Qualitative Data Research Articles

Social media as a learning resource for outdoor enthusiasts: a Canadian perspective

ABSTRACT Outdoor enthusiasts can acquire knowledge and skills about their activities in different ways, one of these being social media. Nonetheless, there is limited scientific literature that allows us to understand how outdoor enthusiasts currently use social media to learn about their activities. This exploratory research, based on a mixed method design, aims to better understand how Canadian outdoor enthusiasts (COE) use social media to learn about their outdoor activities. This study examined how 368 COE use social media to learn about their activities. Chi-square tests and t-tests were applied to analyze differences between participants’ answers and individual characteristics. Results suggest that COE do indeed use social media to learn about their activities. Qualitative data originating from the same survey suggests that COE also use social media to get ideas and inspiration as well as to connect with other outdoor enthusiasts.

The Role of Film-Based Learning Projects in Enhancing Communication Proficiency

Film-based learning projects enhance communication proficiency by immersing students in visual and auditory experiences that improve their understanding, skills, confidence, and creativity in conveying ideas. This study investigates the impact of film-based learning initiatives on students' communication skills through a qualitative methods approach. Data were collected from 150 students using a pre-post-test evaluation, focusing on five key variables: understanding of content, skills improvement, confidence in communication, proficiency in communication, and strategic problem-solving skills. Qualitative data provided a comprehensive understanding of how film-based learning influences communication. It shows students' skills in using SPSS to communicate results from a variety of statistical studies, such as the Wilcoxon signed-rank test and paired sample t-test, which showed a significant improvement in communication ability across these variables. The paired sample t-test highlighted notable gains in communication skills, while the Wilcoxon test confirmed these improvements by analyzing ranks and medians. The findings underscore the effectiveness of film-based interventions in significantly enhancing various aspects of students' communication abilities.

Factors influencing faculty's adoption of engineering technology: A qualitative study

With technologies changing faster than ever before, engineering faculty must continuously update the technologies they use and teach to students to meet accreditation requirements and keep up with industry standards. Many do not, however. Additionally, existing models of technology adoption do not account for all variability within intention to use a technology, nor its actual use. Informed by the Unified Theory of Acceptance and Use of Technology (UTAUT), this study examined which constructs from prior models apply to engineering faculty's adoption of industry-specific technologies, as well as other factors influencing faculty adoption of these technologies for their teaching or research. We interviewed 21 engineering faculty at a Midwestern United States STEM-focused institution about their adoption of engineering technologies. Deductive and inductive coding were used to identify themes within the qualitative data. Constructs from existing models were confirmed to influence faculty engineering technology adoption. We also identified specific Facilitating Conditions (Other People, Digital Resources, Non-Digital Resources, Time, and Formal Training) that faculty leverage to adopt new engineering technologies, and uncovered two additional themes—Access and Personal Traits, including several component traits (Persistence, Humility, Self Efficacy, Growth Mindset, Ambiguity Acceptance, and Curiosity) that influence faculty engineering technology adoption. We propose a new Theory of Faculty Adoption of Engineering Technologies specific to faculty adoption of new engineering technologies. These findings have the potential to help universities determine how to effectively support faculty in providing their students with relevant technological skills for entry into the engineering workforce.

Ocean wave energy learning project (OWELP): a program to communicate alternative energy technology

ABSTRACT Background Efforts to communicate the use of alternative energy as a solution to the continued scarcity of world energy were continuously carried out. However, not all countries with abundant potential for alternative energy sources focus on this, resulting in a lack of human resources who study the field of alternative energy. Purpose This study aims to communicate the topic of ocean wave energy and its technology as an alternative energy source through the Ocean Wave Energy Learning Project (OWELP) program. Sample This study utilized a purposive sampling method on 31 pre-service physics teachers taking environmental physics courses at one of the universities in a small area in Indonesia. Methods This study utilized a mixed-method research of explanatory design. The first stage of quantitative research used a pre-experimental approach with a one-group pretest-posttest design. Data collection instruments were in the form of knowledge test sheets consisting of essay questions, observation sheets on the implementation of lecture programs, rubrics of product assessment, and interview sheets. The next stage is the phase of collecting qualitative data to explain the results obtained in the quantitative phase through interviews. Quantitative data on learning outcomes were analyzed using the Wilcoxon test, a further test of effect size, and N-gain analysis, while the qualitative data were analyzed descriptively. Results The results of the data analysis showed that the OWELP program positively influenced students’ mastery of the concepts. The OWELP program also effectively increased pre-service physics teachers’ mastery of ocean wave energy concepts as an alternative energy source. In addition, the OWELP programcan indirectly equip various skills such as critical thinking, creative thinking, problem-solving, collaboration, and communication. Conclusion The OWELP program can be used to improve pre-service physics teachers’ mastery of the concept of using ocean wave energy as an alternative energy source.

The Impact of Learning Strategies on Psychological Well-being and Academic Performance among University Students: A Case Study at Hanoi Metropolitan University, Vietnam

This study investigates the impact of learning strategies on the psychological well-being and academic performance of university students at Hanoi Metropolitan University, Vietnam. Utilizing a mixed-methods approach, the research combines quantitative data from a cross-sectional survey and qualitative insights from semi-structured interviews. The findings reveal that students who frequently employ cognitive strategies, such as elaboration and organization, and metacognitive strategies, including self-monitoring and goal-setting, report lower levels of stress, anxiety, and depression, and achieve higher academic performance. Quantitative results show a significant difference in GPA between high and low users of these strategies, with a notable reduction in psychological distress among frequent users. Qualitative data further support these findings, highlighting the benefits of strategic learning in managing academic stress and enhancing academic outcomes. The study suggests that educational institutions should integrate training on these strategies into their curricula to improve both student well-being and academic success.

Technological Adoption and Innovative Work Behavior in the Hotel Industry: A Case of Five Selected Hotels in Kampala City, Uganda

The study examined Technological Adoption and Innovative Work Behavior in the Hotel Industry, a Case of Five Selected Hotels in Kampala City, Uganda. The study mainly focused on three specific objectives: To examine the relationship between Property Management Systems and Innovative Work Behavior; to assess the relationship between Mobile Applications and Innovative Work Behavior and to analyze the relationship between Online Booking Platforms and Innovative Work Behavior in selected hotels in Kampala City. The cross-sectional research design employed both qualitative and quantitative data collection techniques. Krejcie and Morgan Sample Size Determination Table was used to select a sample size of 291 participants / respondents from a population of the selected hotels and 233 questionnaires collected for analysis. Data was examined using both descriptive and inferential statistics, including ANOVA, Pearson correlation, and model summaries for regression analysis. The findings show a positive and significant correlation between technological adoption and innovative work behavior (r=.853, P<0.05). This reveals that the integration of property management systems, mobile applications, and online booking platforms significantly influence innovative work behavior by improving efficiency, facilitating collaboration, encouraging adaptive problem-solving, and promoting a culture of continuous improvement. These technologies create an environment where staff are better equipped to focus on creative solutions and respond dynamically to emerging challenges. The research concludes that improving Property Management Systems (PMS) and fostering innovative work behavior in hotels are interconnected goals that drive operational excellence and guest satisfaction; mobile applications are a powerful driver of innovative work behavior in hotels and Online Booking Platforms significantly impact innovative work behavior in hotels by streamlining operations, enhancing data utilization, and encouraging experimentation. The study recommended that hotels should use PMS automation features to handle routine tasks such as guest check-ins/outs, invoicing, and housekeeping assignments. This reduces manual work and frees up staff time for more innovative activities. The study also recommends that hotel should select mobile apps that align with its operational needs and guest service goals, focus on apps that enhance efficiency, data utilization, and guest interaction.

Reshaping curriculum adaptation in the age of artificial intelligence: Mapping teachers' AI‐driven curriculum adaptation patterns

AbstractA national curriculum cannot be uniformly applied in all classrooms. Educators frequently adapt the official curriculum to suit their particular circumstances. In exploring the interplay between artificial intelligence (AI) technologies and curriculum adaptation in education, this study bridges a significant gap in the literature by exploring how AI tools influence teachers' strategies for adapting curricula. Employing an explanatory sequential design, the research analyses both qualitative and quantitative data from 440 teachers, using the Curriculum Adaptation Patterns Scale and focus group semi‐structured interviews. Results indicate a balanced approach among teachers towards extending and revising the curriculum, with less emphasis on omission. Notably, curriculum adaptation practices evolve positively with increased professional experience, differ across disciplines, but remain constant across school levels and educational levels. Qualitatively, teachers reported positive experiences using AI, particularly ChatGPT, to make their lessons better fit students' needs. They've used it to omit parts that aren't needed, add more relevant and personalised content, and revise or replace the content. The findings highlight AI's transformative potential in curriculum adaptation, making education more engaging, relevant and personalised. The study contributes to understanding how AI can support effective curriculum implementation and enhance learning experiences in the digital age.

Community Participation in Ecotourism Project Development: In Wof-Washa National Priority Forest Area

The study focused on investigations of community participation in ecotourism development in Wof-Washa National Priority Forest Areas, using a descriptive design with mixed approach through cross-sectional survey. The study utilized systematic, stratified, and purposeful sampling methods. It also used thematic analysis for qualitative data collected through interviews, and descriptive statistics for quantitative data gathered via questionnaires. Document reviews were used to triangulated this study result with previous findings. The study findings reveal that the current status of community involvement in ecotourism development lean toward degree of tokenism (moderate level), with limited roles, as Arnstein's model, at all stages. Generally, without the participation of community, the development of ecotourism project couldn’t be possible. The researcher suggests that collaborative efforts among all relevant stakeholders are crucial to fostering community participation in the successful implementation of the ecotourism project in Wof-Washa National Priority Forest Area.

Climate Change Education in Ireland: A Crisis in Need of a Meaningful Cross-Curricular Response?

This study examines primary school teachers’ approaches to climate change education (CCE) and the factors that influence this through analysis of data collected in the Irish context. A mixed-methods approach using quantitative and qualitative data gathered through a questionnaire survey and a series of interviews is used. From this, the key barriers and key enablers to teachers’ implementation of CCE are identified. Curriculum, teacher knowledge, pedagogical approaches and content, continuing professional development and influences outside the education system are all identified as enablers/barriers to teachers’ implementation of CCE. These are examined in the context of the international literature in order to ascertain what effects they have on Irish teachers’ approaches to CCE. Findings suggest pathways for curriculum reform and redevelopment in the Irish context, with implications for education regimes internationally.

Prevalence, predictors and outcomes of self-reported feedback for EMS professionals: a mixed-methods diary study

BackgroundProviding feedback to healthcare professionals and organisations on performance or patient outcomes may improve care quality and professional development, particularly in Emergency Medical Services (EMS) where professionals make autonomous, complex decisions and current feedback provision is limited. This study aimed to determine the content and outcomes of feedback in EMS by measuring feedback prevalence, identifying predictors of receiving feedback, categorising feedback outcomes and determining predictors of feedback efficacy.MethodsAn observational mixed-methods study was used. EMS professionals delivering face-to-face patient care in the United Kingdom’s National Health Service completed a baseline survey and diary entries between March-August 2022. Diary entries were event-contingent and collected when a participant identified they had received feedback. Self-reported data were collected on feedback frequency, environment, characteristics and outcomes. Feedback environment was measured using the Feedback Environment Scale. Feedback outcomes were categorised using hierarchical cluster analysis. Multilevel logistic regression was used to assess which variables predicted feedback receipt and efficacy. Qualitative data were analysed using content analysis.Results299 participants completed baseline surveys and 105 submitted 538 diary entries. 215 (71.9%) participants had received feedback in the last 30 days, with patient outcome feedback the most frequent (n = 149, 42.8%). Feedback format was predominantly verbal (n = 157, 73.0%) and informal (n = 189, 80.4%). Significant predictors for receiving feedback were a paramedic role (aOR 3.04 [1.14, 8.00]), a workplace with a positive feedback-seeking culture (aOR 1.07 [1.04, 1.10]) and white ethnicity (aOR 5.68 [1.01, 29.73]). Feedback outcomes included: personal wellbeing (closure, confidence and job satisfaction), professional development (clinical practice and knowledge) and service outcomes (patient care and patient safety). Feedback-seeking behaviour and higher scores on the Feedback Environment Scale were statistically significant predictors of feedback efficacy. Solicited feedback improved wellbeing (aOR 3.35 [1.68, 6.60]) and professional development (aOR 2.58 [1.10, 5.56]) more than unsolicited feedback.ConclusionFeedback for EMS professionals was perceived to improve personal wellbeing, professional development and service outcomes. EMS workplaces need to develop a culture that encourages feedback-seeking to strengthen the impact of feedback for EMS professionals on clinical decision-making and staff wellbeing.

The phenomenon of yoga in the imagination of Turkish nursing students: "The way to place goodness in the heart"

BackgroundThe aim of the research is to shed light on the experiences of a group of nursing students enrolled in a yoga elective course who practiced yoga regularly for 14 weeks, regarding yoga and the phenomenon of doing yoga, with a qualitative approach.MethodsThis qualitative study was conducted at a public university in Izmir, Turkey. The study sample consisted of 61 students enrolled in the 1st-year yoga course at the Department of Nursing, Faculty of Health Sciences. Except for two students, 59 of them participated in the study. Participants attended a face-to-face yoga course once a week for 1.5 h over a 14-week period. Each session comprised 30 min of theoretical instruction and 60 min of practice. In data collection, an interview form containing five questions was used to understand nursing students' experiences and thoughts about practicing yoga. In addition, A4 sized papers in different colors were presented to the participants. The participants were asked to draw and/or cut a shape by choosing the paper in the color that most evokes yoga. Then they were asked to explain why they chose this color and why they drew this shape. Participants were given one hour. After the data were collected, the pictures drawn by the participants and their descriptions of their drawings were transferred to the computer and included in the analysis. Qualitative data were hand-coded by the researchers. Within in-vivo coding, code names were formed from the participants' expressions. The findings analyzed by content analysis were interpreted with the literature under the themes by presenting quotations.ResultsIt was determined that the participants used nature figures (sun, cloud, tree, sky, flower) (f = 75), people doing yoga (f = 12), and sound, light and other figures (bird sound, wave sound, candle, light bulb, traffic light, heart, eye, left key, peace, swing, India, circle, etc.) (f = 29) in the shapes they drew and cut out on A4 sized papers in different colors to describe their experiences and thoughts about practicing yoga. The participants mostly chose blue-green-yellow colors (n = 41). With qualitative question analysis, a list of codes was created from the answers given by the students to the questions for the phenomenon of “doing yoga” (number of codes = 98). After the analysis of the data, four categories were reached. The category names and frequency numbers explaining the phenomenon of practicing yoga were distributed as “symbol of health and serenity (f = 345)”, “the way to place goodness in your heart (f = 110)”, “the most effective way to meet the self (f = 93)” and “no guarantee of relaxation (f = 71)”, respectively.ConclusionsThe results indicate that yoga is perceived by nursing students as a multifaceted practice that evokes a range of emotional and physical responses. Most participants associate yoga with symbols of health, serenity, and self-awareness, often using natural elements and blue-green-yellow the colors to represent these feelings. However, there is also recognition that yoga may not guarantee relaxation for everyone, as some students reported difficulties in meditation, physical discomfort, and challenges in focusing. The study highlights the variability in how individuals experience yoga, emphasizing both its positive effects on well-being and the potential challenges in practice. These findings suggest that while yoga is widely valued for its calming and health-promoting benefits, it may not be universally effective in achieving relaxation or mindfulness.

Exploring the Effective Use of Diagnostic Tests in the High School English Classroom to Support Student Learning: An Action Research Study

This action research study investigated the use of diagnostic tests and feedback to support student learning in a 12th grade English classroom. The researcher developed a diagnostic test to assess students’ strengths and weaknesses in foundational language and literacy skills. The test included multiple-choice, short-answer, and essay questions. The researcher then separated students into an experimental group, which received diagnostic feedback, individualized learning plans, and incentives, and a controlled group which proceeded with the regular curriculum. The individualized learning plans were created based on the results of the diagnostic test and were designed to address each student’s specific needs. The incentives included extra credit points, certificates of achievement, and public recognition. Several sources of quantitative and qualitative data were analysed, including pre and post-test scores, student surveys, teacher surveys, and student work samples. The results indicated that the intervention had a significant positive impact on students’ learning, confidence, and test anxiety compared to the controlled group. Implications for the use of diagnostic assessment in the secondary English classroom are discussed.

The politics of beneficiary selection: A case study of Ghana’s Livelihood Empowerment Against Poverty (LEAP) cash transfer programme

In communities of Sub-Saharan Africa, where local elites participate in the selection of households for cash transfers, there is a tendency to deviate from laid down rules for various reasons. Using qualitative data from selected districts where Ghana’s Livelihood Empowerment Against Poverty (LEAP) programme is implemented, this study investigates the reasons why district and community elites deviate from prescribed selection processes of the LEAP programme. Drawing on the concept of competitive clientelism, the findings suggest that elites are deeply guided by political patronage to fulfil one primary goal, protecting their role in office. Such ambition is facilitated by the discretionary power accorded to elites by the local government system and socio-cultural values deeply rooted in Ghanaian society. In conclusion, the study draws out key lessons from the analysis and suggests a design of beneficiary selection frameworks that acknowledges the nature of domestic politics, institutions of power and powerful actors at the subnational level. The article also highlights the implications of the findings for the broad politics of social protection literature.

Experiences and Supportive Care Needs of Latinx Millennial Caregivers.

Latinx Millennial caregivers are an understudied minority group in the United States. Due to life stage and cultural values, these caregivers struggle to balance conflicting priorities with career, family, and caregiving. They also face systemic barriers and healthcare disparities. Participants (N = 29) were recruited locally and nationally. Qualitative data were collected using five focus groups and one individual interview. Interviews were analyzed by seven coders using thematic analysis with an inductive approach. Meta-themes included (a) the Latinx experience with culture, immigrant status, and structural barriers; and (b) being a super caregiver: being everything to everyone. Additional main themes were identified including family well-being, occupational and financial well-being, social support dynamics, challenges and rewards of family caregiving, and coping strategies. Clinical interventions for Latinx Millennial caregivers should address cultural background, value of family/community, and systemic barriers for care and support.

Exploring students’ perceptions and affordances of Google docs-supported collaborative writing

ABSTRACT Purpose Despite substantial research on students’ perceptions of collaborative writing, only a few studies have provided a deep understanding of their perceptions and attitudes toward computer-supported collaborative writing (CSCW). Previous studies have examined learners’ perceptions and attitudes using questionnaires or interviews at a specific time, typically near the end of the study. Design This mixed method study employed both qualitative and quantitative data and investigated 21 advanced English as foreign language (EFL) learners’ perceptions of collaborative writing, and how these changed after using Google Docs (GD). It also elicited students’ perceived affordances and constraints in using GD for either facilitating or hindering CW. The study used pre – and post-questionnaires, semi-structured interviews, and students’ online GD practice. Findings The results revealed that using GD improved perceptions of CW and increased awareness of its benefits. Interestingly, the perceived challenges of CW changed significantly, indicating that GD may have addressed some of these challenges. Further, the analysis revealed that students perceived GD’s pedagogical and technological affordances, but not its social affordances. While they appreciated how GD’s sharing, editing, visualization, and feasibility features facilitated CW, they did not find it beneficial for social interaction. Several pedagogical implications will be discussed.

Mapping ethical positions concerning a coach’s decision to organise a hypoxic training camp

ABSTRACT On the basis of qualitative literature data, the ethical value of hypoxic training in sports is subject to debate. The objective of the present empirical study was to map various ethical positions with regard to how individuals mentally combined several factors (the hypoxic training’s objective, fairness, planning/monitoring, and method) when judging the acceptability of holding a hypoxic training camp before an event. Two hundred and sixteen participants (including 126 men and 90 women, and 186 athletes and 30 non-athletes) specified their judgement of acceptability in 36 scenarios created by cross-referencing the four factors. A cluster analysis was applied to the whole dataset. Repeated-measures analyses of variance with a 2 × 3 × 3 × 2 factorial design were then applied to each cluster. Lastly, the relationship between the clusters and the participants’ characteristics was assessed in chi-squared tests. The analyses showed four ethical positions: “Moderately acceptable” for 26% of the participants, “Acceptable, depending mainly on monitoring” for 38% of the participants, “Always acceptable” for 20% of the participants, and “Never acceptable unless planned with an expert in hypoxic training and monitored by a physician” for 16% of the participants. Contrary to female participants and non-athletes, male participants and athletes tended to accept the coach’s decision to organise a hypoxic training camp easily. Our study confirmed empirically that hypoxic training does not violate the spirit of sport. Sports stakeholders might refer to our study’s findings to set up a public relations plan that highlights the ethical value of hypoxic training.

Cultural Domain Analysis.

Cultural Domain Analysis (CDA) is a theoretical and methodological approach rooted in cognitive anthropology that investigates how people in a particular culture organize, structure, and perceive ideas. Beginning in the 1960s, CDA developed into a powerful tool for collecting and analyzing data, with applications extending beyond anthropology into other fields, including public health and other social sciences. This paper outlines the procedures and methods used in CDA, its strengths and limitations, and its potential utility in breastfeeding studies. Basic features of key techniques within CDA that include free listing, pile sorting, and cultural consensus analysis are discussed. The paper also highlights how CDA seamlessly combines qualitative and quantitative data to generate culturally meaningful social theories that can inform the development of contextually relevant policies and interventions.

From Treatment to Recovery: Gynecological Survivors' and Caregivers' Perspectives About the Usability of an Educational Resource.

The objective of this study was to understand gynecological cancer (GC) survivors' and their informal caregivers' perceptions about the usability of an educational resource to support their transition from primary cancer treatment into surveillance and/or recovery. After developing an empirical- and experiential-informed educational resource, we used a semi-structured questioning process to understand GC survivors and their caregivers' perceptions about its usability. Data were collected via online focus groups or 1:1 interviews that were audio recorded and transcribed. We used thematic analysis to analyze the data. Ten participants who were survivors or informal caregivers of cervical, ovarian, or uterine/endometrial cancer participated in two rounds of data collection. We grouped qualitative data into two themes: (1) reputable, relevant, and accessible education reduces uncertainty and promotes connection, and (2) individualized delivery of education provided by trusted cancer clinicians. The transition from treatment to surveillance is a challenging time for which reputable, relevant, and accessible educational resources are useful to facilitate an understanding about and self-management of survivorship-related concerns. Survivors and caregivers look to clinicians to provide reputable education to address their needs. This education should be diverse in content and referred to repeatedly throughout the cancer trajectory.

HPV self-collection for cervical cancer screening among survivors of sexual trauma: a qualitative study

Intimate partner violence affects 20–30% of women in the United States. Disparities in routine cervical cancer surveillance have been demonstrated in certain populations, including victims of intimate partner violence (IPV). This study examined and assessed the acceptability of high-risk HPV (hrHPV) self-collection among individuals who have experienced IPV. We conducted an observational study using qualitative data collection and analysis. We interviewed individuals with a history of IPV and who currently reside in Oregon. This study identified key themes describing knowledge and attitudes towards cervical cancer screening for individuals who have experienced IPV. They include: guideline knowledge, prior office-based cervical cancer screening experience, barriers to cervical cancer screening, at-home hrHPV self-collection experience, and testing confidence. Participants experienced fewer barriers and expressed increased comfort and control with hrHPV self-collection process. Individuals with a history of IPV have lower rates of cervical cancer screening adherence and higher rates of cervical dysplasia and cancer than other populations. The patient-centered approach of hrHPV self-collection for cervical cancer screening can reduce barriers related to the pelvic exam and empower patients to reduce their risks of developing cervical cancer by enabling greater control of the testing process.

Comparison of clinical pharmacist practitioners' headache care roles across clinical contexts within the Veterans Health Administration: Optimizing pharmacist integration.

Studies show interdisciplinary treatment is highly effective for addressing chronic pain syndromes, including headache disorders. Increasingly, advanced practice pharmacists work collaboratively with physicians to apply their unique skills to enhance patient outcomes. This qualitative study aimed to elucidate the potential in the Veterans Health Administration (VHA) for increased roles of clinical pharmacist practitioners (CPPs)-advanced practice pharmacists with a scope of practice-in collaborative, interdisciplinary headache care teams. Our research question was: How do CPPs integrate with interdisciplinary headache care teams in Headache Centers of Excellence (HCoE) and non-HCoE VHA facilities, and how can their roles be configured to optimize headache specialty care services? This cross-sectional qualitative study used purposive sampling to recruit CPPs providing headache care within HCoEs and in non-HCoE VHA facilities for virtual, recorded, individual interviews. Multi-stage qualitative data analysis entailed: team discussions; immersion/crystallization for close reading of transcripts to identify emerging patterns of HCoE/non-HCoE comparison of CPPs' experiences; team data sorting using spreadsheets; and further immersion into sorted data for final identification of comparisons and interpretation of the data. A total of 15 CPPs involved in headache care were interviewed, with about half working in HCoEs and half in non-HCoE VHA facilities across the United States. CPPs' roles within and outside HCoEs have considerable overlap as both groups co-manage patients with headache with physicians. CPPs have independent and collaborative responsibilities as they extend headache specialists' services by providing direct patient care and referring to additional providers for headache treatment. When their roles differ within and outside HCoEs it is largely due to level of integration on interdisciplinary headache or pain teams. CPPs in HCoEs collaborate with headache neurologists and interdisciplinary teams; some outside HCoEs do as well, while others work with primary care. CPPs' weekly time dedicated specifically to headache tends to be greater in HCoEs. Nevertheless, most interviewees in both groups stated patient need exceeds CPP availability at their facilities for conducting detailed chart reviews, initial visits to understand the context of patients' headache, and scheduled follow-ups over time to monitor and adjust treatment. CPPs also consult with and educate physicians on headache pharmacy, particularly regarding appropriate use of non-formulary medications. Findings from this study suggest that CPPs' roles in headache care are valuable to clinical colleagues and their patients and should be leveraged and expanded within HCoEs and non-HCoE VHA facilities. When substantively integrated into interdisciplinary headache care teams, CPPs offer unique knowledge, headache management and patient behavior change skills, extend headache specialists' services, and provide both patient and physician education. These combined responsibilities contribute to enhancing patient outcomes and facilitating ongoing access to high quality, evidence-based headache care.