Qualitative Data Research Articles

Evaluating the feasibility and acceptability of a co-designed physical activity intervention for rural middle schoolers: a pilot study

BackgroundLack of physical activity is a concern for children across diverse backgrounds, particularly affecting those in rural areas who face distinct challenges compared to their urban counterparts. Community-derived interventions are needed that consider the unique context and additional physical activity barriers in under-resourced rural settings. Therefore, a prospective pre-post pilot/feasibility study of Hoosier Sport was conducted over 8-weeks with 6th and 7th grade children in a low-socioeconomic rural middle school setting. The primary objective of the present study was to assess trial- and intervention-related feasibility indicators; and the secondary objective was to collect preliminary assessment data for physical activity levels, fitness, psychological needs satisfaction, and knowledge of physical activity and nutrition among participating youth.MethodsThis prospective 8-week pilot/feasibility study took place in the rural Midwestern United States where twenty-four middle school students participated in a mixed-methods pre-post intervention during physical education classes. The intervention included elements like sport-based youth development, individualized goal setting, physical activity monitoring, pedometer usage, and health education. Data were collected at baseline (T1) and post-intervention (T3), with intermediate measures during the intervention (T2). Qualitative data were integrated through semi-structured interviews. Analytical methods encompassed descriptive statistics, correlations, repeated measures ANOVA, and thematic analysis.ResultsKey findings indicate robust feasibility, with intervention-related scores (FIM, AIM, and IAM) consistently surpassing the “good” threshold and 100% retention and recruitment success. Additionally, participants showed significant physical performance improvement, shifting from the 25th to the 50th percentile in the 6-minute walk test (p < 0.05). Autonomy and competence remained high, reflecting positive perceptions of program practicality. Nutrition knowledge, initially low, significantly improved at post-intervention (p < 0.01), highlighting the efficacy of targeted nutritional education in Hoosier Sport.ConclusionsThis study pioneers a community-engaged model for physical activity intervention in under-resourced rural settings. Positive participant feedback, coupled with improvements in physical fitness and psychosocial factors, highlights the potential of the co-design approach. The findings offer valuable insights and a practical template for future community-based research, signaling the promising impact of such interventions on holistic well-being. This research lays the foundation for subsequent phases of the ORBIT model, emphasizing collaborative, community-driven approaches to address the complex issue of declining physical activity levels among adolescents.

The current status and challenges of bioethics education in undergraduate medical education in Karachi, Pakistan

BackgroundThe importance of including bioethics in the medical curricula has been recognized globally. Certain countries including Pakistan continue to lag behind although some developments have occurred recently.ObjectivesThe research aimed to provide a snapshot of bioethics education in undergraduate medical colleges in Karachi, Pakistan. The secondary objectives included identifying factors promoting or inhibiting integration of bioethics into the curriculum.MethodsA two-pronged strategy was used to collect data including a website review of medical colleges, in existence for more than ten years, recognized by the Pakistan Medical and Dental Council (PMDC), the regulating body for undergraduate medical education in Pakistan. The other arm employed in-depth interviews with medical educationists in colleges fulfilling inclusion criteria. Data from the website was analyzed and presented as frequencies. Qualitative data was analyzed using content analysis method which involved coding of transcripts, multiple readings and arriving at subthemes and themes iteratively.ResultsThirteen medical colleges were included for the website review, of which four were from public sector. Three medical colleges used the word “ethics” in their vision and mission statement and four had provided a detailed curriculum for ethics on their website.Thematic framework included four broad themes: 1) Need for Bioethics Education, 2) Current Status of Bioethics Education 3) Challenges in integration of bioethics in medical curriculum and 4) Recommendations for integration of bioethics in the Curriculum. Participants were in agreement that bioethics was important in development of future physicians. Participants identified various challenges, foremost being shortage of trained faculty, lack of institutional buy-in and overcrowded curriculum.ConclusionThe study identified sporadic inclusion of bioethics in undergraduate medical curricula, left to the discretion of individual institutions. Since Karachi is a cosmopolitan city, the findings may reasonably reflect the situation in other parts of the country. While bioethics is recognized as an important field, it will continue to remain an orphan subject in the curricula unless the regulatory and accreditation bodies make it compulsory for institutions to include ethics in their curricula.

Disaster induced displacement and durable solutions in Africa

AbstractClimate change represents a significant challenge to the sustainability of the global economy. Many African countries have suffered the repercussions of environmental and climate deterioration, most notably internal displacement. This article sought to examine the impact of climate change within the context of internal displacement in Africa and to preview and describe the trends of internally displaced people in Africa. The study used a mixed methods approach. Qualitative data was obtained from online repositories, and it was analyzed using content analysis. Quantitative data was obtained from World Bank portal and it was analysed using descriptive statistics. Research findings have shown that Africa is plagued by a high number of internally displaced people. It was also established that climate change leads to income inequality, the exposure of people to poverty, and the destruction of infrastructure. These adverse effects affect the capacity of African economies to attain selected Sustainable Development Goals. In terms of policy recommendations, it was suggested that there is a need to strengthen the regional and continental bodies, invest in climate change adaptation measures, broaden the definition of refugees to include climate refugees, and promote robust research and capacity building.

Relationship of psychological capital, transformational leadership, and internal communication to work engagement in organizations

Organization A, which represents the country in the oil and gas industry and is tasked with managing oil and gas activities in Indonesia to ensure national energy security, requires employees with high work engagement. This requires enthusiasm, dedication, and perseverance to contribute fully to their work. However, human resource management surveys and several phenomena analyzed show that work engagement in Organization A is low. This research consists of two studies: a research study and an intervention study. This research aims to analyze the relationship between psychological capital (individual internal factors), transformational leadership (individual external factors), and internal communication (organizational factors) on work engagement using a sample of 267 employees of Organization A. Using a quantitative design supported by qualitative data, and found that individual psychological capital, transformational leadership style, and internal communication in the organization significantly predicted work engagement. Among these factors, internal communication predicted work engagement beyond psychological capital and transformational leadership. An intervention study involving 23 participants was designed to determine the effectiveness of an internal communication strategy training program in increasing work engagement. Results from the intervention study showed significant improvements in participants' pre-test and post-test scores, indicating the effectiveness of the program in increasing work engagement.

“If I die for touching him, let me die”: a rapid ethnographic assessment of cultural practices and Ebola transmission in high-risk border regions of Tanzania

BackgroundEbola Virus Disease (EVD) is a rare but contagious disease caused by Ebola Virus (EBOV). The first Ebola outbreaks were reported in the Democratic Republic of Congo (DRC) before subsequent reported cases in Western and East African countries, including Uganda, which borders Tanzania. Proximity to EVD-infected countries raises the prospect of cross-border transmission, raising alarm in Tanzania. This study aimed to explore the cultural practices likely to prevent or escalate EVD transmission in the event of its outbreak in the country.MethodsThis rapid ethnographic assessment employed observation, interviews, and focus group discussions to collect data from people with diverse characteristics in five regions of Tanzania Mainland namely, Kagera, Kigoma, Mwanza and Songwe regions and Zanzibar Island. The qualitative data was then subjected to thematic analysis.FindingsCultural practices may escalate the transmission of EVD and hinder its prevention and control. These cultural practices include caring sick people at home, confirmation of death, mourning, and body preparation for burial. Communal life, ceremonies, and social gatherings were other aspects observed to have the potential for compounding EVD transmission and hindering its containment in case of an outbreak.ConclusionCultural practices may escalate EVD transmission as identified in the study settings. As such, Risk Communication and Community Engagement (RCCE) activities should be interventionist in transforming cultural practices that may escalate the spread of EVD as part of preparedness, prevention, and control efforts in the event of an outbreak.

In-person psychoeducational intervention to reduce rehospitalizations and improve the clinical course of major depressive disorder: a non-randomized pilot study.

Emerging issues in the management of major depressive disorder (MDD) comprise a nonadherence to treatment and treatment failures, depressive recurrence and relapses, misidentification of incoming exacerbated phases and consequently, a chronification of depression. While antidepressant drugs constitute the standard of care for MDD, effective psychosocial interventions are needed to reduce rehospitalizations and other adverse events. The present study primarily investigated the effects and impact of implementing a structured psychoeducational intervention on the clinical course of MDD. A non-randomized comparative, pragmatic, pilot, single-center study of adults with nonpsychotic moderate or severe episode of MDD recently discharged from a psychiatric hospitalization. The consecutive subjects were allocated either to the intervention group (N=49) or to the attention control group (N=47), based on their preference. The psychoeducational intervention was based on a modified Munoz's Depression Prevention Course. Subjects were followed up prospectively for two years. The absolute changes in Beck anxiety inventory scale, Zung's depression questionnaire, and Montgomery and Äsberg depression rating scale (MADRS) total scores at 6-month follow-up were comparable between the two groups. There were lower rates of the rehospitalization within one year (2.1% vs. 16.7%; P<0.001) and less rehospitalizations after one year (6.3% vs. 25%; P<0.001), lower rates of the ongoing sickness absence (11.5% vs. 29.2%; P<0.001), less persons with disability due to MDD at 1-year follow-up (1% vs. 11.5%; P=0.002), and less nonadherent subjects who self-discontinued treatment (6.3% vs. 28.1%; P<0.001) among participants in the intervention group compared to the control group. The disability due to MDD at 1-year follow-up was predicted by the absence of the psychoeducational intervention (P=0.002) and by the MADRS total score at 6-month follow-up (OR 1.10; 95% CI 1.003-1.195; P=0.044). Qualitative data indicated the intervention was desired and appreciated by the participants, as well as being practical to implement in Slovakian clinical settings. The results suggest the psychoeducational intervention based on a modified Munoz's Depression Prevention Course has beneficial effects in adults with MDD recently discharged from a psychiatric hospitalization. The findings implicate the psychoeducational intervention may offer a new approach to the prevention of depressive relapses.

Evaluating the feasibility and acceptability of a co-designed physical activity intervention for rural middle schoolers: a pilot study

BackgroundLack of physical activity is a concern for children across diverse backgrounds, particularly affecting those in rural areas who face distinct challenges compared to their urban counterparts. Community-derived interventions are needed that consider the unique context and additional physical activity barriers in under-resourced rural settings. Therefore, a prospective pre-post pilot/feasibility study of Hoosier Sport was conducted over 8-weeks with 6th and 7th grade children in a low-socioeconomic rural middle school setting. The primary objective of the present study was to assess trial- and intervention-related feasibility indicators; and the secondary objective was to collect preliminary assessment data for physical activity levels, fitness, psychological needs satisfaction, and knowledge of physical activity and nutrition among participating youth.MethodsThis prospective 8-week pilot/feasibility study took place in the rural Midwestern United States where twenty-four middle school students participated in a mixed-methods pre-post intervention during physical education classes. The intervention included elements like sport-based youth development, individualized goal setting, physical activity monitoring, pedometer usage, and health education. Data were collected at baseline (T1) and post-intervention (T3), with intermediate measures during the intervention (T2). Qualitative data were integrated through semi-structured interviews. Analytical methods encompassed descriptive statistics, correlations, repeated measures ANOVA, and thematic analysis.ResultsKey findings indicate robust feasibility, with intervention-related scores (FIM, AIM, and IAM) consistently surpassing the “good” threshold and 100% retention and recruitment success. Additionally, participants showed significant physical performance improvement, shifting from the 25th to the 50th percentile in the 6-minute walk test (p < 0.05). Autonomy and competence remained high, reflecting positive perceptions of program practicality. Nutrition knowledge, initially low, significantly improved at post-intervention (p < 0.01), highlighting the efficacy of targeted nutritional education in Hoosier Sport.ConclusionsThis study pioneers a community-engaged model for physical activity intervention in under-resourced rural settings. Positive participant feedback, coupled with improvements in physical fitness and psychosocial factors, highlights the potential of the co-design approach. The findings offer valuable insights and a practical template for future community-based research, signaling the promising impact of such interventions on holistic well-being. This research lays the foundation for subsequent phases of the ORBIT model, emphasizing collaborative, community-driven approaches to address the complex issue of declining physical activity levels among adolescents.

Disaster induced displacement and durable solutions in Africa

AbstractClimate change represents a significant challenge to the sustainability of the global economy. Many African countries have suffered the repercussions of environmental and climate deterioration, most notably internal displacement. This article sought to examine the impact of climate change within the context of internal displacement in Africa and to preview and describe the trends of internally displaced people in Africa. The study used a mixed methods approach. Qualitative data was obtained from online repositories, and it was analyzed using content analysis. Quantitative data was obtained from World Bank portal and it was analysed using descriptive statistics. Research findings have shown that Africa is plagued by a high number of internally displaced people. It was also established that climate change leads to income inequality, the exposure of people to poverty, and the destruction of infrastructure. These adverse effects affect the capacity of African economies to attain selected Sustainable Development Goals. In terms of policy recommendations, it was suggested that there is a need to strengthen the regional and continental bodies, invest in climate change adaptation measures, broaden the definition of refugees to include climate refugees, and promote robust research and capacity building.

Heritage Resilience and Identity: Lesson from Trabocchi Coast about Climate Change Adaptation Strategies

Climate change and land use are major drivers of environmental and socioeconomic transformations in landscapes and in coastal areas. The objective of this study was to present an interdisciplinary and participatory research methodology for analysing the evolutionary process of a coastal case study, the Trabocchi Coast in the Abruzzo Region (Italy), from multiple perspectives, including climate change, technological history, conservation protocols, and social function. The goal was to assess the resilience of these coastal structures, i.e., their ability to cope and adapt to changes while maintaining their identity and recognition. The adopted approach combined qualitative and quantitative data from the meteorological analyses, literature review, and field investigations involving a participatory workshop, from which a significant portion of the analysed results presented here emerged. The results indicate that the Trabocchi Coast has undergone significant changes in recent decades, posing a serious threat to cultural heritage due to climate change (sea-level rise, coastal erosion, storms, flooding and salinisation), changes in use and mass tourism. However, these changes have also presented challenges and opportunities for coastal development, stimulating diverse resilient responses from local communities, ranging from resistance to innovation. The paper discusses the factors that may make the Trabocchi Coast a model of resilience considering these changes. This is supported by the role of local institutions as guarantors of the cultural heritage value of the trabocchi in that specific landscape context, as evidenced by the approval of the “Costa dei Trabocchi Special Territorial Project” by the Abruzzo Region in 2023.

Practical manual for the implementation of service and process improvement methodologies, quality models and tools

This study seeks to identify the common factors in the methodologies, practices and management models, as well as in the quality tools used by leading national companies through a systematic review in which the city of Guayaquil was taken as a sample reference, investigating the achievement of procedures in institutions that have adopted this simplification model. It responds to a result of the research project carried out by students and teachers of the TES: Practical manual for the implementation of methodologies for the improvement of services and processes, models and quality tools. The authors used instruments such as interviews, SWOT analysis, Ishikawa diagrams, among others, to collect qualitative and quantitative data. The technique used was documentary review, using record cards as an instrument. The results obtained allow us to conclude that the authors' analysis highlights the need to apply specific strategies to improve organizational efficiency. They also seek to reflect the impact that quality management has had on the country's competitiveness. In addition, the importance of adopting proactive approaches to address the challenges identified in other studies is emphasized.

Balancing Social and Cultural Priorities in the UN 2030 Sustainable Development Goals (SDGs) for UNESCO World Heritage Cities

There is a strong relationship between heritage-led urban regeneration and the UN initiatives for Sustainable Development (SD). These include the Intangible Cultural Heritage Convention (ICH; 2003) and Historic Urban Landscape (HUL; 2011) under the UNESCO mandate and the Sustainable Development Goals (SDGs; 2015) and the New Urban Agenda (NUA; 2016) under the UN mandate. Despite the presence of those initiatives, regeneration in a World Heritage city often leads to the disappearance of intangible heritage, gentrification, excessive tourism, and social exclusion. Therefore, this paper critically identifies the shortcomings of those initiatives in addressing social and cultural sustainability. It uses the recently inscribed city of As-Salt on the WHL to showcase how the relevant SDGs’ targets and indicators are problematic in monitoring and measuring the sustainability of urban regeneration practices in WH cities. This is achieved by investigating where heritage and culture are embedded within the descriptions of goals and indicators in the three initiatives (SDGs, NUA, and HUL) document. A content analysis, using the NVivo qualitative data analysis tool, was conducted in order to identify complementarity, synergies, and correlations among the goals and indicators related to social and cultural sustainability. This paper concludes by suggesting an integrated approach under the umbrella of the SDGs for a more sustainable heritage-led urban regeneration alternative for cities acquiring UNESCO WH status.

ADVANTAGES OF USING TRANSLATION, PARAPHRASING, AND PODCASTS TO IMPROVE NATURAL WRITING SKILLS

Most EFL students find it difficult to articulate themselves clearly in written assignments. To overcome those flaws, twenty-five college students enrolled in the program. The WhatsApp program was employed as a classroom tool because of online learning. The teacher modified the audio materials in an attempt to strengthen the pupils' inadequate writing abilities. The students observed the native speakers' use of grammar in their transcribing and used that to understand grammar usage. To help with vocabulary development, the students also translate it into their native tongue. The students recount the podcasts' material to improve their speaking flow. The information the students learned from the podcast materials was applied to the description of images. Students utilized paraphrasing applications to complete the proofreading assignments. It is a procedure to hone their writing abilities. It is discovered by qualitative data analysis that students can successfully produce natural writing by using paraphrasing tools, translation services, and podcasts. Instructors can teach pertinent subjects with the use of this kind of material. It is also causing other researchers to become aware of more pertinent discoveries.

Exploring HIV-Infected Women's Attitudes Toward Disclosing Their Diagnosis

Background: HIV disclosure plays a crucial role in HIV prevention efforts because it allows individuals to make informed decisions about their sexual health and reduces the risk of transmitting the virus to others. Objectives: This study aimed to explore the attitudes of HIV-infected women toward disclosing their diagnosis. Methods: This qualitative study was conducted between June 2021 and September 2022 in Mashhad, Iran. Participants were selected through purposeful sampling with maximum variation. Sixteen HIV-positive women were interviewed in-depth using a semi-structured interviewing process to gather qualitative data. Data were analyzed using inductive qualitative content analysis. Results: The main theme that emerged from the analysis was a dual attitude toward HIV disclosure, consisting of two categories: Perceived well-being and perceived personal and social challenges. Perceived well-being included the promotion of well-being, gaining family support, and promoting compassion and understanding. Perceived personal and social challenges encompassed the stigma's shadow on interactions, breaches of confidentiality, facing legal challenges of marriage breakdown, and family well-being concerns. Conclusions: The study highlights that negative attitudes toward HIV disclosure are primarily influenced by social factors. Nurses and midwives can play a key role in promoting acceptance and support for these individuals by advocating for culturally sensitive national programs, providing education to the community on HIV disclosure, and offering non-judgmental care.

Barriers to social enterprise growth in developing countries: proposition of a multilevel approach

Purpose The purpose of this study is to investigate the hybridity of social enterprises (SEs) by examining the barriers to growth they face at the individual, organizational and institutional levels. Through this investigation, the study aims to contribute to our understanding of hybrid SEs and advance knowledge in the field. Design/methodology/approach This exploratory study uses Gioia’s grounded theory method to analyze qualitative data from 16 interviews conducted with established SEs, dissolved SEs and consulting centers in Vietnam. Findings SEs do have barriers to growth that distinguish them from traditional enterprises. Hybrids face barriers to growth at individual, organizational and institutional levels. This study offers a theoretical framework and provides the process model of SE barriers to growth. The SE growth process demonstrates the complex and dynamic interplay of specific components within two groups: organizational capacities and the SE ecosystem elements. This highlights the roles of various actors and institutions within the ecosystem in enhancing organizational capabilities and removing barriers to SE growth, extending knowledge of the SE, barriers to growth and the ecosystem literature. Research limitations/implications This paper has two main limitations. First, it is an empirical research conducted in a specific context, so the results may not be universally applicable. Second, it has a qualitative approach, which has limitations in comparing differences among different groups, such as hybrids versus traditional enterprises. However, these limitations also open numerous possibilities for further research directions. For instance, future research could apply this theoretical framework to conduct surveys in diverse contexts and use quantitative analysis to further examine the model of hybrid constraints. Originality/value The findings of this paper contribute to a more holistic understanding of barriers to growth facing SEs, which is an under-researched topic in the Vietnamese context. This paper offers a theoretical framework of barriers and the process of growth, providing potential recommendations for practitioners seeking to support SEs in addressing their unique challenges, and suggests avenues for further research in this area.

A Simple and Systematic Approach to Qualitative Data Extraction From Social Media for Novice Health Care Researchers: Tutorial.

Social media analyses have become increasingly popular among health care researchers. Social media continues to grow its user base and, when analyzed, offers unique insight into health problems. The process of obtaining data for social media analyses varies greatly and involves ethical considerations. Data extraction is often facilitated by software tools, some of which are open source, while others are costly and therefore not accessible to all researchers. The use of software for data extraction is accompanied by additional challenges related to the uniqueness of social media data. Thus, this paper serves as a tutorial for a simple method of extracting social media data that is accessible to novice health care researchers and public health professionals who are interested in pursuing social media research. The discussed methods were used to extract data from Facebook for a study of maternal perspectives on sudden unexpected infant death.

Effectiveness of a Multifaceted Implementation Strategy to Increase Equitable Hospital at Home Utilization: An Interrupted Time Series Analysis.

The number of Hospital-at-Home (HaH) programs rapidly increased during the COVID-19 pandemic and after issuance of Centers for Medicare and Medicaid Services' (CMS) Acute Hospital Care at Home (AHCaH) waiver. However, there remains little evidence on effective strategies to equitably expand HaH utilization. Evaluate the effects of a multifaceted implementation strategy on HaH utilization over time. Before and after implementation evaluation using electronic health record (EHR) data and interrupted time series analysis, complemented by qualitative interviews with key stakeholders. Between December 2021 and December 2022, we identified adults hospitalized at six hospitals in North Carolina approved by CMS to participate in the AHCaH waiver program. Eligible adults met criteria for HaH transfer (HaH-eligible clinical condition, qualifying home environment). We conducted semi-structured interviews with 12 HaH patients and 10 referring clinicians. Two strategies were studied. The discrete implementation strategy (weeks 1-12) included clinician-directed educational outreach. The multifaceted implementation strategy (weeks 13-54) included ongoing clinician-directed educational outreach, local HaH assistance via nurse navigators, involvement of clinical service line executives, and individualized audit and feedback. We assessed weekly averaged HaH capacity utilization, weekly counts of unique referring providers, and patient characteristics. We analyzed themes from qualitative data to determine barriers and facilitators to HaH use. Our evaluation showed week-to-week increases in HaH capacity utilization during the multifaceted implementation strategy period, compared to discrete-period trends (slope-change odds ratio-1.02, 1.01-1.04). Counts of referring providers also increased week to week, compared to discrete-period trends (slope-change means ratio-1.05, 1.03-1.07). The increase in HaH utilization was largest among rural residents (11 to 34%). Barriers included HaH-related information gaps and referral challenges; facilitators included patient-centeredness of HaH care. A multifaceted implementation strategy was associated with increased HaH capacity utilization, provider adoption, and patient diversity. Health systems may consider similar, contextually relevant multicomponent approaches to equitably expand HaH.

Physical Activity Interventions in People with Diabetes: A Systematic Review of The Qualitative Evidence

Objectives: The aim of this systematic review is to summarize the results of qualitative research into people with type 2 diabetes mellitus (T2DM) and their propensity to engage in physical activity (PA), and to identify and analyse their experiences and opinions of interventions and programs designed to increase their adherence to PA recommendations. Design: Systematic review of qualitative studies extracted from databases using the SPIDER systematic search method. The review included studies that combined qualitative and mixed methods research and compiled the experiences and opinions of people with T2DM who had participated in interventions to increase their levels of PA. A thematic summary of qualitative data was performed. Results: The review comprised nine studies published between 2017 and 2021, which included 170 people. Four themes and ten subthemes were identified. The four themes include: (1) factors related to PA, (2) factors related to the program, (3) factors related to the support the participants received and (4) factors related to the person. Conclusion: The support patients receive, both from family/friends and from health providers, is key to consolidating changes in habits and in promoting individualized health education. Future interventions and health policies should reinforce programs designed to promote PA that prioritize the experiences of people in order to increase their adherence to PA programs.

The impact of arts on prescription on individual health and wellbeing: a systematic review with meta-analysis

IntroductionThe evidence-base for the impact of participating in the arts for different aspects of health and wellbeing is growing. Arts on Prescription has gained increasing recognition as a method for fostering connections among individuals and communities, however, to date no systematic review of the impact on individual health and wellbeing has been conducted. This review aims to provide an understanding of individual health and wellbeing outcomes from participation in Arts on Prescription programmes.MethodsMajor electronic databases were systematically searched, including Cochrane Library; Web of Science; ProQuest; CINAHL; Arts &amp;amp; Humanities; Ebsocohost; Pubmed; PsycINFO. Other databases were also used: Google Scholar and websites of specific organizations, e.g., NHS Evidence, Kings Fund, Health foundation, Nuffield Trust and NESTA and University of Florida Arts-in Medicine Repository. The review used PRISMA reporting structures. Critical Appraisal Skills Programme (CASP) templates were used for qualitative and quantitative studies, and the Mixed Methods Appraisal Tool (MMAT) for studies with a mixed methods protocol to assess quality and risk of bias. A narrative review of the qualitative data was conducted. For quantitative outcomes, a meta-analysis for studies that met inclusion criteria was conducted, and a narrative review made of secondary and heterogeneous outcomes and approaches.Results7,805 records were identified but only 25 records were included as studies with a focus on the impact on individual health and wellbeing. Studies were conducted in Australia, Denmark, Sweden, United Kingdom, and the United States. Programmes were held in community settings, arts venues, GP surgeries, primary healthcare settings, and one school. Most interventions varied from 8 to 10 weeks and included a wide range of different arts activities. Qualitative themes included social benefits, psychological benefits and progression opportunities. The meta-analysis showed a statistically significant improvement in wellbeing, and the narrative review identified promising outcomes that require further evidential support (e.g., reductions in anxiety and depression).DiscussionArts on Prescription programmes are an appropriate intervention for improving psychosocial wellbeing, providing both social and psychological benefits as well as progression opportunities. We discuss the various qualitative and quantitative outcomes, along with potential ‘active ingredients’ and barriers to participation (physical, psychological and social).Systematic review registrationPROSPERO, identifier CRD42023408974, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023408974.

Barriers to social enterprise growth in developing countries: proposition of a multilevel approach

Purpose The purpose of this study is to investigate the hybridity of social enterprises (SEs) by examining the barriers to growth they face at the individual, organizational and institutional levels. Through this investigation, the study aims to contribute to our understanding of hybrid SEs and advance knowledge in the field. Design/methodology/approach This exploratory study uses Gioia’s grounded theory method to analyze qualitative data from 16 interviews conducted with established SEs, dissolved SEs and consulting centers in Vietnam. Findings SEs do have barriers to growth that distinguish them from traditional enterprises. Hybrids face barriers to growth at individual, organizational and institutional levels. This study offers a theoretical framework and provides the process model of SE barriers to growth. The SE growth process demonstrates the complex and dynamic interplay of specific components within two groups: organizational capacities and the SE ecosystem elements. This highlights the roles of various actors and institutions within the ecosystem in enhancing organizational capabilities and removing barriers to SE growth, extending knowledge of the SE, barriers to growth and the ecosystem literature. Research limitations/implications This paper has two main limitations. First, it is an empirical research conducted in a specific context, so the results may not be universally applicable. Second, it has a qualitative approach, which has limitations in comparing differences among different groups, such as hybrids versus traditional enterprises. However, these limitations also open numerous possibilities for further research directions. For instance, future research could apply this theoretical framework to conduct surveys in diverse contexts and use quantitative analysis to further examine the model of hybrid constraints. Originality/value The findings of this paper contribute to a more holistic understanding of barriers to growth facing SEs, which is an under-researched topic in the Vietnamese context. This paper offers a theoretical framework of barriers and the process of growth, providing potential recommendations for practitioners seeking to support SEs in addressing their unique challenges, and suggests avenues for further research in this area.

‘It's just one step too far’: Negotiating physical activity for perinatal mental health

BackgroundPhysical activity is recommended as a self-help strategy for some mild to moderate perinatal mental illnesses. Despite this, we know very little about how women remain active, or take up physical activity, in the context of changing family life and perinatal mental illness. We seek to explore: a) how women negotiate physical activity for their mental health during transitions into parenthood and the early years; and b) the experiences of women with perinatal mental illness in relation to physical activity. MethodsAn anonymous UK-wide qualitative online survey was used to better understand how physical activity may be used for perinatal mental health, barriers to activity and changes over time. 186 women with babies and children up to four years completed the survey. Reflexive thematic analysis was used to analyse the qualitative data and generate themes. ResultsThemes generated from this data were: 1) negotiating being active for perinatal mental health (the benefits and how these women remained active); 2) barriers to PA associated with mental illness (some women were active but still experienced general barriers to further PA, and there were several emotional barriers from mental illness); and 3) PA, guilt and the importance of valuing walking (guilt about not being active enough, guilt and feelings of failure exacerbated by questions about PA levels without support offered; regular walking not valued as PA exacerbating feelings of guilt). Conclusions and ImplicationsThis study provides new empirical data on the experiences of new mothers’, physical activity and mental health with important implications for physical activity messaging and support for women during this time through maternity care. Individualised conversations are important and the value of walking and incidental activity from activities that mothers and families find enjoyable should be promoted.