Open-ended Responses Research Articles

Patient experiences of buprenorphine dispensing from a mobile medical unit

BackgroundOverdose deaths continue to rise within the United States, despite effective treatments such as buprenorphine and methadone for opioid use disorder (OUD). Mobile medical units with the ability to dispense buprenorphine have been developed to engage patients and eliminate barriers to accessing OUD treatment. This study reports survey responses of patients of a mobile medical unit dispensing buprenorphine in areas of Chicago, IL with high overdose rates.MethodsAll patients who were dispensed buprenorphine via the mobile medical unit were invited to participate in a 7-item anonymous survey between May 24, 2023, and August 25, 2023. The survey included 5-point satisfaction scale, multiple-choice, and open-ended questions. Outcomes included satisfaction with buprenorphine dispensing from the mobile medical unit, satisfaction with filling buprenorphine at a pharmacy in the past, barriers experienced at pharmacies when filling buprenorphine, and whether the client would have started treatment that day if the mobile medical unit had not been present. Satisfaction scale and multiple-choice question responses were assessed using descriptive statistics. Wilcoxon signed-rank test was used to compare median satisfaction levels between receiving buprenorphine from the mobile medical unit versus filling a buprenorphine prescription at a community pharmacy. Open-ended questions were analyzed qualitatively using inductive thematic analysis.Results106 unique patients were dispensed buprenorphine from the mobile unit during the study period. Of these patients, 54 (51%) completed the survey. Respondents reported high satisfaction with the buprenorphine dispensing process as a part of a mobile medical unit. Of those who had previously filled buprenorphine at a pharmacy, 83% reported at least one barrier, with delays in prescription dispensing from a community pharmacy, lack of transportation to/from the pharmacy, and opioid withdrawal symptoms being the most common barriers. 87% reported they would not have started buprenorphine that same day if the mobile medical unit had not been present. Nearly half of survey participants reported having taken buprenorphine that was not prescribed to them. Qualitative analysis of open-ended survey responses noted the importance of convenient accessibility, comprehensive care, and a non-judgmental environment.ConclusionsMobile medical units that dispense buprenorphine are an innovative model to reach patients with OUD who have significant treatment access barriers. This study found that patients who experienced barriers to accessing buprenorphine from a pharmacy were highly satisfied with the mobile medical unit’s buprenorphine dispensing process. Programs seeking to develop mobile buprenorphine dispensing programs should consider patient priorities of accessibility, comprehensive care, and welcoming, non-judgmental environments.

What supports do autistic adolescents and adults need? Perspectives of self-reporting adults and caregivers.

Increasingly, autistic adolescents and adults are accessing occupational therapy. However, limited evidence exists on the type of supports that are important to them. Examining the patterns of supports valued by autistic adolescents and adults will inform the design of occupational therapy services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important. This study involved two anonymous online surveys. Survey one involved 54 items and was distributed to caregivers of autistic adolescents and/or adults. Survey two included 41 items and was distributed to self-reporting autistic adults. Surveys sought closed and open-ended responses about the support needs of autistic individuals living in Australia. Quantitative data were analysed as counts and frequencies of responses, whereas short-answer responses were analysed through content analysis. There was no consumer or community involvement in the completion of this project. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Quantitative data from both autistic adolescents' and adults' closed-answer responses showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Content analysis of open-ended responses, performed separately for each participant group, revealed six categories: employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. Results highlight that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy practice. Differences between the priorities of autistic individuals and their caregivers highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs. Increasingly, autistic adolescents and adults are accessing occupational therapy services. However, limited information exists regarding the type of supports that are important to them. Understanding what supports are valued by autistic adolescents and adults will support occupational therapists deliver effective and individualised services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important to them. This study involved two anonymous online surveys. Survey one was completed by caregivers of autistic adolescents and/or adults. Survey two was completed by self-reporting autistic adults. Surveys included both open-ended and closed-answer responses to better understand the support needs of autistic individuals living in Australia. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Closed-answer response questions from both the caregivers and self-reporting autistic adolescents and adults showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Open-ended response questions revealed six main priorities including, employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. This study found that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy. Further, participant responses highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs.

COVID-19 memories young adults may share: exploring event properties and motivations for transmission

ABSTRACT The COVID-19 pandemic has left an enduring mark on human history. This study investigates the intergenerational transmission of COVID-19 memories through a unique approach involving 49 participants aged 18-30. Specifically, participants were prompted to share a COVID-19 memory they would choose to transmit to their future children. Furthermore, participants provided reasons for selecting that particular memory, utilising a memory functions scale and open-ended responses. Applying Transition Theory, we examined the transitional impact, event importance, previous rehearsal, and valence of reported memories. Results revealed that 88% of memories revolve around distinctive events inducing psychological and material changes. Perceived as significant, negative, and transitional, these memories are predominantly public in nature. Predictors of event importance include previous rehearsal and psychological change. Participants share memories primarily for directive purposes, intending to inform future generations. The results imply that transitions not only organise personal memories but may also direct and shape memories for public events.

Registered nurses' perceptions of nursing student preceptorship: Content analysis of open-ended survey questions.

Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open-ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41-50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction.

Teaching – It’s a No Brainer, Right?: Using an Assessment Course to Bust Educators’ Neuromyths

Misinformation about the brain, known as neuromyths, is prevalent among educational practitioners and often inadvertently (mis)informs instructional strategies. In the current study, a mixed methods design was used to test how resources and instruction on neuromyths implemented within an assessment course impacted elementary education pre-service teachers’ (PSTs’) beliefs about the brain. Specifically, this study aims to address: (1) Where do PSTs learn neuromyths? (2) Does an explicit focus on “neuromyth-busting” in a required course shift PSTs’ understanding of neuroeducational science? (3) What are PSTs’ understanding of neuroeducational science and the impacts on their practice after this course? Results from a pre-/post-survey show that many of the PSTs’ neuromyth beliefs shifted by the end of the course. Through open-ended survey responses, PSTs reported that they learned neuromyths from a variety of resources and their thoughts about neuromyths are multifaceted and complex. By the end of the course, PSTs related what they learned about the brain to the importance of differentiating instruction. Findings indicate that using a mixed methods approach provides a well-rounded view of PSTs’ beliefs in neuromyths. Incorporating information about the brain in education courses may be an effective way to promote critical thought and dispel common neuromyths among PSTs.

Unraveling Indonesian Public R&D Institutions’ Perspectives on Chatgpt: An Analytical Approach To Decoding Open-Ended Surveys Through Topic Modeling

<p>The rapid development of artificial intelligence (AI) technologies like ChatGPT has made global management easier. Since 2020, AI has been widely utilized for all purposes, notably due to its ease in access for scientific production. This study aims to analyze open-ended questions and responses from web-based survey in Indonesian public research and development (R&D) institutions using topic modeling. A total of 205 data points were obtained through web-based surveys conducted among researchers in Indonesian public R&D institutions. To learn their thoughts on the use of ChatGPT (Chat Generative Pre-Trained Transformer), two AI language topic modeling, Latent Dirichlet Allocation (LDA) and Principal Component Analysis (PCA), were employed to detect survey topic structures and show the results. Three theme groups represent the institution's research cohort. Based on generational disparities in birth year and functional position level, this study selected the seven most popular topics from three themes of researchers' opinions on ChatGPT. Researchers of certain age generations and functional position levels focused on new AI technologies, efficiency, and production gains, while others valued methodological innovation, ethics, and scientific integrity. When formulating a strategy for incorporating AI into the public R&D institution's future research agendas, it is imperative to include diverse perspectives.</p>

Stakeholders’ views of the Baby Friendly Initiative implementation and impact: a mixed methods study

BackgroundThe Baby Friendly Hospital Initiative (BFHI) was launched in 1991 as an intervention to support healthy infant feeding practices, but its global coverage remains around 10%. This study aimed to explore stakeholders’ views of the Baby Friendly Initiative (BFI) programme, the barriers and facilitators to accreditation and its perceived impact.MethodsA mixed methods approach was used. An online survey was distributed through numerous professional networks from September 2020 to November 2020. Quantitative data were analyzed using descriptive statistics, with simple content analysis undertaken on open-ended responses. Individual semi-structured interviews were also undertaken and analyzed using inductive thematic analysis.ResultsA total of 322 respondents completed the survey in part or in full, mainly from the United Kingdom. Fifteen key stakeholders and two maternity service users undertook interviews. Respondents were from various professional backgrounds and currently worked in different roles including direct care of women and their families, public health, education and those responsible for purchasing health services. Survey respondents viewed the BFI to have the greatest impact on breastfeeding initiation, duration, and infant health outcomes. Three overall themes were identified. The first was “BFI as an agent for change”. Most participants perceived the need to implement the whole package, but views were mixed regarding its impact and the accreditation process. Secondly, BFI was regarded as only “one part of a jigsaw”, with no single intervention viewed as adequate to address the complex cultural context and social and health inequities that impact breastfeeding. Finally, “cultural change and education” around breastfeeding were viewed as essential for women, staff and society.ConclusionsThe BFI is not a magic bullet intervention. To create a more supportive breastfeeding environment within society a holistic approach is required. This includes social and cultural changes, increased education ideally starting at school age, and advancing positive messaging around breastfeeding within the media, as well as fully banning breastmilk substitute advertising. Although the BFI comprises a whole package, few survey respondents rated all aspects as equally important. Additional evidence for the effectiveness of each element and the importance of the whole package need to be established and communicated.

A cross-sectional survey assessing clinicians' perspectives towards redesigning the surveillance model for head and neck cancer: can we do better?

Service delivery of post-treatment surveillance in head and neck cancer (HNC) varies across institutions in Australia. To better understand current practices and develop protocols that maximize service capacity or incorporate emerging technologies, especially in under-resourced regional and remote communities, it is important to obtain the perspectives of clinicians that regularly manage patients with HNC. This cross-sectional study utilized an online survey distributed via email to specialists recruited from HNC-associated networks across Australia. The survey captured information on current practices and explored clinician perspectives towards re-designing the current surveillance model to incorporate telehealth or patient-reported outcome measures (PROMs). Quantitative data was analyzed using descriptive statistics while open-ended survey comments were analyzed using a content analysis approach. Forty participants completed the survey (25 surgeons, 9 medical oncologists, 5 radiation oncologists and 1 oral medicine specialist). Most clinicians used either institution-specific guidelines (44%) or National Comprehensive Cancer Network guidelines (39%), with the remaining 17% using surveillance intervals based on patient symptoms. Following treatment, 53% of participants imaged patients only when there was clinical suspicion of recurrence or new symptoms. Planned surveillance imaging was conducted at 6 or 12-monthly intervals based on the HNC subtype. Fifty-seven percent of clinicians were open to redesigning the surveillance model, specifically in low-risk patients who did not require nasoendoscopic examination. Seventy-one percent had concerns regarding the feasibility of telehealth appointments, citing disparities in digital health equity. Additionally, 61% felt PROMs are currently underutilized and were open to incorporating HNC-specific PROMS into surveillance. Open-ended responses indicated that within the current surveillance model, "fragmented service provision" and "administration issues" were significantly impacting on timing of care. Surveyed HNC clinicians feel that current post-treatment surveillance can be fragmented and potentially lead to delayed care. They are open to incorporating PROMS to assist in surveillance scheduling, especially in low-risk patients.

Factors and Perceptions Associated with Post-Pandemic Food Sourcing and Dietary Patterns among Urban Corner Store Customers in Baltimore, Maryland.

Diet-related disease is rising, disproportionately affecting minority communities in which small food retail stores swamp supermarkets. Barriers to healthy food access were exacerbated by the pandemic. We examined the following: (1) individual- and household-level factors in a sample of Baltimore community members who regularly shop at corner stores and (2) how these factors are associated with indicators of dietary quality. Cross-sectional data were collected using an online survey to capture sociodemographics, anthropometrics, and food sourcing, spending, and consumption patterns. Concurrent quantitative and qualitative analyses were conducted in Stata 18 and ATLAS.ti. This study was set in Baltimore, Maryland, USA. The participants included adults (n = 127) living or working in Baltimore who identified as regular customers of their neighborhood corner store. The respondents were majority Black and low-income, with a high prevalence of food insecurity (62.2%) and overweight/obesity (66.9%). Most (82.76%) shopped in their neighborhood corner store weekly. One-third (33.4%) of beverage calories were attributed to sugar-sweetened beverages, and few met the recommended servings for fruits and vegetables or fiber (27.2% and 10.4%, respectively). Being Black and not owning a home were associated with lower beverage and fiber intake, and not owning a home was also associated with lower fruit and vegetable intake. Food insecurity was associated with higher beverage intake, while WIC enrollment was associated with higher fruit and vegetable and fiber intakes. Open-ended responses contextualized post-pandemic food sourcing and consumption in this setting. This paper helps characterize the consumers of a complex urban food system. The findings will inform future strategies for consumer-engaged improvement of local food environments.

Suicide prevention providers' perspectives on addressing social determinants of health for at-risk Veterans

ObjectiveSuicide prevention is a top clinical priority within the Department of Veterans Affairs (VA). While research consistently shows that suicide risk is associated with adverse social determinants of health (SDH, e.g., housing instability, unemployment, justice involvement), less is known about the extent to which suicide prevention staff are aware of and able to address these risk factors. This study aimed to understand the experiences of VA Suicide Prevention Coordinators (SPCs) with referring Veterans at risk of suicide to services that address SDH. MethodIn January–February 2022, 171 VA SPCs completed a questionnaire about their experiences connecting Veterans with SDH-focused services. Descriptive statistics summarized closed-response items and a thematic analysis was conducted for open-ended responses. ResultsThe majority of SPCs agreed that adverse SDH contribute to suicide risk and that services to address SDH could reduce suicide risk for Veterans. While most SPCs were aware of on-site SDH services, many reported barriers to connecting Veterans with those services including insufficient resources, lack of staff time, and eligibility criteria. ConclusionChanges at the organizational and policy levels are needed to provide comprehensive suicide prevention services that connect at-risk Veteran with services to address adverse SDH.

The impact of virtual and augmented reality on presence, user experience and performance of Information Visualisation

The fast growth of virtual reality (VR) and augmented reality (AR) head-mounted displays provides a new medium for interactive visualisations and visual analytics. Presence is the experience of consciousness within extended reality, and it has the potential to increase task performance. This project studies the impact that a sense of presence has on data visualisation performance and user experience under AR and VR conditions. A within-subjects design recruited 38 participants to complete interactive visualisation tasks within the novel immersive data analytics system for genomic data in AR and VR, and measured speed, accuracy, preference, presence, and user satisfaction. Open-ended user experience responses were also collected. The results implied that VR was more conducive to efficiency, effectiveness, and user experience as well as offering insight into possible cognitive load benefits for VR users.

The paradoxes of U.S. graduate assistantships in education: navigating competing tensions and the impact of stress on graduate wellbeing

Purpose Graduate students employed in graduate teaching and research assistantship positions have a unique experience of the institution because of their status as student-employees. Graduate assistants (GAs) face specific challenges around their well-being as they navigate various relationships and environments throughout their educational trajectory. The purpose of this study is to examine the specific workplace challenges GAs experience and their overall effect on GA wellbeing. Design/methodology/approach This research study examines graduate assistant responses from 12 US research universities to the Faculty Survey of student Engagement for Graduate student Instructors survey. This study’s analysis examined the open-ended responses (n = 493) at the end of the survey that asked participants for additional comments regarding their departmental and/or institutional experiences. Three waves of coding were implemented by the authors to identify common themes and areas of concern on GA working conditions. Findings The findings led to the creation of a concept map on GA working conditions that include three main components: contextual factors, stress and well-being and competing tensions. Within each component are subthemes related to social identity, funding, campus climate, time and priority concerns and assistantship structure and support. The map demonstrates the enmeshed connection across areas. Practical implications Findings suggest institutional investments through programming, system-level changes and interpersonal support to improve GA working conditions and their well-being. Originality/value Research on GA experiences with working conditions and well-being in a US context is limited. This study is valuable because many graduate students who occupy graduate assistantships are asking for increased pay and benefits at their institution. Graduate assistantship labor organizing is occurring alongside institutions’ focus on improving health outcomes for graduate students.

Socioeconomic determinants and reasons for non-acceptance to vaccination recommendations during the 3rd - 5th waves of the COVID-19 pandemic in Hungary

BackgroundIn Hungary, although six types of vaccines were widely available, the percentage of people receiving the primary series of COVID-19 vaccination remained below the EU average. This paper investigates the reasons for Hungary’s lower vaccination coverage by exploring changing attitudes towards vaccination, socio-demographic determinants, and individual reasons for non-acceptance during the 3rd - 5th pandemic waves of COVID-19.MethodsThe study’s empirical analysis is based on representative surveys conducted in Hungary between February 19, 2021, and June 30, 2022. The study used a total of 17 surveys, each with a sample size of at least 1000 respondents. Binomial logistic regression models were used to investigate which socio-demographic characteristics are most likely to influence vaccine hesitancy in Hungary. The study analysed 2506 open-ended responses to identify reasons for vaccine non-acceptance. The responses were categorised into four main categories and 13 sub-categories.ResultsBetween the third and fifth wave of the pandemic, attitudes towards COVID-19 vaccination have significantly changed. Although the proportion of vaccinated individuals has increased steadily, the percentage of individuals who reported not accepting the vaccine has remained almost unchanged. Socio-demographic characteristics were an important determinant of the observed vaccine hesitancy, although they remained relatively stable over time. Individuals in younger age groups and those with lower socioeconomic status were more likely to decline vaccination, while those living in the capital city were the least likely. A significant reason behind vaccine refusal can undoubtedly be identified as lack of trust (specifically distrust in science), facing an information barrier and the perception of low personal risk.ConclusionAlthough compulsory childhood vaccination coverage is particularly high in Hungary, voluntary adult vaccines, such as the influenza and COVID-19 vaccines, are less well accepted. Vaccine acceptance is heavily affected by the social-demographic characteristics of people. Mistrust and hesitancy about COVID-19 vaccines, if not well managed, can easily affect people’s opinion and acceptance of other vaccines as well. Identifying and understanding the complexity of how vaccine hesitancy evolved during the pandemic can help to understand and halt the decline in both COVID-19 and general vaccine confidence by developing targeted public health programs to address these issues.

Thinking style preferences of Chinese and Western physicians: A mixed-methods study

IntroductionTraditional Chinese medicine (TCM) and Western medicine (WM) stem from distinct cultural and regional contexts, with the primary difference in their approaches to clinical reasoning. This study aims to investigate the cognitive preferences of TCM and WM physicians in clinical diagnosis and treatment, providing valuable insights for the advancement of TCM. MethodsWe implemented a two-phase mixed methods approach comprising questionnaires and semi-structured interviews. The Thinking Style Inventory (TSI) was used to evaluate the thinking styles of physicians through convenience sampling. Additionally, a total of six physicians (three practicing TCM and three WM) were selected by purposive sampling and open-ended responses regarding self-cognition and influencing factors were analyzed using thematic analysis. ResultsA total of 150 surveys and six interviews consistently indicated a preference among both TCM and WM physicians for Legislative, Executive, Hierarchical, Liberal, and External styles. In contrast, TCM physicians exhibited a tendency towards Legislative and Liberal styles, whereas WM physicians leaned towards Executive and Judicial styles. Thematic analysis of the interviews revealed four themes: self-understanding, thinking characteristics, influencing factors, and style changes. ConclusionOur study identified that within TCM and WM, a blend of shared characteristics and distinct individuality in thinking styles existed, exhibiting variations in the growth processes of physicians. Both TCM and WM physicians attributed the formation of their thinking styles to factors such as education, internship experience, Chinese social culture and personal disposition. Furthermore, empirical research methods emerged as effective tools for studying clinical reasoning in healthcare contexts.

P-496 Being a solo mother: an exploration of parenting experiences and support needs of women who intentionally choose to become mothers without a partner

Abstract Study question What support sources do solo mothers in the UK use, how supported do they feel and what areas are lacking? Summary answer Most solo mothers feel supported by family, friends and paid childcare and are confident in their parenting despite finding it difficult to ask for help. What is known already An increasingly common family type, often referred to as ‘solo mothers,’ ‘single mothers by choice’ or ‘choice mothers’, is defined by women who intentionally choose to become mothers without the involvement of a partner. Solo mothers are a relatively homogenous group, who are generally well-educated, employed in professional careers, and financially stable, with most becoming mothers in their mid-thirties/forties. Although solo mothers are frequently described as self-determined and motivated individuals with a strong preparedness for parenting that encompasses both economic and social resources, there is a notable absence of research on their specific parenting experiences and support needs. Study design, size, duration A cross-sectional study was conducted using an online survey. The questionnaire was distributed via solo mother-specific Facebook groups and through newsletters, emails and social media of the Donor Conception Network (DCN). A total of 139 participants responded between July 2021 and February 2022. Participants/materials, setting, methods Most participants were aged 36-45 (53%, 74), had one child (73%, 102) under the age of 11 (88%, 140). Almost all solo mothers had used donated sperm from an unknown donor through a clinic or sperm bank (95%, 132) and around a fifth used donated eggs (22%, 31). All quantitative data was treated as non-parametric and were analysed using descriptive statistics and Spearman’s Rho Correlation tests. Open-ended questionnaire responses were analysed using qualitative content analysis. Main results and the role of chance The most commonly used sources of support for solo mothers in the UK were family members (89%, 123) and non-solo mother friends (80%, 110). Paid childcare was used by 71% (98) of participants with solo mothers using it at least a few times per week. Facebook, particularly solo mum-specific groups, and resources from the Donor Conception Network (DCN, a support organisation for families formed using donor conception) were used by nearly three quarters of respondents (70%, 94 and 71%, 98, respectively). The majority of participants felt supported (78%, 108) but around a quarter (23%, 25) mentioned the need for financial support and the difficulties of relying on a single salary and having to pay for costly childcare. Most solo mums felt confident in their parenting (87%, 122) but found it difficult to ask for help from others (56%, 77). Barriers to asking for help included challenges to autonomy and self-identity, inability to recognise the need for support, fear and apprehension with others, and the emotional aspect of asking for support. There were positive correlations between feeling supported and confidence in parenting (ρ = 0.405, p <.001) and feeling supported and ease in asking for help (ρ = 0.458, p <.001). Limitations, reasons for caution The use of solo mother-specific Facebook groups and DCN resources to recruit solo mothers may have introduced some bias in the sampling methods which may have led to our participants not being more broadly representative of UK solo mothers. Wider implications of the findings Whilst solo mothers may typically be highly educated and financially stable, this is not always the case. Some face challenges in accessing and paying for practical and emotional support. Future research should address provision of better support, given the increasing numbers of solo mother families in the UK and elsewhere. Trial registration number not applicable

A mixed-methods analysis of moral injury among healthcare workers during the COVID-19 pandemic.

During the COVID-19 pandemic, healthcare workers faced grave responsibilities amidst rapidly changing policies and material and staffing shortages. Moral injury, psychological distress following events where actions transgress moral beliefs/ expectations, increased among healthcare workers. We used a sequential mixed methods approach to examine workplace and contextual factors related to moral injury early in the pandemic. Using a Total Worker Health® framework, we 1) examined factors associated with moral injury among active healthcare professionals (N = 14,145) surveyed between May-August 2020 and 2) qualitatively analyzed open-ended responses from 95 randomly selected participants who endorsed moral injury on the survey. Compared to inpatient hospital, outpatient (OR = 0.74 [0.65, 0.85]) or school clinic settings (OR = 0.37 [0.18, 0.75]) were associated with lower odds of moral injury; while group care settings increased odds (OR = 1.36 [1.07, 1.74]). Working with COVID+ patients (confirmed+ OR = 1.27 [1.03, 1.55]), PPE inadequacy (OR = 1.54 [1.27, 1.87]), and greater role conflict (OR = 1.57 [1.53, 1.62]) were associated with greater odds of moral injury. Qualitative findings illustrate how outside factors as well as organizational policies and working conditions influenced moral injury. Moral injury experiences affected staff turnover and patient care, potentially producing additional morally injurious effects. Worker- and patient-centered organizational policies are needed to prevent moral injury among healthcare workers. The generalizability of these findings may be limited by our predominantly white and female sample. Further research is indicated to replicate these findings in minoritized samples.

Anti-Asian biases in federal grant reviews: Commentary on Yip et al. (2021).

Prior to the 2021 American Psychologist special issue "Rendered Invisible: Are Asian Americans a Model or a Marginalized Minority?" (Yip et al., 2021), only seven articles on Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations were published in the journal in 3 decades. The special issue interrogated sources of invisibility and marginalization of AANHPIs not only in the field of psychology but also in the broader national landscape. The current commentary provides a deeper dive into one of the primary drivers of AANHPI invisibility, anti-Asian biases encountered during the federal grant review process, which contributes to low funding rates and insufficient research on AANHPI communities. Despite comprising over 6% of the U.S. population, less than 1% of the National Institutes of Health's funding portfolio supports science on AANHPI populations. This qualitative study revealed thematic barriers encountered during National Institutes of Health grant reviews. A one-time survey was circulated to professional scientific networks to obtain open-ended responses regarding applicants' and reviewers' experiences proposing research with AANHPI samples, resulting in data from N = 16 respondents. Respondents were asked to indicate their role in the review process (e.g., investigator, applicant, reviewer, other) and to provide open-ended responses detailing experiences of bias. Thematic coding revealed six principal themes: (1) invalidation, (2) limited reviewer knowledge, (3) oppression Olympics, (4) White comparison groups, (5) model minority myth, and (6) homogeneity of AANHPI groups. Building off these themes, this commentary concludes with five actionable policy and institutional recommendations aimed at achieving a more inclusive national research enterprise for AANHPI investigators and communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Identification of core competencies for exercise oncology professionals: A Delphi study of United States and Australian participants.

Integration of exercise into standard oncology care requires a highly skilled workforce of exercise professionals; however, competency requirements have not kept pace with advancements in the field. Therefore, the aim of this study was to obtain consensus on core competencies required for an exercise professional to be qualified to work with adults undergoing active cancer treatment. A three-round modified electronic Delphi process was used. In Round 1, an international group of 64 exercise oncology stakeholders (i.e., exercise oncology professionals (n = 29), clinical referrers (n = 21), and people with lived experience (n = 14)) responded to open-ended prompts eliciting perspectives regarding competencies needed for an exercise oncology professional to work with adults receiving active cancer treatment. Subsequently, only exercise oncology professionals participated, ranking the importance of competencies. In Round 2, professionals received summary feedback, ranked new competencies generated from open-ended responses, and reranked competencies not reaching consensus. In the final round, professionals finalized consensus ranking and rated frequency and mastery level for each. Consensus was reached on 103 core competencies required for exercise professionals to be qualified to deliver care to adults undergoing active cancer treatment. The core competencies represent 10 content areas and reflect the needs of clinical referrers and people with lived experience of receiving cancer treatment. The core competencies identified reflect significant advancements in the field of exercise oncology. Results will underpin the development of education, certification, and employment requirements for exercise oncology professionals, providing a critical step toward achieving routine integration of exercise into standard oncology care.

Voices from within: Tracing Chinese Public Perceptions of Democracy in the New Era

AbstractDespite the Chinese Communist Party’s (CCP) emphasis on whole process people’s democracy and democracy with Chinese characteristics, the type of democracy desired by the Chinese people remains debatable. Using two nationwide surveys conducted in 2015 and 2019, this study examines how ordinary Chinese people view democracy during Xi Jinping’s new era. Acknowledging the constraints of conventional methodologies, this study adopts a novel approach that uses automated text analysis to dissect open-ended survey responses about democracy. The results reveal that Chinese citizens primarily associate democracy with freedom of speech, consultation, and minben rather than competitive elections. Furthermore, this study reveals that a higher level of education, more frequent internet usage, and higher household income are positively correlated with a liberal perspective on democracy. This suggests that although the Chinese communist regime may not face immediate pressure to implement open elections, growing support for consultation and freedom may necessitate a greater focus on procedural democracy building by the CCP. By supplementing traditional research methods, this study contributes to a better understanding of China’s regime resilience and its potential future trajectories.

Improving and Analyzing Open-Ended Survey Responses

Improving and Analyzing Open-Ended Survey Responses