Mixed Methods Research Study Research Articles

A Mixed-Method Research Study of Dual Enrolled Students’ Experiences in a Research Course: Research Capital Development?

Early college and dual enrollment initiatives provide students opportunities for college credit courses and increased academic engagement. The purpose of this mixed methods research study was to examine the case of 79 dual-enrolled students in a research methodology course using online surveys and focus groups. Students perceived increased knowledge regarding undergraduate research content, whereas their perceived research usefulness decreased slightly. Likewise, students felt increased comfort with research and expressed perceived benefits but felt anxiety by setting different types of expectations and comparisons. Findings add to the relevant literature by mixing quantitative and qualitative data in this case study to allow for meta-inferences about the dichotomy of being a dual-enrolled student taking research courses, and by suggesting the notion of research capital related to the dynamics of dual enrollment programs in a Southeastern state.

Factors Influencing Oral Health Behaviours, Access and Provision of Dental Care for Autistic Children and Adolescents in Countries with a Very High Human Development Index: Protocol for a Mixed Methods Systematic Review.

Autistic children and adolescents are at high risk of dental disease and experience oral health inequalities. They consistently show high levels of unmet needs in relation to their oral health and access to dental care. There are no systematic reviews that bring together the evidence on the factors that influence oral hygiene behaviours, and access to and provision of dental care for autistic children and adolescents. A systematic search will be carried out in eight international databases and in grey literature of qualitative, quantitative and mixed method research studies from countries with a High Development Index which relate to oral health behaviours, and access to and provision of dental care. Only studies where participants are autistic children and adolescents aged 19 years or under, parents/guardians/caregivers, support staff, or oral health care providers will be included. Quantitative and qualitative data will be synthesized together through data transformation using a convergent integrated approach. Thematic synthesis will be used to carry out an inductive analysis of the data. The findings from the systematic review which this protocol generates will be used in the development of an appropriate local clinic care pathway for autistic children/adolescents and to inform national policies and practices. Prospero registration: CRD 42021248764.

Development and Assessment of a Multi-User Virtual Environment Nursing Simulation Program: A Mixed Methods Research Study

BackgroundRecent technological advancements have enabled multi-user virtual environments that can provide safe and interactive training opportunities for healthcare providers. This study aims to develop a multi-user virtual simulation program for metacognition and evaluate the students’ satisfaction, clinical judgment, and nursing competencies. MethodsMixed methods was used. A virtual reality simulation program based on an existing curriculum model and experiential learning theory was developed. The five scenarios were evaluated for content validity and tested for pilot. A total of 57 senior nursing students participated. Clinical judgment and nursing competencies were scored, and interviews were conducted with focus groups. ResultsTotal scores for nursing competency before and after the simulation program were 243.6(29.82) and 264.0(34.53), respectively, with a significant increase of 20.4 (t = 4.690, p < .001) post-session. Total scores for clinical judgment ranged from 22.2 to 32.0 (out of 44 maximum possible points). Overall, most of the participants were able to achieve their learning outcomes through the program. ConclusionsThe findings suggest that the use of virtual simulation is effective in enhancing nursing competence by enhancing metacognition.

Mixed-method analysis of the quad council competencies for public health nurses.

Evaluate the knowledge, skills, and attitudes (KSA) of public health nurses (PHNs) related to the eight Domains of the 2011 Quad Council Competencies for Public Health Nurses (QCC-PHN). This manuscript is Part 2 of an exploratory study published in the Public Health Nursing journal on PHNs' knowledge, skills, attitudes, and application of the Quad Council Competencies (Harmon etal., 2020). In this mixed-method descriptive research study, the multisite team conducted an online survey among a convenience sample of 296 PHNs to determine differences in KSA for each of the eight QCC-PHN Domains. Analysis of variance (ANOVA) testing revealed differences in KSA for the QCC-PHN, Domains. Post-hoc tests and qualitative thematic analysis of PHNs open-ended comments were used to provide additional data. ANOVA results showed significant differences in knowledge and skills in all Domains and a significant difference in attitude in only one domain, Domain 7. Post-hoc test results showed significant differences in KSA between position titles for most Domains. Recommendations include using the QCC-PHN to standardize the professional and diverse roles of the PHN workforce.

A Comparative Study of Death Anxiety Levels and Reflections among University Students

This concurrent mixed-method research study aimed to validate the psychometric properties of Templer Death Anxiety Scale (TDAS) and compare death anxiety reflections of 332 university students at English Language Teaching (ELT) and English Language and Literature (ELL) departments at a state university in Turkey. The data were collected through the TDAS and semi-structured interviews. According to statistical results, the four-factor model of TDAS was confirmed in this study. Also, department and gender were associated with differences among the participants. In light of phenomenological analyses of the interviews, both ELT and ELL students mostly defined death as a state such as infinity, darkness, inception, endlessness, salvation, freedom, annihilation, uncertainty, and eternity. As for the symbols, the ELT participants used events like traffic accident, sudden death, flying, voyage to symbolise death whereas the ELL participants used some states like innocence, freedom, emptiness, coldness, darkness, loneliness to symbolise death. The results offer a new perspective for death anxiety research in terms of including a different group of participants and highlighting changing attitudes of ELL and ELT students towards death and death anxiety. Educational implications are also discussed.

Pragmatism as a paradigm for patient-oriented research.

BackgroundMixed methods research studies continue to pervade the field of health care, where pragmatism as a research paradigm and patient‐oriented research (POR) as an engagement strategy are combined to strengthen the process and outcomes of the research. Pragmatists use the most appropriate research methods to address issues at hand, where complex social problems need multipronged approaches. As an emerging healthcare research strategy, POR actively engages individuals with lived experience across all stages of the research process. While POR continues to garner attention within mixed‐methods research designs, there is a paucity of literature that considers POR in relation to pragmatism.ObjectiveAs POR grows in popularity within the field of health care, there is a need to explore the theoretical and epistemological alignment with pragmatism and the implications to research.MethodsTo address this need, we provide a critical review of the literature to examine the synergies between POR and pragmatism, and argue for the adoption of pragmatism as a paradigm for conducting POR.Main ResultsThis article begins with a discussion of the philosophical underpinnings informing the pragmatic paradigm. It then identifies key alignments between POR and pragmatism across three intersecting concepts: democratic values, collaborative approaches to problem‐solving and the pursuit of social justice.Discussion and ConclusionsReflecting on our experiences engaging with patient partners in a mixed‐methods POR study titled READY2Exit, we illustrate the relevance of pragmatism to POR by applying these concepts to practice. Implications and considerations for conducting POR within the pragmatic paradigm are also described.Patient or Public ContributionThis paper provides a critical review of the literature and did not directly involve patients or the public. The authors reflected on their experiences collaborating with five young adult patient partners in the READY2Exit study (case exemplar described in this article) to demonstrate the relevance of the pragmatic paradigm to POR. We acknowledge and thank the young adult patient partners for their contributions to the research, for encouraging us to think critically about patient engagement in research, and for sharing their experiences.

The Association between Sibship Composition and Child Eating Behaviors

Development of eating habits and patterns during childhood can have life-long effects on weight and health status. Family structure, functioning, and interactions during mealtimes may influence the development of eating behaviors among children. The objective of this study was to examine the association between sibship composition and child eating behaviors among preschoolers in Saudi Arabia. One hundred and fifteen mothers were recruited through various preschools around the city of Jeddah, Saudi Arabia. A previously validated Arabic version of the Children’s Eating Behavior Questionnaire (CEBQ) was completed over the telephone along with questions assessing sibship composition and demographic characteristics. Spearman correlations and adjusted linear regression models were examined to assess the association between sibship composition and child eating behaviors. Adjusting for covariates, number of older siblings was positively associated with emotional over eating, food responsiveness, and the desire to drink. Number of older sisters was positively associated with the desire to drink but negatively associated with food fussiness. Having a greater number of older (rather than younger) siblings may be associated with food-approach eating behaviors. Having a greater number of older sisters may be associated with less food fussiness. Focusing on older siblings in encouraging healthy eating habits and appropriate food choices may be beneficial in promoting adaptive eating behaviors and prevention of excessive energy intake and weight gain. Future longitudinal and mixed-methods research studies with larger sample sizes are needed in order to better understand the underlying mechanisms for the associations between sibship composition and child eating behaviors

The Impact of Ambassador Animal Facilitated Programs on Visitor Curiosity and Connections: A Mixed-Methods Study

Many zoos and aquariums offer opportunities for visitors to have up-close encounters with ambassador animals; however, the impacts of these experiences on visitors’ connections to animals are not well documented. We used observations and family interviews in a sequential mixed-methods research study to explore how animal ambassador programs impact participants. We found that the type of ambassador animal did not affect the number of questions or comments made by participants during programs, suggesting broad interest in animals. Programs in which facilitators prompted participants with questions were especially successful at eliciting questions and guiding the topics of those questions, fueling deeper curiosity. Interviewees described themselves as “animal people” and self-reported practicing conservation behaviors, suggesting that their animal affiliative and pro-environmental identities could be leveraged to discuss conservation issues and encourage solutions-based behaviors. Lastly, opportunities to meet ambassador animals increased participants’ feelings of connecting to animals, building on previous research and corroborating findings. Programs should consider how to further build on these positive learning and affective outcomes by capitalizing on opportunities to provide deep insights into conservation issues and actions related to the ambassador animals.

LGBTQ+ Psychosocial Concerns in Nursing and Midwifery Education Programmes: Qualitative Findings from a Mixed-Methods Study.

LGBTQ+ people experience significant physical and psychosocial health issues and concerns, and encounter barriers when accessing healthcare services. We conducted a mixed-methods research study across all Schools of Nursing and Midwifery in the United Kingdom and Ireland using a survey and qualitative interviews. This was to identify the current content within nursing and midwifery pre-registration programmes in relation to LGBTQ+ health and to identity best practice and education innovation within these programmes. The survey was completed by 29 academics, with 12 selected to participate in a follow-up in-depth qualitative interview. Analysis of the data from the survey and interviews identified five themes: there is variable programme content; academics are developing their own programmes with no clear consistency; LGBTQ+ health is being linked to equality and diversity; there are barriers to education provision; and these is some evidence of best practice examples. The findings of the study support the need to develop and implement a curriculum for LGBTQ+ health in nursing and midwifery pre-registration programmes with learning aims and outcomes. Academics need support and tools to prepare and deliver LGBTQ+ health content to nurses and midwives as they ultimately have the potential to improve the experiences of LGBTQ+ people when accessing healthcare.

Youth, Caregiver, and Provider Perception of the Transition from Pediatric to Adult Care for Youth with Chronic Diseases.

Youth with chronic diseases are required to transition from pediatric to adult care across the world at variable ages in their adolescent years. The aim of this study is to examine perspectives of young patients, caregivers, and physicians in the transition process. This 3-phase mixed methods research study gathered data using an iterative approach with the collaboration of youth coresearchers. Physician opinions were gathered through a survey. Further data were collected through 15 semistructured, standardized interviews of adolescent medicine physicians. Perspectives of adolescents and young adult (AYA) patients and their caregivers were gathered independently using a 20-item survey. Quantitative data were analyzed with descriptive statistics and sorted by theme. In phase 1, respondents rated current transition processes as an average 5.19/10 on a 10-point Likert scale (1 = poor and 10 = excellent) with no participants rating 9 or 10 of 10. The top barrier identified was a lack of communication between pediatric and adult doctors (71.0%). The top ranked strategy for improvement was to provide formal transition guidelines (69.8%). In phase 2, specific concerns include lack of insurance coverage, lack of physicians available to take on youth transitioning to adult care who are also knowledgeable regarding pediatric conditions, and lack of funding or staff support for transition clinics. In phase 3, most of the youth surveyed (52%) reported that their physicians have not involved them in conversations about transitioning. AYA patients prefer the point of transfer to occur with other life transitions such as graduation, and caregivers prefer transfer to happen during times of stability where their children can dedicate adequate time to their health. Fulfilling youth desire for increased patient autonomy and ownership can help overcome their poor perception of the transition process. Increased physician training in adolescent health and improvements in post-transition community plans may be beneficial to prevent loss to follow-up among young patients across medical disciplines. Successful transition into adult care requires a unique process for each youth and requires adequate preparation from the pediatric front, empowerment of young patients and their families, and continuity of care by adult providers.

Choosing an engineering major: A conceptual model of student pathways into engineering

AbstractBackgroundIncreasing interest and participation in engineering is vital if the United States is to create the larger technological and scientific labor force it needs to meet the challenges of the 21st century. Students' pathways into the different engineering majors provide important information for this effort.PurposeThis study addresses which factors across life stages (pre‐high school, high school, and early college) are associated with engineering major choice. The quantitative analysis identifies which demographic characteristics and academic achievement variables are correlated with engineering major choice, whereas the qualitative analysis examines when and why students choose a specific engineering major.MethodsInformed by the life course perspective, this convergent mixed methods research study applies Logit regression and thematic analysis. Data sets include more than 20,000 observations of student‐level academic records (2001–2015) as well as interviews conducted with 20 students at a large, research‐intensive university in the Midwest.ResultsQuantitative results indicate that student demographic factors and measures of academic achievement—including passing scores on advanced placement tests, scholastic aptitude test scores, and high school and college first‐year grade point averages—are associated with engineering major choice. Qualitative findings show that across the life stages, the source of social influence in engineering major choice varies; while family and teachers play larger roles before and during high school, peers and university personnel play larger roles in early college.ConclusionThe conceptual model comprehensively synthesizes the key factors associated with engineering major choice, highlighting the importance of demographic factors, academic achievement, social networks, and access to role models from pre‐high school, high school, and early college.

Prevalence of methodological transparency in the use of mixed methods research in library and information science research in South Africa and Nigeria, 2009–2015

Methodological transparency facilitates rigorous, trustworthy, and reliable mixed methods research (MMR). Because divergent views on the conceptualization of mixed methods can create confusion for researchers, methodological transparency can help researchers to replicate methods in other studies and attract them to mixed methods research. Many studies have been conducted to assess the utilization of mixed methods research in several disciplines, but few in library and information science (LIS) have studied how authors describe the methods used. This study investigated the clarity and detail provided about methodology in mixed methods research articles in LIS, focusing on South Africa and Nigeria. Content analysis was used to assess 104 doctoral theses, of which 10 used mixed methods. Results suggest that methodological transparency in MMR research is underrepresented in LIS. This study contributes to the discussion on how LIS can enhance the quality of mixed methods research studies by underscoring the importance of methodological transparency in such studies. Researchers and LIS educators can use the gaps identified by this study to use and report mixed methods appropriately in future research.

Factors and expectations influencing concussion disclosure within NCAA Division I athletes: A mixed methodological approach

BackgroundParticipation in sports is associated with many benefits to all aspects of health; however, it also comes with the risk of injury, particularly concussions. Self-disclosure and care seeking following a concussion are especially important because of the lack of outwardly visible signs and/or symptoms. Although recent research has explored factors affecting concussion disclosure, use of isolated methodologies limits the ability to contextualize how disclosure or nondisclosure occurs. Therefore, the purpose of this study was to describe the factors and expectations of National Collegiate Athletic Association (NCAA) athletes that may influence concussion disclosure. MethodsThis mixed-methods convergent parallel research study included 25 NCAA Division I athletes representing 13 sports, all of whom completed a concussion-education session with pre-/post-test surveys and a semistructured interview. Eligible athletes were at least 18 years old and on an NCAA roster. The surveys focused on previous concussion-related disclosure behaviors, knowledge, attitudes, beliefs, norms, and intentions about disclosing concussion. Interviews focused on the athletes’ experiences related to concussion disclosure. Survey data were analyzed using descriptive statistics and Mann-Whitney U tests. Interviews were analyzed using a Consensual Qualitative Research tradition. ResultsParticipants had good concussion knowledge (median = 46.0), positive attitudes (median = 38.0), strong beliefs (median = 13.0), and strong intentions to disclose concussion symptoms (median = 7.0). None of the constructs differed by participants’ gender. Although quantitative findings were mostly positive, interview data highlighted factors that may explain why some participants are successful in disclosing concussions and why others may find disclosure difficult. Educational efforts, sport culture, and medical professional presence were the primary facilitators discussed by participants. Stigma, pressure, and a lack of team support were perceived as disclosure barriers. ConclusionThe context in which concussion disclosure occurs or does not occur is vital to the success of educational interventions. Interventions must prioritize stakeholder- and team-based perspectives on concussion to establish a network supportive to disclosure.

Integration of e-Consumer Elements in Adult and Community Education

Kenya, like other countries in Africa and across the world is in the grip of technological advances leading its agencies and parastatals to digitize their operations. A pertinent question, therefore, is whether adult and community education, in its current packaging in Kenya, is empowering the participants to engage in using e-consumer services actively, meaningfully, and in beneficial ways in their daily transactions. This study, therefore, sought to investigate the level of integration of e-Consumer elements in Adult and Community Education. The study adopted a mixed-method research study targeting adult learners in Nairobi County, adult education officers, and adult education instructors. The study collected data using interviews and questionnaires. The study established that integration of ICT services in adult centers is still facing numerous challenges which are evident by the poor use of e-consumer services by the adult learners.

Barriers and facilitators to the implementation of nurse\u2019s role in primary care settings: an integrative review

BackgroundThe rapid evolution of the epidemiological picture and the recent SARS-COV-2 pandemic has expressed the vulnerabilities of health systems and focuses attention on the population’s needs.The nurse’s figure in the care teams is universally identified; however, the implementation of the role within some care settings turns out to be complex and challenging. This integrative review aims to identify the barriers and facilitators in implementing the role of the nurse in primary care settings.MethodsAn integrative review was conducted on the Medline and Cinahl databases until 9 June 2020. Qualitative, quantitative, and Mixed-method research studies were selected to identify studies related to the barriers and facilitators of the nurse’s role in nursing facilities’ primary care. For the extraction of the results, the Consolidating Framework for Research Implementation (CFIR) was used to identify the factors that influence implementation in health care.ResultsFollowing the duplicates’ removal, the search identified 18,257 articles, of which 56 were relevant to the inclusion criteria; therefore, they were included in the summary.The selected studies were conducted in thirteen countries, most from Oceania, Europe, North America, Latin America, and the Caribbean.The barriers reported most frequently concern the nursing profession’s regulatory and regulatory aspects within the contexts of care, cultural and organizational aspects, training, and the transfer of specific skills, which were previously designated to doctors.The facilitators are mainly linked to the nurse’s adaptability to the various contexts of care, recognizing the patient’s role, and the desire to develop multidisciplinary and effective working groups to respond to the health needs of the population in primary care contexts.ConclusionThis review highlighted the main barriers and facilitators in implementing the nurse’s role in primary care settings. These results offer useful elements for stakeholders to identify effective strategies in preparing programs and activities for implementing the nurse’s role, acting on the elements identified as barriers and favouring the aspects that emerge as facilitators.

Using Gaze Tracking as a Research Tool in the Deaf Health Literacy and Access to Health Information Project: Protocol for a Multisite Mixed Methods Study and Preliminary Results.

BackgroundPrevious studies have identified the internet as a major source of health information. Reliable and accessible sources of web-based health information are critical for cultivating patient-centered care. However, the accessibility and use of web-based health information remains largely unknown for deaf individuals. We used gaze-tracking technology to understand the navigation and use of web-based health information by deaf adults who communicate with sign language and by hearing adults.ObjectiveThis paper discusses our protocol for implementing gaze-tracking technology in a study that included both deaf and hearing participants. We report the preliminary results and lessons learned from the implementation of the protocol.MethodsWe conducted gaze-tracking sessions with 450 deaf signers and 450 hearing participants as a part of a larger, multisite mixed methods research study. Then, we conducted qualitative elicitation interviews with a subsample of 21 deaf and 13 hearing participants, who engaged in a search task and reviewed their gaze recordings. To our knowledge, no study has implemented a similar research protocol to better understand the experiences of deaf adults. As such, we also examined research staff notes and observations from team meetings regarding the conduct of gaze-tracking data to delineate lessons learned and best practices for research protocols in this area.ResultsFindings from the implementation of this study protocol highlight the use of gaze technology with deaf participants. We developed additional protocol steps to minimize gaze disruption from either lipreading or communicating in sign language. For example, research assistants were often unable to maintain eye contact with participants while signing because of the need to simultaneously point at the computer monitor to provide instructions related to gaze study components, such as the calibration process. In addition to developing ways to effectively provide instructions in American Sign Language, a practice exercise was included in the gaze tracker session to familiarize participants with the computer and technology. The use of the playback feature permitted a deeper dialogue between researchers and participants, which we found vital for understanding the experiences of deaf participants.ConclusionsOn the basis of our experience using the study protocol through a large research project, incorporating gaze-tracking technology offers beneficial avenues for better understanding how individuals interact with health information. Gaze tracking can determine the type and placement of visual content that attracts attention from the viewers of diverse backgrounds, including deaf individuals. The lessons learned through this study will help future researchers in determining ideal study designs, such as suitable protocols and participant characteristics (eg, deaf signers), while including gaze trackers in their projects. This approach explored how different ways of presenting health information can affect or enable visual learners to engage and use health information effectively.International Registered Report Identifier (IRRID)RR1-10.2196/26708

A mixed-methods investigation to understand and improve the scaled-up infection prevention and control in primary care health facilities during the Ebola virus disease epidemic in Sierra Leone

BackgroundThe 2014–2015 Ebola epidemic in West Africa became a humanitarian crisis that exposed significant gaps in infection prevention and control (IPC) capacity in primary care facilities in Sierra Leone. Operational partners recognized the national gap and rapidly scaled-up an IPC training and infrastructure package. This prompted us to carry out a mixed-methods research study which aimed to evaluate adherence to IPC practices and understand how to improve IPC at the primary care level, where most cases of Ebola were initially presenting. The study was carried out during the national peak of the epidemic.DiscussionWe successfully carried out a rapid response research study that produced several expected and unexpected findings that were used to guide IPC measures during the epidemic. Although many research challenges were similar to those found when conducting research in low-resource settings, the presence of Ebola added risks to safety and security of data collectors, as well as a need to balance research activities with the imperative of response to a humanitarian crisis. A participatory approach that attempted to unify levels of the response from community upwards helped overcome the risk of lack of trust in an environment where Ebola had damaged relations between communities and the health system.ConclusionIn the context of a national epidemic, research needs to be focused, appropriately resourced, and responsive to needs. The partnership between local academics and a humanitarian organization helped facilitate access to study sites and approvals that allowed the research to be carried out quickly and safely, and for findings to be shared in response forums with the best chance of being taken up in real-time.

Aquatic Exercise and Its Effect on Participation, Quality of Life, and Falls Self-efficacy in Older Adults: A Pilot Study

Background: Falls are extremely common in the older adult population, and fear of falling has been cited as one of the main reasons older adults may choose not to participate in social activities. Exercising in the water can provide support from buoyancy that helps reduce this fear, leading to increased participation in meaningful activities. Purpose: The purpose of this mixed-methods research study was to determine whether participation in an aquatic exercise program was an effective way to increase falls self-efficacy, social participation, and quality of life in older adults. Methods: Twelve adults, aged 62 to 77 years, participated in 1-hour aquatic exercise sessions, twice per week for 4 weeks. Participants completed a demographic questionnaire, and 3 pre/posttest measures: the Keele Assessment of Participation (Keele), the Falls Efficacy Scale-International (FES-I) for falls self-efficacy, and the World Health Organization's Quality of Life Scale (WHOQOL-BREF) for quality of life. They also completed an expectations check sheet and one open-ended question asking about the meaning and effect of the program. Results: Although there were no significant differences found between pre/posttest scores on the Keele, there was a statistically significant difference in reported falls self-efficacy with respect to ability to climb and descend stairs (P = .046). There was also a statistically significant difference on the WHOQOL-BREF for access to available information (P = .025) and for participant satisfaction with ability in performing activities of daily living (P = .046), as well as a significant increase in the number of anticipated benefits versus the number of gained benefits (P = .032). Qualitatively, participants reported improved body functions, increased social interactions, and experiencing enjoyment and motivation with the change in activity. Relevance: Participation in aquatic exercise may have positive effects on falls self-efficacy, social participation, and quality of life in older adults. This was a small sample size, however, and further research is recommended.

Teachers Perceptions of Google Classroom: Revealing Urgency for Teacher Professional Learning

As the use of educational technology is at the forefront of today’s educational revolution, it is imperative that educators are employing online learning environments such as Google Classroom to enhance 21st century pedagogy and student learning. Through this mixed method research study, it has been concluded that using Google Classroom will assist educators in creating learning environments which boast organization, accessibility, mobility, and 21st century learning skills. This research reveals there continues to be gaps between the possibilities of eLearning and the training of teachers to use it and develop their teaching practices within a technological mainstream that moves beyond positivism about its value. The researcher recommends that teachers receive immediate and sustained professional learning regarding the use of Google Classroom. This learning should focus on the pedagogical side of technology integration in order to enhance 21st century learning.

Collaborative care model for depression in rural Nepal: a mixed-methods implementation research study

IntroductionDespite carrying a disproportionately high burden of depression, patients in low-income countries lack access to effective care. The collaborative care model (CoCM) has robust evidence for clinical effectiveness in improving...