Mixed Methods Study Research Articles

Police Leadership Education: Digital Didactics, Perceived Learning and Perceived Increased Competence as Police Leaders

Police leadership is an essential part of policing, as is the education of police leaders. Our study responds to the call for research on how to transform police leadership education into practice. In this longitudinal mixed-methods single case study we investigate two research questions: 1) How do the digital didactics of the digital police leadership course contribute to students’ perceived learning? 2) How are the knowledge and skills acquired in the digital police leadership course perceived to be applied 1.5 years after course completion? We collected data from students enrolled in a 12-week course. This course offered 24 students a two-day on-site course introduction, while the rest of the course was taught online. Data was collected through five surveys and follow-up interviews with six participants. The results show that police leaders perceived increased competence in being a police leader, report enhanced ability to bridge theory and practice, and improved their digital skills. They also reported increased confidence in the leadership role and increased sharing of competence after study completion. The findings suggest that digital didactics may achieve embedded police education as it can provide an interplay of individual and organizational factors.

Multi-stakeholder Governance Toward Mitigating Marine Plastic Waste in Hoi An Coastal City, Vietnam

Background and objective: Marine plastic waste is a pressing environmental issue that requires coordinated efforts across various stakeholders to mitigate its impacts effectively. This research examines the multi-stakeholder governance approach towards reducing marine plastic waste in Hoi An coastal city, Vietnam. The study explores the roles and interactions of key stakeholders, including government agencies, local communities, businessmen, scientists, and international agencies, in addressing marine plastic pollution.Methods: Through a combination of interviews, policy analysis, and field observations, this research identifies the challenges and opportunities in implementing sustainable waste management practices. A mixed-methods approach study was conducted and collected data from August 2022 to February 2023, June 2023 to September 2023 and July-August 2024. Two hundred and three random online survey samples were collected. Additionally, forty in-depth interviews were conducted with government officers, businesspeople, researchers, and international agency representatives and each interview lasted for about one hour. The research used both purposive and snowball sampling to maximise the breadth of actors’ perspectives.Results: The research found that effective mechanisms and collaborative governance among diverse stakeholders such as government officials, businesses, communities, international organizations, and scientists are crucial for significantly reducing marine plastic waste. It also underscores the importance of community engagement in preventing plastic waste from entering the ocean and highlights the role of market-driven forces in plastic waste mitigation. Furthermore, the findings emphasize the need to expand scientific and international support to achieve the ultimate goal of reducing marine plastic waste.Conclusion: This study offers insights into best practices and policy recommendations that can be applied to other coastal regions facing similar environmental challenges. By fostering a collective responsibility approach, Hoi An can serve as a model for other coastal cities in Vietnam and beyond in their efforts to combat marine plastic pollution.

Discoveries or doubts: a qualitative study of the transformative potential of portfolio meetings.

To adapt to medical school, students need to change their approaches to learning and study. Transformative learning through critical reflection on disorienting learning experiences supports perspective change to direct new activity. We explored how portfolio meetings support changes in students' perspectives towards learning and study during the transition to studying medicine. This qualitative mixed methods study explored changes in medical students' perspectives before and after two portfolio meetings with a mentor during the first year of medicine. Adopting a constructionist approach, we analyzed interview transcripts and written reflections from a diverse sample of students using reflexive thematic analysis. The findings were integrated during analysis. Transformative learning theory was our interpretive lens. Our analysis revealed five themes. Two themes represented students' initial apprehension about portfolio meetings: The Disclosure Dilemma and A Question of Priorities. The theme "Seeing the Big Picture" described new perspectives from reflection on learning while preparing for meetings. Clarity from Dialogue described changed perspectives to learning and study after meetings. In the theme Dialogue Disappointment, meetings perceived as unhelpful led to persisting doubts about the value of portfolio meetings. Transformative learning was evident when students described new insights into their learning leading to goal-setting and new study strategies. When initial meetings were helpful, doubts about portfolio meetings were dispelled, enhancing student engagement in future meetings. Not all meetings were transformative, highlighting the importance of student and mentor preparation and training. Further research is needed to determine whether early portfolio experiences shape later engagement in clinical contexts.

Inclusion and Integration of Youth Needs in Youth Empowerment Programmes: A Mixed-Method Study of Nairobi and Trans Nzoia Counties

Inclusion and Integration of Youth Needs in Youth Empowerment Programmes: A Mixed-Method Study of Nairobi and Trans Nzoia Counties

Cost management analysis of Objective Structured Clinical Examination (OSCE): guide to the universities of medical sciences

BackgroundThe Objective Structured Clinical Examination (OSCE) is a crucial assessment tool for evaluating learners’ ability to apply theoretical knowledge in practical clinical situations. It is widely accepted by both students and educators, and the costs associated with conducting OSCE assessments vary depending on the field of study, how it is implemented, staffing needs, standardized patients, and duration of the examination. This study examines the expenses related to administering OSCEs in medical universities.MethodConducted from June to September 2023; this mixed-method study elucidated the cost intricacies of executing a two-day OSCE with 14 eight-minute stations for 100 nursing students. This process unfolds in two phases: a qualitative segment comprising text reviews and 45-minute in-depth interviews with faculty members and OSCE experts, leading to the development of a validated checklist, followed by a quantitative phase in which the tool was distributed to 25 faculty members and 5 specialists for completion.ResultThe examination costs were delineated into three primary components: time, human resources, equipment, consumables, and necessary supplies. In 2023, the total implementation cost of the OSCE for 100 students across 14 clinical stations was $1028.07, with an estimated per-learner cost of $37.50. Human resources incurred the highest expenditure ($1649.37); while supply costs were relatively lower ($1072.17). Educational infrastructure expenses were excluded because the study focused on the Nursing and Midwifery Faculty’s Clinical Skills Center.ConclusionVarious factors influence OSCE costs, including national production capabilities of medical supplies, institutional credibility, governance status, examination frequency, student demographics, assessor composition, station count, course content, and examinee volume. The insights derived from this comprehensive examination are significant as entry benchmarks for healthcare systems and higher-level academic evaluations. Understanding OSCE cost dynamics facilitates resource optimization and assessment strategy refinement, thereby improving medical education efficacy.

Planning and evaluating an integrated clinical exercise oncology service: an exploratory mixed-methods study

BackgroundThis project aimed to design and evaluate the potential to integrate an exercise oncology service into clinical care in a local healthcare system. The goal was to inform the design of an implementation strategy to promote its sustainable use in standard care.MethodsThis two-phase, exploratory study used a mixed-methods approach. First, qualitative measures were used to understand the context for exercise integration into oncology care by clinicians and administrators in the healthcare system. Next, the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework guided a comprehensive evaluation of the exercise service. Reach and Adoption were measured via number of patients enrolled in the program relative to those treated. Adoption was measured via referrals from stakeholders. Implementation was described using the program structure and delivery. Maintenance was described using hospital funding decisions. Effectiveness was assessed using the Bellarmine Norton Assessment Tool (BNAT) and Functional Assessment of Cancer Therapy – Fatigue Scale.ResultsPhase 1 context analysis suggested critical elements to guide program delivery, including limiting participants to post-primary treatment (surgery, chemotherapy and radiation) and streamlining referral process. The Phase 2 evaluation demonstrated suboptimal program reach (2%); significant program effectiveness (improved physical function (BNAT; p = 0.05 ) and decreased fatigue (p < 0.05)); receptiveness to program adoption (75%); and strong potential for program maintenance.ConclusionsTraditional approaches to exercise oncology research trials are not easily integrated into healthcare systems. Designing an exercise program for meaningful integration and sustainment requires understanding the context where the program will be delivered, followed by intentional and continuous engagement with key stakeholders to ensure the program continues to meet the needs of the system. Initial exploration of the settings is critical to inform a comprehensive implementation strategy.Trial registrationclinicaltrials.gov: NCT06039488. Prospectively Registered Sept 15th, 2023.

Ethnic studies and student development: Cultivating racially marginalized adolescents' critical consciousness.

There is debate around offering ethnic studies to high school students. Ethnic studies connects learning to students' lives and analyzes the workings of racism to construct avenues toward equity. As the debate unfolds, it is critical to examine ethnic studies' implications for youth development and the mechanisms that link it to student outcomes. One of ethnic studies' long-stated goals is fostering students' critical consciousness. Critical consciousness refers to critical reasoning around inequality (critical reflection), motivation to challenge inequality (critical motivation), and action taken to disrupt inequality (critical action). Little research has examined youth critical consciousness development within ethnic studies-a consciousness-raising system. Consequently, this longitudinal mixed-methods study examines students' critical consciousness development in ethnic studies and sheds light on the contextual characteristics (i.e., critical school socialization) that foster critical consciousness. Analyses of 459 ninth-grade students' (52% girls, 4% nonbinary; 1% Asian, 1% Black, 4% multiracial, 64% Latinx, 7% Native American, 15% described their own race, 7% skipped the question; Mage = 13.92) survey data, and focus group data with 19 students, revealed that ethnic studies-enrolled students grew more in their critical reflection than nonenrolled students. However, the quantitative data demonstrated decreasing critical motivation among all students, whereas the qualitative data suggested emergent critical motivation among ethnic studies-enrolled students. Furthermore, critical school socialization and teacher pedagogy were key to ethnic studies consciousness-raising. Altogether, this study highlights that ethnic studies fosters youth critical consciousness-a worthwhile outcome that should be considered in policy debates about ethnic studies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Examining the Impact of PBIS Experience on MTSS Implementation in Secondary Schools: A Mixed Methods Study

This sequential explanatory mixed methods study with a complementarity rationale examined the differential experiences of MTSS implementation in three Positive Behavior Interventions and Supports (PBIS)-implementing and three non-implementing secondary schools in the Midwestern United States. Using a survey and follow-up interviews with a sample of 25 secondary school leadership team (SLT) members, this study sought to understand (1) their beliefs and attitudes toward MTSS prior to implementation and (2) unique barriers and facilitators to MTSS implementation in secondary education following initial MTSS implementation. Overall, the results of this study indicated that generally, SLT members had positive beliefs and attitudes toward MTSS prior to implementation which were maintained a year later at follow-up. Additionally, several differential barriers and facilitators to implementation emerged between PBIS and non-PBIS schools, though shared barriers and facilitators were also evident. Lastly, experience with PBIS differentially impacted the experiences of SLT members from PBIS and non-PBIS schools. Implications for secondary school practitioners, schools, and local educational agencies are discussed.

Characterization of Telecare Conversations on Lifestyle Management and Their Relation to Health Care Utilization for Patients with Heart Failure: Mixed Methods Study.

Telehealth interventions where providers offer support and coaching to patients with chronic conditions such as heart failure (HF) and type 2 diabetes mellitus (T2DM) are effective in improving health outcomes. However, the understanding of the content and structure of these interactions and how they relate to health care utilization remains incomplete. This study aimed to characterize the content and structure of telecare conversations on lifestyle management for patients with HF and investigate how these conversations relate to health care utilization. We leveraged real-world data from 50 patients with HF enrolled in a postdischarge telehealth program, with the primary intervention comprising a series of telephone calls from nurse telecarers over a 12-month period. For the full cohort, we transcribed 729 English-language calls and annotated conversation topics. For a subcohort (25 patients with both HF and T2DM), we annotated lifestyle management content with fine-grained dialogue acts describing typical conversational structures. For each patient, we identified calls with unusually high ratios of utterances on lifestyle management as lifestyle-focused calls. We further extracted structured data for inpatient admissions from 6 months before to 6 months after the intervention period. First, to understand conversational structures and content of lifestyle-focused calls, we compared the number of utterances, dialogue acts, and symptom attributes in lifestyle-focused calls to those in calls containing but not focused on lifestyle management. Second, to understand the perspectives of nurse telecarers on these calls, we conducted an expert evaluation where 2 nurse telecarers judged levels of concern and follow-up actions for lifestyle-focused and other calls (not focused on lifestyle management content). Finally, we assessed how the number of lifestyle-focused calls relates to the number of admissions, and to the average length of stay per admission. In comparative analyses, lifestyle-focused calls had significantly fewer utterances (P=.01) and more dialogue acts (Padj=.005) than calls containing but not focused on lifestyle management. Lifestyle-focused calls did not contain deeper discussions on clinical symptoms. These findings indicate that lifestyle-focused calls entail short, intense discussions with greater emphasis on understanding patient experience and coaching than on clinical content. In the expert evaluation, nurse telecarers identified 24.2% (29/120) of calls assessed as concerning enough for follow-up. For these 29 calls, nurse telecarers were more attuned to concerns about symptoms and vitals (19/29, 65.5%) than lifestyle management concerns (4/29, 13.8%). The number of lifestyle-focused calls a patient had was modestly (but not significantly) associated with a lower average length of stay for inpatient admissions (Spearman ρ=-0.30; Padj=.06), but not with the number of admissions (Spearman ρ=-0.03; Padj=.84). Our approach and findings offer novel perspectives on the content, structure, and clinical associations of telehealth conversations on lifestyle management for patients with HF. Hence, our study could inform ways to enhance telehealth programs for self-care management in chronic conditions.

Psychometric Properties and Meaningful Change Thresholds of the Vitiligo Area Scoring Index

Defining meaningful improvement using the Total Vitiligo Area Scoring Index (T-VASI) and the Facial VASI (F-VASI) aids interpretation of findings from clinical trials evaluating vitiligo treatments; however, clear and clinically meaningful thresholds have not yet been established. To assess concept validity and measurement performance of the T-VASI and F-VASI in patients with nonsegmental vitiligo and to identify meaningful change thresholds. This mixed-methods study consisted of a secondary analysis of a phase 2 multicenter double-blind dose-ranging randomized clinical trial and embedded qualitative interviews conducted at 35 sites in Canada, France, Japan, and the US. The secondary analysis included the trial's adult patients with nonsegmental vitiligo (T-VASI ≥5 and F-VASI ≥0.5 at baseline). Psychometric performance of the T-VASI and F-VASI and thresholds for meaningful change were evaluated using clinician- and patient-reported information. The trial's embedded interviews were used to qualitatively assess content validity and patient perceptions of meaningful repigmentation. Data analyses were performed from March to July 2023. Participants were randomized to 6-, 11-, or 22-mg/day upadacitinib or placebo for 24 weeks. Psychometric performance of the T-VASI and F-VASI and thresholds for meaningful changed plus content validity and patient perceptions of meaningful repigmentation. Measurement instruments included the T-VASI, F-VASI, Vitiligo Noticeability Scale, Total-Patient Global Vitiligo Assessment, Face-Patient Global Vitiligo Assessment, Total-Physician Global Vitiligo Assessment (PhGVA-T), Face-Physician Global Vitiligo Assessment (PhGVA-F), Patient's Global Impression of Change-Vitiligo, Physician's Global Impression of Change-Vitiligo (PhGIC-V), Vitiligo Quality-of-Life Instrument, Dermatology Life Quality Index, the Hospital Anxiety and Depression Scale, and transcribed verbatim interviews with patients. The psychometric analysis included 164 participants (mean [SD] age, 46 years; 103 [63%] females) and the qualitative analysis included 14 participants (mean [SD] age, 48.8 [12.2] years; 9 females [64%] and 5 males [36%]). Intraclass correlation coefficients were 0.98 for T-VASI and 0.99 for F-VASI in patients with clinically stable vitiligo between baseline and week 4, supporting test-retest reliability. At baseline and week 24, correlations were moderate to strong between T-VASI and PhGVA-T (r = 0.63-0.65) and between F-VASI and PhGVA-F (r = 0.65-0.71). Average baseline and week-24 VASI scores decreased with repigmentation (ie, increasing PhGVA scores). Least-square mean VASI scores increased with greater repigmentation as measured by the PhGIC-V. Least-square mean VASI scores also differed between patients with improved PhGIC-V and those with no change or worsened V-PhGIC scores. Using a multiple anchor approach, improvements of 30% in T-VASI and 50% in F-VASI scores reflected meaningful repigmentation between baseline and week 24. This mixed-methods study found that the T-VASI and F-VASI are reliable, valid, able to differentiate between clinically distinct groups, and responsive in patients with nonsegmental vitiligo. The thresholds for meaningful change were lower than those historically used in clinical trials, suggesting that T-VASI 50 and F-VASI 75 are conservative estimates and reflect improvements that would be meaningful in patients with nonsegmental vitiligo. ClinicalTrials.gov Identifier: NCT04927975.

The Impact of AI Techniques on Human-AI Interaction Quality in Project Management: A Mixed-Methods Study

Artificial intelligence (AI) is changing how organizations work through its integration with project management. This study looks at how AI approaches affect the quality of human-AI interaction in project management settings. The main research issue focuses on figuring out how various AI approaches affect the quality of interactions. A mixed-methods approach was used in the study, integrating qualitative case studies with quantitative questionnaires. Forty-five (45) respondents, comprising project managers and developers from various organizations in Lagos State, Nigeria, were among the participants. While qualitative interviews probed participant experiences, quantitative data offered numerical insights. It was revealed that image-based AI increases engagement by providing visual signals, while speech-based AI improves social presence and trust. Additionally, performance, communication, and trust are all related. This implies that open communication promotes trust, which influences the project's success. By being transparent and adapting AI implementation to the specifics of each project, project managers and AI engineers can foster confidence and regularly assess the efficacy of AI.

The interplay of job embeddedness, collective efficacy, and work meaningfulness on teacher well-being: a mixed-methods study with digital ethnography in China

IntroductionThis study examines the influence of teacher job embeddedness, collective efficacy, and work meaningfulness on the psychological well-being of Chinese teachers. The focus is on understanding how these constructs contribute to teacher well-being through a mixed-methods approach.MethodsA two-stage structural equation modeling (SEM) analysis was conducted using quantitative data collected from 406 in-service Chinese teachers. The study also incorporated a qualitative phase involving digital ethnography within online teaching communities to provide deeper insights into teachers’ experiences.ResultsThe quantitative analysis revealed significant positive direct effects of job embeddedness, collective efficacy, and work meaningfulness on psychological well-being, with work meaningfulness showing the strongest effect. The mediating role of work meaningfulness partially explained the relationships between job embeddedness, collective efficacy, and teacher well-being. The qualitative findings supported and expanded upon these results, emphasizing the role of a supportive school community and strong administrative leadership.DiscussionThe results suggest that enhancing job embeddedness, collective efficacy, and work meaningfulness can significantly contribute to teachers’ psychological well-being. These findings provide actionable insights for school leaders and policymakers in the Chinese educational system to foster environments that promote teacher well-being.

Learning Approaches of First-Year University Students: A mixed-method study in Chile

In Chile, the low retention rates among first-year university students are an issue of concern. Additionally, the sustained growth in enrolment in higher education poses challenges for universities due to inequalities in the students' basic and secondary education, increasing the risk of dropout. This study analysed the learning approaches among first-year students in English and Physical Education at three universities in the La Araucanía region and their impact on academic performance and retention rates. The research was carried out using a mixed methodological design, with a quantitative predominance of sequential order QUANT-qual with three phases, starting with a questionnaire to identify learning approaches, complemented with semi-structured interviews with students and concluding with the triangulation of the results obtained in the first and second phases. In the first phase 114 students participated, 46 males and 68 females, and in the second phase 10 students participated, 4 males and 6 females. The results indicated that participants adopted a deep learning approach with a prevalence of moderate intensity. A superficial learning approach correlates with university retention rates, but there is no significant relationship between learning approaches and academic performance. Qualitative findings showed that deep motivation and superficial learning strategies continuously influence participants when they face academic demands.

Error-based Activity Applications in Sixth Grade Fraction Teaching

This study aims to determine how the error-based activity (EBA) applications used in teaching fractions to sixth-grade students affect the academic achievement of the students, the perceived error climate in the classroom, student math anxiety levels, the permanence of the knowledge, and student views on the EBA applications. In the quantitative part of this research, a mixed-method study, a quasi-experimental design with a pretest-posttest control group was used to examine the effects of EBA applications on math achievement, math anxiety levels, classroom error climate, and permanence. A purposive sampling method was used to collect the quantitative data for the study. In the qualitative part of this research, a case study, semi-structured interviews were conducted with nine volunteers from the experimental group to determine the student views of EBA practices. Analyzing the data obtained showed that EBA had a positive effect on student success, positively affected the perceived error climate in the classroom, and effectively reduced student math anxiety levels and made the knowledge permanent. Apart from this, the results indicated that EBA applications positively affect students in terms of cognitive and affective aspects, increase the quality of teaching, and can be effective in different subjects and courses.

Utilization of cervical cancer screening services among women aged 18 to 59 years in Laikipia East Sub-County, Kenya

INTRODUCTION Cervical cancer, a preventable disease, continues to be the leading cause of death resulting from cancers in Kenya. Despite free cervical cancer screening services in all government hospitals in Laikipia County, the screening uptake remains low at 19% compared to the WHO target of 70%. Hence, understanding the barriers and facilitators is important in informing targeted interventions. MATERIALS AND METHODS A mixed-method cross-sectional study was done in Laikipia East Sub-County, Kenya, between July and August 2022. The participants were women aged between 18 to 59 years. Data was collected on demographic factors and cervical cancer screening utilization. Also, qualitative data was collected using 5 FGDs and 6 KIIs to get more insights. Chi-square tests and odds ratios were calculated using STATA version 15 to assess associations and determine the level of significance. RESULTS Out of the 272 participants, 32.4% (n=88) had ever screened for cervical cancer. The logistic regression analysis indicates that as women age, their likelihood of undergoing screening increases, particularly for those aged 50-59, who show a tenfold higher likelihood of screening [ OR 10.40 (3.20-33.82), p-value &lt;0.001]. Conversely, unemployment is associated with a reduced likelihood of screening [OR 0.42 (0.18-0.99), p-value 0.047] while individuals earning 50-200 USD per month exhibit an increased likelihood [OR 2.25 (1.30-3.87) p-value 0.004]. However, religion, marital status, and education level factors do not show a significant association with the utilization of cervical cancer screening as indicated by p-values of 0.735, 0.069, and 0.765, respectively. CONCLUSION AND RECOMMENDATIONS Laikipia county government offers free cervical cancer screening in all government-run facilities but many, especially those aged 25-49, lack awareness. It is vital to boost awareness through community education on cervical cancer causes and prevention, emphasizing screening as preventive. Affordable treatment is also crucial for community reassurance post-diagnosis.

Fidelity, acceptability, and feasibility of the revised functional autonomy measurement system for hospitalised people: An implementation study.

The revised functional autonomy measurement system (SMAF-R) is an outcome measure of activity performance and resource needs. This study aimed to measure the implementability of the SMAF-R as a routine outcome measure in acute and subacute inpatients. This was a mixed-methods implementation study. Occupational therapists were asked to complete the SMAF-R in hospitalised people with an anticipated length of stay greater than 48 hours over a 12-month period (n= 13,348). A baseline audit of SMAF-R completion rates was conducted, and behaviour change interventions were delivered over 12 months. The Implementability of Healthcare Interventions conceptual framework was used to evaluate fidelity (completion rates), acceptability (staff survey with quantitative and qualitative responses), and feasibility (change in SMAF-R scores from admission to discharge). Quantitative and qualitative (analysed thematically) data were integrated. Occupational therapists and other staff working to improve outcome measure completion within the electronic medical record and other allied health teams were consulted when developing and delivering behaviour change interventions. Peak completion of the SMAF-R did not meet an 80% fidelity success rate (admission: 32% in acute and 66% in subacute; discharge: 12% in acute and 48% in subacute). Two thirds of occupational therapists reported the SMAF-R was an acceptable measure to use, but only 38% liked using it. Thematic analysis revealed three themes: (1) A greater understanding of the relevance of the SMAF-R influenced acceptability; (2) using the SMAF-R within an electronic medical record may facilitate completion; and (3) it takes more time to complete SMAF. Patients made clinically significant improvements in SMAF-R scores during their hospital stay (median difference 16.5 [6.5-27.0], p< 0.001, n= 764). Although most occupational therapists reported the SMAF-R was acceptable, there were mixed opinions regarding the relevance of the SMAF-R in this setting, which may have impacted fidelity. Additional prompting and training (especially regarding understanding SMAF-R relevance to practice) may assist with improving SMAF-R completion. Further research is required to assess the psychometric properties of the SMAF-R in the hospital environment. The revised functional autonomy measurement system (SMAF-R) is an assessment tool used to measure performance in everyday activities (such as showering) and the resources needed to complete these tasks (e.g., a shower chair or someone's help). Occupational therapists can use it at the start of a patient admission and again at the end in different hospital settings to assess patients' needs and see if they improve. This study aimed to measure (1) how often occupational therapists use the SMAF-R with patients in hospital, (2) how acceptable occupational therapists find the SMAF-R, and (3) whether the SMAF-R shows changes in patients' abilities during their hospital stay. Before the study, usual completion of the SMAF-R was measured, and it was found to be completed in less than 1% of patients. Strategies were introduced to improve SMAF-R completion over 12 months. After this, completion of the SMAF-R improved to between 9% and 38% in different hospital settings. Changes in SMAF-R scores showed that patients improved during their time in hospital. Most occupational therapists reported the SMAF-R was an acceptable measure, but less than half liked using it. The low completion rates suggested that either the SMAF-R was not fit for purpose in this setting or that more support is needed to increase completion.

A mindfulness-based intervention for Substance Use Disorder in a Brazilian vulnerable population: a feasibility mixed method study

IntroductionSubstance Use Disorder (SUD) is a chronic condition that impacts various facets of an individual’s life, and society as a whole. The Mindfulness-Based Relapse Prevention (MBRP) protocol is an innovative intervention that can help to prevent relapse, particularly when used as a post-treatment approach. However, although there is significant evidence of its effectiveness in studies from high-income countries (HICs), there is a dearth of studies examining its feasibility and efficacy in low- and middle-income countries (LMICs). Thus, this study investigates the feasibility of MBRP as an adjunct to outpatient treatment for SUD in a socially vulnerable Brazilian population.MethodsThe study employed a mixed-methods design in eight Psychosocial Care Centers for Alcohol and Drugs (CAPS-ad) in the city of São Paulo, and involved 140 participants, 24 healthcare professionals and 7 CAPS-ad managers. In total, 17 MBRP intervention groups were conducted. The study assessed qualitative indicators of acceptability, demand, implementation, adaptation, integration, and limited efficacy testing through group interviews, in-depth interviews and field diary records. It also included limited efficacy testing of the protocol using a quantitative pre-post pilot study to investigate consumption behavior, using the Timeline Followback (TLFB) assessment method; depression, using the Center for Epidemiologic Studies Depression (CES-D) scale; anxiety, using the state trait anxiety index (STAXI-2); craving, using the Penn Alcohol Craving Scale (PACS); readiness to change, using the Readiness-to-Change Ruler (RCR); and severity of dependence, using the Severity of Dependence Scale (SDS). The qualitative data were triangulated with the quantitative data to comprehensively evaluate the feasibility of the intervention.ResultsThe sample comprised socially vulnerable participants with a high dropout rate, primarily due to social factors. Despite facing challenges in respect of regular engagement and initial cultural misperceptions of meditation, the intervention showed positive acceptance and mental health benefits, including impacts on consumption behavior.DiscussionThe study emphasizes the importance of adapting the format of the protocol to better suit vulnerable populations, and to ensure its effective integration into the public healthcare system. Future research should explore protocol modifications, assess its effectiveness in different contexts, and conduct cost-benefit analyses for broader implementation.

Emotional Earmarking: Insights into Remittances and Emotions from a Mixed Methods Study of Migrant Households in Rural Philippines

Overseas remittances improve the economic conditions and influence the financial behaviors of international migrants’ families that remain in the country of origin. Remittances affect family relationships in the hometown and across transnational borders, but migration research has not yet analyzed these family dynamics through the lens of household finance. Recent studies address the remittance–emotion nexus partially and statically rather than holistically and dynamically, delivering an insufficient understanding of complex and evolving links mediated by the sending, using, and investing of remittances. Built on an existing family financial socialization model, and using mixed methods for case studies in two rural municipalities of the Philippines, this study sets out to determine how emotions come into play as families strive to use remittances productively. A central finding is that migrant households employ what we call emotional earmarking to bring about economic benefits along with concurrent emotional benefits to family relationships. This emotional earmarking can help families (as well as migration and development stakeholders) in the productive use of remittances and the maintenance of family connections despite the physical absence of migrant members.

Effectiveness of Field Experience Program in the United Arab Emirates (UAE): A Mixed-Methods Study of Stakeholders’ Perceptions in the Light of Vision 2030

The quality of field experience training is vital for the pre-service teachers’ professional development. However, limited research works on field experience training programs limits the formation of optimised educational policies in the UAE. Further, proper understanding of the stakeholders’ perceptions is essential for forming suitable educational policies. Therefore, this study employed a mixed-methods model to investigate the perceptions of pre-service teachers and instructors about their field experience training. The pedagogic standards set by Danielson was used as the framework for assessing the perceptions of the participants regarding their pedagogy. Further, ‘Bem’s self-perception theory’ was applied while making detailed assessments on the perceptions of participants. By using a random sampling method, 113 pre-service teachers and 15 instructors were recruited. Descriptive as well as inferential statistics was used for the quantitative assessments whereas thematic analysis was used in the qualitative phase. Quantitative analysis suggested that most of the respondents perceived that they are well-prepared for the professional teaching career. However, some respondents indicated that stakeholders have little role in the decision-making process and there is a lack of opportunity to interact with the parents/community. The qualitative analysis also affirmed the lack of stakeholders’ involvement. Other significant factors include: insufficient co-ordination, conflicts with mentors, inadequate training, and lack of exposure to research. Consequently, this study has made suggestions for rectifying these issues. It is anticipated that findings of present research will add on to the essential knowledgebase for achieving the goals set for education sector, as per UAE’s Vision 2030.

Saudi EFL Students’ Attitudes Toward the Target Culture and Its Relationship with Their Linguistic Backgrounds

Culture and language have long been focal points of investigation, and both have been intensively discussed in the academic literature, but little attention has been paid to the influence of EFL students&amp;rsquo; linguistic backgrounds on their attitudes toward the target culture, especially in the Saudi context. This mixed-method study aimed to explore the impact of learners&amp;rsquo; linguistic backgrounds (mainly their language academic achievement levels and contexts of language learning) on their attitudes toward the target culture. The data was collected using an online questionnaire. A total of 84 students from the Faculty of Language and Translation at King Khaled University participated in this study. A Pearson correlation coefficient test and thematic analysis were used to interpret the data. The results showed a significant relationship between the participants&amp;rsquo; linguistic backgrounds and their attitudes. The results also indicated that the participants had an overall positive attitude toward the integration of the target culture into language learning. In light of the findings, EFL students&amp;rsquo; linguistic background should be taken into consideration before embedding the target culture into language learning.