Iterative Qualitative Analysis Research Articles

Playing away from home: a qualitative sentiment analysis of online viewers’ non-social emotions on sex tourism vlogs

ABSTRACT Popular yet so controversial, sex tourism remains a significant attraction in Southeast Asia, generating an abundance of scholarly explorations. However, little is known about the emotions expressed by viewers on user-generated content regarding this contentious form of tourism. Thus, this qualitative sentiment analysis, which aims to dilate non-social emotions found in comments expressed by online viewers on video content featuring sex tourism in Southeast Asia, is conducted. Through Data Miner, online comments (n = 10,864) were gathered and extracted from purposively selected sex tourism vlogs on YouTube, which were then subjected to Phronetic Iterative Qualitative Data Analysis (PIQDA) (Tracy, 2013). A member-checking procedure was performed further to establish the validity of the study’s findings. Interestingly, a model dubbed YouTube online viewers’ non-social emotions on sex tourism as a magnetic field consisting of labelled emotions known as enabling and disabling has emerged in this qualitative study. Notably, enabling emotions capture distinct emotions of interest, admiration, joy, amusement, satisfaction, sexual desire, excitement, awe, and romance. The second notion, disabling emotions, encapsulates patent emotions of dislike, anger, boredom, sadness, confusion, emphatic pain, disappointment, disgust, fear, anxiety, and awkwardness. Theoretical and practical implications, limitations, and recommendations on non-social emotions in tourism were discussed in this paper.

Multidisciplinary proactive e-consults to improve guideline-directed medical therapies for patients with diabetes and chronic kidney disease: an implementation study

IntroductionWe hypothesized that multidisciplinary, proactive electronic consultation (MPE) could overcome barriers to prescribing guideline-directed medical therapies (GDMTs) for patients with type 2 diabetes (T2D) and chronic kidney disease (CKD).Research design...

Using a Novel Gameplay Intervention to Target Intrusive Memories After Work-Related Trauma: Iterative Qualitative Analysis of Intensive Care Unit Staff Experiences.

Many intensive care unit (ICU) staff experience intrusive memories following work-related traumatic events, which can lead to long-term mental health outcomes and impact work functioning. There is a need for interventions that target intrusive memories in this population; however, factors such as mental health stigma and difficulty in fitting interventions into busy schedules can pose barriers. The Brief Gameplay Intervention For National Health Service Intensive Care Unit Staff Affected By COVID-19 Trauma (GAINS) study tested a brief, digital imagery-competing task intervention (including computer gameplay) with the aim of reducing the recurrence of intrusive memories, which holds promise for overcoming some of these barriers. This substudy aims to explore barriers and facilitators to the uptake and practical use of the intervention by ICU staff, along with its acceptability, and iteratively explore the impact of intervention optimizations to further refine the intervention. The GAINS study is a randomized controlled trial comparing access to a brief digital imagery-competing task intervention for 4 weeks with usual care followed by delayed access to the intervention. The participants were ICU staff who worked during the COVID-19 pandemic and experienced intrusive memories. All participants were sent a questionnaire at 4 weeks to gather data about intervention acceptability. Nested within the randomized controlled trial, a subset of 16 participants was interviewed, and data were analyzed using thematic analysis drawing from a framework approach. Both quantitative and qualitative data indicated high acceptability of the intervention. Intervention use data show that, on average, staff were able to target approximately 73% (3.64/4.88) of their intrusive memories and engaged with the Tetris component for the full 20 minutes per session. Overall, on the acceptability questionnaire, staff found the intervention easy to use, helpful, and highly acceptable. The interviews generated four themes: approach to the intervention, positives of the intervention, negatives of the intervention, and improvements and optimizations. Findings highlighted barriers that ICU staff experienced: stigma, feeling weak for seeking help, not wanting colleagues to know they were struggling, and skepticism. However, they provided suggestions on how barriers could be overcome and discussed the advantages of the intervention when compared with other treatments. Although participants described many positive aspects of the intervention, such as being easy to use, enjoyable, and leading to a reduction in the frequency or intensity of intrusive memories, they also raised practical issues for implementation. The intervention has the potential to overcome stigma and reduce the frequency of intrusive memories after traumatic events among ICU staff. Further refinement is needed to improve the adoption and reach of this intervention. A limitation is that we could not interview the National Health Service staff who were unable or unwilling to take part in the trial.

Exploring the value of family shared reading with young people who have Profound and Multiple Learning Disabilities (PMLD)

Shared reading with young children is promoted as good practice in national and international policy. Existing literature explores cognitive and developmental benefits of family shared reading for young, typically developing children, but much less is known about benefits for young people with learning disabilities. Additionally, the analysis of ‘benefit’ is often cast in economic terms to society rather than through the sociological lens of everyday ‘family practice’. This paper explores the significance of shared reading for two young people with Profound and Multiple Learning Disabilities (PMLD), a group traditionally characterised as having a developmental age of 24 months or less and who may therefore continue to enjoy shared reading far beyond early childhood. Drawing on iterative qualitative data analysis of semi-structured interviews with two mothers, findings suggest that shared reading is a valued everyday practice fulfilling a range of functions such as emotional regulation, marking time and routine, and inclusion with siblings. The paper considers ways to support shared reading within PMLD families in research, policy and practice.

Public Attitudes Towards Vaccine Passports in Alberta During the "Pandemic of the Unvaccinated": A Qualitative Analysis of Reddit Posts.

Objective: The goal of this study is to understand the attitudes and beliefs towards mandatory vaccination policies in Alberta, Canada in September 2021, during the fourth wave of COVID-19. Methods: 9400 posts between 1st September and 30th September 2021 were collected from the subreddit r/Alberta with Pushshift.io. Posts and comments were manually screened to determine their relevance to research objectives, and then coded using inductive coding and iterative qualitative analysis methods. Results: Inductive coding methods yielded five key themes: 1) opinions related to autonomy and consent, 2) concerns about COVID-19 vaccine passport enforcement, 3) concerns about government, 4) concerns about the logistics of passports, and 5) opinions relating to the necessity of passports to prevent lockdowns. Conclusion: Overall, the data presented favorable opinions towards an Albertan vaccine passport within r/Alberta. Anti-vaccine and anti-mandate opinions were often less extreme than those present in the literature, although this may be due to r/Alberta subreddit moderators removing those more extreme comments. Most reservations were due to issues of bodily autonomy, though concerns about the government and logistics also played a meaningful role.

Organizational Factors in Clinical Data Sharing for Artificial Intelligence in Health Care

Limited sharing of data sets that accurately represent disease and patient diversity limits the generalizability of artificial intelligence (AI) algorithms in health care. To explore the factors associated with organizational motivation to share health data for AI development. This qualitative study investigated organizational readiness for sharing health data across the academic, governmental, nonprofit, and private sectors. Using a multiple case studies approach, 27 semistructured interviews were conducted with leaders in data-sharing roles from August 29, 2022, to January 9, 2023. The interviews were conducted in the English language using a video conferencing platform. Using a purposive and nonprobabilistic sampling strategy, 78 individuals across 52 unique organizations were identified. Of these, 35 participants were enrolled. Participant recruitment concluded after 27 interviews, as theoretical saturation was reached and no additional themes emerged. Concepts defining organizational readiness for data sharing and the association between data-sharing factors and organizational behavior were mapped through iterative qualitative analysis to establish a framework defining organizational readiness for sharing clinical data for AI development. Interviews included 27 leaders from 18 organizations (academia: 10, government: 7, nonprofit: 8, and private: 2). Organizational readiness for data sharing centered around 2 main constructs: motivation and capabilities. Motivation related to the alignment of an organization's values with data-sharing priorities and was associated with its engagement in data-sharing efforts. However, organizational motivation could be modulated by extrinsic incentives for financial or reputational gains. Organizational capabilities comprised infrastructure, people, expertise, and access to data. Cross-sector collaboration was a key strategy to mitigate barriers to access health data. This qualitative study identified sector-specific factors that may affect the data-sharing behaviors of health organizations. External incentives may bolster cross-sector collaborations by helping overcome barriers to accessing health data for AI development. The findings suggest that tailored incentives may boost organizational motivation and facilitate sustainable flow of health data for AI development.

K-12 trade books’ representation of earthquake safety and protective actions: A content analysis

Meaningful learning resources for earthquake safety and survival have become an increasingly important topic among geoscientists, especially educators and researchers. Various members of the public, especially K-12 (ages 5–18) learners, continue to depend on scientific trade books available at their local public and school libraries for information about earthquake concepts. To our knowledge, no research has empirically examined how trade books represent earthquake safety and survival actions. In this research, we combine an iterative qualitative inductive and deductive analysis to explore the representation of earthquake safety and protective actions in 50 trade books. We categorize these actions into time-based practices related to preparedness before an earthquake, protective actions during an earthquake, and recovery after an earthquake. These trade books emphasize preparedness by means of building earthquake-resistant structures and urban planning, and efforts toward community resilience and keeping home supplies. The recommended personal protective action during an earthquake in the United States (“Drop, Cover, and Hold On”) is emphasized in the majority of the trade books, as well as other protective actions related to emotional actions and current technological automated actions such as earthquake early warning systems. Finally, the books highlight actions such as damage evaluation and support as ways to recover after an earthquake. Our findings highlight the issues between accepted earthquake safety and survival actions and the limited and/or inaccurate knowledge represented in some trade books. We provide interpretations of how presentation of limited or inaccurate information may increase confusion about appropriate protective actions. The inclusion of accepted and recommended protective actions in future trade books and the use of earthquake drills in public libraries as a supplement for trade book users may improve understanding and implementation of appropriate actions. We further demonstrate the potential of trade book contents in fostering earthquake education through library-community partnerships.

Youth participatory action research as an empowerment-based method for community change

ABSTRACT Youth participatory action research (YPAR) centers the experiences of young people as experts in issues impacting their lives. The process of engaging in YPAR has potential to create positive outcomes for youth researchers, including skills associated with empowerment. As such, YPAR is a valuable method for building community power and capacity for change. Little is understood about the process by which empowerment happens through YPAR, including how youth develop a sense of themselves as changemakers and the indicators that an empowering space and process have been created. The current study identified components of youth empowerment rooted in the experiences of young people who were involved in YPAR. Data were collected through an initiative between university researchers and three community-based organizations. The project included development of three YPAR teams with a total of 15 youth and young adult researchers. Data for this study were drawn from post-project focus groups and observation tools that were completed at each YPAR team meeting. Using a theory-driven coding structure for empowerment, the researchers used an iterative qualitative analysis process to identify key indicators of empowerment that emerged from the data. Examples of how they manifested provide valuable insight to community practitioners as well as community-engaged researchers as they work to support community leadership and power building.

Effective Classroom Management in Middle Level Schools: A Qualitative Study of Teacher Perceptions

Disruptive student behavior is a significant challenge in schools and a predictor of student failure. Effective classroom management is a crucial skill that middle level teachers must acquire to foster student engagement and learning. This qualitative study explored the experiences and perceptions of 35 middle level teachers in both general education and special education settings regarding effective classroom management techniques. Eight focus group interviews were conducted with 25 general education teachers and 10 special education teachers at one of five middle schools in Kansas, Missouri, or Utah. Focus group transcripts were analyzed using iterative qualitative content analysis to identify themes and subthemes. Findings revealed that effective classroom management includes teachers’ use of appropriate positive and negative reinforcement, student buy-in to reward systems, positive immediate feedback to students, teachers’ consistent follow-through with consequences, and positive teacher-student relationships. We also report similarities and differences between middle level general education and special education teachers’ perceptions. Limitations and areas for future research are addressed.

Humanistic nursing tailored to the needs of young men with cancer.

The goal of this study is to describe and understand humanistic nursing that is tailored to the needs of young men (18-39 years) with cancer. Eight young men with cancer (n = 8, average age = 28 years) were interviewed individually. Two themes emerged from the interviews: (1) trust between nurse and patient is paramount; and (2) this patient population has needs that are not currently being met through the humanistic nursing approach. The results of the iterative qualitative analysis of the data suggest that humanistic nursing tailored to young men with cancer should address their need to express their feelings, to be active and to receive psychological support.

Situating intuition in engineering practice

AbstractBackgroundA defining characteristic of expertise is the use of intuition to navigate tasks. The construct of intuition and its importance is well‐studied in other disciplines, but little is known about how it translates to engineering. Existing literature on intuition does not clearly define the construct and its relationship to problem solving, which creates a substantial gap in our understanding of intuition and its applicability to engineering.PurposeThis study's purpose is to better understand the relationship between expertise, decision‐making, and intuition from the perspective of engineering practitioners. We additionally seek to define engineering intuition from this same perspective.Design/MethodsSeventeen semi‐structured interviews were conducted with engineering practitioners with at least 6 years of experience. Sensitizing concepts tied to models of expertise development and dual process cognition were used to guide the study's design and data analysis. Iterative qualitative analysis culminating in code mapping supported the development of a definition and theory of engineering intuition.ResultsThis study's result is an emergent definition of engineering intuition and a complementary framework called Leveraging Intuition Toward Engineering Solutions (LITES). LITES uniquely situates intuition as part of the problem‐solving process among experienced engineering practitioners and describes how practitioners use their intuition.ConclusionsThis work advances knowledge of the relationship between intuition and expertise in engineering education by providing a definition of engineering intuition and a framework describing intuition's role in engineering problem solving. This contribution furthers efforts to equip current and future engineers with the necessary skills to navigate existing and upcoming societal challenges.

Beyond the Screen: Exploring Vaporwave Musicians’ Communicative Identity Work

ABSTRACT While vaporwave musicians create surreal soundscapes from under the cover of anonymity, they also engage in complex and humanizing identity work processes. We applied a communication theory of identity (CTI) lens to semi-structured interviews conducted with 18 self-identified vaporwave musicians. Grounded in the experiences of vaporwave musicians, our iterative qualitative analysis revealed that participants constantly contend with friction between personal, enacted, relational, and communal identities. This study’s contributions include extending CTI literature into a new realm of music subculture, suggesting new avenues for understanding identity within digital communities, and emphasizing the importance of lived participant experiences.

Contemporary issues, opportunities, and resources for the U.S. outdoor recreation profession

The purpose of this study was to understand the contemporary issues, opportunities, and resource needs of U.S. outdoor recreation professionals. In Spring 2021, we conducted focus groups with members of the Society of Outdoor Recreation Professionals and Association of Outdoor Recreation and Education. Iterative qualitative analysis of professionals' perspectives using both inductive and matrix coding yielded key themes including: 1) justice, equity, diversity, and inclusion (JEDI), 2) social-ecological health, 3) societal demand, 4) industry direction, and 5) professional identity. While certain themes (i.e., JEDI) existed in previous trends studies, others illustrate the relative novelty of professionals’ experiences of the outdoor recreation boom both pre- and during the COVID-19 pandemic. In sum, we provide an inventory of current issues, opportunities, and resource needs for outdoor recreation professionals, which can inform future advocacy and planning by professional organizations. The overall development in the field of outdoor recreation will be influenced by the aspects: • Key issues will be 1) justice, equity, diversity, and inclusion (JEDI), 2) social-ecological health, 3) societal demand, 4) industry direction, and 5) professional identity. • JEDI was the most salient theme across organizational membership affiliation, indicating the importance of ongoing social justice efforts led by the outdoor recreation industry. • Participants' focus on the negative ecological health impacts and positive human health benefits stemming from outdoor recreation solidly situates the industry within One Health and other ongoing public health efforts. • In some cases, different needs exist across the supply and demand segments of the outdoor recreation profession, particularly related to professional identity and livable wages. • Workforce development opportunities include, but are not limited to, investment and training in community and stakeholder engagement through SCORP processes, planning for social media's influence of recreation resources, and additional human resources to adapt to surging demand.

Trends and Characteristics of #HIVPrevention Tweets Posted Between 2014 and 2019: Retrospective Infodemiology Study.

BackgroundTwitter is becoming an increasingly important avenue for people to seek information about HIV prevention. Tweets about HIV prevention may reflect or influence current norms about the acceptability of different HIV prevention methods. Therefore, it may be useful to empirically investigate trends in the level of attention paid to different HIV prevention topics on Twitter over time.ObjectiveThe primary objective of this study was to investigate temporal trends in the frequency of tweets about different HIV prevention topics on Twitter between 2014 and 2019.MethodsWe used the Twitter application programming interface to obtain English-language tweets employing #HIVPrevention between January 1, 2014, and December 31, 2019 (n=69,197, globally). Using iterative qualitative content analysis on samples of tweets, we developed a keyword list to categorize the tweets into 10 prevention topics (eg, condom use, preexposure prophylaxis [PrEP]) and compared the frequency of tweets mentioning each topic over time. We assessed the overall change in the proportions of #HIVPrevention tweets mentioning each prevention topic in 2019 as compared with 2014 using chi-square and Fisher exact tests. We also conducted descriptive analyses to identify the accounts posting the most original tweets, the accounts retweeted most frequently, the most frequently used word pairings, and the spatial distribution of tweets in the United States compared with the number of state-level HIV cases.ResultsPrEP (13,895 tweets; 20.08% of all included tweets) and HIV testing (7688, 11.11%) were the most frequently mentioned topics, whereas condom use (2941, 4.25%) and postexposure prophylaxis (PEP; 823, 1.19%) were mentioned relatively less frequently. The proportions of tweets mentioning PrEP (327/2251, 14.53%, in 2014, 5067/12,971, 39.1%, in 2019; P≤.001), HIV testing (208/2251, 9.24%, in 2014, 2193/12,971, 16.91% in 2019; P≤.001), and PEP (25/2251, 1.11%, in 2014, 342/12,971, 2.64%, in 2019; P≤.001) were higher in 2019 compared with 2014, whereas the proportions of tweets mentioning abstinence, condom use, circumcision, harm reduction, and gender inequity were lower in 2019 compared with 2014. The top retweeted accounts were mostly UN-affiliated entities; celebrities and HIV advocates were also represented. Geotagged #HIVPrevention tweets in the United States between 2014 and 2019 (n=514) were positively correlated with the number of state-level HIV cases in 2019 (r=0.81, P≤.01).ConclusionsTwitter may be a useful source for identifying HIV prevention trends. During our evaluation period (2014-2019), the most frequently mentioned prevention topics were PrEP and HIV testing in tweets using #HIVPrevention. Strategic responses to these tweets that provide information about where to get tested or how to obtain PrEP may be potential approaches to reduce HIV incidence.

Managing Uncertainty for and With Family: Communication Strategies and Motivations in Familial Uncertainty Management for Hereditary Cancer.

The management of uncertainty is integral to health and illness. Individuals manage uncertainty about their health through communication enmeshed in family systems, but existing theorizing focuses on individuals without accounting for family processes. An iterative qualitative analysis of 42 dyadic, family interviews (N = 84) revealed (a) moments in the context of hereditary cancer that involved individual-centered and familial uncertainty appraisal and management, (b) family members' communication strategies to prompt relatives to engage familial uncertainty, and (c) the communicative (re)creation and negotiation of family models for uncertainty management. The findings illuminate tensions that individuals encounter across their lifespan as they appraise and manage uncertainty about hereditary cancer risks. This study extends uncertainty management theory to encompass familial uncertainty management and contributes insights useful for the management of hereditary cancer.

Reading #NativeTwitter: A Qualitative Study of Indigenous Language Twitteratures

How can we think with Indigenous literary theorists and digital humanists to make sense of the literary contribution of Indigenous peoples on Twitter? Methods for how to read and make sense of the stories of Indigenous people online emerge by challenging traditional definitions of literature and locating Indigenous tweets as an emerging form of literary genre: Indigenous twitterature. Twitter's unique technology (including limited word count, hashtagging, and retweeting functions) helps Indigenous storytellers to craft and develop this emerging Indigenous literary genre. Through an iterative qualitative analysis, which utilizes a blend of coding and close reading of an archive of tweets focused on Indigenous language learning and survivance, we demonstrate this emerging genre of Indigenous twitteratures, which is thematically organized in terms of poetry, bite-sized teachings, Word of the Day twitteratures, bite-sized essays, and hypertextual relations. We describe these themes and elucidate the conceptual and ethical interventions Indigenous twitteratures make in Indigenous literary and digital studies—specifically, in navigating refusals against literary exclusion, in advocating for generous and inclusive Indigenous literary elsewheres, and in honoring and upholding place-based relations within online spaces.

The Experiential Learning Pathway of Cancer Survivors as They Recover Their Lives Post-Treatment: A Qualitative Study

For many cancer survivors, post-treatment challenges are predominantly related to their personal and social lives. These challenges are part of an experiential learning process linked to a survivor’s identity, their desire to preserve independence, their social roles, and responsibilities along with a return to their normal lives. We used interpretive description to describe the experiential learning process of cancer survivors as they recover post-treatment. Data from five group discussions with 27 participants were combined with data from 9 in-depth individual interviews that examined post-treatment challenges. Through an iterative qualitative analysis, we uncovered 3 experiential learning pathways. Narrative vignettes are used to portray and highlight learning involved in accepting loss, asking for help, and rebuilding authentic social networks. Experiential learning shares recognizable features among individuals identified as milestones. These lead to a greater understanding of how cancer survivors acquire a new sense of self and recover their lives post-treatment.

Supporting people living with dementia and care partners throughout the COVID‐19 pandemic: Health service directions from the first wave in Calgary, Alberta

BackgroundThe emergence of COVID‐19 (SARS‐CoV‐2) as a novel coronavirus in late 2019 necessitated public health measures that have impacted the provision of care for people living with dementia and their families. The rapid shift to virtual care across health and social care sectors meant that providers did not have the opportunity to benefit from an evidence‐based understanding about how and which services can safely and effectively be delivered virtually prior to public health measures being implemented. Additionally, isolation resulting from social distancing may be harming well‐being for families as formal and informal supports become less accessible.MethodTo understand lived experiences and necessary changes in models of care delivery for people living with dementia during the COVID‐19 pandemic in Canada, we remotely interviewed 20 dyads of people living with dementia and their care partners who normally attend a dementia specialty clinic in Calgary, Alberta, during a period where essential businesses were closed and health care had abruptly transitioned to telemedicine. Participants were 50% female and a majority of clinic patients in the dyad had a diagnosis of Alzheimer’s Disease (75%). A reflexive thematic analysis was used to analyze the interview and field note data.ResultThemes regarding virtual service provision emerged through the iterative qualitative data analysis: (1) continuation of community‐based services for care partners and families delivered in innovative ways to meet support needs during the pandemic; (2) guidance in adapting to technology to enable accessible and effective treatment in a virtual care environment; (3) adapting the process and structure of virtual appointments to operationalize critical information provision while maintaining dignity for the person living with dementia.ConclusionThe rapid move to virtual healthcare has influenced how and when people access health services. Health system innovation in the way we structure service models and care provision can mitigate barriers to maintaining high quality virtual health care for people living with dementia. In‐depth understandings of how health systems can provide high‐quality care in new virtual settings is key to maintaining quality of life for community‐dwelling people living with dementia and care partners in times of public health emergencies.

Dispensing and practice use patterns, facilitators and barriers for uptake of ulipristal acetate emergency contraception in British Columbia: a mixed-methods study.

Background:Ulipristal acetate 30 mg became available as prescription-only emergency contraception in British Columbia, Canada, in September 2015, as an addition to over-the-counter levonorgestrel emergency contraception. In this study, we determined dispensing and practice use patterns for ulipristal acetate, as well as facilitators of and barriers to emergency contraception for physicians, pharmacists and patients in BC.Methods:In the quantitative component of this mixed-methods study, we examined ulipristal acetate use from September 2015 to December 2018 using a database that captures all outpatient prescription dispensations in BC (PharmaNet) and another capturing market sales numbers for all oral emergency contraception in BC (IQVIA). We analyzed the quantitative data descriptively. We conducted semistructured interviews from August to November 2019, exploring barriers and facilitators affecting the use of ulipristal acetate. We performed iterative qualitative data collection and thematic analysis guided by Michie’s Theoretical Domains Framework.Results:Over the 3-year study period, 318 patients filled 368 prescriptions for ulipristal acetate. Use of this agent increased between 2015 and 2018. However, levonorgestrel use by sales (range 118 897–129 478 units/yr) was substantially higher than use of ulipristal acetate (range 128–389 units/yr). In the 39 interviews we conducted, from the perspectives of 12 patients, 12 community pharmacists, and 15 prescribers, we identified the following themes and respective theoretical domains as barriers to access: low awareness of ulipristal acetate (knowledge), beliefs and experiences related to shame and stigma (beliefs about consequences), and multiple health system barriers (reinforcement).Interpretation:Use of ulipristal acetate in BC was low compared with use of levonorgestrel emergency contraception; lack of knowledge, beliefs about consequences and health system barriers may be important impediments to expanding use of ulipristal acetate. These findings illuminate potential factors to explain low use of this agent and point to the need for additional strategies to support implementation.

Couples talk about breastfeeding: Interviews with parents about decision-making, challenges, and the role of fathers and professional support.

Despite health benefits, sustained breastfeeding rates remain low in the United States, and the role of partners in breastfeeding is not well understood. Using a grounded theory approach, the current qualitative study explored how couples communicate regarding breastfeeding decisions and challenges. Mother-father dyads (n = 16) completed individual semi-structured interviews 1 year after the birth of their first child. Following iterative qualitative analysis, three phases of breastfeeding communication emerged: Should we try this? (Mother’s opinion counts) How do we make this work? (adjusting and problem-solving) and How do we settle into a routine? (gaining confidence, resolving issues) Findings underscore the complexity of defining the partner role in breastfeeding.