Longitudinal Interviews Research Articles

The evolution of academic advisor and resident dyadic coaching relationships: a two-year longitudinal qualitative study.

Implementing competency based medical education (CBME) has generated enormous amounts of assessment data. To help residents synthesize and use these data, some programs have appointed academic advisors (AA) to 'coach over time'. This study explored how resident and faculty AA dyads perceived their relationship developing and evolving, and the extent to which it aligned with 'coaching over time'. Over a two-year period at four separate time-points, we conducted longitudinal qualitative interviews with nine dyads of Internal Medicine residents (32 interviews) and their paired AA (27). We used constructivist grounded theory to develop a conceptual understanding of how AA-resident relationships evolved. Three major themes were identified. 'Building the Relationship' included elements perceived to facilitate or impede growth of the relationship. Most relationships flourished, facilitated by passage of time, 'fit' between the two, and often by working together clinically. Still, many residents perceived the need to 'save face' with their AAs. 'Enacting the AA Role' had features that appeared to align more with mentorship than coaching. 'Finding Meaning in the Relationship' underscored the perceived value fostered by the longitudinal pairing. The relationships often, but not always, achieved far-reaching benefits, though not necessarily limited to those intended by the program. Our study helps us understand what 'coaching over time' might look like for large residency programs wherein residents rotate through many sites and services. The dyads created an opportunity for a coaching relationship to form and develop in beneficial ways, though it was different to and went beyond the narrower focus on meeting CBME requirements.

“Employees Without Fixed Shifts”: Lessons Learned from Pandemic Experiences of Mothers Who Have Disabled Children

The aim of the research is to reveal the experiences and challenges experienced by mothers of disabled children during the Covid-19 Pandemic in the context of the ideology of motherhood and to ensure that lessons are drawn for possible crisis that may occur in the future. The research was carried out using a cross-sectional qualitative research design with descriptive phenomenological approach. Determined by maximum variation sampling, the participants of the research are women living in the same house with their disabled children. Semi-structured in-depth interviews were conducted with 17 women. The data were analyzed through inductive thematic analysis. The themes emerged from the study in line with their experiences of physical, psychological and survival, accessibility to education and regression, protection and safety, social assistance and social support challenges and the new roles they have assumed to cope with these challenges. Mothers with disabled children face coping difficulties and need empowerment, independence, and responsibility sharing. Support services and protective-preventive interventions are recommended. Further research should include longitudinal interviews with participants during and after crisis situations and fathers to understand the connection between gender roles and this issue.

Military Commitment and Identity as Implicit Religion: A Key to Understanding the Loss of Profundity in the Transition from Military to Civilian Life

This article is based on a rare longitudinal interview study on the transition from military to civilian life in which participants shared their experiences over the course of ten years. The challenges of transition included disconnection from a collective life that had previously offered service members identity, community, camaraderie and purpose – experiences that can be understood as the partial loss of something profound. An abductive analysis was conducted which centred on the integrating foci of commitment and the creation of a military identity derived from implicit religion. When viewed through this lens, the significance or strength of implicit religion and belief, in the context of military commitment, can be described as paramount and sacred – worthy of dying for. The findings offer a novel understanding of the profound experiences related to military communal life, purpose, and identity during active service (that is, the conceptualization as implicit religion) as well as the loss of these implicit religious elements during the transition out of military life, and how the participants have thought about and dealt with this loss in various ways.

Perceptions, experiences and concerns with sexually transmitted infections among current and former PrEP users: a longitudinal qualitative study of gay, bisexual and queer men in Canada.

Background Pre-exposure prophylaxis (PrEP) use has been attributed to heightened rates of sexually transmitted infections (STIs), ostensibly due to increased condomless anal sex (CAS) and greater frequency of STI testing. Few qualitative studies have assessed how gay, bisexual and queer men (GBQM) who use PrEP perceive STIs and how these attitudes have evolved post-PrEP uptake. We investigated the perspectives of current and former PrEP users on STIs. Methods Annual, in-depth longitudinal interviews were conducted with 38 current and former PrEP users in Ontario (n =18) and British Columbia (n =20), Canada, as part of a mixed-methods implementation science study (2020-2022). Over 3years, 109 interviews were conducted. Data analysis included reflexive thematic coding and longitudinal recurrent cross-sectional analysis using NVivo 12. Results Four STI-related themes emerged: (1) lack of STI-related concerns due to treatment and prevention optimism, (2) stigma-related concerns, (3) perceived risk among other PrEP users due to increased CAS, and (4) inconsistent testing concerns among non-PrEP users. Over time, some STI-related anxieties decreased with increased knowledge and reduced stigma. However, concerns persisted for other participants due to perceived risky sexual behaviours among other PrEP users and non-PrEP users. Both current and former PrEP users who expressed STI-related apprehensions consistently indicated adopting risk-reduction strategies, including condom use and having fewer sexual partners throughout the study. Conclusions Findings show how varied STI perceptions and experiences among current and former PrEP users shaped sexual decision-making over time. Providers, public health experts, and policymakers should develop a more comprehensive strategy to address STI concerns among GBQM.

Managing families, managing time. Parents’ work-family difficulties and work-family strategies over time

ABSTRACT This article contributes expanded knowledge about parents’ difficulties in reconciling work and family and their work-family strategies by studying how these difficulties and strategies change over time, e.g. from the early childhood years to the school-age/preteen years. Drawing on qualitative, longitudinal interviews with Swedish parents of school-age children who were interviewed when their first child was about 1.5 years of age, and then later when that child was 11 years of age, the article addresses the following research questions: What are the main difficulties in the parents’ reconciliation of paid work and caring responsibilities, and how have these difficulties changed over time? What are the parents’ most important work-family strategies for reconciling paid work and caring responsibilities and how have these strategies changed over time? The article draws on theories of work-family conflict, gender and time, and the results indicate change and continuity concerning the work-family difficulties and work-family strategies. Time famine appears to be a central difficulty that is consistent throughout the years. The findings also indicate gendered aspects of some of the strategies.

“I think they are actually a bit racist in not giving us everything that we need in terms of medication”: Racialised governance and asylum seeker access to healthcare in England

This paper critically examines the lived experiences of asylum seekers accessing primary and secondary healthcare in England. We employ a framework of racialised governance to assess how historical and political processes of racialisation can manifest in healthcare. It draws upon longitudinal interviews with asylum seekers currently living in the North and South of England. Our findings evidence the multiple barriers to healthcare for asylum seekers in England, including the complexity and opacity of the English healthcare system; significant difficulties accessing face-to-face appointments; denial of access to interpreters; and being dismissed and disbelieved by administrators and clinicians. We demonstrate how these barriers to healthcare can be racialised, marking asylum seekers as a racialised ‘Other’ and contributing to inadequate care. We do also, however, find positive experiences of healthcare and document cases in which poor access to healthcare among asylum seekers aligns with wider institutional resource constraints within the NHS. Nevertheless, we argue that the racialisation of healthcare is fuelled by a politically racist policy agenda, accompanied by complex and often opaque healthcare entitlements for asylum seekers, which together legitimate misinformed and, at times, prejudicial attitudes within the NHS, leading to inconsistent care for asylum seekers across NHS Trusts. We argue it is essential to listen carefully to the healthcare experiences of asylum seekers to understand how equitable and accessible services can – and should – be provided.

Disparities in Receipt of Early Intervention Services by Toddlers with Autism Diagnoses: an Intersectional Latent Class Analysis of Demographic Factors.

We examined receipt of general early intervention services and autism-specific specialized services across demographic groups among toddlers with autism diagnoses who were receiving Part C Early Intervention (EI). Latent class analysis (n = 508) identified five demographically distinct subgroups associated with intersecting marginalization and privilege. Analyses of longitudinal parent interviews (n = 225) revealed service receipt disparities across these demographically distinct latent classes; children from White, U.S. born, English-proficient parents with incomes above poverty level received more EI services (M = 12.0h/week) than other subgroups, with children from Latiné immigrant families receiving the fewest hours (M = 6.9h/week). Across all groups, average intervention hours were 8.8h/week. Despite early identification, racial, ethnic, and other sociodemographic disparities were evident in receipt of Part C Early Intervention services, indicating the need to address barriers to equitable care.

A Seat at the Table: Family Conferences for Infants with Neurological Conditions.

Objective: We aimed to characterize parents' perspectives on the value of and opportunities to improve conferences between parents of critically ill infants and the health care team. Background: The parent perspective on the value of family conferences in the intensive care unit is not well characterized. Methods: In this descriptive qualitative study, parents of infants with neurological conditions in the intensive care unit at a U.S. academic medical center completed longitudinal semi-structured interviews about their experiences making decisions and communicating with clinicians. Parents were included if they had an upcoming family conference to discuss goals of care or neurological prognosis. This secondary data analysis targets interview content about family conferences. Parent responses were characterized using a conventional content analysis approach. Results: Fifty-two parents of 37 infants completed 123 interviews. Parents described valuing when clinicians (1) provided space to process emotions, (2) prioritized "big picture" discussions about serious decisions, (3) dedicated time to parent questions, and (4) responded to parent concerns and made an effort to foster consensus. Parent-identified opportunities for improvement included: (1) having the team assume responsibility for calling regular meetings, (2) prioritizing attendance of consistent and supportive team members, and (3) summarizing meeting content for parents and documenting discussions for clinicians. Conclusions: These findings demonstrate that parents of infants with neurological conditions value family conferences as an important venue for communicating with the health care team. Future studies should explore the feasibility and impact of regularly scheduled family conferences, attendees dedicated to parent support, and accessible meeting summaries on therapeutic alliance, parent well-being, and communication quality.

Introduction to special issue: youth, rural places and marginalisation

ABSTRACT This Special Issue on Youth, Rural Places and Marginalisation, brings together nine papers from six countries – Australia, England, Denmark, Finland, Norway and Sweden – to explore young people's experiences of living in rural locations. We focused on rural youth for two main reasons: firstly, there are relatively few sociological studies of young people's experience of rural life and, secondly, academics and policymakers have tended to frame discussions about young people and rural places in negative terms. Together the papers here use a wide range of methods – quantitative and qualitative longitudinal approaches, questionnaire surveying, face-to-face and online qualitative interviews, ethnography, visual methods, ‘mobile probes', ‘walk-along' and ‘drive-along' interviews – in order to understand young people's everyday life. We were particularly interested in the stories of young people who appeared to resist ‘the mobility imperative' and chose to stay rather than leave their rural homes. Our introduction focuses on ‘rethinking concepts of staying'; ‘gender and the risks of staying' and ‘geographies of rural opportunities'. We conclude with a call for a sociological imagination of rural youth that avoids romanticizing narratives of ‘the rural idyll’ or which paints rural places and populations as backward or lacking.

A complex ePrescribing antimicrobial stewardship-based (ePAMS+) intervention for hospitals: mixed-methods feasibility trial results

BackgroundAntibiotic resistant infections cause over 700,000 deaths worldwide annually. As antimicrobial stewardship (AMS) helps minimise the emergence of antibiotic resistance resulting from inappropriate use of antibiotics in healthcare, we developed ePAMS+ (ePrescribing-based Anti-Microbial Stewardship), an ePrescribing and Medicines Administration (EPMA) system decision-support tool complemented by educational, behavioural and organisational elements.MethodsWe conducted a non-randomised before-and-after feasibility trial, implementing ePAMS+ in two English hospitals using the Cerner Millennium EPMA system. Wards of several specialties were included. Patient participants were blinded to whether ePAMS+ was in use; prescribers were not. A mixed-methods evaluation aimed to establish: acceptability and usability of ePAMS+ and trial processes; feasibility of ePAMS+ implementation and quantitative outcome recording; and a Fidelity Index measuring the extent to which ePAMS+ was delivered as intended. Longitudinal semi-structured interviews of doctors, nurses and pharmacists, alongside non-participant observations, gathered qualitative data; we extracted quantitative prescribing data from the EPMA system. Normal linear modelling of the defined daily dose (DDD) of antibiotic per admission quantified its variability, to inform sample size calculations for a future trial of ePAMS+ effectiveness.ResultsThe research took place during the SARS-CoV-2 pandemic, from April 2021 to November 2022. 60 qualitative interviews were conducted (33 before ePAMS+ implementation, 27 after). 1,958 admissions (1,358 before ePAMS+ implementation; 600 after) included 24,884 antibiotic orders.Qualitative interviews confirmed that some aspects of ePAMS+ , its implementation and training were acceptable, while other features (e.g. enabling combinations of antibiotics to be prescribed) required further development. ePAMS+ uptake was low (28 antibiotic review records from 600 admissions; 0.047 records per admission), preventing full development of a Fidelity Index. Normal linear modelling of antibiotic DDD per admission showed a residual variance of 1.086 (log-transformed scale). Unavailability of indication data prevented measurement of some outcomes (e.g. number of antibiotic courses per indication).ConclusionsThis feasibility trial encountered unforeseen circumstances due to contextual factors and a global pandemic, highlighting the need for careful adaptation of complex intervention implementations to the local setting. We identified key refinements to ePAMS+ to support its wider adoption in clinical practice, requiring further piloting before a confirmatory effectiveness trial.Trial registrationISRCTN Registry ISRCTN13429325, 24 March 2022.

What can the taxonomy of predicative possession in Malwai Punjabi tell us?

Abstract The study aims to examine the syntactic and semantic behaviors of predicative possession (i.e., have-possessive constructions) in Malwai Punjabi, an underdocumented dialect within the Indo-Aryan language family. Data were collected from longitudinal online interviews with native speakers as consultants, with audio recordings for transcribed target sentences. The results revealed that all the alienable possession, either permanent/temporary or abstract/concrete, could be marked by the postposition koḷ ‘near/with’, whereas inalienable possession, such as whole-part relation and kinship, could not be encoded using koḷ. The prototypicality model and schema-based metaphors explained why koḷ was widely used to express alienable possession in Malwai Punjabi. The analysis of companion and proximity schemata also justified the extended semantics of predicative possession, suggesting a metaphorical mapping of accompaniment and location onto possession. From a typological angle, the case study can not only provide further evidence for the existence of split possession but also contribute to a cognitive understanding of predicative possession in relation to other languages.

Civic reasoning depends on transcendent thinking: Implications of adolescent brain development for SEL

Accumulating evidence from developmental social-affective neuroscience and educational research reveals striking affordances for adolescents’ academic, psychosocial and neural development of transcendent thinking—the disposition to integrate concrete, context-specific thinking and emotions into deliberations on the abstract, systems-level, ethical and personal implications of information, ideas, and skills. Here, we highlight the coordinated psychological and neural processes by which adolescents leverage transcendent thinking for civic reasoning. From qualitative field data, we argue that civic reasoning in the context of academic learning supports the coordination of conceptual understanding with intellectual agency, identity and communal orientation, leading youth toward process-oriented, rather than outcome-oriented, approaches to learning. From longitudinal interview and neuroimaging data, we argue that civic reasoning drives developmental coordination among brain networks involved in agency, self-awareness, and consciousness; internal reflection, abstraction and narrative; emotional feelings; memory; executive functioning and attention. These brain changes longitudinally predict resilience, identity development, and wellbeing (Gotlieb et al., 2024b). This transdisciplinary research underscores the power of civic reasoning for adolescents’ healthy development into young adulthood, and the benefits of schooling designed to center civic reasoning and personal reflection. In today’s globalized society, civic reasoning may be among the most important core social-emotional dispositions for youth and community thriving. Impact statementCivic reasoning is among the most important capacities youth must develop to sustain a functioning and equitable democratic society, and hence should be among the central aims of education. New research is demonstrating that adolescents’ dispositions toward civic reasoning, and the emotionally motivated transcendent thinking that undergirds it, are associated with a cascade of beneficial brain and psychosocial developmental effects that extend into young adulthood. Organizing adolescent education around civic reasoning and reflection could provide a powerful opportunity to support youths’ deep scholarly learning and psychosocial development in a coordinated way.

Prospectively investigating the impact of AI on shared decision-making in post kidney transplant care (PRIMA-AI): protocol for a longitudinal qualitative study among patients, their support persons and treating physicians at a tertiary care centre

IntroductionAs healthcare is shifting from a paternalistic to a patient-centred approach, medical decision making becomes more collaborative involving patients, their support persons (SPs) and physicians. Implementing shared decision-making (SDM) into...

Rising to the challenge: The motivation to champion routine intimate partner violence screening in rural emergency departments.

To understand the motivations of champions who worked to bring about system and practice change that supported routine screening for intimate partner violence (IPV) in two rural emergency departments (EDs). Practice changes are required to achieve routine and effective identification and response to IPV. Nurses play a significant role in affecting such practice change. This paper identifies the motivations of champions in the ED setting who successfully brought about such change. The EDs of two Level 5 tertiary hospitals within a rural Local Health District (LHD) of New South Wales, Australia. Twenty-three individuals who identified as champions and worked to introduce routine IPV screening in two rural hospital EDs. Qualitative longitudinal semi-structured interviews employing a process of constant comparison and an interpretive framework to analyse data thematically. Interviews were carried out between June and August 2017 and again between July and August 2019. Over the period of the study, routine screening was established, and screening rates steadily increased from a low baseline to a significantly higher rate. Three aspects of champion motivation emerged from the analysis: formation of an identity as a champion, making a difference to a significant social justice issue and providing quality and community-relevant care. This study is the first study to report on champions and their motivation as they supported IPV practice change in the ED. The findings highlight the capacity for innovation in rural health services, with important implications for other settings looking to translate similar programs. Understanding motivating factors may assist in improved utilisation and support for champions. This is vital if champions are to bring about required practice change within their service and ensure the needs of individuals experiencing IPV are effectively met.

Regional divergence in France and international integration: Is foreign direct investment attraction policy part of the problem?

What if certain policy actions that a country takes to promote international integration also promote regional divergence at home? Different policy options available to regions and countries for promoting inward foreign direct investment are considered in a global production networks framework. Theory and evidence suggest that certain pro-integration policies can be divergence-promoting. Mixed evidence for France for the period 1990–2019, including longitudinal statistics and interviews with managers at regional investment promotion agencies, supports this conclusion. If policy itself is encouraging regional divergence, this would help explain the origins of, and also potentially remedies to, the ‘discontent’ in Europe’s peripheral regions. It would also raise questions about the political and social consequences of pro-integration policy prescriptions that flow from the New Economic Geography.

Active support as good support in group homes? A longitudinal interview study with service users

ABSTRACT Background: Support from staff plays an important role in quality of life for people with intellectual disability. This study focuses on service users' views of Active Support as good support and whether Active Support increases the quality of everyday support in group homes. Method: Nine service users were interviewed at baseline and at follow-up one year after staff received Active Support training. Thematic analyses were used to develop themes. Results: Three main themes were created: (1) Home is more than just a place, it is a feeling; (2) Good care is caring with accessible communication; and (3) Time is precious. Participants were more satisfied with most of the support at follow-up, particularly choice-making, control in everyday life, relationships, and emotional support. Conclusions: Active Support corresponds well with service users’ perceptions of good support. In future studies of Active Support service users' voices should be a part of the follow-up.

You can take a person out of the military, but you can't take the military out of the person: findings from a ten-year identity study on transition from military to civilian life.

This article takes its starting point in a longitudinal interview study that began in 2013 with the aim of investigating identity reconstruction during the transition from military to civilian life. Annual follow-up interviews were conducted for 3 years, after which there was a break for 7 years until 2023 when a new interview cycle was conducted. The article presents the findings from this interview round. The purpose of the study was to describe the ways in which military identity had impacted the selves and lives of the participants. An inductive approach was employed in the analysis and an abductive approach used in the interpretative phase. The results showed, among other things, that a military identity, containing a particularly strong work ethic, had grown salient over the years. This military identity salience amplified the perception of a contrasting civilian work ethic, which generated moral frustration and even conflict. It was seen as imperative to maintain consistency between a military work ethic and the identity standard as a civilian employee rather than to modify the behavior to another standard, i.e., a civilian standard. These results were counterintuitive given the earlier interview cycles. A military work ethic was generally a powerful asset but could have negative health outcomes, manifesting as burnout. The results reflect the challenges in operating multiple identities tailored to contrasting moral regimes. Future longitudinal qualitative and quantitative research approaches to self-identity work among former service members are warranted.

Lived experiences of food insecurity and food charity among asylum seekers in England: racialized governance and a “culture of suspicion”

ABSTRACT We critically examine the lived experience of food insecurity among asylum seekers in England, adopting a framework of racialized governance to consider how experiences are situated within historical and political processes. We draw upon longitudinal interviews from January 2023-February 2024 with people, including asylum seekers, living on a low-income in the North and South of England. Food insecurity was unavoidable for asylum seekers subject to No Recourse to Public Funds; food charities did little to mitigate food insecurity and could be sites of racialized stigma. The racialization of food insecurity among asylum seekers was fuelled by a politics of “racialized governance” which gained cultural traction through media narratives and manifested in everyday interactions around food. Developing literature on food insecurity among asylum seekers through new empirical and theoretical insights, we show how food charities can be racialized spaces where “non-white” asylum seekers are responded to according to a differential humanity.

Understanding how and why travel mode changes: analysis of longitudinal qualitative interviews

BackgroundEncouraging alternatives to the car such as walking, cycling or public transport is a key cross-sector policy priority to promote population and planetary health. Individual travel choices are shaped by individual and environmental contexts, and changes in these contexts – triggered by key events – can translate to changes in travel mode. Understanding how and why these changes happen can help uncover more generalisable findings to inform future intervention research. This study aimed to identify the mechanisms and contexts facilitating changes in travel mode.MethodsProspective longitudinal qualitative cohort study utilising semi-structured interviews at baseline (in 2021), three- and six-month follow up. Participants were residents in a new town in Cambridgeshire, UK, where design principles to promote walking, cycling and public transport were used at the planning stage. At each interview, we followed a topic guide asking participants about previous and current travel patterns and future intentions. All interviews were audio recorded and transcribed. Data analysis used the framework approach based on realist evaluation principles identifying the context and mechanisms described by participants as leading to travel behaviour change.ResultsWe conducted 42 interviews with 16 participants and identified six mechanisms for changes in travel mode. These entailed increasing or reducing access, reliability and financial cost, improving convenience, increasing confidence and raising awareness. Participants described that these led to changes in travel mode in contexts where their existing travel mode had been disrupted, particularly in terms of reducing access or reliability or increasing cost, and where there were suitable alternative travel modes for their journey. Experiences of the new travel mode played a role in future travel intentions.ImplicationsApplying realist evaluation principles to identify common mechanisms for changes in travel mode has the potential to inform future intervention strategies. Future interventions using mechanisms that reduce access to, reduce reliability of, or increase the financial cost of car use may facilitate modal shift to walking, cycling and public transport when implemented in contexts where alternative travel modes are available and acceptable.

The experiences of patients with oesophageal cancer receiving chemoradiotherapy treatment: a qualitative study embedded in the SCOPE2 trial

ObjectivesThis qualitative study explored patients’ experiences and perceptions of the SCOPE2 trial. SCOPE2 examined radiotherapy dose escalation in patients with inoperable oesophageal cancer treated with definitive chemoradiotherapy (dCRT).SettingRecruitment at five...