Qualitative Multiple Case Study Research Articles

Supporting post-stroke access to services and resources for individuals with low income: understanding usual care practices in acute care and rehabilitation settings

Purpose Following stroke, individuals who live in a low-income or are at risk of living in a low-income situation face challenges with timely access to social services and community resources. Understanding the usual care practices of stroke teams, specifically, how they support this access to services and resources, is an important first step in promoting the implementation of practice change. Method A qualitative multiple-case study of acute care, inpatient, and outpatient rehabilitation stroke teams in an urban area of Canada. Semi-structured interviews and questionnaires about the workplace context were conducted with 19 professionals (social workers, occupational therapists, physiotherapists, speech-language pathologists) at four sites. Results In their usual practice, stroke teams prioritized immediate care needs. The stroke team professionals did not address income or resources unless it directly affected discharge. Usual care was influenced by factors such as time constraints, lack of knowledge about services and resources, and social service system limitations. Conclusion To better support post-stroke access to social services and resource for low-income individuals, a multidisciplinary approach, with actions beginning earlier on and extending throughout the continuum of care, is recommended, in addition to system-level advocacy.

Strategies for Successful Change Implementation: Insights from Senior Business Leaders

Approximately 75% of organizations' change initiatives fail to attain the expected results, affecting business growth and survival. Grounded in Lewin's three-step Model of Change, this qualitative multiple-case study explored strategies senior business leaders used to implement positive change. The participants were five senior business leaders who successfully experienced positive change management in their organizations. Data were collected from face-to-face semistructured interviews and various organizational documents and analyzed using Yin's five-phase analysis technique. The three business strategies for successful change implementation that emerged from data analysis were improving leadership support, implementing clear communication, and sustaining an influential organizational culture. A key recommendation was that open and effective communication allowed employees to understand the benefits of change and helped them embrace it. The implications for a positive social change included the potential for continued business growth and increased employment opportunities in the local communities.

Centering marginalized positive youth development constructs: examining perspectives and experiences of racially, ethnically, and gender minoritized practitioners and youth

ABSTRACT Positive youth development (PYD) measurement tools are influenced by the social positionalities, ideologies, and interests of those who create them. Historically, racial, ethnic, and gender-minoritized practitioners and youth program participants have been excluded from the development and testing of PYD measures. In particular, they have been excluded from the conceptual work of defining and operationalizing central PYD constructs, from which PYD measurement and implementation are rooted. Furthermore, the existing constructs are subjective qualities, characteristics, and normative behaviors. The role and impact of power, privilege, and oppression on PYD are often missing from PYD constructs, yet they play an important role in PYD practice with racially, ethnically, and gender-diverse youth. This paper aims to center the knowledge and experiences of marginalized youth practitioners and youth in the conceptualization of PYD constructs. A multiple qualitative case study design and a purposive, convenience sampling approach were used to identify programs within a publicly funded, county-wide initiative in the pacific northwest that serves Black, Indigenous, or person of color, immigrant or refugee, and/or trans- or non-binary youth. The inductive analysis identified three key constructs: racial and social identity development, socio-emotional development, and youth-centered program environment. Participants emphasized communitarian understandings of identity development, a clear articulation of social justice principles across constructs, and emphasized relational practices and environmental factors over youth characteristics. We outline results in detail and discuss how youth and adult service providers’ perspectives can help inform a more empowering and relevant model for evaluating PYD interventions.

Entrepreneurial Decision-Making Approaches of Award-Winning Women Business Operators in Kandy District of Sri Lanka

Women's entrepreneurship has been widely identified as a driver of economic and social development worldwide. However, literature in women entrepreneurship argues that women entrepreneurs lag behind men and women business operators are constrained. Despite numerous constraints faced by Sri Lankan women business operators, some have overcome such barriers and become successful, and also have achieved provincial and national level recognitions through winning awards. Women business operators who have earned such recognitions warrant investigations to unravel the entrepreneurial decision-making approaches they have adopted to overcome various challenges in constrained environments. Therefore, this research aims to study the entrepreneurial decision-making approaches of award-winning women business operators in the Kandy district of Sri Lanka using theoretical lenses of Effectuation and Causation. A qualitative multiple case study design was adopted and 30 in-depth interviews were conducted with successful women business operators who have been awarded in "Star Awards". The analysis revealed that entrepreneurial decision-making approach of the respondents does not change with the sector (i.e. manufacturing and service) they operate. Women business operators have become more effectual when starting up their businesses and have combined the causation approach with effectuation when growing their businesses.

African American small consulting business sustaining strategies

More than 80% of small consulting businesses fail within the first 5 years of operation. Small consulting company owners are concerned about failing within the first five years because they lack innovative strategies. Grounded in the resource-based view theory, this qualitative multiple case study aimed to explore strategies African American consulting company owners use for longevity beyond 5 years. The participants comprised African American owners of three consulting businesses located in the northeast region of the United States who successfully sustained their business beyond 5 years. Data collection included semi-structured interviews with consulting company owners and reviewing company documents. A key recommendation includes conducting feasibility screening and designing and using a strategy canvas to identify opportunities.

Tinkering the Teacher–Technology Nexus: The Case of Teacher- and Technology-Driven Personalisation

Teacher-driven personalisation can be challenging to facilitate, especially in large heterogeneous classes and during demanding courses. Because of the growing digitalisation, more possibilities arise towards technology-driven personalisation. Nonetheless, little is known about how teachers interact with or implement digital personalised learning (DPL) tools in the classroom. This study explores two research questions: (RQ1) what personalisation strategies are enacted by teachers while implementing a DPL-tool for programming? and (RQ2) how does the teacher–technology interaction take shape? A qualitative multiple case study was established, comprising four cases (two pairs of co-teachers and two teachers who teach individually) implementing a DPL-track for programming in first grade of secondary education (12-to-14-year-old students). Within-case and cross-case analyses of interviews and observations revealed that, although the technology-driven personalisation remained unchanged over the cases, teachers used different personalisation strategies while enacting the DPL-track. Subsequently, various forms of the teacher–technology relationship were observed. Based on the findings, (1) a teacher–technology interaction continuum and (2) a new concept, i.e., ‘the teacher–technology nexus’, are presented as they can be of value for the elaboration of theory on the implementation of DPL-tools in real life classrooms.

Disability and homeschooling: Parents experiences in Kazakhstan

AbstractThere are several special education provisions for children with disabilities in Kazakhstan, including home education which is characterized as an alternative model of education to mainstream and private educational organizations. Hence, parents become the central figure in managing the home education process as the meeting special needs of children depends on their knowledge and experience. The present study explores parents’ experiences in home educating a child with special needs in one town outside the capital city of Nursultan. The data was collected through face‐to‐face interviews with six parents in a qualitative multiple case study design. The findings highlight the way the diagnosis of a child’s special needs impacts the psychological, social and financial dimensions of parents’ life. Moreover, the findings of the present study illustrate some of the challenges and opportunities parents experience in home‐educating their children. These include teachers’ specialised knowledge and skills, social isolation, involvement in school activities, and the provision of educational resources for home education.

Basic Education Sector Service Delivery: Challenges Faced by Managers and Practitioners in Botswana

The purpose of this study was to explore the conceptualisation, practices and experiences of Education managers and practitioners regarding service delivery in the Botswana basic education sector. The study used a qualitative multiple case study, which employed social constructivism to investigate the quality-of-service delivery in the basic education sector in Botswana. Thematic analysis was used to analyse data generated through semi-structured interviews, document reviews and questionnaires. The findings of the study show that all 23 participants did not efficiently and effectively deliver services to customers. It was revealed that this was due to a top-down approach, inadequate resources, insufficient support during training and non-compliance to the implementation of service delivery policy reforms. The contribution of this study comes from the use of Public Service Dominant Theory (PSDT) and Expectancy theory in the basic education sector. This theoretical framework shifts the paradigm towards new ways of looking at things. The findings of the study call for policymakers and policy implementers to be equipped with skills and competencies, so that they would be able to understand their expectations and/or the different roles they play in policy implementation and compliance. The study found that there was a gap between policy and practice and this gap can be closed by policymakers fully interacting with policy implementers in the formulation of policy reforms aimed at improving service delivery. More research is required to identify efficient and effective ways of implementing and complying with service delivery policy reforms. Keywords: Basic education sector, Botswana, expectancy theory, implementation challenges, public service dominant theory.

Understanding the views of children with profound and multiple learning difficulties for person‐centred planning

AbstractBackgroundAll children have the right to express their views about matters affecting them and participate in decision‐making for their future irrespective of their intellectual ability. This study explores the adult role in understanding the views of children with profound and multiple learning difficulties who are not using a formal communication system and require adults to speak on their behalf.MethodsThe study employs a qualitative multiple case study design involving three children with profound and multiple learning difficulties attending one special school. Social constructivist grounded theory approaches inform data gathering and analysis. Eight interviews are conducted with parents and professionals to explore how they understand the children's views and how this understanding informs person‐centred planning, combined with observations of the children in school and observations of their person‐centred planning meetings.FindingsAdult participants consider the children in the study to have agency and ability to affect the world around them. They believe the children can express their likes, dislikes and what they want but they think the children would have difficulty communicating their views about their health, medical needs and disability. They describe a range of observable actions made by a child to which they give meaning when interpreting the child's views. The actions a person takes as a child's communication partner can enable the child to develop and communicate their views. A process of observation and comparison allows adults to explore different interpretations of a child's views. Perspectives offered by professionals from different fields enable a child's views to be understood in different ways.ConclusionsAdults develop their understanding of the children's views over time in relational and social contexts. Different interpretations of a child's communication are considered when adults collaborate, leading to socially constructed understandings of a child's views. Adults infer the meaning of a child's views about what is important to them for the future from their understanding of the child's views in the present, which informs person‐centred planning.

The impact of sexual orientation conversion therapies on transgender individuals

ABSTRACT The purpose of sexual orientation change efforts (SOCE) is to change an individual’s sexual orientation, not necessarily gender identity. Given that sexual orientation is a distinctly different construct than gender identity, sexual conversion therapy methods may be different for transgender individuals, and the impact may also be different. This qualitative multiple case study (N =4) investigated the experiences and impact of SOCE on transgender individuals in the Midwest using a phenomenological approach to develop the common meaning of a concept based on individuals’ shared lived experiences. Semi-structured interviews were used to gather data on participants'’ experiences of having undergone SOCE, and these data were used to uncover and describe cross-cutting themes. Participants identified the following as influences for having undergone SOCE: transphobia in the household environment, residence in a gender-normative environment, and religiosity in interpersonal relationships. The methods used by religious practitioners and those practicing reparative therapy; included electric shock therapy, electric shock on genitals paired with homosexual stimuli, physical abuse, and sexual abuse. The immediate negative impacts of SOCE included feelings of inauthenticity, pretend acceptance of their biological sex, and conformation to gender norms. Lasting effects included loss of faith, lack of trust, sexual dysfunction, and negative self-esteem.

Key aspects of establishing research, knowledge, and innovation‐based hubs as part of the local innovation ecosystem

The purpose of this research is to increase the understanding of the principles of forming different types of hubs as spaces for collaborative R&D and innovation. This article offers valuable new knowledge regarding the establishment of hubs as part of the local innovation ecosystem. The paper will, through a qualitative multiple case study, shed light on the research issue of the establishment of hubs through an analysis of empirical data collected from three different types of hubs: a research hub, knowledge hub, and innovation hub. As a result, we introduce new building blocks of hubs to support managers and practitioners in forming collaborative hub structures.

Critical learning episodes in the EFL classroom: a multimodal (inter)action analytical perspective

Abstract The present study centers on exploring how different modes such as speech, gesture, gaze, body posture, and head movement are employed by an EFL teacher and his students during a Critical Learning Episode (CLE). CLEs are brief instances of classroom interaction where the instructor and the researcher believe that learning is being fostered or inhibited. This article is part of a larger qualitative multiple-case study that took place at a private Colombian University. The lesson was videotaped and then analyzed within a Multimodal (Inter)action Analysis framework. Findings indicate that CLEs are created in a highly embodied, multimodal, and ecological manner through different modal configurations. Besides speech and writing, modes such as gestures, posture, gaze, and head movement played not a marginal, but prominent role, in performing various pedagogical classroom activities such as enhancing shared/ focused attention, strengthening alignment, helping teachers and learners to visually make meaning of morphological and syntactical units, and serving as devices to check for understanding.

From Fast to Slow: An Exploratory Analysis of Circular Business Models in the Italian Apparel Industry

The apparel industry is a substantial contributor to global environmental pollution at any stage of the supply chain. Clothing production and transportation generate a large volume of waste and high greenhouse gas emissions, often exploiting cheap labour in developing countries. Consequently, stakeholders are becoming more aware of the environmental and human rights implications of the apparel industry. This paper aims to investigate how fashion companies are redesigning their value chain to meet growing stakeholder demands for sustainability and circular economy. Using purposeful sampling, a qualitative multiple case study design involving 21 Italian apparel companies adopting circular business models was conducted. Data were collected through remote semi-structured interviews, supplemented by secondary data to provide a richer context for our investigation. The research findings are interpreted through the theoretical lens of Institutional theory, showing the primary factors leading to the transition from fast to slow fashion business models. Notably, customer demand for supply chain transparency and the selection of certified suppliers strongly influence the development of apparel firms' business models, pushing companies to a radical change in their value proposition, creation, and delivery. This study guides practitioners, highlighting circular business model innovations and emerging digital technologies enabling apparel businesses to manage stakeholder engagement and promote sustainable development strategically.

Dynamic contextual factors, individual agency and adoption of e-commerce in SMEs

This article provides an explanation of how dynamic contextual factors and individual agency influence the adoption of electronic commerce (e-commerce) in small and medium-sized enterprises (SMEs) in Pakistan. Eight multiple qualitative case studies were undertaken, involving 24 face-to-face semi-structured interviews and were thematically analysed using NVivo. This study found that the Technology-Organization-Environment (TOE) factors and additional extended micro-level (individual agency) factors strongly influenced the adoption of e-commerce practices by the managers of Pakistani SMEs. Managers need to address factors such as digital readiness, recruiting of skilled ICT expertise, reluctance of customers to switch their preference from traditional business selling methods to e-commerce, obtaining government and local institutional support, and recognizing the characteristics and individual agency of their owner-managers. On top of these factors, there is a strong need to improve the Information and communication technology (ICT) infrastructure in order for manager to prepare for and to embrace the e-commerce practices in their respective companies. This article extends Tornatzky and Fleischer’s TOE framework by adding the micro-level context of individual agency. Additionally, this article proposes practical implications for policymakers, governments, and local business support agencies.

A model of luxury lodge experience quality

Experience quality has been studied for many decades in various contexts. While understanding of experience quality has advanced, its context-specific and multi-dimensional nature has challenged its conceptualisation. With the rise of experiential accommodation in tourism and hospitality, luxury lodges have been increasingly recognised in the industry and by customers as the emblem of luxury experiences, albeit receiving limited scholarly attention. Through a qualitative multiple-case study methodology, utilising high-engagement research techniques, this study explores the dimensions and determinants of luxury lodge experience quality. The study presents an experience quality model grounded in empirical data, bridging various experience quality theoretical perspectives to explain the luxury lodge experience, and demonstrating generalisation capabilities for other service contexts. The study contributes to the ongoing discourse on experience quality, particularly in the context of small luxury accommodation. The study also offers important practical implications for luxury accommodation operators on designing, staging and managing quality experiences.

Effective Talent Management Practices of Small and Medium-Size Businesses

Effective Talent management strategies to acquire, develop, and retain employees are essential, as 73% of business leaders in the United States identified that good human resources practices favorably affect the efficiency and effectiveness of business operations. Based on the people capability maturity model and transformational leadership theory, the purpose of this qualitative multiple case study was to explore the successful strategies that leaders of small and medium-size businesses (SMBs) used to acquire, develop, and retain employees. The case population comprised five SMBs’ leaders who had successfully used talent management strategies to acquire, develop, and retain employees for more than 5 years, and four employees who had worked with the SMBs for more than 5 years. The selected leaders participated in face-to-face semistructured interviews while the employees participated in a focus group. The data analysis process followed Yin’s five-phase analysis cycle; entailed an analysis of interview responses from individual interviews, the focus group interview, and a review of related documents. Four themes emerged from the data analysis: conducting management assessments, following recruitment and selection guidelines, empowering and enabling employees, and fostering workplace loyalty. A recommendation is that SMBs’ leaders prepare training manuals from their successful procedures for internal use and benchmarking with other SMBs. The study’s findings could contribute to positive social change by enabling leaders to improve employee development and retention for more productive employees and higher revenues to benefit society through employees becoming mentors and volunteers in local communities.

COVID-19 as a Magnifying Glass: Exploring the Importance of Relationships as Education Students Learn and Teach Robotics via Zoom

Ed+gineering, an NSF-funded program, adapted hands-on robotics instruction for online delivery in response to the COVID-19 pandemic. This qualitative multiple case study shares the experiences of participating education students in spring 2021 as they collaborated virtually with engineering students and fifth graders to engineer bioinspired robots in an afterschool technology club adapted to be virtual. The online context reduced the education students’ interactions with people other than the engineering students and fifth graders on their team and thus positioned COVID-19 as a metaphorical magnifying glass amplifying the critical role that these relationships played in influencing the project’s outcomes. Through analyzing short-answer reflections, the researchers observed patterns in the ways the education students’ interactions with their engineering and fifth-grade partners shaped their teaching self-efficacy and intention to integrate engineering and coding. Education students appeared to gain the most self-efficacy from feeling supported by, but not dependent upon, their engineering partners, and from adopting engineering-teaching roles. Satisfying interactions with fifth graders and successful production of functioning robots appeared to enhance education students’ intention to integrate engineering and coding into their future instruction. Education students reported gaining self-efficacy for both engineering and coding during the experience, but were more likely to report feeling confident about teaching engineering than teaching coding at the project’s end. Implications and lessons learned are shared, which may be particularly relevant for educators who prepare elementary education students to teach engineering in K-6 settings.

Interpolating Peace in the Curriculum: How Peace Education is Feasible Through Art among Malaysian Pre-Schoolers

Children should not be left behind in discussing about peace. In this qualitative study, it discovers the potential use of visual aids for teaching peace values among young children. It aims to explore the use of visual representations, such as pictures and video clips in a study of peace education to develop their understanding of the principles and values of peace. This study employed a qualitative multiple case study approach to investigate twenty children’s artworks (between the age of 5 to 6 years old). They have been selected using purposive sampling method. In-depth semi-structured interviews and field notes were also used to triangulate data extracted from the drawing and successfully portrayed peace elements in their artworks. Later the codes were extracted and organized to find the emerging themes. The focus was to analyze the KEMAS preschoolers’ drawings and their reactions to the drawings and selected video clippings provided in the research framework. Using Feldman’s model of art criticism, each drawing was analyzed using the thematic analysis and interpreted using a network of coding. Some of the themes extracted from their artworks are unity and safety symbols, love and happiness, togetherness and survival, peace, conflict, and tranquility. The findings suggested that pictures and video clippings could be a suitable method for conveying powerful messages, including abstract concepts, such as peace and war to young children. Young children have a dissimilar capability to make sense of their surrounding world and putting it into words unlike adults. The use of pictures and clippings would give a practical advantage in helping researchers gather valuable information about how peace education can be taught to children of young age. The need for further research is deemed essential to extend the link between how children learn about peace values and the use of multiple means to teach peace education effectively to students of various ages.

Factors that support and hinder recovery and adjustment after traumatic brain injury: a qualitative multiple case study

Background/Aims The numbers of individuals acquiring brain injuries in childhood is increasing. The deficits caused by brain injury can often have long-term implications that require support from caregivers, friends and the community. This study was conducted to gain an understanding of the shared perspectives of parental caregivers and their adolescent children as to what factors supported and hindered recovery and adjustment after traumatic brain injury. Methods In this qualitative multiple case study, semi-structured interviews were conducted with a purposive sample of four individuals with traumatic brain injury and their five parental caregivers. A thematic, cross-case analysis was used to identify factors that support and hinder recovery and adjustment. Results Seven themes were identified from the interviews: lack of educational resources about traumatic brain injury; poor consistency of care; caregiver stress and guilt; disconnection and isolation; connection, empathy and social support; being high achieving and resourceful; and authentic relationships between adolescents with traumatic brain injury and their parents. Conclusions The findings highlight the need for improved access to follow-up or community-based services for adolescents with traumatic brain injury who do not experience a hospital or inpatient rehabilitation stay. Additionally, healthcare providers should capitalise on the relationships between adolescents with traumatic brain injury and their parents to support recovery. The information gained from this study can be used to inform allied health professionals when developing and implementing interventions to support recovery in adolescents with traumatic brain injury and their parental caregivers.

Environmental learning across generations: spontaneous encounters and interactions between young children, mothers and teachers

ABSTRACT While research demonstrates that family and school dynamics play a role in shaping children’s behaviour, little is known about the actual and potential bi-directional influences young children have on their teachers’ and mothers’ environmental learning. This study begins to fill this gap in early childhood education for sustainability (ECEfS) research by recognising young children as agents of intergenerational learning for sustainability. It explores the ways in which young children (aged 4–7 years), in Malta, influence the way mothers and teachers learn about the environment and environmental issues. Socio-cultural and ecological theoretical perspectives framed this research. Designed within an interpretive methodology, this qualitative multiple case study generated data through classroom observations, semi-structured interviews with children, mothers and teachers, and document analysis, thus enabling the triangulation of data. Findings revealed instances of intergenerational environmental learning between children and adults (teachers and mothers), and vice versa. The implications of these findings in relation to ECEfS are explored. New approaches to support intergenerational environmental learning at familial, school and societal levels, starting in early childhood, are discussed. Lastly, areas for further research are identified.