Longitudinal Interviews Research Articles

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...

Residential Instability and Children’s Mental Health: Emotional and Behavioral Consequences of Frequent Relocation

Residential instability, characterized by frequent relocations, poses significant risks to children’s mental health, impacting their emotional and behavioral development. This study explores the emotional and behavioral consequences of frequent relocations on children aged 5 to 15, using a mixed-methods approach that combines longitudinal quantitative data and qualitative interviews. The findings reveal that children who experience three or more relocations within five years exhibit significantly higher levels of anxiety, depression, and attachment issues, alongside increased externalizing behaviors such as aggression and defiance and internalizing behaviors such as social withdrawal and anxiety. Academic performance also suffers, with lower average scores in core subjects like mathematics and reading observed among frequently relocated children. These outcomes are moderated by factors such as parental support, community integration, and economic stability, highlighting the complex interplay between individual, familial, and contextual variables. The study underscores the need for targeted interventions and supportive policies to mitigate the negative impacts of residential instability and promote children’s mental health and well-being. Future research should focus on the long-term effects, specific vulnerable populations, and protective factors to better understand and address the challenges faced by children in unstable housing situations.

A Microfinance Intervention With or Without Peer Support to Improve Mental Health Among Transgender and Nonbinary Adults (the Creating Access to Resources and Economic Support Study): Protocol for a Randomized Controlled Trial.

Transgender and nonbinary (TNB) people experience economic and psychosocial inequities that make them more likely to be subject to financial and mental health harms exacerbated by the COVID-19 pandemic. Sustainable, multilevel interventions are needed to address these harms. The onset of the COVID-19 pandemic galvanized many TNB-led organizations to provide emergency financial and peer support for TNB people negatively impacted by the pandemic. However, the efficacy of these interventions has not been evaluated. The Creating Access to Resources and Economic Support (CARES) study seeks to assess the efficacy of feasible, acceptable, and community-derived interventions to reduce economic and psychological harms experienced by transgender people in the wake of the COVID-19 pandemic. The study aims to (1) compare the efficacy of microgrants with peer mentoring with that of microgrants without peer mentoring in reducing psychological distress, (2) examine mechanisms by which microgrants with or without peer mentoring may impact psychological distress, and (3) explore participants' intervention experiences and perceived efficacy. We will enroll 360 TNB adults into an embedded, mixed methods, 3-arm, and 12-month randomized controlled trial. Participants will be randomized 1:1:1 to arm A (enhanced usual care), which will receive a single microgrant plus monthly financial literacy education, arm B (extended microgrants), which will receive enhanced usual care plus monthly microgrants, or arm C (peer mentoring), which will receive extended microgrants combined with peer mentoring. All intervention arms last for 6 months, and participants complete semiannual, web-based surveys at 0, 6, and 12 months as well as brief process measures at 3 and 6 months. A subset of 36 participants, 12 (33%) per arm, will complete longitudinal in-depth interviews at 3 and 9 months. Full recruitment began on January 8, 2024, and, as of July 26, 2024, a total of 138 participants have enrolled. Recruitment is expected to be completed no later than March 31, 2025, and the final study visit will take place in March 2026. This national, web-based study will demonstrate whether an intervention tailored to reduce material hardship and improve peer support among TNB adults will reduce psychological distress. Its equitable, community-academic partnership will ensure the rapid dissemination of study findings. ClinicalTrials.gov NCT05971160; https://clinicaltrials.gov/study/NCT05971160. DERR1-10.2196/63656.

Embracing Global and Local

The paper explores cases of immigrant/expatriate game developers (“game expats”) in Finland, focusing on the influence of global platforms and local game development practices. Results from qualitatively analyzing longitudinal interview transcripts (n=64) collected from 2020 to 2023 indicate that the migration of game expats is inherently bound to globally shared and fast-changing game development tools and platforms (e.g., shared game engines, publishing channels). Thus, an individual’s digital compatibility with global technical practices positively affects the motivation to migrate. Meanwhile, countries and companies each have different ways of implementing game development practices into work (e.g., different terminology, prioritization). The individuals’ ability to adapt to such local interpretations of practices positively affects settlement and motivation to stay. However, despite the pluralistic nature of game development — of both global and local factor’s influence — the incidents of cultural encounters and tryouts were often perceived as a risk amongst game developers. This negative perception leads to game expats’ assimilation and self-exploitative work attitudes. Therefore, the paper calls for a joint effort of industrial and societal game ecosystem stakeholders to encourage cultural competence and tolerance in the ecosystem to nurture sustainable talent pools and inclusive game work environments.

Opportunities and limits: exploring young people’s views of staff care in residential alcohol and other drug services

ABSTRACT Young people in residential alcohol and other drug (AOD) services build meaningful relationships with workers during their stays. In this paper we use an ethics of care framework to explore what young people said about care, how it was delivered and what they valued about it. Drawing on three waves of longitudinal interviews conducted with 38 young people over 12 months, we discuss our findings according to two overarching themes – opportunities enabled by care and limits to care. Young people’s descriptions highlight the potential for care to challenge stigma, enhance self-worth and wellbeing, enable respectful staff-client relationships, and foster positive relationships crucial for maintaining engagement. At the same time, young people described challenges around providing both individual and collective care, coproducing care in structured environments, and facilitating care as young people transition out of residential services. These findings shed light on the delicate balance between care provision and contextual constraints within AOD settings. This emphasises the need for ethical relationships built on clear communication, mutual respect, and ongoing forms of care. Recognising the value of care work, especially in transitions out of acute treatment services, is essential for reshaping funding approaches to prioritise meaningful and continuing care.

A Brief Alcohol Intervention (BAI) to reduce alcohol use and improve PrEP outcomes among men who have sex with men in Vietnam: study protocol for a randomized controlled trial

BackgroundIn Vietnam and other global settings, men who have sex with men (MSM) have become the population at greatest risk of HIV infection. Although HIV pre-exposure prophylaxis (PrEP) has been implemented as a prevention strategy, PrEP outcomes may be affected by low persistence and adherence among MSM with unhealthy alcohol use. MSM have a high prevalence of unhealthy alcohol use in Vietnam, which may affect PrEP outcomes.MethodsDesign: We will conduct a two-arm hybrid type 1 effectiveness-implementation randomized controlled trial of a brief alcohol intervention (BAI) compared to the standard of care (SOC) at the Sexual Health Promotion (SHP) clinic Hanoi, Vietnam.Participants: Sexually active MSM (n=564) who are newly initiating PrEP or re-initiating PrEP and have unhealthy alcohol use will be recruited and randomized 1:1 to the SOC or BAI arm. A subgroup of participants (n=20) in each arm will be selected for longitudinal qualitative interviews; an additional subset (n=48) in the BAI arm will complete brief quantitative and qualitative interviews after completion of the BAI to assess the acceptability of the intervention. Additional implementation outcomes will be assessed through interviews with clinic staff and stakeholders (n=35).Intervention: Study participants in both arms will receive standard care for PrEP clients. In the BAI arm, each participant will receive two face-to-face intervention sessions and two brief booster phone sessions, based on cognitive behavioral therapy and delivered in motivational interviewing informed style, to address their unhealthy alcohol use.Outcomes: Effectiveness (PrEP and alcohol use) and cost-effectiveness outcomes will be compared between the two arms. Intervention implementation outcomes (acceptability, feasibility, adoption) will be assessed among MSM participants, clinic staff, and stakeholders.DiscussionThis proposed trial will assess an alcohol intervention for MSM with unhealthy alcohol use who initiate or re-initiate PrEP, while simultaneously preparing for subsequent implementation. The study will measure the effectiveness of the BAI for increasing PrEP persistence through reducing unhealthy alcohol use in a setting where excessive alcohol consumption is a normative behavior. If effective, implementation-focused results will inform future scale-up of the BAI in similar settings.Trial registrationNCT06094634 on clinicaltrials.gov. Registered 16 October 2023.

Race, ethnicity, and stratification within the first-generation student experience

ABSTRACT Students are embedded in intersecting structural and cultural contexts that differentially constrain and enable their opportunities and aspirations. The educational experiences of first-generation students differ from the traditional narrative of continuing-generation students. Yet, few scholars have been able to capture potentially distinct educational experiences by the race or ethnicity of first-generation students. Using longitudinal qualitative interview data from 75 first-generation and continuing-generation students, this paper explores whether first-generation students’ varying identities and backgrounds influence their educational experiences. My findings suggest that not only are there differences in how first-generation students of color experience and manage racial discrimination compared to White first-generation students, but there are also differences in how first-generation students of color benefit from engagement with certain race-specific student organizations. Additional insights into variation within first-generation student experiences can shine a light on the unique supportive mechanisms and challenges first-generation students of color experience while pursuing their higher educational goals.