Mixed Methods Study Research Articles

A baseline survey of levels of motivation, well-being, and employment preferences of newly qualified social workers in the UK

ABSTRACT The aim of this study is to examine levels of motivation, wellbeing, and employment preferences of newly qualified social workers who graduated in 2022. A mixed-method study design was employed using standardized measurements for wellbeing, measurable scales for motivation and employment preferences, and qualitative questions about job preferences. The online survey was completed by 176 final-year social work students in Northern Ireland during the summer 2022. The current paper reports Time 1 data from a longitudinal project examining levels of motivation, well-being, resilience, and employment preferences of graduates over a 12-month period. Quantitative data were analyzed using SPSS (version 26). Wellbeing scores were compared using Mann-Whitney U tests, and motivation was compared using Fisher’s exact tests. Qualitative data from responses to open-ended questions was analyzed using six-step approach to thematic analysis. There were no significant differences in wellbeing scores or levels of motivation between participants based on age, sex, caring responsibilities, or disability. The majority were motivated to find employment in social work (98.3%), in Northern Ireland (97.7%), in statutory Health and Social Care Trusts (71.1%). However, stakeholders need to improve support systems and stability within teams, enhance remuneration, and ensure workloads are manageable.

When time theft promotes performance: Measure development and validation of time theft motives.

The prevailing viewpoint has long depicted employee time theft as inherently detrimental. However, this perspective may stem from a limited understanding of the underlying motives that drive such behavior. Time theft can paradoxically be motivated by neutral and even laudable intentions, such as promoting work efficiency, thus rendering it potentially beneficial and constructive. Across three mixed-methods studies, we explore the motives behind employee time theft, develop and validate an instrument to assess these motives, and examine how they differentially predict time theft behavior. Specifically, in Study 1, we use a qualitative method and identify 11 types of time theft motives. Study 2 embarks on the development of measures of these motives, subsequently validating their factor structure. Study 3 examines their incremental variance in predicting time theft behavior by controlling for personality and demographic variables. Overall, these studies reveal that employees' engagement in time theft can be driven not solely by self-oriented motives but also by others- and work-oriented motives. Further, each of these motives provides incremental value in understanding time theft behavior. Implications for both research and practice emanating from these findings are also discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Untangling purpose: examining the nuanced influence of personal meaning and beyond-the-self orientation on youth mental health in unprecedented times

ABSTRACT This modified sequential explanatory mixed methods study explores how the components of purpose (personal meaningfulness and a beyond-the-self orientation) impact youth mental health outcomes (depressive and anxiety symptoms) in the context of COVID-19. We hypothesized that youth with higher scores on the components of purpose (goal-directedness, personal meaningfulness, and beyond-the-self orientation) would be less likely to experience anxiety and depressive symptoms during COVID-19. We also explored in what ways youths’ descriptions of their own prosocial behavior align with the relation between purpose and mental health. Data are from two waves of the Boy Scouts of America (BSA) Building Evidence in Scouting Together study. Quantitative data are from 4,896 youth and a subsample of 94 youth completed qualitative personal communication Results indicate the personal meaning component of purpose is protective against depressive and anxiety symptoms. However, the beyond-the-self orientation of purpose is associated with higher levels of depressive and anxiety symptoms. In addition, differences were found between youth who reported higher and lower levels of depressive and anxiety symptoms, and personal meaning and a beyond-the-self orientation for the following themes: 1) Empathy for others, 2) Desire to change the situation, 3) Solutions to change the situation, 4) Helping at home, 5) Following health advice, and 6) Scouting-specific examples. Taken together, this study provides useful insights into how each component of purpose can uniquely promote or provide a buffer for depression and anxiety among youth.

Informality, affordability, and mortgage stress during the COVID-19 pandemic: A mixed-methods study of urban low-income households in Mumbai’s periphery

ABSTRACT The preexisting global urban housing affordability crisis worsened during the COVID-19 pandemic. Within nations, households belonging to various socioeconomic strata differentially experienced housing affordability issues, with the low-income households disproportionately bearing the affordability stress compared to the higher-income households. We use a mixed-methods approach to investigate the consequences of COVID-19-induced mortgage stress in 154 low-income homebuyers living in the periphery of the Mumbai Metropolitan Region in India. We draw upon the Conservation of Resources theory to study the stress outcomes due to affordability issues and understand its linkages with household financial wellbeing. A quantitative survey of 154 study participants revealed a significant relationship between mortgage stress and financial well-being mediated by financial stress. Further, qualitative analysis of in-depth interviews of 16 study participants using a comparative lens suggested that the pandemic-induced affordability issues disproportionately affected households with informal employment. Overall, the findings highlight a dynamic nature of affordability and its peculiar interplay with informality, emphasizing the urgency to reorient housing policies toward affordability and informality issues.

Acceptability of HPV vaccination for cervical cancer prevention amongst emerging adult women in rural Mysore, India: a mixed-methods study

BackgroundIndia has the highest number of estimated deaths from cervical cancer globally, with most cases attributed to Human papillomavirus (HPV). The World Health Organization recommends primary HPV vaccination for girls ages 9–14, with catch-up vaccination for young women ≥ 15 if feasible. India authorized a new, inexpensive HPV vaccine in 2022; given anticipated vaccine expansion, we conducted a mixed-methods study exploring acceptability of HPV catch-up vaccination for young emerging adult women in rural Mysore, India.MethodsBetween September 2022-April 2023, participants were recruited with assistance from community health workers. In the qualitative phase, gender-stratified, audio-recorded focus group discussions (FGDs) were conducted in Kannada with emerging adults ages 18–26. FGDs were transcribed, translated, and analyzed using rapid approach to identify key HPV vaccination attributes. In the quantitative phase, a conjoint analysis was conducted to assess the impact of seven vaccination attributes on likelihood to vaccinate (LTV). Women ages 18–26 ranked LTV in eight hypothetical vaccination scenarios, and the relative impact of each attribute on LTV was calculated. All participants received education about cervical cancer, HPV, and HPV vaccination.ResultsFifty-two young adults (female = 31, male = 21) participated in seven FGDs, and 101 women participated in the conjoint analysis. Average age of the 153 participants was 22.5 years, 66.7% had married, and all had completed high school. Only 17.9% had heard of cervical cancer, and 2.7% knew of the HPV vaccine. FGDs identified seven HPV vaccination attributes: cost, vaccination location, family support, peer influence, dose number, side effects, and risk of acquiring HPV. In the conjoint analysis, all attributes except dose number significantly impacted LTV. Family support (impact score = 19.37, p < 0.0001) and peer influence (impact score = 18.01, p < 0.0001) had the greatest influence, followed by cost (impact score = 16.64, p < 0.0001) and HPV risk (impact score = 12.31, p < 0.0001). Vaccination location (government centers preferred) and side effects were also significant.ConclusionParticipants had poor knowledge of cervical cancer and HPV. Social attributes (family support, peer influence) had greatest impacts on LTV, and future studies should explore family-based interventions and peer education. Providing free vaccines at government centers through India’s national immunization program would maximize catch-up HPV vaccination for rural young women.

The COVID-19 infodemic as a major driver for vaccine hesitancy in conflict settings: a mixed-method study

Since COVID-19 emerged in China, social media has spread fake news and conspiracy theories faster than the virus, causing the population to take false actions and follow misleading information, which leads to hospitalization, and even deaths, especially in conflict settings. Therefore, efforts to address health misinformation on social media have become urgent. For these reasons, we monitored social media following the vaccine rollout in Yemen and assessed the impact of the infodemic on the population's vaccine hesitancy in Yemen. To triangulate our data, we executed a mixed method approach in which qualitative data via online social listening was gathered using the WHO Early AI-supported Response with Social Listening (EARS) platform, and then complemented and verified with a Knowledge, Attitude and Practices (KAP) survey. Our results showed that social media in Yemen were exhibited contradictory facts and information gaps about the COVID-19 vaccine. The unaddressed questions and concerns on Facebook and Twitter have been filled with all types of misinformation, including rumors and conspiracy theories about the vaccine. Furthermore, the government's weak Risk Communication and Community Engagement (RCCE) have caused an enormous mistrust in its public health actions and stimulated negative behaviours towards the COVID-19 vaccine. The online social listening results were complemented with the survey findings as one third (38%) of the respondents admitted that COVID-19 vaccine misinformation affected their health decisions and almost two-third (61%) showed unwillingness to take the COVID-19 vaccine which clearly demonstrate the Yemenis hesitation in making health decisions including vaccine uptake. Our study highlights the importance of strengthening health communication and infodemic management to mitigate vaccine hesitancy and increase public confidence in the COVID-19 vaccine.

VIVALDI ASCOT and Ethnography Study: protocol for a mixed-methods longitudinal study to evaluate the impact of COVID-19 and other respiratory infection outbreaks on care home residents’ quality of life and psychosocial well-being

IntroductionOlder adults in care homes experienced some of the highest rates of mortality from SARS-CoV-2 globally and were subjected to strict and lengthy non-pharmaceutical interventions, which severely impacted their daily...

A mixed-methods longitudinal examination of weight-related self-monitoring and disordered eating among a population-based sample of emerging adults

BackgroundWeight-related self-monitoring (WRSM) apps are used by millions, but the effects of their use remain unclear. This study examined longitudinal relationships between WRSM and disordered eating among a population-based sample of emerging adults.MethodsParticipants (n = 138) were recruited from EAT 2010–2018 (Eating and Activity over Time study) to participate in a mixed-methods (quantitative and qualitative) longitudinal study to understand the impacts of WRSM. In 2018, participants (Mage=21.7 ± 1.9 years) reported motivations for use and types of WRSM apps used. Dependent variables collected in 2022 (Mage=25.7 ± 1.9 years) included past year total number of disordered weight control behaviors, disordered muscle building behaviors, compulsive exercise, and binge eating. Linear and logistic regressions were used adjusting for sociodemographics, body mass index, and baseline disordered eating. Semi-structured interviews (n = 25) were analyzed using inductive thematic analysis.ResultsParticipants using WRSM apps for weight management demonstrated an increase in disordered weight control behaviors over time (β = 0.894, p = .012). Using WRSM apps for “healthy” eating was marginally associated with an increase in disordered weight control behaviors. (β = 0.673, p = .052). Qualitatively, participants reported varied temporality between WRSM and disordered eating, but believed that app use encouraged restriction/binge cycles and normalized disordered eating.ConclusionsFindings suggest there may be individual variation in the relationships between WRSM and disordered eating, but that using WRSM apps with the motivation of managing eating or weight may increase disordered eating in some. Additionally, WRSM apps may normalize or encourage disordered eating. Therefore, safeguards, including screening and monitoring, are needed to ensure WRSM does not cause or escalate harm among WRSM users.

Effect of simulation-based emergency airway management education on the knowledge, skills and perceived confidence of medical interns

Background: An effective airway management education program is a crucial part of the undergraduate medical education curriculum. Theoretical instructions and practical demonstrations are the major modalities of medical education in Nepal. Simulation-based education (SBE) programs have not yet been implemented effectively. We aimed to determine the effects of an SBE program on the knowledge, skills, and perceived confidence of medical interns regarding emergency airway management. Methods: This mixed methods study comprised both quantitative and qualitative components. The study participants were 47 medical interns who had participated in the SBE program. Results: The mean age of the 47 participants was 24.74 years. There were 33 (70.21%) male and 14 (29.79%) female participants. The knowledge, skills, and perceived confidence scores of the participants for airway management preparation, basic airway management, endotracheal intubation, and laryngeal mask airway (LMA) insertion improved significantly following the SBE program (P&lt;0.001). Analysis of the participants’ feedback indicated that they largely approved of the SBE program. The majority of students and faculty expressed a willingness to include similar programs in the undergraduate medical education curriculum. Conclusion: This study demonstrated through quantitative and qualitative metrics that SBE can enhance the knowledge, skills, and perceived confidence in performing emergency airway management among medical interns. We recommend measures to include and effectively implement SBE in the undergraduate medical education curriculum of Nepal.

Development and Evaluation of a Web-Based Platform for Personalized Educational and Professional Assistance for Dementia Caregivers: Proposal for a Mixed Methods Study.

Alzheimer disease (AD) and AD-related dementia are prevalent concerns for aging populations. With a growing older adult population living in the United States, the number of people living with dementia is expected to grow, posing significant challenges for informal caregivers. The mental and physical burdens associated with caregiving highlight the importance of developing novel and effective resources to support caregivers. However, technology solutions designed to address their needs often face low adoption rates due to usability issues and a lack of contextual relevance. This study focuses on developing a web-based platform providing financial and legal planning information and education for dementia caregivers and evaluating the platform's usability and adoptability. The goal of this project is to create a web-based platform that connects caregivers with personalized and easily accessible resources. This project involves industrial, academic, and community partners and focuses on two primary aims: (1) developing a digital platform using a Dementia Care Personalization Algorithm and assessing feasibility in a pilot group of caregivers, and (2) evaluating the acceptability and usability of the digital platform across different racial or ethnic populations. This work will aid in the development of technology-based interventions to reduce caregiver burden. The phase I study follows an iterative Design Thinking approach, involving at least 25 dementia caregivers as a user feedback panel to assess the platform's functionality, aesthetics, information, and overall quality using the adapted Mobile Application Rating Scale. Phase II is a usability study with 300 dementia caregivers in Texas (100 African American, 100 Hispanic or Latinx, and 100 non-Hispanic White). Participants will use the digital platform for about 4 weeks and evaluate its usefulness and ease of use through the Technology Acceptance Survey. The study received funding from the National Institute on Aging on September 3, 2021. Ethical approval for phase I was obtained from the Texas A&M University Institutional Review Board on December 8, 2021, with data collection starting on January 1, 2022, and concluding on May 31, 2022. Phase I results were published on September 5, 2023, and April 17, 2024, respectively. On June 21, 2023, ethical approval for human subjects for phase II was granted, and participant recruitment began on July 1, 2023. Upon completing these aims, we expect to deliver a widely accessible digital platform tailored to assist dementia caregivers with financial and legal challenges by connecting them to personalized, contextually relevant information and resources in Texas. If successful, we plan to work with caregiving organizations to scale and sustain the platform, addressing the needs of the growing population living with dementia. DERR1-10.2196/64127.

Satisfaction of chronic patients with community-based health insurance schemes and related factors: Explanatory sequential mixed methods study.

Chronic disease poses a serious threat to accessible, high-quality healthcare. Community-based health insurance (CBHI) schemes provide the poor with financial security. However, there is no evidence in Ethiopia on how satisfied chronic patients are with the schemes. The objective of the current study was to evaluate the satisfaction of chronic patients with the schemes and identify contributing factors. A hospital-based explanatory sequential mixed methods study on 632 chronic patients and 12 key informants was carried out between February 28 and May 31, 2022, in the hospitals of East Gojjam, Northwest Ethiopia. Hospitals and study participants were selected using multistage sampling methods. Quantitative data was entered using Epi Data 3.1 and exported to SPSS version 25 for analysis. P value <0.05 was used to consider significant association in multivariable binary logistic regression. Thematic analysis was a method to manually review qualitative data. A narrative approach was used for integrating the two data. The mean age of study participants was 46.1 (46.1± 5.2, range: 25-82). Patients aged 45 to 64 made up the majority of the population (60.6%). Rheumatoid arthritis affected the preponderance of individuals (36.4%). The overall level of satisfaction of chronic patients with the CBHI scheme was 31% (95% CI; 27-35%). Respect and friendliness (AOR = 7.05; CI: 3.71-13.36), knowledge of benefits packages (AOR = 2.02; CI: 1.24-3.27), partial or non-availability of drugs (AOR = 0.24, AOR = 0.21, respectively), waiting times (AOR = 1.84; CI: 1.12-3.0), and availability of laboratory tests (AOR = 1.59; CI: 1.01-2.48) were significantly associated with participants' satisfaction with the schemes. Our study revealed that the overall satisfaction of chronic patients was quite low and affected by the availability of drugs and laboratory tests, caregivers' respect and friendliness, waiting times, and participant knowledge. Therefore, stakeholders must concentrate on reducing waiting times, improving the availability of drugs and laboratory tests at each hospital, opening back up community pharmacies, and promoting awareness about benefits packages primarily through health education. The main focus of researchers needs to be on nationally representative studies that include more important factors.

Antiretroviral therapy adherence among peripartum women with HIV in Kenya: an explanatory mixed methods study using dry blood spot measures and narrative interviews

ABSTRACT Adherence to antiretroviral therapy (ART) remains sub-optimal among pregnant and postpartum women with HIV (PPWH) in high HIV prevalence low resource settings with few effective behavioral interventions. A large body of qualitative literature has established general barriers and facilitators to ART adherence in PPWH at various levels (individual, interpersonal, structural). However, research exploring the underlying behavioral mechanisms of ART adherence in PPWH with objectively verified adherence biomarkers is extremely limited. We conducted 24 in-depth interviews with postpartum women in western Kenya who had linked ART drug concentrations obtained from three dried blood spot samples across the peripartum period. Among PPWH with a low drug concentration (n = 13) compared to those with continuously high drug concentrations (n = 11), distinct themes emerged related to HIV status disclosure, social support, interactions with the health system, and health beliefs. By combining ART biomarkers with patient reported challenges, there is the potential for real-time interventions to support sustained ART adherence among PPWH and improve maternal and infant health outcomes.

Implementation, delivery, and utilization of iron fortified rice supplied through public distribution system across different states in India: An exploratory mixed-method study.

Food fortification with micronutrients is one of the cost-effective and sustainable methods to prevent micronutrient deficiencies at community level. The rice fortified with iron, folic acid, and vitamin B12 is being supplied through various social welfare schemes in India in a phased manner and planned to cover the entire country by March 2024. We have conducted a situational analysis to assess the rollout of fortified rice supplied through the Public Distribution System (PDS) and to evaluate the accessibility, availability, acceptability, and utilization of fortified rice by the beneficiaries of the PDS. This was a mixed-method, sequential exploratory study conducted in six districts from six different states of India that had begun distribution of fortified rice through PDS in pilot mode during 2020-2021. In each district, the district supply officer of the PDS, Food Corporation of India (FCI) or State Food Corporation (SFC) warehouse supervisor, and four Fair Price Shop (FPS) dealers were interviewed. Under each FPS, a minimum of seven beneficiary households were randomly selected and interviewed using a structured questionnaire. The in-depth interviews were conducted with different stakeholders using theme guides. All the interviewed stakeholders were aware about their roles and responsibilities and purpose to distribute fortified rice. There was a continuous supply of fortified rice (across all visited districts) to beneficiaries through a well-established system. Acceptability and compliance to intake of fortified rice was good with no reported gastrointestinal adverse outcomes following fortified rice intake. There was an efficient roll-out of fortified rice though PDS with a good compliance to intake of fortified rice. It is feasible to design and conduct a study to assess the impact of fortified rice on anemia and iron storage at the community level.

Co-sleeping fathers’ perceptions of sleep quality with intentional and unintentional co-sleeping

ABSTRACT Objective Nearly 45% of Australian families intentionally or unintentionally co-sleep, including bedshare. Parents’ intentionality to co-sleep can influence their perceptions of sleep quality, family functioning and overall satisfaction. Yet very little is known about fathers’ perspectives and experiences of co-sleeping with their children. This mixed-method study aimed to explore paternal co-sleeping intention and its association with perceived sleep quality. Method Fathers with children who co-slept completed an online survey about their sleep arrangements and intentionality from the Sleep Practices Questionnaire, and their sleep quality from the Sleep Quality Scale. Open-ended responses about intentionality were analysed thematically. Results One hundred and forty-one fathers were included in the analysis. Quantitative analysis found that fathers’ whose children were sleeping where definitely intended had significantly better perceived sleep quality than fathers whose children were sleeping in an unintended location. A thematic analysis provided insight into the reasons for this relationship. Conclusions This study offers insight into fathers’ experiences of co-sleeping including bedsharing, and responsive night-time infant care practices. Paternal night-time involvement in infant care can influence father-infant bonding, maternal and paternal mental health and overall family functioning. The results and their implications for professionals working with fathers during the perinatal period are discussed.

Assessment of knowledge, attitude, and practices toward malaria in the Lunglei district, Mizoram, North-East India

BackgroundThe western districts of Mizoram (Lunglei, Mamit, and Lawngtlai) are malaria hotspots. Understanding the knowledge, attitude, and practices of the tribal communities in Mizoram’s western districts will aid the development of specific interventions.MethodsAn explanatory sequential mixed-method study was conducted from April to November 2023 in the Lunglei district. In a community-based cross-sectional survey of 353 participants, the knowledge, attitude, practices, and care-seeking behaviour toward malaria were assessed using a semi-structured questionnaire. Data was analysed using SPSS version 29 software; univariate variables were presented in percentage, and bivariate and multivariate variables were analysed using the chi-square test and logistic regression, respectively. This was followed by in-depth telephonic interviews of twelve participants, and the data was analysed using NVivo.ResultsOut of the 353 respondents, 77.9%, 82.7%, 55.5%, and 63.2% of the participants had good knowledge, attitude, practices, and care-seeking behaviour, respectively. The in-depth qualitative interviews highlighted the villagers’ good knowledge of the various aspects of malaria transmission, treatment, and prevention practices (indoor residual spraying and use of insecticide-treated nets).ConclusionHigh disease endemicity, awareness programmes and vector control interventions might be contributing to the overall good knowledge, attitude, and practices toward malaria among the villagers. In addition to vector control measures, active parasite surveillance is key to malaria control in this region.

The link between patient safety competence and adverse event among master of nursing students: a cross-sectional mixed-methods study

BackgroundPatient safety (PS) is a core competency for registered nurses. However, there is a gap between the PS competence of nursing students and their clinical experience in PS. This study explored the effect of PS competence levels on the occurrence of adverse events (AEs) among nursing master’s students in China.MethodsA sequential mixed methods design was used, with a purposive sample across seven colleges. A total of 327 graduate nursing students, aged 22 to 38, participated in the survey, and 15 participated in qualitative interviews. The Health Professional Education in Patient Safety Survey (H-PEPSS) assessed the students’ competence levels in PS. The respondents also reported any AEs that they had been involved in over the past year.ResultsA total of 78 AEs occurred in the past year, with 17.7% of the participants involved 1 to 3 AEs. The most common AEs were medication administration errors (30.77%) and improper use of medical equipment/supplies (28.20%). Students acquired more competencies from the clinical setting than from the classroom setting. Three competencies learned from classroom settings were associated with clinical AEs: low clinical safety skills [OR = 0.61], inappropriate identify, response to and disclosing AE and close calls [OR = 0.454], and low confidence in working in teams with other health professionals [OR = 2.168]. Qualitative data analysis revealed five themes: recognizing AEs, reducing harm by addressing immediate risks to patients and others involved, promoting safe medication and clinical practice, managing members’ authority and team dynamics, and dealing with inter-professional conflict.ConclusionsThe quantitative and qualitative data align, supporting the enhancement of students’ PS competence.

Recommendations of the Blue Ribbon Committee II for the Optimization of Surgical Education and Training in the United States: The Surgical Trainee Perspective.

This study aims to appraise recommendations from an expert panel of surgical educators on optimizing surgical education and training in the setting of contemporary challenges. The Blue Ribbon Committee (BRC II), a group of surgical educators, was convened to make recommendations to optimize surgical training considering the current changes in the landscape of surgical education. Surgical trainees were recruited to assess their impressions of the recommendations. A mixed-methods study design was employed, with a survey, followed by focus group interviews. Participating residents and fellows were recruited through a purposeful sampling approach. Descriptive statistics were applied to analyze the survey data, and a thematic data analysis on interview transcripts was employed. The majority of trainee respondents (n=16) thought that all of the subcommittee recommendations should be included in the final BRC II recommendations and paper. According to the interviews, overall, the feedback from the trainees was positive, with particular excitement around work-life integration, education support and faculty development, and funding pitfalls. Some themes about concerns included a lack of clarity about the recommendations, concern about some recommendations being in conflict with one another, and a disconnect between the initial BRC II survey and the subsequent recommendations. The residents gathered for this focus group were encouraged by the thought, effort, and intention that gathered the surgical leaders across the country to make the recommendations. While there were areas the trainees wanted clarity on, the overall opinion was in agreement with the recommendations.

Effectiveness and User Experience of a Smoking Cessation Chatbot: Mixed Methods Study Comparing Motivational Interviewing and Confrontational Counseling.

Cigarette smoking poses a major public health risk. Chatbots may serve as an accessible and useful tool to promote cessation due to their high accessibility and potential in facilitating long-term personalized interactions. To increase effectiveness and acceptability, there remains a need to identify and evaluate counseling strategies for these chatbots, an aspect that has not been comprehensively addressed in previous research. This study aims to identify effective counseling strategies for such chatbots to support smoking cessation. In addition, we sought to gain insights into smokers' expectations of and experiences with the chatbot. This mixed methods study incorporated a web-based experiment and semistructured interviews. Smokers (N=229) interacted with either a motivational interviewing (MI)-style (n=112, 48.9%) or a confrontational counseling-style (n=117, 51.1%) chatbot. Both cessation-related (ie, intention to quit and self-efficacy) and user experience-related outcomes (ie, engagement, therapeutic alliance, perceived empathy, and interaction satisfaction) were assessed. Semistructured interviews were conducted with 16 participants, 8 (50%) from each condition, and data were analyzed using thematic analysis. Results from a multivariate ANOVA showed that participants had a significantly higher overall rating for the MI (vs confrontational counseling) chatbot. Follow-up discriminant analysis revealed that the better perception of the MI chatbot was mostly explained by the user experience-related outcomes, with cessation-related outcomes playing a lesser role. Exploratory analyses indicated that smokers in both conditions reported increased intention to quit and self-efficacy after the chatbot interaction. Interview findings illustrated several constructs (eg, affective attitude and engagement) explaining people's previous expectations and timely and retrospective experience with the chatbot. The results confirmed that chatbots are a promising tool in motivating smoking cessation and the use of MI can improve user experience. We did not find extra support for MI to motivate cessation and have discussed possible reasons. Smokers expressed both relational and instrumental needs in the quitting process. Implications for future research and practice are discussed.

Perioperative pathways for children with neurodevelopmental conditions and behaviours that challenge: An evaluation of parent experiences for service improvement.

To elicit experiences of parents of children with neurodevelopmental conditions using a new perioperative pathway. Parents of children accessing an adapted perioperative clinical pathway in a tertiary children's hospital between July 2019 and December 2020 were invited to participate. A mixed method study was conducted comprising a short survey questionnaire followed by telephonic interviews. From 67 postal surveys sent out, 20 were completed. Six out of 20 parents participated in phone interviews and one parent submitted written prose. Parents were positive about their experiences. Six themes emerged: Negative past experiences (highlighting the need for adapted perioperative pathways); Reasonable adjustments (improving child and parent's hospital journey); Facilitating communication, convenience and collaboration; Parent's satisfaction and relief; Barriers to overcome and Areas in need of improvement were discussed. Parents of children with neurodevelopmental conditions report great satisfaction and relief from their experiences of a more efficient, streamlined and stress-free way for their child to have tests or procedures done. Parents report improved communication, convenience and collaboration with staff resulted in timely, safe and high-quality care.

Willingness of joining online support groups among men who have sex with men living with HIV in Shandong Province of China: A mixed methods study.

Online support groups afford new opportunities to help individuals affected by HIV/AIDS to seek social support from peers. The study aimed to understand the willingness and associated factors of joining online support groups among men who have sex with men (MSM) living with HIV. The study followed a mixed method approach, with qualitative in-depth interviews followed by a quantitative cross-sectional survey in three cities of Shandong Province, China from 2019 to 2020. The in-depth interviews were audio-taped, transcribed verbatim and analyzed using thematic approach. In the quantitative analysis, explanatory variables included sociodemographic, behavioral, clinical, psychological, and demand factors. Univariate and multivariable logistic regressions were conducted to examine the associated factors of willing to join online support groups. A total of 576 and 20 participants were included in the quantitative survey and qualitative interviews, respectively. Only 24.7% (142/576) of participants in the quantitative study were willing to join the online support group. Multivariable analysis showed the associated factors included income level, sexual orientation and availability of information. The barriers to joining online support groups included privacy disclosure concern and psychological pressure exposed to HIV-related information. Facilitators included information acquisition, mutual medication reminding, and emotional support. MSM living with HIV in China had relatively low willingness to join the online support groups. This study highlighted the importance of safeguarding privacy, involving professional mental health providers, and providing high-quality information when establishing online support groups for people living with HIV.