Longitudinal Qualitative Interviews Research Articles

Implementation of back to living well, a community-based program for the tertiary prevention of low back pain: a study protocol

BackgroundThe current literature supports the effectiveness of exercise, education, and self-management interventions for the long-term management of persistent low back pain. However, there is significant uncertainty about the implementation of interventions related to barriers, facilitators, and patient’s preferences. This study will evaluate the Back to Living Well program implementation from a participant and organizational perspective. More specifically we address the following objectives: 1) identify program barriers and facilitators from participants’ perspectives, 2) identify factors related to program, personal and contextual factors that contribute to negative and positive outcomes, and outcome trajectories, 3) identify factors influencing participants’ selection of an in-person or e-health program, and 4) evaluate program specific barriers and facilitators from the organization and care delivery perspectives.MethodsThis study will utilize a mixed-method convergent design including a longitudinal cohort strand and a longitudinal qualitative interview strand. The RE-AIM framework will be used to assess program implementation. Participants (n = 90, 1:1: in person or virtual) who choose to register in the program as well as staff (n = 10 to 15) involved in the delivery of the program will be invited to participate. Participants will participate in a 12-week physical activity, education, and self-management program. Implementation outcomes will be measured at 3-, 6-, 12-months, and six months after the end of the follow-ups. Interview scripts and directed content analysis will be constructed based on the Theoretical Domains Framework and the Neuromatrix Model of Pain, Theoretical Domains Framework. Staff interviews will be constructed and analyzed using the Consolidated Framework for Implementation Research. Participants will also complete pain, disability, quality of life and psychological questionnaires, wear an activity tracker at all time points, and complete weekly pain and activity limitation questions using a mobile application.DiscussionThe study results will provide evidence to inform potential future implementation of the program. An effective, appropriately targeted, and well implemented exercise program for the long-term management (i.e., tertiary prevention) of LBP could minimize the burden of the condition on patients, the health care system and society.Trial registrationClinicalTrials.gov NCT05929846. This (Registration Date: July 3 2023) study has been approved by the Hamilton Integrated Research Ethics Board Project ID#15,354.

Resiliency process in the family after childhood leukaemia diagnosis: A longitudinal qualitative study.

To construct a conceptual framework on the process of family resilience during the first year following childhood leukaemia diagnosis. A longitudinal qualitative interview study. A longitudinal qualitative study following a grounded theory methodology was employed. Semi-structured interviews were conducted with parents of children with leukaemia in a general hospital. The participants were recruited through purposive and theoretical sampling and longitudinal engagement was achieved by conducting interviews at 1, 3, 6, and 12 months after the leukaemia diagnosis. The core category and categories were saturated following the enrolment of parents of children with leukaemia. Data collection and analyses were performed simultaneously. Sixteen parents of children with leukaemia participated. The core category of 'families living with childhood leukaemia' refers to the process of family resilience during the first year following childhood leukaemia diagnosis, which includes three phases: (1) destruction and resiliency period; (2) adjustment and consolidation period; and (3) growth and planning period. This study explored the dynamic, complex and continuous processes of resilience among families coping with childhood leukaemia during the first year following diagnosis. Further research should design tailored family interventions that characterise the different phases of family resilience, aiming to support family well-being, integrity and functioning. Both families and healthcare professionals must create an enabling environment that supports families coping with difficulties. Understanding the different phases of family resilience allows healthcare professionals to provide holistic care that meets the demands of families with childhood leukaemia. Unique knowledge emerged about the family's resiliency process when facing childhood leukaemia, suggesting a family-led revolution in understanding and managing childhood leukaemia. Therefore, the development of phased, resilience-based family interventions is imperative. This study was reported using the COREQ checklist. Patients contributed via study participation.

Experiences with advance care planning in amyotrophic lateral sclerosis: Qualitative longitudinal study with people with amyotrophic lateral sclerosis and their family carers

Background: It is unclear when people with amyotrophic lateral sclerosis and their family carers think about their future, what they would prefer in terms of care, and how their ideas change over time. Aim: Understanding experiences with advance care planning of persons with amyotrophic lateral sclerosis and their family carers—and if, when, how, and why these experiences change over time. Design: A qualitative longitudinal interview study. Analysis involved content analysis, followed by a two-step timeline method to describe changes in advance care planning experiences within and across participants. Setting/participants: Nine persons with amyotrophic lateral sclerosis and nine family carers who were interviewed three times over a 9-month period. Results: All participants thought about future care, but few talked about it. Over time, advance care planning experiences were influenced by intertwined elements: (1) experienced physical decline and related future care needs; (2) how persons with amyotrophic lateral sclerosis identify themselves as patients; (3) obtaining information about diagnosis and prognosis; (4) professionals initiating conversations about medical aspects of end-of-life decisions; (5) balancing between hope to remain stable and worry about the future; and (6) protecting themselves and each other from worries about the future. Conclusion: This study emphasizes how factors such as coping with the disease and relational dynamics shape individuals’ thoughts about future care over time and how psychological, social, and medical factors are interwoven in advance care planning. The findings advocate for a process-oriented perspective, portraying advance care planning as an ongoing dialog, encompassing the needs, concerns, and emotions of both people with amyotrophic lateral sclerosis and their family carers.

Early Exit Decisions in Finland: Investigating the Limbo between Unemployment and Retirement

Despite efforts to extend careers, workers continue to withdraw from working life before reaching the old-age pension age. The complexities behind early exit decisions have been extensively studied to understand the individual factors influencing the decision-making processes. However, fewer studies have attempted to understand how underlying cultural notions of age shape these decisions. Using qualitative longitudinal interview data from Finland, this article examined how individuals in the Finnish unemployment pathway to retirement position themselves between unemployment and retirement by drawing on age-specific discourses. Findings show that early exit was framed as the least problematic career option, although colored with ambiguity and anxiety. Individuals did not view themselves as retirees, and some expressed interest in continuing work. Nevertheless, age norms together with experienced, internalized, and expected ageism pushed individuals toward exit, highlighting the need to better understand and support individuals experiencing late-life unemployment.

Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study.

COVID-19 restrictions created barriers to "business as usual" in healthcare but also opened the door to innovation driven by necessity. This manuscript (1) describes how ADVANCE, an in-person group perpetrator program to reduce intimate partner violence (IPV) against female (ex)partners by men in substance use treatment, was adapted for digitally-supported delivery (ADVANCE-D), and (2) explores the feasibility and acceptability of delivering ADVANCE-D to men receiving substance use treatment. Firstly, the person-based approach and mHealth development framework were used to iteratively adapt ADVANCE for digitally-supported delivery including conceptualization, formative research, and pre-testing. Then, a non-randomized feasibility study was conducted to assess male participants' eligibility, recruitment, and attendance rates and uptake of support offered to their (ex)partners. Exploratory analyses on reductions in IPV perpetration (assessed using the Abusive Behavior Inventory; ABI) and victimization (using the revised ABI; ABI-R) at the end of the program were performed. Longitudinal qualitative interviews with participants, their (ex)partners, and staff provided an understanding of the program's implementation, acceptability, and outcomes. The adapted ADVANCE-D program includes one goal-setting session, seven online groups, 12 self-directed website sessions, and 12 coaching calls. ADVANCE-D includes enhanced risk management and support for (ex)partners. Forty-five participants who had perpetrated IPV in the past 12 months were recruited, forty of whom were offered ADVANCE-D, attending 11.4 (SD 9.1) sessions on average. Twenty-one (ex)partners were recruited, 13 of whom accepted specialist support. Reductions in some IPV perpetration and victimization outcome measures were reported by the 25 participants and 11 (ex)partners interviewed pre and post-program, respectively. Twenty-two participants, 11 (ex)partners, 12 facilitators, and 7 integrated support service workers were interviewed at least once about their experiences of participation. Overall, the program content was well-received. Some participants and facilitators believed digital sessions offered increased accessibility. The digitally-supported delivery of ADVANCE-D was feasible and acceptable. Remote delivery has applicability post-pandemic, providing greater flexibility and access. Given the small sample size and study design, we do not know if reductions in IPV were due to ADVANCE-D, time, participant factors, or chance. More research is needed before conclusions can be made about the efficacy of ADVANCE-D.

The Impact of Welfare Conditionality on Experiences of Job Quality

This article contributes to emerging debates about how behavioural conditionality within welfare systems influences job quality. Drawing upon analysis of unique data from three waves of qualitative longitudinal interviews with 46 UK social security recipients (133 interviews), we establish that the impact of welfare conditionality is so substantial that it is no longer adequate to discuss job quality without reference to its interconnections to the welfare system. More specifically, we identify how conditionality drives welfare recipients’ experience of four core dimensions of job quality: disempowering and propelling claimants towards inadequate pay, insecurity and poor employment terms, undermining multiple intrinsic characteristics of work and creating what we term a new ‘Work–Life–Welfare balance’. Instead of acting as a neutral arbitrator between jobseekers and employers, the welfare system is exposed as complicit in reinforcing one-sided flexibility through one-sided conditionality, by emphasising intensive job-seeking, while leaving poor-quality work provided by employers unchecked.

Local management of the COVID-19 pandemic in Norway: a longitudinal interview study of municipality chief medical officers

Objective To explore the experiences and views of Norwegian Municipality Chief Medical Officers (MCMOs) on preparedness, collaboration, and organization during the COVID-19 pandemic to gain insight into local crisis management of value for future pandemic responses. Design Longitudinal qualitative interview study. We conducted semi-structured digital interviews with nine MCMOs working in different municipalities in Norway from September to December 2020. Five MCMOs were re-interviewed from January to April 2021. We used thematic analysis to analyze the data. Results Through the analysis, three major themes were identified in the material; 1) The view of preparedness changed from being low-priority and dormant to the desire to strengthen preparedness as a permanent measure; 2) The nature of the pandemic forced a change in internal and external communication and collaboration for the MCMOs towards direct dialogue, teamwork and digital networking; 3) The pandemic changed the role and position of the MCMO within the municipal organization. Although most MCMOs were given a leading role in the municipal pandemic response, some MCMOs experienced that they were not positioned to fully exercise their intended role. In our material, de-authorization of the MCMO role seemed to coincide with the increasing size and organizational complexity of the municipality. Conclusions The Norwegian pandemic response and outcome have been regarded as successful internationally. Although the MCMOs managed to implement flexible and quick responses facilitated by teamwork, dialogue, and joint sensemaking, they also identified several challenges and shortcomings of the Norwegian pandemic preparedness requiring organizational and financial changes to sustain future health system resilience.

Solidarity and reciprocity during the COVID-19 pandemic: a longitudinal qualitative interview study from Germany.

While solidarity practices were important in mitigating the Coronavirus Disease 2019 (COVID-19) pandemic, their limits became evident as the pandemic progressed. Taking a longitudinal approach, this study analyses German residents' changing perceptions of solidarity practices during the COVID-19 pandemic and examines potential reasons for these changes. Adults living in Germany were interviewed in April 2020 (n = 46), October 2020 (n = 43) and October 2021 (n = 40) as part of the SolPan Research Commons, a large-scale, international, qualitative, longitudinal study uniquely situated in a major global public health crisis. Interviews were analysed using qualitative content analysis. While solidarity practices were prominently discussed and positively evaluated in April 2020, this initial enthusiasm waned in October 2020 and October 2021. Yet, participants still perceived solidarity as important for managing the pandemic and called for institutionalized forms of solidarity in October 2020 and October 2021. Reasons for these changing perceptions of solidarity included (i) increasing personal and societal costs to act in solidarity, (ii) COVID-19 policies hindering solidarity practices, and (iii) a perceived lack of reciprocity as participants felt that solidarity practices from the state were not matching their individual efforts. Maintaining solidarity contributes to maximizing public health during a pandemic. Institutionalized forms of solidarity to support those most in need contribute to perceived reciprocity among individuals, which might increase their motivation to act in solidarity. Thus, rather than calling for individual solidarity during times of crisis, authorities should consider implementing sustaining solidarity-based social support systems that go beyond immediate crisis management.

Priority populations’ experiences of isolation, quarantine and distancing for COVID-19: protocol for a longitudinal cohort study (Optimise Study)

IntroductionLongitudinal studies can provide timely and accurate information to evaluate and inform COVID-19 control and mitigation strategies and future pandemic preparedness. The Optimise Study is a multidisciplinary research platform established...

Following the changes in young people’s drinking practices before and during the pandemic with a qualitative longitudinal interview material

ABSTRACT The paper analyses how the Covid-19 pandemic affected young people’s alcohol-related assemblages, trajectories of becoming and identity claims in Sweden. The data is based on longitudinal qualitative interviews among heavy and moderate drinking young people (n = 23; age range 15–24 years). The participants were interviewed two to three times before the Covid-19 pandemic and once at the end of it, between 2017 and 2021. The analysis draws on actor-network theory and narrative positioning approach. The analysis demonstrates how the lockdown produced trajectories of becoming boring, normal, stress-free, self-caring, self-confident and shielded. In these trajectories, drinking was positioned into relations that either increased young people’s capacities for well-being or decreased them. Due to the lockdown, some participants learnt to be moved by relations that contributed to replace drinking with competing activities, while others experienced that the lockdown made drinking a more attractive activity, turning it into a collective force that helped them to overcome isolation. The results show how drinking is a heterogeneous activity which may increase or decrease young people’s capacities for well-being, depending on what kinds of assemblages and trajectories of becoming it is embedded in.

Patient (pt) Experiences of Receiving Idecabtagene Vicleucel (Ide-Cel, bb2121) Versus Standard (Std) Regimens for the Treatment (Tx) of Relapsed/Refractory Multiple Myeloma (RRMM) in the Randomized, Controlled KarMMa-3 Clinical Trial: Analysis of Longitudinal Qualitative Interviews

Introduction: Ide-cel is a first-in-class B-cell maturation antigen (BCMA)-directed chimeric antigen receptor T cell therapy approved by the United States (US) Food and Drug Administration; the European Medicines Agency; and Japan's Ministry of Health, Labour, and Welfare for treating adult pts with RRMM who were triple-class exposed (TCE) to an immunomodulatory (IMiD) agent, proteasome inhibitor (PI), and anti-CD38 monoclonal antibody and who experienced disease progression/relapse after last therapy. The phase 3 multicenter, open-label, randomized controlled KarMMa-3 trial (NCT03651128) enrolled pts with RRMM who were TCE (including an IMiD agent, PI, and daratumumab [DARA]) after 2-4 prior lines of therapy. Pts were randomized 2:1 to receive either ide-cel or 1 of 5 std regimens (DARA, pomalidomide [POM], dexamethasone [DEX]; DARA, bortezomib, DEX; ixazomib, lenalidomide, DEX; carfilzomib and DEX; elotuzumab, POM, DEX). At median follow-up (18.6 mo), median progression-free survival (13.3 vs 4.4 mo) and response rate (71% vs 42%) were significantly higher in the ide-cel versus std regimen arm (Rodriguez-Otero P, et al. N Engl J Med 2023;388:1002-1014). In addition to the standard pt-reported outcomes instruments, trial-embedded interviews provide further insights into the patient Tx experience (Delforge M, et al. J Clin Oncol 2023;41[suppl 16]. Abstract 8032). This study assessed Tx experience, changes in health-related quality of life, and advantages and disadvantages of assigned Tx for pts enrolled in the KarMMa-3 trial. Methods: To obtain pts' experiences and perspectives in their own words while on the assigned Tx arms during the study, qualitative interviews were embedded into the KarMMa-3 trial. Pts were randomized (1:4) to participate in a series of optional qualitative interviews conducted at baseline (BL), and 3 and 6 mo post Tx. Interviews were audio-recorded and transcribed. Non-English interviews were transcribed directly into English. Transcripts were analyzed in MAXQDA qualitative analysis software; inter-coder agreement exercises were completed to ensure reliability. Analytic approaches included thematic analysis and longitudinal analysis across aspects of health and well-being. Results: In total, 64 pts (n = 43 ide-cel, n = 21 std regimen) across 9 countries in Europe and in the USA participated in ≥ 1 interview. Across both arms, 60, 48, and 38 pts completed interviews at BL, and 3 and 6 mo post Tx, respectively. The mean (median) age of interviewed pts at time of consent in the trial was 60.5 (60) years, and 33% were female. When describing their overall well-being during the previous 4 weeks at 3 mo, 53% of ide-cel pts described their well-being as mostly improved versus 19% in the std regimen arm. In the ide-cel arm, 59% and 56% of pts reported improvements in physical health versus 19% and 10% of pts in the std arm at 3 and 6 mo from BL, respectively; 25% and 28% of pts in the ide-cel arm reported worsening physical health at 3 and 6 mo from BL versus 63% and 80% of pts in the std arm (Table 1). In the ide-cel arm, 47% and 48% of ide-cel pts described improvements in physical functioning at 3 and 6 mo from BL versus 19% and 20% of std regimen pts, respectively; 22% and 16% of pts in the ide-cel arm versus 50% and 60% of pts in the std arm reported worse physical functioning at 3 and 6 mo from BL. Regarding Tx advantages, ide-cel pts reported efficacy (n = 25, 58%), minimal side effects (n = 21, 49%), avoidance of other therapies (n= 16, 37%), and having a 1-time Tx (n = 12, 28%). Std regimen pts also described efficacy (n = 10, 48%) and minimal side effects (n = 8, 38%) as Tx advantages. Disadvantages discussed by pts treated with ide-cel included lack of efficacy (n = 10, 23%), side effects after infusion (n = 9, 21%), or none (n = 9, 21%). Greater proportions of std regimen pts described side effects (n = 9, 43%) and lack of efficacy (n = 7, 33%). Additional well-being results for both arms are presented in Table 1. Conclusions: This study provides unique insight into key pt perceptions of ide-cel Tx compared to std regimens. Overall, pts receiving ide-cel reported more positive changes 6 mo post Tx than pts receiving std regimens, specifically in physical health and functioning. Fewer pts treated with ide-cel described side effects than pts receiving std regimens. These data show that ide-cel as a 1-time infusion can alleviate the burden of managing complex medication regimens in TCE early-line relapse pts.

Use of dyadic longitudinal interviews in health services research: a case example

Abstract Introduction/background Pregnancy loss (PL) is common (∼25% of pregnancies). PL has a negative psychological impact on women and growing evidence that partners are impacted too. Thus PL is a unique public health issue - a “couple” problem that affects both partners. With millions of pregnancies each year, a significant number of pregnant women and their partners will have experienced prior PL and may be vulnerable in pregnancy given their reproductive history. But are their needs met by the standard pregnancy care? This study used dyadic, longitudinal interviews to examine: what are couples’ perceptions of the health care and support provided in a subsequent pregnancy after PL and do their needs change across a pregnancy? The combination of dyadic and longitudinal methods is rarely used in health services research, but seems especially well-placed to examine how needs for health care change across the pregnancy and the perception of both partners. Methods Semi-structured dyadic interviews were conducted with 15 couples over four time periods across a new pregnancy after PL (after pregnancy test and once in each trimester). Couples were recruited from a national cohort of couples with PL. Interviews were held in person or via Zoom in Denmark. Qualitative dyadic and longitudinal interview data were analyzed using thematic analysis with a focus on identification of common themes within and across couples and trimesters. Results and analysis Dyadic data showed that both partners experienced anxiety and worry about the safety of the fetus and possibility of miscarrying. Longitudinal data revealed that couples believed that standard pregnancy care in the first trimester of pregnancy was insufficient for their needs. They wished for ongoing access to regular scans and close monitoring to provide reassurance and detect problems early. They reported that their needs for care were met through antenatal care provided in the later stages of pregnancy. Key messages • Dyadic longitudinal interviews generate nuanced data about a shared experience of receiving health care across a pregnancy. • A better understanding of needs can inform development and provision of effective health care and support to fill identified gaps and promote overall family, maternal and infant health.

Vulnerability and Response-Ability in the Pandemic Marketplace: Developing an Ethic of Care for Provisioning in Crisis

This paper draws on the ethics of care to investigate how citizens grappled with ethical tensions in the mundane practice of grocery shopping at the height of the Covid-19 pandemic. We use this case to address the broader question of what it means ‘to care’ in the context of a crisis. Based on a qualitative longitudinal cross-country interview study, we find that the pandemic transformed ordinary shopping spaces into places fraught with a sense of fear and vulnerability. Being forced to face one’s own vulnerability created an opportunity for individuals to relate to one another as significant others through a sense of “response-ability”, or the capacity of people to respond to ethical demands through situated ethical reasoning. We argue for a practical ethos of care in which seemingly small decisions such as how often to go shopping and how much to buy of a particular product serve as a means to relate to both specified and generalized others—and through this, ‘care with’ society. Our study contributes to displacing the continuing prevalence of an abstract and prescriptive morality in consumption ethics with a situated and affective politics of care. This vocabulary seems better suited to reflect on the myriad of small and unheroic care acts in times of crisis and beyond.

“Like One Long Battle:” Employee Perspectives of the Simultaneous Impact of COVID-19 and an Electronic Health Record Transition

BackgroundHealthcare organizations regularly manage external stressors that threaten patient care, but experiences handling concurrent stressors are not well characterized.ObjectiveTo evaluate the experience of Veterans Affairs (VA) clinicians and staff navigating simultaneous organizational stressors—an electronic health record (EHR) transition and the COVID-19 pandemic—and identify potential strategies to optimize management of co-occurring stressors.DesignQualitative case study describing employee experiences at VA’s initial EHR transition site.ParticipantsClinicians, nurses, allied health professionals, and local leaders at VA’s initial EHR transition site.ApproachWe collected longitudinal qualitative interview data between July 2020 and November 2021 once before and 2–4 times after the date on which the health system transitioned; this timing corresponded with local surges of COVID-19 cases. Interviewers conducted coding and analysis of interview transcripts. For this study, we focused on quotes related to COVID-19 and performed content analysis to describe recurring themes describing the simultaneous impact of COVID-19 and an EHR transition.Key ResultsWe identified five themes related to participants’ experiences: (1) efforts to mitigate COVID-19 transmission led to insufficient access to EHR training and support, (2) clinical practice changes in response to the pandemic impacted EHR workflows in unexpected ways, (3) lack of clear communication and inconsistent enforcement of COVID-19 policies intensified pre-existing frustrations with the EHR, (4) managing concurrent organizational stressors increased work dissatisfaction and feelings of burnout, and (5) participants had limited bandwidth to manage competing demands that arose from concurrent organizational stressors.ConclusionThe expected challenges of an EHR transition were compounded by co-occurrence of the COVID-19 pandemic, which had negative impacts on clinician experience and patient care. During simultaneous organizational stressors, health care facilities should be prepared to address the complex interplay of two stressors on employee experience.

EquiPrEP: An implementation science protocol for promoting equitable access and uptake of long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP).

Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) was approved by the U.S. Food and Drug Administration in December 2021. This initial phase of implementation represents a prime opportunity to ensure equitable LAI-PrEP provision to communities often underrepresented in PrEP care before disparities in access and uptake emerge. Herein, we describe the EquiPrEP Project which utilizes an equity-oriented implementation science framework to optimize LAI-PrEP rollout in an urban safety-net clinic in New York City. The primary objectives of this project are to: (1) increase LAI-PrEP initiation overall; (2) increase uptake among groups disproportionately impacted by the HIV epidemic; (3) preserve high PrEP retention while expanding use; and (4) identify barriers and facilitators to LAI-PrEP use. EquiPrEP will enroll 210 PrEP-eligible participants into LAI-PrEP care with planned follow-up for one year. We will recruit from the following priority populations: Black and/or Latine men who have sex with men, Black and/or Latine cisgender women, and transgender women and nonbinary individuals. To evaluate implementation of LAI-PrEP, we will utilize equity-focused iterations of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and the Consolidated Framework for Implementation Research (CFIR), in addition to longitudinal surveys and qualitative interviews. Novel LAI-PrEP formulations carry tremendous potential to revolutionize the field of HIV prevention. Implementation strategies rooted in equity are needed to ensure that marginalized populations have access to LAI-PrEP and to address the structural factors that hinder initiation and retention in care.

Socialized to care: Nursing student experiences with faculty, preceptors, and patients.

Effective socialization of nurses has led to positive outcomes for both hospitals and nurses, including higher retention and greater job satisfaction. The importance of faculty, preceptors, and patients in the socialization of nursing students has been documented extensively in the literature. The research presented in this article examines data from qualitative, longitudinal interview transcripts of 15 students as they progressed through a 2-year nursing program to determine how these three types of influence socialize nursing students, and at which points in their education. Using multiple perspective qualitative longitudinal interviews, I interviewed participants every semester of nursing school about their experiences. From the data, these three parties have an impact at different points in their socialization, starting with faculty who socialize students to nursing school by helping them think like nurses. Next, preceptors can be barriers or facilitators of learning by demonstrating how to act like nurses and providing insight about how and why nurses may act the way that they do. Finally, patients help students put everything together by applying classroom lessons to clinical settings. The research concludes with implications for research, practice, and policy.

The dreams they are a-changin’: Mixed-methods longitudinal research on young people’s patterns of orientation

At the end of secondary general track schooling, young people experience an important transition; in Austria, they have to decide on further schooling or vocational training. Aspirations shape this transition and decisions herein. In this contribution, we explore patterns in formation, change or stability of educational and occupational aspirations. Based on an exploratory longitudinal mixed-methods approach with adolescents aged about 14 years in wave 1, we untangle the multidimensional phenomenon of (educational and occupational) aspirations. We analyze three waves of qualitative longitudinal interviews and develop a typology of young people’s educational and occupational orientation processes over time. In a statistical analysis of three waves of the panel survey data with the same age group, we compare and integrate findings on stability and change of aspirations and analyze the influence of sociodemographic characteristics on these patterns. With this mixed-methods longitudinal design, we gain an in-depth understanding of young peoples’ thoughts, ideas and worries during this transitional phase. We also learn about the resources that shape the orientation process and related patterns in time.

Feasibility of a randomised controlled trial of financial incentives to promote alternative travel modes to the car

IntroductionAlternatives to the car, such as walking, cycling and public transport can integrate physical activity into everyday life. Interventions promoting alternatives to the car targeting individual behaviour have shown modest effects, and supportive environments appear important. MethodsThis mixed-method study assesses the scientific and operational feasibility of conducting a randomised controlled trial (RCT) of individual financial incentives within a supportive physical environment. We invited residents of Northstowe, Cambridgeshire, UK who had not previously claimed financial incentives to complete a baseline questionnaire assessing socio-demographic characteristics and travel behaviour. On completion, households were randomly assigned to (1) control – claimed incentives online; (2) intervention - received incentives via email; and (3) intervention plus - received greater value incentives via email. We assessed incentive use via questionnaires at three and six months. Longitudinal qualitative interviews at baseline, three months and six months elicited views of incentives and factors influencing use. Results99 residents from 88 households (household response rate: 88/475 (19%)) completed the baseline questionnaire and were randomised at household level. The local authority delivered all incentives. Compared to the control group, incentive use was higher in the intervention and intervention plus groups at six months, but there was little difference between intervention and intervention plus group. Qualitative data suggests that incentives worked by prompting existing intentions, raising awareness of alternative travel modes and to a lesser degree by reducing travel cost. This resulted in some new leisure travel behaviour, but most often to subsidise existing travel. Qualitative data suggests that existing travel preferences and environmental conditions influenced incentive use. ConclusionIt is feasible to deliver an RCT in collaboration with a local authority and future trials should account for recruitment challenges. Reducing the effort required to obtain incentives increased their use, but future research should investigate the surrounding enabling environmental contexts.

Depletion through Social Reproduction and Contingent Coping in the Lived Experience of Parents on Universal Credit in England

Abstract We report data from longitudinal qualitative interviews with thirteen people claiming Universal Credit (UC) immediately before and during the COVID-19 pandemic in England. The article utilizes concepts from feminist theory: “Social Reproduction” and “Depletion.” We make several novel contributions, including bringing depletion into conversation with the related concept of “contingent coping.” We argue that the lived experience of UC involves material and emotional depletion, but that UC also helps recipients to “cope” contingently with this depletion. In this sense, depletion through social reproduction is an ongoing and harmful state of being. We show how highly conditional and disciplinary welfare policies both partially mitigate but also accentuate structural pressures associated with an unequal, insecure, and competitive labor market.

Being cut off from social identity resources has shaped loneliness during the coronavirus pandemic: A longitudinal interview study with medically vulnerable older adults from the United Kingdom

AbstractLoneliness is a pernicious problem in older adulthood, associated with physical decline and isolation from valued social groups. However, the long‐term evolving experiences of ageing, identity and loneliness have yet to be elucidated. We use a Qualitative Longitudinal Research interview approach with nine vulnerable older adults (Agemean = 79.4 years), in which five participants were interviewed twice between 2019 and 2020, and four participants were interviewed at three‐time points from 2019 to 2021. This study aims to understand the unfolding experiences of ageing, social identity and loneliness during a prolonged period of social isolation during the Coronavirus pandemic. A theoretically guided thematic analysis highlights that participants initially experience ‘Categorisation as Vulnerable and Loss of Agency’ and ‘Shrinking Social Worlds’, leading to ‘Undermining of Reciprocal Support’ and ‘Fears of Persistent Loneliness’. Findings suggest that interventions to ameliorate loneliness among older adults would benefit from addressing age‐based stereotypes and emphasising the value of reciprocal contributions that older adults can make to their networks, as well as scaffolding and enhancing social identification with new groups. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.