary care in hepatitis B elimination in the UK migrant context, a mixed-methods study

Background300 million individuals live with chronic hepatitis B (CHB), with consequences including cirrhosis and cancer. In the UK migrants are disproportionately affected. Many are unaware of their diagnosis and face barriers accessing services. The WHO has called for elimination by 2030. Primary care (PC) is ideally placed but poorly engaged and utilised in CHB care. This study aims to explore UK PC contribution and approaches to strengthen CHB care from migrant and PC perspectives. MethodsAn online survey (21 questions on CHB knowledge/practice/barriers/care delivery) was advertised to PC practitioners. In-depth views were explored through (i) PC focus groups, (ii) semi-structured interviews with migrants with CHB lived experience. Results were analysed to give descriptive statistics and qualitative data using reflexive-thematic analysis. Findings218 survey questionnaires, five PC focus-groups (n=16), and sixteen migrant participant interviews were completed. 63·5% of PC practitioners reported regularly seeing patients from high-prevalence countries but only 14·2% had screening policies and 80·3% were unaware of WHO targets. Barriers to CHB screening and management included knowledge, unstandardised pathways, workload, and stigma. 75·8% were under-confident interpreting results. Facilitators included simplified algorithms, specialist support, translated materials and peer-support. Almost 60% stated they would be comfortable with a CHB shared-care model with specialist oversight and funding. Contact-tracing, vaccination, and re-engaging those lost-to-care were identified improvement areas. Focus-groups reflected survey data, preliminary themes included potential of integrated care and empowerment of PC. Migrant participant interview data highlighted the impact of missed opportunities for CHB care on patient experience, importance of “making that first contact count” and sharing power and knowledge through a culturally competent patient-centred approach. InterpretationIntegrated CHB care is in line with patient and provider preference and could support elimination progress. PC needs to be equipped with simplified pathways, sustainable integrated-care models, specialist support, funding, and culturally competent resources. FundingJC was funded by Hospital for Tropical Diseases Centenary Fellowship and now funded by Wellcome PhD Programme for Primary Care Professionals.

사립유치원 경력교사가 경험하는 직무에 대한 고민과 요구

The purpose of this study is to find out the concerns and demands of the job experienced by experienced teachers in private kindergartens. To this end, seven experienced teachers who obtained the qualification as first-class full-time kindergarten teachers in Seoul were selected as participants for in-depth interviews. As a result of the study, from the concerns about the job experienced by experienced teachers in private kindergartens to the concerns arising from the kindergarten working environment, it was found that 'concerns of experienced teachers about unstable teaching jobs', 'concerns of experienced teachers for new job expansion', and 'challenges for adaptation to the new environment of experienced teachers'. The concerns arising from the perception of experienced members were 'excessive burden of work given to experienced teachers' and 'difficulty in recognizing and performing roles as intermediaries'. The demands for jobs experienced by experienced kindergarten teachers in private kindergartens were 'improving the reasonable treatment and treatment of experienced teachers' and 'development of teacher education programs for differentiated experienced teachers' due to the improvement of the institutional level. The improvements at the individual level were 'activation of mentoring using experienced teachers' and 'operation of a kindergarten professional learning community for experienced teachers'. It is expected that the job environment of experienced kindergarten teachers will be improved through this study.

Co-designing the INHSU Prisons Hepatitis C Advocacy Toolkit using the Advocacy Strategy Framework

BackgroundThe World Health Organization (WHO) has established targets to eliminate the hepatitis C virus (HCV) by 2030. Prisons are a key focus of elimination efforts, however, access to HCV services in prisons remains low globally. With the aim of increasing advocacy efforts to help address this gap, the International Network on Health and Hepatitis in Substance Users (INHSU) Prisons, developed a Prisons Hepatitis C Advocacy Toolkit. MethodsToolkit development involved a co-design process to ensure advocacy resources met end-user needs. A scoping study was conducted, involving a web-based survey and in-depth interviews, to understand advocacy resource needs of key stakeholders from countries of different socio-economic strata. Data were analysed, and suggested advocacy resources were mapped onto the Advocacy Strategy Framework with the audiences resources are targetting and the changes they aim to influence. Advocacy resources were co-developed and validated by interview participants before incorporation into the web-based platform. ResultsSurvey responses (n = 181) and interview data (n = 25) highlighted several barriers to enhancing HCV services in prisons globally, and an understanding that advocacy efforts are needed to bring about this change. Advocacy resources were suggested for influencing three key audiences: policymakers/funders, implementers, and community. Thereafter, a suite of 20 de novo tools were co-developed with key stakeholders including case studies of evidence-based models of HCV care, policy briefs, HCV infographics, and fact sheets about how to leverage funding and build advocacy campaigns. Findings underscore the importance of capitalising on the knowledge and expertise of potential end-users, to ensure Toolkit resources are context-specific and match their needs. ConclusionThe Toolkit holds promise for progressing the WHO elimination goals by increasing advocacy efforts for enhanced prison HCV services globally. The co-design of Toolkit resources with potential end-users has increased its potential accessibility, acceptability, and inclusivity for a globally diverse audience.

Impact of Trauma on the Lives of Black Men With Multiple Arrests

A mixed-methods study was carried out to better characterize the life course experiences, with a focus on trauma, of men who had perpetrated gun violence and other violent crime, and who had multiple arrests and incarcerations. A small sample of 13 men with a history of a minimum of 12 arrests each as well as histories of gun violence, other violent crime, and incarceration was drawn from a social program providing cognitive therapy and job skills training in a major urban center. Participants completed the Adverse Childhood Experiences Questionnaire and Post Traumatic Stress Disorder Checklist for DSM-5 and completed an in-depth interview. Results demonstrated that the participants had extraordinarily significant levels of trauma exposure but that they had minimal avowed trauma symptoms. The exception is that every participant demonstrated a clinically relevant score on the Arousal subscale (Criterion E). Participants in interviews discussed a number of characteristics of their developmental years. They described near constant exposure to traumatic events, in some cases starting from very young ages. Most participants described a personal experience of numbing or desensitization to their experiences. They described the impact of gangs on both protecting them from trauma and exposing them to trauma, and they described their subsequent experiences of incarceration. They offered recommendations for strategies to minimize violent crime in communities.

Barriers influencing the sustainable development of community-based tourism (CBT): evidence from Ciaotou heritage village in Taiwan

PurposeIn recent years, community-based tourism (CBT) in the global market has been combined with specific themes in order to establish various tourism activities. Relatively few studies have comprehensively investigated how this type of CBT should be developed. Therefore, this study takes CBT with festival themes combined with community characteristics as a case study, which explores what obstacles exist in CBT with a combination of community characteristics – the industrial history of sugar factories and external themes, such as, formal flower displays.Design/methodology/approachThe thematic analysis is employed for data analysis of interviews. All interview participants were stakeholders.FindingsThis study identifies five types of obstacles: policy-related, environmental-related, innovation-related, industry-related and communication-related. Based on these findings, it is vital to consider both community and other characteristics of CBT. At the same time, after evaluating the rational perceptions of different stakeholders within the same type of obstacle, this study proposes a more specific and comprehensive development strategies for CBT.Originality/valueTo the best of the authors' knowledge, this is the first study of community agricultural tourism which collected the viewpoints of different stakeholders – tourists, residents, community associations, local businesses and the government. This study employs in-depth analysis of external policies and environmental and agricultural factors to discover and develop relevant coping strategies and implications.

Assessment of relationship between emotional intelligence and conflict resolution among nurse managers at tertiary Health Institutions of North Eastern States of Nigeria

Conflict in health care settings may be effectively managed if nurse managers possess conflict management skills such as reconciliation, listening, and effective communication to bring individuals closer and work together to find fair solutions and meet balanced needs. The study aimed at identifying the relationship between emotional intelligence and conflict resolution among nurse managers at tertiary Health Facilities, in the Northern States of Nigeria. The objectives of the study are to assess the level of emotional intelligence among nurse managers, also to identify the most common types of conflict, determine the causes of conflict, determine the conflict resolution strategies applied by the nurse managers and to identify relationship between emotional intelligence and conflict resolution among nurse managers in tertiary health institutions of North Eastern States. A mixed methods research design (quantitative and qualitative methods) was used. A total of 188 nurse managers and three Head Nursing Services departments formed the sample size. The nurse managers were given structured questionnaires and the Head of the Nursing Services department was interviewed (key informant interview). Three instruments were employed for data collection; Interview Guide, Structured Questionnaire and Participants Demographics Sheet. A simple random sampling technique was used for the study. The obtained data were coded and computed in an SPSS Version 26 and analyzed using percentages, mean and standard deviation for descriptive statistics while the Pearson Correlation Coefficient was used for the inferential statistics. The result of the study revealed that most of the nurse managers have a fair level of emotional intelligence when dealing with conflict among nurse managers. It also revealed that the most common type of conflict among nurses was related to environmental factors. The working environment was the highest cause of conflict among nurses. Social skill strategy was mostly used in conflict resolution. The study revealed that there was no significant relationship between years of experience and conflict resolution r=0.173. Based on the findings the researcher concluded that most of the respondents highly make use of social awareness in the application of emotional intelligence in conflict resolution, most of the causes of conflict among nurses were related to a working environment, and social skills were mostly used in conflict resolution among nurses. Based on the findings of the study, the researcher recommended that other sources of conflict management should be identified for nurse managers to manage conflict, nurse managers should use the skills they have to solve problems and conflict management to be part of a school of nursing curriculum.

Health Catch-UP!: a realist evaluation of an innovative multi-disease screening and vaccination tool in UK primary care for at-risk migrant patients

BackgroundMigrants to the UK face disproportionate risk of infections, non-communicable diseases, and under-immunisation compounded by healthcare access barriers. Current UK migrant screening strategies are unstandardised with poor implementation and low uptake. Health Catch-UP! is a collaboratively produced digital clinical decision support system that applies current guidelines (UKHSA and NICE) to provide primary care professionals with individualised multi-disease screening (7 infectious diseases/blood-borne viruses, 3 chronic parasitic infections, 3 non-communicable disease or risk factors) and catch-up vaccination prompts for migrant patients.MethodsWe carried out a mixed-methods process evaluation of Health Catch-UP! in two urban primary healthcare practices to integrate Health Catch-UP! into the electronic health record system of primary care, using the Medical Research Council framework for complex intervention evaluation. We collected quantitative data (demographics, patients screened, disease detection and catch-up vaccination rates) and qualitative participant interviews to explore acceptability and feasibility.ResultsNinety-nine migrants were assessed by Health Catch-UP! across two sites (S1, S2). 96.0% (n = 97) had complete demographics coding with Asia 31.3% (n = 31) and Africa 25.2% (n = 25), the most common continents of birth (S1 n = 92 [48.9% female (n = 44); mean age 60.6 years (SD 14.26)]; and S2 n = 7 [85.7% male (n = 6); mean age 39.4 years (SD16.97)]. 61.6% (n = 61) of participants were eligible for screening for at least one condition and uptake of screening was high 86.9% (n = 53). Twelve new conditions were identified (12.1% of study population) including hepatitis C (n = 1), hypercholesteraemia (n = 6), pre-diabetes (n = 4), and diabetes (n = 1). Health Catch-UP! identified that 100% (n = 99) of patients had no immunisations recorded; however, subsequent catch-up vaccination uptake was poor (2.0%, n = 1). Qualitative data supported acceptability and feasibility of Health Catch-UP! from staff and patient perspectives, and recommended Health Catch-UP! integration into routine care (e.g. NHS health checks) with an implementation package including staff and patient support materials, standardised care pathways (screening and catch-up vaccination, laboratory, and management), and financial incentivisation.ConclusionsClinical Decision Support Systems like Health Catch-UP! can improve disease detection and implementation of screening guidance for migrant patients but require robust testing, resourcing, and an effective implementation package to support both patients and staff.

A Process Evaluation in a Randomized Controlled Trial among Adults with Acetabular Dysplasia

Abstract Introduction The 2021 framework from the UK’s Medical Research Council defines evaluation as a theory-driven approach to examine how well an intervention works. However, the application of these guidelines can be challenging. Therefore, using a process evaluation case study on an exercise and patient education intervention for adults with acetabular dysplasia, we reflect on which specific aspects were relevant for the evaluation of the intervention and why. We focus on detailing methods to assess implementation (process, dose, reach), acceptability, mechanisms of change, and the impact of contextual factors. Methods Two hundred trial participants aged 18-50 years will be recruited from a University Hospital in Denmark and randomised to intervention and control groups. The process evaluation adopts a concurrent mixed-methods design involving self-report questionnaires at baseline and 6-month follow-up, training records and semi-structured focus groups with intervention providers (n = 10) and healthcare managers (n = 4-6). The mechanisms of change will be explored through semi-structured one-to-one interviews (at baseline and 6-month follow-up) with 15-20 purposefully sampled trial participants, and additionally, through exploratory examinations of associations between dose and change in health outcomes at 6-month follow-up), via simple linear regression models. The acceptability and contextual factors will be explored through one-to-one participant interviews, plus focus groups with 4-6 healthcare managers. Thematic analyses of the interviews will focus on expectations, experiences, events, personal understandings and interpersonal and organisational interactions. Conclusions The presentation will explore how the operational aspects of the intervention can be assessed through a process evaluation and how these findings may improve and expand any future implementation efforts.

Feasibility and end-user perceptions of a novel digital care assistant and support program for people after stroke or transient ischemic attack (CAPS)

Abstract Background The Care Assistant and support Program for people after Stroke (CAPS) or transient ischaemic attack (TIA) is a clinician-led program designed to improve the secondary prevention of stroke. The program combines person-centred goal setting and risk-factor monitoring through a web-based clinician portal, SMS goal-aligned messages, a mobile application (app), and a wearable device. We aimed to determine the feasibility of CAPS among people living with stroke or TIA, and clinicians who would deliver the program in future. Methods Open label single group pre-posttest mixed-methods evaluation of the 12-week program. Eligible lived-experience participants were recruited through the Australian Stroke Clinical Registry. Eligibility: diagnosis of stroke or TIA in preceding 6 months - 3 years, ≥18 years old, smartphone/tablet ownership, living in the community. Following surveys and interviews of lived-experience participants, ten clinicians experienced in stroke care were invited to participate in focus groups to discuss the program. We used descriptive statistics to evaluate feasibility outcomes, i.e. participant perceptions of usability, acceptability and satisfaction, and clinician perceptions on program design and delivery. Results From 600 invitations, 34 eligible participants commenced the program (27% female, 33% TIA, median 1.7 years from index event; one withdrew). Usability of the CAPS app was rated as ‘Good’ to ‘Excellent’ (System Usability Scale), with moderate sustained usage by study conclusion (>60%). Participants frequently reviewed their health data within the app (average twice a day/participant over 12 weeks), and entered their health measurements an average 73 times/participant. The majority (≥90%) of participants thought the program fitted well into their daily lives or helped engage them in self-monitoring, with 76% indicating they would use the program, if publicly available. Clinician participants included three nurses, three allied health professionals, two neurologists, a stroke consultant, and a general practitioner (GP) in focus groups. Overall, eight had positive perceptions of the CAPS program. Three clinicians indicated the measurements collected in the app captured "vital information", and five saw the value of CAPS to improve secondary prevention. Recommended modifications to the program included tracking atrial fibrillation and blood cholesterol. Seven believed participants would receive the most benefit from the program if delivered within three months post-discharge. Six indicated that GP-led multidisciplinary care was the best model to deliver CAPS. Conclusions The CAPS program was feasible to deliver and acceptable to people living with stroke or TIA. Clinicians saw the value of CAPS for secondary prevention, with feedback prompting further focus groups with GPs to develop the potential model of care. Findings have informed the design of a Phase II randomised feasibility trial.

Indigenous Experiences and Contributions to Western Scientific Knowledge Systems: An Ethnographic Exploration

Knowledge systems are embedded in sets of values, worldviews, and cosmologies that affect the whole process of knowledge production. Employing an ethnographic method that integrates participant observation, interviews, and focus groups, I explore the contributions, ideas, points of view, and metaphors that individuals of Indigenous origins introduce to the scientific method when they enter Western scientific knowledge systems. This ethnographic exploration focuses on a group of students with a variety of Indigenous backgrounds participating in a field course on introduction to Ecology. Native-born students contribute innovations to the knowledge production process by shaping research questions, methodologies, and result interpretations. These innovations stem from diverse worldviews and epistemologies, and while they could significantly impact scientific knowledge production, the students may not fully appreciate their own relevance. This work may serve as a testimony of the processes of reflection and negotiation with the scientific methods, practices, and values that native students undergo when participating in a Western scientific context.

“We Evangelists Are Creative”: Yoruba Pentecostals’ Music-Making on Prayer Mountains in Nigeria

There is a growing interest in scholarship on the creative forms of Pentecostalism in Africa and globally. This study extends the conversation by exploring music-making in prayer mountain spirituality in Nigeria. Specifically, it examines the roles of music makers and their creative processes in prayer mountain liturgy. In addition, it discusses factors that aid creativity among music makers in the prayer mountains. Two popular prayer mountains, namely Orí-òkè Ikoyi in Ikoyi and Orí-òkè Bàbà Àbíyè in Ede, Osun State Nigeria, were selected for the study. Data for the study were generated through participant observations and interviews with music makers including prayer and song leaders as well as instrumentalists on both prayer mountains. Using the dynamic inspiration theory, the study reveals that music-making in Orí-òkè is a triadic process that is spiritually, musically, and situationally integrated. I argue that with Orí-òkè music and musicians, we can further grasp the interplay of human (social) and non-human (spiritual) agency in Pentecostal creative and musical practices.

Development and Initial Validation of a Scale to Measure Social Abuse in Intimate Partner Relationships.

Social abuse represents a distinct form of intimate partner violence characterized by intentional violations of a victim's social rights and inherent need to belong. This is achieved by tactics such as severing, interfering with, and surveilling the victim's social connections as well as limiting their social participation. Such abuse often results in victims experiencing social isolation, potentially causing adverse mental health outcomes and failure to seek help. This study aimed to develop and validate the Social Abuse Scale (SAS) to measure social abuse in intimate partner relationships. After generating the preliminary items, content validity testing was performed. Ten international experts reviewed the items and assessed their relevance. Additionally, 17 interview participants assessed the items for clarity and ease of response. Thereafter, the SAS was administered to 251 individuals, either currently in or who had an intimate relationship in the previous year. The final SAS comprised 30 items unified under a single-factor structure, which accounted for approximately 69.77% of the total variance. Confirmatory factor analysis confirmed the model's satisfactory fit. The instrument showed excellent internal consistency, as evidenced by Cronbach's alpha and a McDonald's omega value of .986. The SAS can be employed to investigate the prevalence of social abuse, its underlying mechanisms, and its impacts, and it can also assist in further development and evaluation of programs aimed at its prevention.

Turn-Taking in Political Interviews and Its Impact on Building Government Credibility

Television political inquiry is conducted through question-and-answer exchanges with host and government officials on prominent livelihood issues, which helps to improve the efficiency of government governance. Interview participants’ identity, communicative intention, power, and contextual factors have a significant impact on the discourse choices of both parties. This research clarifies the mechanism by which communicators mobilize appropriate discourse strategies to promote the solution of social problems. It adopts qualitative research method and conversation analysis to interpret interview participants’ talk-in-interaction and discourse strategies in “Ask Government Affairs of Shandong”. Research finds that adjacency pairs in political interview perform social behaviors such as greetings, requests, suggestions, apologies, acknowledgement. Interview participants’ turn-taking is divided into claiming for the turn, holding the turn, and giving up the turn. Discourse strategies such as insertion, interruption, and repetition are adopted to claim for the turn. Discourse markers and conversation repair are applied in communicators’ turn-holding stage. Communicators adopt explicit nominations, vague job designations, and silence strategies to give up the turn. Clear, accurate, and highly relevant official responses are conducive to projecting a responsible government image and improving government credibility. The phenomenon of avoidance, hesitation, and pause in official response is likely to cause the masses to question government officials’ work capability, which is not conducive to establishing a positive and trustworthy government image. Suggestions for optimizing the process setting of political interview and official responses are provided to enhance the effect of political enquiry.

A Virtual Reality Approach to Overcome Glossophobia among University Students

In the contemporary academic landscape, university students frequently deliver presentations in front of their peers and faculty, often leading to heightened levels of Public Speaking Anxiety (PSA). This study explores the potential of Virtual Reality Exposure Therapy (VRET) to alleviate PSA among students. Our study introduces "Manch," a realistic VR environment that simulates classroom public speaking scenarios with lifelike audience interactions and a slide-deck presentation feature. The study was conducted with N=28 participants, showing a significant reduction in PSA levels post-VR exposure, thereby establishing VR's efficacy in mitigating PSA. Additionally, we also incorporated a unique qualitative analysis through participant interviews, offering deeper insights into individual experiences with VRET. Manch shows great promise as a tool for future studies and interventions aimed at reducing PSA, particularly among university students.