Mixed Method Comparative Study Research Articles

Preservice music educators’ perceived self-efficacy in teaching students with disabilities following special education coursework: A comparative mixed-methods study

Preservice music educators’ (PMEs) experiences teaching students with disabilities (SwD) often occurs through general education coursework. Researchers have examined the effect of content-specific course work on PMEs preparation to teach music to SwD but have not examined if differences in course and clinical settings impact their self-reported feelings of self-efficacy. The purpose of this study was to examine whether differences in the delivery (online or in-person) of music-specific coursework and clinicals affected PMEs confidence to teach music to SwD. Students who participated in an online course reported a significant decrease in their self-efficacy ( t (17) = 3.57, p = .002, d = 0.89), while those who participated in an in-person course reported a significant increase ( t (10) = 7.116, p = .001, d = 2.15). Although no statistical significance was found between groups ( t (28) = 0.976, p = .33, d = 0.36), a comparative analysis of interview data provided nuanced differences. Applications for preservice music educator needs and instruction are discussed.

Implementing an artificial intelligence command centre in the NHS: a mixed-methods study.

Hospital 'command centres' use digital technologies to collect, analyse and present real-time information that may improve patient flow and patient safety. Bradford Royal Infirmary has trialled this approach and presents an opportunity to evaluate effectiveness to inform future adoption in the United Kingdom. To evaluate the impact of the Bradford Command Centre on patient care and organisational processes. A comparative mixed-methods study. Operational data from a study and control site were collected and analysed. The intervention was observed, and staff at both sites were interviewed. Analysis was grounded in a literature review and the results were synthesised to form conclusions about the intervention. The study site was Bradford Royal Infirmary, a large teaching hospital in the city of Bradford, United Kingdom. The control site was Huddersfield Royal Infirmary in the nearby city of Huddersfield. Thirty-six staff members were interviewed and/or observed. The implementation of a digitally enabled hospital command centre. Qualitative perspectives on hospital management. Quantitative metrics on patient flow, patient safety, data quality. Anonymised electronic health record data. Ethnographic observations including interviews with hospital staff. Cross-industry review including relevant literature and expert panel interviews. The Command Centre was implemented successfully and has improved staff confidence of better operational control. Unintended consequences included tensions between localised and centralised decision-making and variable confidence in the quality of data available. The Command Centre supported the hospital through the COVID-19 pandemic, but the direct impact of the Command Centre was difficult to measure as the pandemic forced all hospitals, including the study and control sites, to innovate rapidly. Late in the study we learnt that the control site had visited the study site and replicated some aspects of the command centre themselves; we were unable to explore this in detail. There was no significant difference between pre- and post-intervention periods for the quantitative outcome measures and no conclusive impact on patient flow and data quality. Staff and patients supported the command-centre approaches but patients expressed concern that individual needs might get lost to 'the system'. Qualitative evidence suggests the Command Centre implementation was successful, but it proved challenging to link quantitative evidence to specific technology interventions. Staff were positive about the benefits and emphasised that these came from the way they adapted to and used the new technology rather than the technology per se. The COVID-19 pandemic disrupted care patterns and forced rapid innovation which reduced our ability to compare study and control sites and data before, during and after the intervention. We plan to follow developments at Bradford and in command centres in the National Health Service in order to share learning. Our mixed-methods approach should be of interest to future studies attempting similar evaluation of complex digitally enabled whole-system changes. The study is registered as IRAS No.: 285933. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129483) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 41. See the NIHR Funding and Awards website for further award information.

Assessing the Accuracy of Generative Conversational Artificial Intelligence in Debunking Sleep Health Myths: Mixed Methods Comparative Study With Expert Analysis.

Adequate sleep is essential for maintaining individual and public health, positively affecting cognition and well-being, and reducing chronic disease risks. It plays a significant role in driving the economy, public safety, and managing health care costs. Digital tools, including websites, sleep trackers, and apps, are key in promoting sleep health education. Conversational artificial intelligence (AI) such as ChatGPT (OpenAI, Microsoft Corp) offers accessible, personalized advice on sleep health but raises concerns about potential misinformation. This underscores the importance of ensuring that AI-driven sleep health information is accurate, given its significant impact on individual and public health, and the spread of sleep-related myths. This study aims to examine ChatGPT's capability to debunk sleep-related disbeliefs. A mixed methods design was leveraged. ChatGPT categorized 20 sleep-related myths identified by 10 sleep experts and rated them in terms of falseness and public health significance, on a 5-point Likert scale. Sensitivity, positive predictive value, and interrater agreement were also calculated. A qualitative comparative analysis was also conducted. ChatGPT labeled a significant portion (n=17, 85%) of the statements as "false" (n=9, 45%) or "generally false" (n=8, 40%), with varying accuracy across different domains. For instance, it correctly identified most myths about "sleep timing," "sleep duration," and "behaviors during sleep," while it had varying degrees of success with other categories such as "pre-sleep behaviors" and "brain function and sleep." ChatGPT's assessment of the degree of falseness and public health significance, on the 5-point Likert scale, revealed an average score of 3.45 (SD 0.87) and 3.15 (SD 0.99), respectively, indicating a good level of accuracy in identifying the falseness of statements and a good understanding of their impact on public health. The AI-based tool showed a sensitivity of 85% and a positive predictive value of 100%. Overall, this indicates that when ChatGPT labels a statement as false, it is highly reliable, but it may miss identifying some false statements. When comparing with expert ratings, high intraclass correlation coefficients (ICCs) between ChatGPT's appraisals and expert opinions could be found, suggesting that the AI's ratings were generally aligned with expert views on falseness (ICC=.83, P<.001) and public health significance (ICC=.79, P=.001) of sleep-related myths. Qualitatively, both ChatGPT and sleep experts refuted sleep-related misconceptions. However, ChatGPT adopted a more accessible style and provided a more generalized view, focusing on broad concepts, while experts sometimes used technical jargon, providing evidence-based explanations. ChatGPT-4 can accurately address sleep-related queries and debunk sleep-related myths, with a performance comparable to sleep experts, even if, given its limitations, the AI cannot completely replace expert opinions, especially in nuanced and complex fields such as sleep health, but can be a valuable complement in the dissemination of updated information and promotion of healthy behaviors.

Aligning the steering of governmental organizations a comparative mixed-methods study in Denmark using stewardship theory

ABSTRACT Stewardship theory offers considerable promise for strengthening trust between governments and organizations implementing policy. Recent studies show stewardship is partially applicable to the steering of public organizations yet it is not clear under what conditions. This study asserts that the steering of governmental organizations needs to be aligned with preferences and conditions of organizations, combining principal-agent and stewardship theory. The article adopts a unique nested comparative mixed methods study focusing on perceived and preferred steering of Danish agencies and educational institutions. The study finds a higher alignment of steering for agencies, mostly because participants experience real partnerships and closer proximity.

Usability and Usefulness of a Symptom Management Coaching System for Cancer Patients treated with Immune Checkpoint Inhibitors: a Comparative Mixed-Methods Study (Preprint)

Usability and Usefulness of a Symptom Management Coaching System for Cancer Patients treated with Immune Checkpoint Inhibitors: a Comparative Mixed-Methods Study (Preprint)

WITH OR WITHOUT THE CROWD? THE INFLUENCE OF CODER CHARACTERISTICS ON CODING DECISIONS COMPARING CROWDWORKERS AND TRADITIONAL CODERS.

Standardized manual content analysis is an important methodology to capture the messages in journalistic and social media. Specifically, for supervised machine learning aproaches, human-generated training data is needed. The process of coding as well as the selection of suitable coders is crucial for obtaining good data quality. However, little research has been done on how the coding process should be designed and how personal characteristics of the coders might influence data quality. This blind spot becomes even more crucial because coding is nowadays increasingly performed with the help of crowdworkers. When working with such anonymous coders, the process of coding can then be less controlled by the researchers, which can lead to loss of quality. In our comparative mixed-methods study we compare data from a content analysis on the topic of legalizing abortion (n = 300 tweets). We conducted this in two ways: Firstly, with a team of four student coders who also received training and secondly with 150 crowdworkers. All coders had to complete a short survey on their socio-demographics and personality traits. The results show that both validity and reliability are higher for the student coders, especially for tricky coding tasks. Further, multivariate (logistic) regression analysis reveals that personal characteristics such as formal education and emotional sensitivity also have an impact on coding quality. Hence, with a reflective selection of coders as well as a thoughtful design of the coding process and the codebook, the quality of data collection can be increased—even when relying on crowdworkers.

Evaluation of the Performance of Generative AI Large Language Models ChatGPT, Google Bard, and Microsoft Bing Chat in Supporting Evidence-Based Dentistry: Comparative Mixed Methods Study.

The increasing application of generative artificial intelligence large language models (LLMs) in various fields, including dentistry, raises questions about their accuracy. This study aims to comparatively evaluate the answers provided by 4 LLMs, namely Bard (Google LLC), ChatGPT-3.5 and ChatGPT-4 (OpenAI), and Bing Chat (Microsoft Corp), to clinically relevant questions from the field of dentistry. The LLMs were queried with 20 open-type, clinical dentistry-related questions from different disciplines, developed by the respective faculty of the School of Dentistry, European University Cyprus. The LLMs' answers were graded 0 (minimum) to 10 (maximum) points against strong, traditionally collected scientific evidence, such as guidelines and consensus statements, using a rubric, as if they were examination questions posed to students, by 2 experienced faculty members. The scores were statistically compared to identify the best-performing model using the Friedman and Wilcoxon tests. Moreover, the evaluators were asked to provide a qualitative evaluation of the comprehensiveness, scientific accuracy, clarity, and relevance of the LLMs' answers. Overall, no statistically significant difference was detected between the scores given by the 2 evaluators; therefore, an average score was computed for every LLM. Although ChatGPT-4 statistically outperformed ChatGPT-3.5 (P=.008), Bing Chat (P=.049), and Bard (P=.045), all models occasionally exhibited inaccuracies, generality, outdated content, and a lack of source references. The evaluators noted instances where the LLMs delivered irrelevant information, vague answers, or information that was not fully accurate. This study demonstrates that although LLMs hold promising potential as an aid in the implementation of evidence-based dentistry, their current limitations can lead to potentially harmful health care decisions if not used judiciously. Therefore, these tools should not replace the dentist's critical thinking and in-depth understanding of the subject matter. Further research, clinical validation, and model improvements are necessary for these tools to be fully integrated into dental practice. Dental practitioners must be aware of the limitations of LLMs, as their imprudent use could potentially impact patient care. Regulatory measures should be established to oversee the use of these evolving technologies.

A comparative study of disabled people's experiences with the video conferencing tools Zoom, MS Teams, Google Meet and Skype

ABSTRACT The paper presents a comparative mixed methods study of the accessibility and usability for disabled people of four video conferencing tools, Zoom, MS Teams, Google Meet and Skype. Useable responses were obtained from 81 disabled people with diverse characteristics, mainly in the UK, though some groups had low representation. None of the tools was considered fully accessible and useable. Zoom was both the most commonly used and the most frequently preferred (56.1%) tool, with MS Teams second in usage and a trailing second in preferences (15.9%). It was considered to have better captioning, but otherwise to generally be a poor second to Zoom. Skype was the most commonly used before lockdown, but was considered dated and its limited use was mainly social, whereas the other tools were also used in work and education. The results were used to draw up separate lists of recommendations for developers and meeting organisers and hosts, as the study also identified actions for organisers and hosts to improve meeting accessibility. Developer recommendations include several easy to set customisation and user friendly interface features, involving disabled people and specific accessibility features, including compatibility with assistive technology, keyboard shortcuts for all functions and automatically-on high quality captions.

Nursing students' experiences of different learning spaces: A comparative mixed methods study

Clinical skills are traditionally taught face-to-face in nursing education. The COVID-19 pandemic triggered a surge in online learning, prompting the creation of an innovative method of teaching clinical skills online. This study aimed to explore students’ experiences of learning clinical skills in on-campus and off-campus learning spaces and determine which learning space students preferred. Undergraduate nursing students (n=135) undertook a mixed-method survey. Quantitative data analysis revealed that on-campus students reported higher satisfaction with the realism of the clinical skill learning activity (p=0.015). Off-campus students practiced the clinical skill more frequently (p=0.024). Thematic analysis of qualitative data identified themes of feedback, logistics, opportunities to practice, realism, and feeling comfort. Responses provided insight into students’ preferred experiential learning styles, preferences for learning spaces, and how they engaged in deliberate practice. Preferred experiential learning styles may influence how students undertake deliberate practice and their preference for face-to-face or online learning. This study indicates that off-campus learning can complement on-campus training to cater to diverse learning styles and foster deliberate practice.

COVID-19 Impacts on Christian and Muslim Organizations in Germany: A Comparative Mixed Methods Study

The COVID-19 pandemic profoundly influenced all areas of life and day-to-day operations. This paper studies the impact of the pandemic on Muslim and Christian organizations in Germany. The focus is activity implementation, time investment, staff changes, and working processes of full-time staff and volunteers. On the basis of a quantitative survey ( n = 454) and qualitative in-depth interviews with organizational representatives from 2021 to 2022 ( n = 31), we follow a convergent, parallel mixed methods design to understand pandemic-related work changes, key challenges, and crisis management. Our quantitative analysis reveals differences in the activity performances in Muslim and Christian organizations both before and since the pandemic outbreak. While the monthly time investment of volunteers dropped significantly in Christian organizations during the pandemic, the working time of employees increased significantly in Muslim organizations. The qualitative analysis reveals distinct impacts on work processes and workloads in the organizations. Differences are due to organizational legal statuses, internal conditions, and different activity foci. Overall, our study indicates that religious organizations and their staff are resilient and adaptable. It contributes comparative data on faith-based organizations in Germany and highlights their important role in civil society. For future research, we recommend cross-national comparative studies.

Similarities and differences in motivation in cross-disciplinary biomedical, policy, and education health science teams: a mixed methods comparative case study using the MATRICx

PurposeThis study aims to investigate individual motivations for participating in collaborative health knowledge producing teams (KPTs), as well as satisfaction gained by participation in science teams. The authors focus on understanding motivators across team types, levels of engagement and alignment within and across teams and need satisfaction in a total of six science teams. Areas of strong congruence and divergence of motivating factors can be aligned across (i) learning and professional growth satisfaction, (ii) respect, collegiality and enjoyment satisfaction and (iii) accomplishment and discovery satisfaction. Levels of satisfaction are hierarchically mapped showing their relation to more external and communal foci to motivations that seek satisfaction of individual needs.Design/methodology/approachThis mixed method comparative study uses data from the motivation assessment for team readiness integration and collaboration (MATRICx) tool and themes generated from semi-structured interviews. This methodology provided a means to compare a hierarchy of motivations against levels of collaborative engagement, as well as individual needs satisfaction and ultimately the identification of higher and lower-level motivations related to self and external foci.FindingsThe findings indicate that there are both similarities and differences in motivations in different health science teams when one compares biomedical, education and policy teams. A comparison of MATRICx data from across team types and teams suggests areas of strong congruence as well as areas of divergence in motivation factors.Originality/valueThe paper and its findings use a novel tool along with qualitative research techniques to identify motivation in KPTs and uses these data to understand what type of needs satisfaction are important across three areas of health science teaming. Our research informs team leaders, facilitators and consultants about the important motivations team members have entering teams and has the potential to provide a blueprint to ensure peak performance as individual team members seek to address their ever-growing professional needs.

Drivers and barriers in developing sustainability leadership – a case of natural scientists at Ugandan universities

PurposeAlthough natural science disciplines significantly contribute to sustainable development goals (SDGs), little research attends to how higher education institutions (HEIs) influence the development of leadership skills needed among sustainability leaders. This paper aims to examine the leadership development experiences of natural scientists at the forefront of disciplines associated with SDGs to identify barriers and drivers to sustainability leadership skills development at HEIs.Design/methodology/approachA mixed-methods comparative study was used, integrating qualitative interviews among 21 natural scientists and 11 non-scientists, two focus group discussions and a cross-sectional survey of 221 leaders. The theory of planned behaviour was used as the analytical frame to identify themes emerging from the data as facilitators or barriers to leadership development.FindingsThere was a statistically significant difference between scientists and non-scientists in the attitudes, beliefs and perceptions that drive participation in leadership development activities. Attitudes belittling leadership skills, limited integration of leadership skills in medical, engineering and agricultural curricula and a social identity of superior learning efficacy impede natural scientist students at HEIs from engaging in leadership development.Research limitations/implicationsFurther research using a larger sample could assess the prevalence and effect of the drivers and barriers on sustainability leadership effectiveness.Practical implicationsBeyond integrating leadership skills in HEIs curricula, the development of sustainability leadership requires deliberate elevation of the value of leadership skills within natural sciences, specifically by addressing attitudes, beliefs and workload challenges that impede scientists’ engagement in co-curricular activities.Originality/valueIntegrating multiple disciplines provides generalised insights into the context of leadership development among natural scientists at HEIs. This study identifies specific drivers and barriers affecting leadership development at HEIs in a developing country setting.

Men’s perception of information and psychological distress in the diagnostic phase of prostate cancer: a comparative mixed methods study

BackgroundPrevious studies indicate that men experience frustration and uncertainty when confronted with an elevated prostate specific antigen (PSA) test and during further diagnostics for prostate cancer. The novel Stockholm3 test is an algorithm-based test that combines plasma protein biomarkers, genetic markers and clinical variables in predicting the risk of PCa. The test was introduced in a western part of Norway as a new tool for detecting prostate cancer. This study aimed to explore and compare men’s perception of information and possible experience of distress between a PSA group and a Stockholm3 group during the diagnostic phase of prostate cancer.MethodsThis study is a part of the trailing research evaluating the impact of the change from PSA to Stockholm3. It is a multicenter study using a comparative mixed method design. Data were collected in a PSA group (n = 130) and a Stockholm3 group (n = 120) between 2017 and 2019. Quantitative data were collected using questionnaires and qualitative data were collected using semi-structured interviews (n = 20). The quantitative and qualitative data were analysed and compared separately and then merged in a side-by-side discussion. The study adheres to the GRAMMS guidelines for reporting mixed-methods research.ResultsCompared with the PSA group, men in the Stockholm3 group reported that the information from the general practitioners was better. Similarly, men in the Stockholm3 group were more likely to indicate that they had received sufficient information regarding how examinations would be conducted. No differences were found between the groups regarding waiting time and distress. Three themes emerged from the qualitative analysis of the two groups: “Information affects the experience of comprehension”, “Stepping into the world of the healthcare system”, and “Periodically feelings of distress”.ConclusionThe Stockholm3 test may facilitate the provision of information to patients. However, some patients in both groups experienced distress and would benefit from more information and additional support from healthcare professionals. Routines that ensure sufficient information from the interdisciplinary healthcare team should be of priority during the diagnostic phase of prostate cancer in order to provide patients with predictability and to avoid unnecessary distress.

Teachers’ motivation to choose teaching and remain in the profession: A comparative mixed methods study in Jamaica, Poland and Turkey

The comparative, mixed methods international and cross-cultural study aimed to determine the factors that motivated teachers in Jamaica, Poland and Turkey to choose teaching as a career and ascertain what motivated the teachers at different stages to remain in teaching. Data were collected through the use of the questionnaire, which experts validated and had an overall reliability coefficient of 0.77 and focus group interviews. A total of 186 teachers participated in the quantitative phase of the study, whilst 75 participated in the qualitative phase. The findings showed that extrinsic, intrinsic, and altruistic motivation, roles and responsibilities, and opportunities were the main reasons teachers in the three countries chose the teaching profession. Teachers in the different stages of their careers remain in the profession because of a strong sense of vocation, a passion for teaching, a need to make a positive difference in students’ life, job satisfaction, and connected with its rewards of being a teacher. It was recommended that researchers interested in this area could use a more representative sample size to generalize the findings.

Patient Safety Culture in European Hospitals: A Comparative Mixed Methods Study.

Background: Poorly organized health systems with inadequate leadership limit the development of the robust safety cultures capable of preventing consequential adverse events. Although safety culture has been studied in hospitals worldwide, the relationship between clinician perceptions about patient safety and their actual clinical practices has received little attention. Despite the need for mixed methods studies to achieve a deeper understanding of safety culture, there are few studies providing comparisons of hospitals in different countries. Purpose: This study compared the safety culture of hospitals from the perspective of nurses in four European countries, including Croatia, Hungary, Spain, and Sweden. Design: A comparative mixed methods study with a convergent parallel design. Methods: Data collection included a survey, participant interviews, and workplace observations. The sample was nurses working in the internal medicine, surgical, and emergency departments of two public hospitals from each country. Survey data (n = 538) was collected with the Hospital Survey on Patient Safety Culture (HSOPSC) and qualitative date was collected through 24 in-depth interviews and 147 h of non-participant observation. Survey data was analyzed descriptively and inferentially, and content analysis was used to analyze the qualitative data. Results: The overall perception of safety culture for most dimensions was ‘adequate’ in Sweden and ‘adequate’ to ‘poor’ in the other countries with inconsistencies identified between survey and qualitative data. Although teamwork within units was the most positive dimension across countries, the qualitative data did not consistently demonstrate support, respect, and teamwork as normative attributes in Croatia and Hungary. Staffing and workload were identified as major areas for improvement across countries, although the nurse-to-patient ratios were the highest in Sweden, followed by Spain, Hungary, and Croatia. Conclusions: Despite all countries being part of the European Union, most safety culture dimensions require improvement, with few measured as good, and most deemed to be adequate to poor. Dimension level perceptions were at times incongruent across countries, as observed patient safety practices or interview perspectives were inconsistent with a positive safety culture. Differences between countries may be related to national culture or variability in health system structures permitted by the prevailing European Union health policy.

Evaluating children’s websites from an information visualization perspective: findings of a comparative mixed-methods study

Purpose This study aims to evaluate the selected children’s websites in terms of information visualization features based on the criteria existing in the related literature and expert scrutiny. Design/methodology/approach A mixed-methods (qualitative-quantitative) study was conducted with a descriptive-comparative approach. A set of 80 English websites, as well as 24 quality Persian websites, were selected constituting a sample size of 104 websites. A conceptual model was developed from an extensive literature review on information visualization in children’s websites. In the quantitative part, a checklist derived from the conceptual model and based on the heuristic evaluation method was distributed among 20 related experts, the data of which were then analysed through Partial Least Squares using SmartPLS 3.0. Findings Confirmatory factor analysis showed high-reliability indicators and fit indices in measurement and structural models showing that the conceptual model had the necessary validities among the expert evaluators. Path coefficients showed that layout design and user interface design were the first and last priorities among the dimensions. It was also found that English websites were much more successful than Persian websites in supporting the features of information visualization. Originality/value The current study has implications for the effective use of standard features related to information visualization in children’s websites usable for designers, media specialists, parents, instructors and librarians, which would also make the children more engaged to better use, learn and interact with the websites.

A comparative mixed methods study on health information seeking among US‐born/US‐dwelling, Korean‐born/US‐dwelling, and Korean‐born/Korean‐dwelling mothers

AbstractMore knowledge and a better understanding of health information seeking are necessary, especially in these unprecedented times due to the COVID‐19 pandemic. Using Sonnenwald's theoretical concept of information horizons, this study aimed to uncover patterns in mothers' source preferences related to their children's health. Online surveys were completed by 851 mothers (255 US‐born/US‐dwelling, 300 Korean‐born/US‐dwelling, and 296 Korean‐born/Korean‐dwelling), and supplementary in‐depth interviews with 24 mothers were conducted and analyzed. Results indicate that there were remarkable differences between the mothers' information source preference and their actual source use. Moreover, there were many similarities between the two Korean‐born groups concerning health information‐seeking behavior. For instance, those two groups sought health information more frequently than US‐born/US‐dwelling mothers. Their sources frequently included blogs or online forums as well as friends with children, whereas US‐born/US‐dwelling mothers frequently used doctors or nurses as information sources. Mothers in the two Korean‐born samples preferred the World Wide Web most as their health information source, while the US‐born/US‐dwelling mothers preferred doctors the most. Based on these findings, information professionals should guide mothers of specific ethnicities and nationalities to trustworthy sources considering both their usage and preferences.

The interaction of healthcare service quality and community-based health insurance in Ethiopia.

Community-based health insurance (CBHI) as a demand-side intervention is presumed to drive improvements in health services quality, and the quality of health services is an important supple-side factor in motivating CBHI enrollment and retention. There is, however, limited evidence on this interaction. This study examined the interaction between quality of health services and CBHI enrollment and renewal. A mixed-method comparative study was conducted in four agrarian regions of Ethiopia. The study followed the Donabedian model to compare quality of health services in health centers located in woredas/districts that implemented CBHI with those that did not. Data was collected through facility assessments, client-exit interviews, and key informant interviews. In addition to manual thematic analysis of qualitative data, quantitative descriptive and inferential analyses were done using SPSS vs 25. The process related (composite index including provider-client interpersonal communication) and outcome related (client satisfaction) measures of service quality in CBHI woreda/districts differed significantly from non-CBHI woredas/districts, but there were no significant differences in overall measures of structural quality between the two. The study found better diagnostic test capacity, availability of tracer drugs, provider interpersonal communication, and service quality standards in CBHI woredas. A higher proportion of clients at CBHI health centers gave high ratings of overall satisfaction with services. Individual and household factors including family size, age, household health care-related expenditures, and educational status, played a more significant role in CBHI enrollment and renewal decisions than health service quality. Key-informants reported in interviews that participation in the scheme increased accountability of health facilities in CBHI woredas/districts, because they promised to provide quality services using the CBHI premium collected at the beginning of the year from all enrolled households. This study indicates a need for follow-up research to understand the nuanced linkages between quality of care and CBHI enrollment.

Review of Preserving Neighborhoods: How Urban Policy and Community Strategy Shape Baltimore and Brooklyn

InPreserving Neighborhoods: How Urban Policy and Community Strategy Shape Baltimore and Brooklyn, Aaron Passell responds to one of the most contentious issues in urban studies of recent years, the relationship between housing supply and housing prices in American cities. Preserving Neighborhoods engages with a particular aspect of the conversation, the question of whether urban preservation policy promotes gentrification by limiting new housing and thus raising the value of inner-city land. The notion that urban preservation causes gentrification has been a bugbear of real estate economists like Edward Glazer (2010), however it has not been subject to sustained empirical scrutiny. Passell’s book sheds great light on this important question through a comparative mixed-methods study of neighborhood preservation in Baltimore, a shrinking legacy city, and Brooklyn, a growing gentrification hot-spot. The book is exemplary in addressing questions of causality in neighborhood change through clearly articulated methodological choices. Passell combines...

How Refugees Experience the Australian Workplace: A Comparative Mixed Methods Study.

There is a growing body of evidence indicating poorer working conditions for migrant workers, particularly refugees, compared with native-born workers. Our objectives were to compare exposure to workplace psychosocial stressors in working refugees with other migrant groups and Australian-born workers of Caucasian ancestry and to describe the working experience of refugees. Cross-sectional surveys collected information on the workplace stressors of job complexity, control, security, bullying, and racial discrimination from six migrant groups (n = 1062) and Caucasian Australians (n = 1051); semi-structured face-to-face interviews were used with currently employed refugees (n = 30). Content analysis examined the qualitative data. Compared to all other groups, working refugees were more likely to report experiencing racial discrimination in the workplace and to report exposure to more than three hazards. Content analysis indicated that working refugees are working below their capacity, in terms of hours and qualifications, and in jobs that were low status and lacked security. Despite challenging work conditions, participants reported adequate health and safety training and feeling a sense of pride in their work. These findings highlight the need for better support for refugees in negotiating the workplace once they find employment and the importance of employers providing an inclusive and equitable workplace.