Mixed Methods Research Articles

Therapists’ self-efficacy and experiences managing clinical risk in teletherapy: a mixed methods exploration

ABSTRACT Before teletherapy usage grew dramatically during COVID-19, clinicians considered it less suitable for patients experiencing high-risk behaviours and related psychopathology (e.g., self-injurious thoughts and behaviours). This mixed methods study assesses clinicians’ concerns by quantitatively and qualitatively exploring their experiences, satisfaction, and self-efficacy using teletherapy for high-risk patients. Mental healthcare providers (N = 75) completed a survey assessing teletherapy usage, attitudes, and risk assessment/management self-efficacy. Nine providers then completed semi-structured interviews on these topics. Clinicians reported more confidence assessing and managing risk in-person as compared to teletherapy, and they reported being more likely to treat high-risk patients face-to-face than virtually. Still, attitudes toward teletherapy were generally positive, and clinicians who confidently managed risk in-person also tended to be confident virtually, often reporting that they could administer evidence-based therapeutic interventions regardless of therapy modality. Qualitative analyses revealed both general and person-specific factors that conferred increased or diminished confidence when managing risk.

An Investigation of the Effectiveness of Augmented Reality Technology Supported English Language Learning Activities on Preschool Children

Early learners experience various difficulties when learning foreign languages. Augmented reality technology can support learning environments and foreign language vocabulary teaching by attracting the attention of early learners. The purpose of this study is to compare the effects of Augmented Reality (AR) technology supported English language learning activities on preschool children with the effects of traditional activities (presentation, lecture, question-answer). In this study, embedded mixed method was used. The sample of the study consisted of 44 five-year-old preschool children (19 boys, 25 girls). Color knowledge test, mood scale, observation, and interview forms were used as data collection tools. As a result of the study, it was concluded that AR-supported English learning activities were more effective than traditional activities on students’ English color vocabulary levels. The children were very happy and they had fun during the experimental process. According to the results of classroom observations, children made weekly progress in cognitive, affective and social/language categories. Implications are discussed in terms of pedagogical insights, practices for AR supported English language learning in preschool, and further research directions.

Time to normalise protected characteristics in written assessments: A mixed methods study

Background Despite increasing endeavours to incorporate teaching material on healthcare for minority groups into medical school curricula, including cultural competency, there is a lack of research exploring medical students' comprehension of this. With age and gender as the only demographic information routinely provided in undergraduate single best answer (SBA) questions, the diversity of patients encountered by doctors in clinical practice is not fairly represented in assessments. This study examined the impact of not declaring gender or explicitly indicating LGBT+ identities and ethnicity, on how medical students evaluate clinical scenarios through SBA questions. Methods 200 medical students across clinical years completed 15 SBA questions in an online simulated exam. Participants were randomised to control and test groups testing different types of patient demographic information in question stems. Results Linear regression modelling demonstrated overall statistically nonsignificant differences between groups. The largest effect size was seen in the LGBT+ question intervention group, which had the fewest white and postgraduate participants. Older and more senior medical students performed better generally. White participants overall significantly outperformed non-white participants; this difference was eliminated when answering a mix of question styles. Using a mix of question styles produced statistically significant differences, with participants scoring worse on LGBT+ and ethnicity style questions. Conclusion Increased depth and breadth of clinical experience enables medical students to approach clinical scenarios with more flexibility. Unfamiliarity with minority patient groups may have impacted their performance in this study. For medical education to remain contemporary in preparing future clinicians to interact with diverse patient groups, assessments need to normalise the presence of these patients.

Bridging the cyber protection gap: An investigation into the efficacy of the German cyber insurance market

AbstractCybersecurity requires an effective risk transfer regime and a well‐functioning insurance market to improve stakeholder resilience. However, rapid cyber threat adaptation, limited data availability, and inadequate risk understanding pose significant challenges for the insurance industry and its customers. This research uses a mixed methods approach to analyze the inclusions, exclusions, and suitability of current cyber policies in the German cyber insurance market. The study analyzes 41 cyber insurance policies, representing about 80% of the German cyber insurance market. This examination is supported by semistructured interviews with 23 cyber insurance experts. The authors find that there are no standardized cyber policy wordings, and insurers use different terms and definitions in their insurance policies. Specifically, the results show a significant lack of clarity around coverages and exclusions. This research contributes to the cybersecurity risk management community and will enable businesses, insurance companies, and policymakers to better understand, measure, and manage cyber risk.

The Roles of Trust in Government and Sense of Community in the COVID-19 Contact Tracing Privacy Calculus: Mixed Method Study Using a 2-Wave Survey and In-Depth Interviews.

Contact tracing technology has been adopted in many countries to aid in identifying, evaluating, and handling individuals who have had contact with those infected with COVID-19. Singapore was among the countries that actively implemented the government-led contact tracing program known as TraceTogether. Despite the benefits the contact tracing program could provide to individuals and the community, privacy issues were a significant barrier to individuals' acceptance of the program. Building on the privacy calculus model, this study investigates how the perceptions of the 2 key groups (ie, government and community members) involved in the digital contact tracing factor into individuals' privacy calculus of digital contact tracing. Using a mixed method approach, we conducted (1) a 2-wave survey (n=674) and (2) in-depth interviews (n=12) with TraceTogether users in Singapore. Using structural equation modeling, this study investigated how trust in the government and the sense of community exhibited by individuals during the early stage of implementation (time 1) predicted privacy concerns, perceived benefits, and future use intentions, measured after the program was fully implemented (time 2). Expanding on the survey results, this study conducted one-on-one interviews to gain in-depth insights into the privacy considerations involved in digital contact tracing. The results from the survey showed that trust in the government increased perceived benefits while decreasing privacy concerns regarding the use of TraceTogether. Furthermore, individuals who felt a connection to community members by participating in the program (ie, the sense of community) were more inclined to believe in its benefits. The sense of community also played a moderating role in the influence of government trust on perceived benefits. Follow-up in-depth interviews highlighted that having a sense of control over information and transparency in the government's data management were crucial factors in privacy considerations. The interviews also highlighted surveillance as the most prevalent aspect of privacy concerns regarding TraceTogether use. In addition, our findings revealed that trust in the government, particularly the perceived transparency of government actions, was most strongly associated with concerns regarding the secondary use of data. Using a mixed method approach involving a 2-wave survey and in-depth interview data, we expanded our understanding of privacy decisions and the privacy calculus in the context of digital contact tracing. The opposite influences of privacy concerns and perceived benefit on use intention suggest that the privacy calculus in TraceTogether might be viewed as a rational process of weighing between privacy risks and use benefits to make an uptake decision. However, our study demonstrated that existing perceptions toward the provider and the government in the contact tracing context, as well as the perception of the community triggered by TraceTogether use, may bias user appraisals of privacy risks and the benefits of contact tracing.

CHAMPP4KIDS: Mixed methods study protocol to evaluate acceptability and feasibility of Parenting for Lifelong Health materials in a Canadian context.

Parents and caregivers play a key role in children's healthy development and well-being. Traditional parenting interventions promote positive parenting practices and are key to preventing child maltreatment. However, numerous barriers can limit access to programs, barriers which were further exacerbated by the COVID-19 pandemic. The Parenting for Lifelong Health group developed mass media and public health communication materials to promote positive caregiving behaviours on a population level. The Champions of Positive Parenting 4 Kids (CHAMPP4KIDS) study will examine the acceptability and feasibility of these materials for service providers and caregivers of children aged 2-6 years in Ontario, Canada. This study will use a convergent mixed-methods design. Consenting service providers (n = 200) and caregivers (n = 100) will complete a quantitative survey to rate, rank and give feedback on Parenting for Lifelong Health tip sheets and social media ads. Caregivers will also complete self-report scales measuring depression and anxiety. We will hold focus group discussions with a sub-sample of surveyed providers (n = 40) and caregivers (n = 25). An adapted Trials of Improved Practices methodology will explore caregiver perspectives after implementing the tip sheets. Primary quantitative outcomes will be descriptive statistics of rankings, Likert Scale scores and descriptive analysis of caregiver depression and anxiety. Qualitative data will be analyzed using Rapid Qualitative Inquiry and triangulated through a convergent coding matrix. The Parenting for Lifelong Health COVID-19 parenting materials offer succinct, engaging parenting information in a mass media format that addresses some challenges associated with accessing in-person programming. The CHAMPP4KIDS study will provide mixed methods insights on the materials' acceptability and feasibility from different groups in a Canadian context, with a focus on marginalized families. The use of Trials of Improved Practices methodology could prove a useful tool for participant-led adaptation of existing parenting, early childhood development and other health intervention materials.

Environmental awareness as a transfiguring factor of the sustainable behavior of the visitor to the Lachay National Reserve

The objective of the research was to understand and explain the relationship between environmental awareness as a factor in transforming the sustainable behavior of visitors to the Lachay National Reserve. The research type is applied, with a mixed research approach and descriptive research method, using a sequential explanatory mixed method and a non-experimental and cross-sectional research design, with a correlational and explanatory scope. The population consisted of 19,326 visitors, with a quantitative method sample of 377 visitors and a qualitative method reaching saturation level in 15 interviews. The applied techniques included observation, document analysis, structured interviews, and surveys. The research resulted in the rejection of the null hypothesis in the quantitative analysis, confirming that environmental awareness is linked to the transformation of sustainable behavior among visitors to the Lachay National Reserve, with a Spearman's Rho correlation coefficient of 0.584, which is statistically significant and moderately positive, with a p-value of 0.000. In the qualitative analysis, environmental awareness transforms sustainable behavior through psychological factors such as environmental-cognitive knowledge, allowing the identification of environmental concerns, and landscape-affective factors. The interaction of cognitive and affective factors enables the generation of pro-environmental behaviors and attitudes

Abstract Creature Animation Video Design for Concentration Therapy of Children With Special Needs

The design of the animated video “Abstract Creature” aims to help concentration therapy for children with special needs in learning to read. This animated learning video is designed with the concept of an abstract creature that moves dynamically and is combined with bright colors that attract children’s attention. Abstract Creature forms the syllables to be read, shows the meaning of the words formed by the syllables, and demonstrates how to read them. This animated video is divided into several chapters of BA-BI-BU-BE-BO syllables that are short in duration and filled with flowing movements. Children will be invited to focus on the movements of abstract creatures that are constantly changing with varying tempos. Mixed-method research was carried out in pre-production data collection, exploration of animation-making techniques at the production stage, and returned with mixed methods at the post-production stage. Through the interactive experience provided by the Abstract Creature animated video, this research can help increase the concentration and endurance of concentration in children with special needs for reading. With this video, it is hoped that children can develop their cognitive and motor skills and can assist in the learning process.
 Keywords: Abstract Creature, children with special needs, learning media, reading, video animation

SAR-CDSS: A Semi-Supervised Cross-Domain Object Detection from Optical to SAR Domain

The unique imaging modality of synthetic aperture radar (SAR) has posed significant challenges for object detection, making it more complex to acquire and interpret than optical images. Recently, numerous studies have proposed cross-domain adaptive methods based on convolutional neural networks (CNNs) to promote SAR object detection using optical data. However, existing cross-domain methods focus on image features, lack improvement on input data, and ignore the valuable supervision provided by few labeled SAR images. Therefore, we propose a semi-supervised cross-domain object detection framework that uses optical data and few SAR data to achieve knowledge transfer for SAR object detection. Our method focuses on the data processing aspects to gradually reduce the domain shift at the image, instance, and feature levels. First, we propose a data augmentation method of image mixing and instance swapping to generate a mixed domain that is more similar to the SAR domain. This method fully utilizes few SAR annotation information to reduce domain shift at image and instance levels. Second, at the feature level, we propose an adaptive optimization strategy to filter out mixed domain samples that significantly deviate from the SAR feature distribution to train feature extractor. In addition, we employ Vision Transformer (ViT) as feature extractor to handle the global feature extraction of mixed images. We propose a detection head based on normalized Wasserstein distance (NWD) to enhance objects with smaller effective regions in SAR images. The effectiveness of our proposed method is evaluated on public SAR ship and oil tank datasets.

Factors Associated With Self-Reported Overdose Reversals Using Naloxone in Little Rock, Arkansas: Implications for Harm Reduction Service Delivery in the US South

Background. The Central Arkansas Harm Reduction Project (CAHR) is located in Little Rock, Arkansas, and is the only harm reduction service provider in the city. This quality improvement study was conducted to inform harm reduction programming decisions. Methods. We used CAHR data among clients who reported methamphetamine and/or opioid use (2021-2022; N = 459). We used an explanatory mixed methods design to identify factors associated with self-reported overdose reversals using naloxone. Results. The average number of reversals was 3.27. Nearly all clients (95%) reported methamphetamine use. The use of both methamphetamine and opioids (vs. opioids only; [Formula: see text] = 0.26, p = .04) was positively associated with a higher number of reversals. Our qualitative analysis provided additional context around methamphetamine and overdose, including leveraging community members connected to large networks of people who use drugs. Conclusion. Future CAHR initiatives will focus on expanding public health education around naloxone and fentanyl for a population increasingly using methamphetamine.

Understanding the determinants of the gender gap in physical activity and sports participation among young adults: a mixed-methods study

Background An underexplored gender gap in physical activity (PA) and sport participation (SP) exists in those aged 18–24 in Ireland, with females less active than males. This research explored the determinants of PA and SP in both males and females through the lens of the Capability-Opportunity-Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF), to enhance our understanding of the gender gap. A mixed methods design was employed involving (1) a quantitative secondary analysis of existing data from the Irish Sports Monitor (ISM) 2019, an evaluation of Irish SP and PA conducted biennially by Sport Ireland, the governing body for sport development in the country, and (2) qualitative semi-structured interviews to explore determinants of PA and SP, using a framework analysis approach. Methods A secondary analysis of existing ISM 2019 data from 158 individuals was conducted to explore gender differences in PA and SP behaviours in relation to capability, opportunity, and motivation. To further explore these differences, individuals (n = 16, 75% female) aged 18–24 were then invited to take part in semi-structured interviews to better understand determinants of their PA and SP behaviours and explore their experiences of the gender gap. Results Despite the gender gap identified through the ISM 2019, a secondary analysis found no significant difference between genders on predictors of PA and SP based on overall COM-B scores. However, semi-structured interviews suggested gender differences regarding self-reported determinants of PA and SP, particularly within the domain of social influence. Conclusions Social influence may be an important factor to target, particularly in relation to perceived support and encouragement, to increase female engagement in PA and SP. More research is required to explore this potentiality.

Experiences of postpartum anxiety during the COVID-19 pandemic: A mixed methods study and demographic analysis.

The first wave of the COVID-19 pandemic saw the reconfiguration of perinatal and maternity services, national lockdowns, and social distancing measures which affected the perinatal experiences of new and expectant parents. This study aimed to explore the occurrence of postpartum anxieties in people who gave birth during the pandemic. An exploratory concurrent mixed-methods design was chosen to collect and analyse the quantitative and qualitative data of an online survey during the first UK lockdown. The survey included the Postpartum Specific Anxiety Scale-Research Short Form-for use in global Crises [PSAS-RSF-C] psychometric tool, and open-ended questions in relation to changes in birth plans and feelings about those changes and giving birth in a pandemic. Differences in measured scores were analysed for the participant's ethnicity, sexual orientation and disability using independent Student's t-tests, and for age, the analysis was completed using Pearson's correlation. Qualitative data from open-ended questions were analysed using a template analysis. A total of 1,754 new and expectant parents completed the survey between 10th and 24th April 2020, and 381 eligible postnatal women completed the psychometric test. We found 52.5% of participants reported symptoms consistent with a diagnosis of postnatal anxiety-significantly higher than the rates usually reported. Younger women and sexual minority women were more likely to score highly on the PSAS-RSF-C than their older or heterosexual counterparts (p<0.001). Younger participants reported anxieties in the 'infant safety and welfare' category, whilst lesbian, gay, bisexual, and pansexual participants scored highly in the 'psychosocial adjustment to motherhood' category. Postpartum anxiety is under-reported, and demographic differences in the rates of postpartum anxiety are under-researched. This research demonstrates for the first time a difference in postpartum anxiety rates amongst sexual minority women.

Parenting Consensual Non-Monogamists’ Perceptions of Parenthood, Intimacy, and Communication

This article presents partial results of a larger mixed methods study about consensual non-monogamists’ perceptions of their parenting and sexual lifestyle, particularly those involving the transition to parenthood, intimacy and communication. Using The Expanding the Movement for Empowerment and Reproductive Justice lens, six participants completed an online questionnaire and a semi-structured interview guide. Consensual non-monogamists are like other parents, yet they prioritise sexual intimacy over emotional intimacy. Communication is very important for them. The quantitative results support the qualitative ones: the participants had a higher level of parenting sense of competence, and the means for emotional and sexual intimacy were lower for primary partners than for secondary ones. Perinatal health care professionals including nurses need to know more about parenting consensual non-monogamists and their partner(s). More research is warranted with this particular group of parents, especially on their experiences of minority stress, resilience and taking a more intersectional research approach.

Mobile-augmented Reality for Improving Student Entrepreneurial Mindset By Business Model Canvas

Modern humans’ existence is characterized by advances in information, communication, and technology. In the current digital era, augmented reality is one method that can be utilized to encourage learning. This study aims to establish how quickly The Business Model Canvas should be introduced through augmented reality to promote an entrepreneurial mindset for student. The methodology used is a survey of the literature, with a particular emphasis on cellular AR for learning and its use in cultural preservation. The exploratory mixed method is used. Researchers investigated data using a qualitative approach and analyzed it using a quantitative technique to generate measurements linked to the efficacy of augmented reality. Exploratory use is thought to be appropriate for developing new theories as well as testing existing ones. The method is called a systematic literature review (SLR). The SLR process includes the processes of problem formulation, information collecting and analysis, interpretation, arranging, and presentation. Using the Search Method Process (SP), data was gathered. Based on the findings of student trials, it is evident that the mobile-augmented reality produced increases student learning outcomes, which is consistent with the findings of Hsu, Wenting, and Hughes’ research. Therefore, mobile-augmented reality has the potential to boost interest in entrepreneurship education. Mobile-augmented reality is expected to increase student attention in entrepreneurship.&#x0D; Keywords: mobile augmented reality, business model, entrepreneurial

Collaborative video production and middle school student collaboration, engagement, and interest

The purpose of this mixed methods, single-case embedded design study was to determine the influence of collaborative video production (CVP) on middle school students’ collaboration, engagement, and interest in content and the video production process. A nomological network including the four-phase interest model developed by Renninger and Hidi was designed by the researchers and served as the theoretical framework. The sample for this study consisted of a total of 285 middle school-aged participants representing grades 6, 7, and 8 over a three-year period. Analysis results of data gathered from a 21-item quantitative student questionnaire and 14 focus groups revealed the development of phases 3 and 4 individual interest in content with CVP serving as a collaborative activity for meaningfully engaging tasks.

Fostering Equity and Diversity Through Essential Mixed Methods Research Inclusive Language Practices

Fostering Equity and Diversity Through Essential Mixed Methods Research Inclusive Language Practices

Preschool Teachers’ Perceptions and Use of Naturalistic Developmental Behavioral Intervention Strategies: An Explanatory Sequential Mixed Methods Investigation

Preschool classrooms serve children of varying abilities, including those who may benefit from social communication intervention. Research supports the use of naturalistic developmental behavioral interventions (NDBI) to effectively increase the social communication skills of young children. Yet, little is known about preschool teachers’ perspectives on and use of NDBI strategies. The purpose of this explanatory sequential mixed methods study was to integrate data from classroom observation, teacher self-report, and qualitative interviews to understand training and support needs for increasing implementation of NDBIs in a preschool classroom context. Eight preschool teachers provided a recording of an intervention session, self-reported their use of NDBI strategies, and participated in an interview to discuss their experiences. Results indicate preschool teacher participants perceive NDBI strategies favorably although they may need targeted support understanding and using NDBI strategies. We discuss implications for practice that may support increased use of NDBIs by preschool teachers.

Mapping Ethical Artificial Intelligence Policy Landscape: A Mixed Method Analysis

As more national governments adopt policies addressing the ethical implications of artificial intelligence, a comparative analysis of policy documents on these topics can provide valuable insights into emerging concerns and areas of shared importance. This study critically examines 57 policy documents pertaining to ethical AI originating from 24 distinct countries, employing a combination of computational text mining methods and qualitative content analysis. The primary objective is to methodically identify common themes throughout these policy documents and perform a comparative analysis of the ways in which various governments give priority to crucial matters. A total of nineteen topics were initially retrieved. Through an iterative coding process, six overarching themes were identified: principles, the protection of personal data, governmental roles and responsibilities, procedural guidelines, governance and monitoring mechanisms, and epistemological considerations. Furthermore, the research revealed 31 ethical dilemmas pertaining to AI that had been overlooked previously but are now emerging. These dilemmas have been referred to in different extents throughout the policy documents. This research makes a scholarly contribution to the expanding field of technology policy formulations at the national level by analyzing similarities and differences among countries. Furthermore, this analysis has practical ramifications for policymakers who are attempting to comprehend prevailing trends and potentially neglected domains that demand focus in the ever-evolving field of artificial intelligence.

Holistic approach of Talent Management for a successful Succession Planning

Preparing ourselves for future volatile economic environment is a challenge. Every Organization needs to develop a succession plan for taking up the roles and responsibility by the next generation leaders. Indian Public Sectors Units (PSUs) often find themselves in a challenging situation while positioning suitable manpower for the key leadership positions in the changing market situation. They adopt several Management Practices to develop future leaders within the organization, as it is more preferable to develop a Talent Pool in-house, rather than acquiring it from outside. Based on various studies in the past, relationship between Succession planning and Talent Management is well established. Yet, the impact of Performance Management in particular, needs to be specifically addressed, critically analyzed and reviewed in depth in line with acquiring, developing and retaining the talent for a successful Succession Planning.&#x0D; Problem statement - how does Performance Management System impact on Succession Planning? what is the relevance in integrating these two and how does it contribute to organizational sustainability? what are the Talent Management processes that support successful Succession Planning?&#x0D; The study involves a sample of Indian PSUs from various sectors. A mixed method approach for data analysis is preferred. Document analysis involves review of Policy/guidelines, Procedures and Reports related to Human Resource Development (HRD); whereas feedback on perception of employees were collected through interactions with key stakeholders and analyzed using thematic analysis to identify linkage between Performance Management and Succession Planning.&#x0D; The study suggests the holistic approach towards Talent Management and its best practices for a successful Succession Planning. It recommends to identify and develop individuals in-house, for the critical and key leadership roles thus achieving organizational sustainability.

The Role and Impact of Private Higher Education Institutions on South Africa's Educational Sector: A Comprehensive Analysis

This study presents a comprehensive analysis of the role and impact of private higher education institutions on South Africa's educational sector. Private institutions have gained prominence in recent years, raising questions about their influence on the overall educational landscape. To address this, a mixed method approach was employed, combining a quantitative analysis, and a comparative analysis. Quantitative analysis examined student enrollment trends, graduation rates, and staffing in private higher education institutions, comparing them with public institutions to assess the influence of private institutions on key educational indicators. The comparative analysis on the other hand, compared the student employability and curricula in private institutions. The literature review analyzed the differences in quality, diversity student support services, leadership, and challenges of PHIEs. This comprehensive analysis contributes to understanding the complex dynamics of private institutions in South Africa's educational sector. It sheds light on their influence on educational quality, student enrollment, accessibility, and the overall educational landscape. The findings inform policymakers, educators, and stakeholders, facilitating evidence-based decision-making to further enhance the educational sector in South Africa.