Qualitative Project Research Articles

Using video observation to foreground children's voices in infant massage research

ABSTRACT This doctoral study examined the function of baby massage in supporting early infant-carer attachment relationships among families facing stressful life experiences. It was designed in response to Bennett, Underdown and Barlow's [Bennett, C., A. Underdown, and J. Barlow. 2013. “Massage for Promoting Mental and Physical Health in Typically Developing Infants Under the Age of Six Months [Online].” Cochrane Database of Systematic Reviews (4): 1–162] meta-analysis of studies examining the effects of baby massage on infant health, and their recommendation that further research focused on the outcomes for families they described as ‘higher risk’. Analysis of the available literature also identified a lack of fine-grained research foregrounding families’ experiences of infant massage. This qualitative project was located in the constructivist paradigm, using a praxeological case study methodology. Innovative techniques and participatory methods were used including an information video and film as a data source and reflective stimulus; approaches which engaged babies and carers as co-inquirers in the research. It also required a robust ethical framework; a ‘matrix’ of approaches to informed consent [Rouse, E. J. 2018. “How Infant Massage Enhances Pedagogical Attachment in Families Facing Challenging Circumstances.” PhD diss., University of Wolverhampton] . This paper positions video as a method that supports detailed observations of young babies and foregrounds their ‘voices’ in the research. It contributes a detailed account of the benefits, challenges and ethical considerations around using video, and argues that it can support adults who care for and work with young children to have a deepened understanding of infant communication.

Planning for and Assessing Rigor in Rapid Qualitative Analysis (PARRQA): a consensus-based framework for designing, conducting, and reporting

BackgroundThe use of rapid qualitative methods has increased substantially over the past decade in quality improvement and health services research. These methods have gained traction in implementation research and practice, wherein real-time adjustments are often made to optimize processes and outcomes. This brisk increase begs the questions: what does rigor entail in projects that use rapid qualitative analysis (RQA)? How do we define a pragmatic framework to help research teams design and conduct rigorous and valid rapid qualitative projects? How can authors articulate rigor in their methods descriptions? Lastly, how can reviewers evaluate the rigor of rapid qualitative projects?.MethodsA team of seven interdisciplinary qualitative methods experts developed a framework for ensuring rigor and validity in RQA and methods suitable for this analytic approach. We conducted a qualitative evidence synthesis to identify gaps in the literature and then drew upon literature, standard procedures within our teams, and a repository of rapid qualitative training materials to create a planning and reporting framework. We iteratively refined this framework through 11 group working meetings (60-90 minutes each) over the course of one year and invited feedback on items to ensure their completeness, clarity, and comprehensibility.ResultsThe Planning for and Assessing Rigor in Rapid Qualitative Analysis (PARRQA) framework is organized progressively across phases from design to dissemination, as follows: 1) rigorous design (rationale and staffing), 2) semi-structured data collection (pilot and planning), 3) RQA: summary template development (accuracy and calibration), 4) RQA: matrix analysis (matrices), and 5) rapid qualitative data synthesis. Eighteen recommendations across these sections specify best practices for rigor and validity.ConclusionsRapid qualitative methods play a central role in implementation evaluations, with the potential to yield prompt information and insights about context, processes, and relationships. However, guidance on how to assess rigor is nascent. The PARRQA framework enhances the literature by offering criteria to ensure appropriate planning for and assessment of rigor in projects that involve RQA. This framework provides a consensus-based resource to support high-level qualitative methodological rigor in implementation science.

A THREAT ANALYSIS: CHALLENGES TO HUMANSECURITY FOR VENEZUELAN MIGRANTS POST-MIGRATION TO TRINIDAD AND TOBAGO

The country of Venezuela which is a close neighbor of Trinidad and Tobago continues to confront a major crisis that has unleashed multiple forms of sociopolitical violenc e against its citizens and has created a plethora of problems and threats including poverty, insecurity, and human rights violations. This ongoing socioeconomic crisis began around 2013 and has become progressively worse. Hyperinflation, escalating starvation, disease, crime and mortality rates are commonplace resulting in massive migration from the country. About seven millio n persons have left Venezuela over the last ten years seeking better lives and safety. About one hundred thousand of these migrants are in Trinidadand Tobago.Outward migration caused by this situation has been linked to numerous new challenges to Venezuelan migrants in Trinidad and Tobago. This paper sought to understand the experiences of these migrants. A cross-sectional qualitative project was conducted to discuss the threat environment for these migrants analysing resettlement threat factors for health, security and general well being through semi-structured interviews(forty).Theanalysis focused on understanding the experiences of Venezuelan migrants during the period 2014-2024 and was conducted during the period March1-April 30 2024. The research revealed threats related to health, safety, education,employment and general well being of Venezuelan migrants that have informe d migration policies, and human rights efforts for Trinidad and Tobago.

A Robust Human–Machine Framework for Project Portfolio Selection

Based on the project portfolio selection and scheduling problem (PPSS), the development of a systematic and scientific project scheduling plan necessitates comprehensive consideration of individual preferences and multiple realistic constraints, rendering it an NP-hard problem. Simultaneously, accurately and swiftly evaluating the value of projects as a complex entity poses a challenging issue that requires urgent attention. This paper introduces a novel qualitative evaluation-based project value assessment process that significantly reduces the cost and complexity of project value assessment, upon which a preference-based deep reinforcement learning method is presented for computing and solving project subsets and time scheduling plans. This paper first determines the key parameter values of the algorithm through specific examples. Then, using the method of controlling variables, it explores the sensitivity of the algorithm to changes in problem size and dimensionality. Finally, the proposed algorithm is compared with two classical algorithms and two heuristic algorithms across different instances. The experimental results demonstrate that the proposed algorithm exhibits higher effectiveness and accuracy.

Understanding needs of Chinese American family caregivers through a life story qualitative project

ABSTRACT The aim of this study is to explore the needs of Chinese American family caregivers of older adults through a life story qualitative study. Through life story narratives, a phenomenological approach revealed that the needs of Chinese American family caregivers, including effect of stress, varied by the following: type of relationship with care receivers, perceived cultural values, relationship quality between caregiver and care receivers, cognitive distortions and conflict strategies in caregiving. Discussion on methods of assisting Chinese American family caregivers through the therapeutic interventions of the life story narrative itself, self-care training, and other key supports revealed in the study will be addressed.

Folding Imperfections: Mixed Methods Insight Into the Limits of Curriculum Change for the Trinidad and Tobago Primary School Curriculum Rewrite

We theorize on the limits of curriculum change in countries of the Caribbean and Global South using integrated evidence derived from a qualitatively driven, mixed methods evaluation (MME) of the Primary School Curriculum Rewrite (PCR) in Trinidad and Tobago. We use a folding metaphor and implementation science to explain how an imperfect system might produce a flawed curriculum product that misdirects sensemaking and generates resistance during curriculum change. The formative process evaluation consisted of two complete research projects, with the second qualitative project prioritized. Project 1 was a quantitative survey of 454 teachers in 58 schools. Project 2 was a multiple case study of subjectivities-in-action in 9 schools of varied implementation outcomes. Findings from Project 1 showed mostly acceptable implementation outcomes and small associations between antecedents and outcomes. However, findings from Project 2 suggested that 6 of 9 schools were classified as nonusers, defined as implementing institutions with most teachers still exploring or installing the new curriculum or reverting to the old curriculum. In the thematic, cross-case analysis, participants at the various sites identified curriculum imperfections, inadequate training, and work intensification as core barriers to change. To achieve curriculum change, Caribbean countries such as Trinidad and Tobago will require improved systems for curriculum engineering.

Developing and managing qualitative analysis protocol for a large‐scale, multisited project

AbstractCollaboration and communication serve as the foundation of team‐based research, and this extends to the analysis phase of a project. This article discusses the work involved in developing, communicating, and managing the analysis plan for a large‐scale, multisited project. To generate an effective analysis plan, we considered what data were needed to reach our project goals and then selected methods and designed data collection tools accordingly. Once data collection commenced, we developed a basic codebook that provided an overarching structure but flexibility for localized tailoring. We then coordinated updates to the coding scheme and conducted reliability checks on the analyses. All of this required regular communication and constant monitoring of progress toward project goals. While only one example, this article provides insights and guidelines for other researchers working on large, team‐based, and/or multisited qualitative projects.

Comparing South Dakota Pharmacist Perspectives of Pharmacy Services in Rural versus Urban settings

BackgroundAccess to healthcare services is a major barrier to residents of the rural state of South Dakota. As a highly accessible member of the healthcare team, outpatient pharmacists can play a key role in a patient's healthcare journey. There is a need to identify the unique barriers and facilitators pharmacists in both rural and urban areas face to maximize the impact of their role. ObjectiveThe objective of this work was to compare perceptions of rural and urban pharmacists regarding the facilitators and barriers to providing patient care in South Dakota. MethodsThis qualitative project highlights results from interviews and focus group sessions with a convenience sample of South Dakota pharmacists. Participants were recruited using a referral word-of-mouth system, contracts with healthcare market research agencies, newspaper advertisements, and posters displayed in public locations in South Dakota. Practice location was characterized as rural or urban based on United States Department of Agriculture definitions. Findings from interviews and focus group sessions were coded and analyzed using content analysis by two student researchers. ResultsParticipants included 12 rural-practicing and 21 urban-practicing pharmacists in South Dakota. In both rural and urban areas, key barriers included communication with providers (50% rural; 50% urban), lack of electronic health record access (25% rural; 14% urban), not enough staff (22% rural; 20% urban), and patient misunderstanding the scope of pharmacy (22% rural; 40% urban). Barriers specific to rural areas included time to provide services (22%), having smaller facilities (27%) and provider hesitation regarding collaborative practice agreements (29%). There were no urban-specific barriers. Facilitators specific to urban areas included frequent communication with patients (6.1%) and good quality support staff (9.1%). There were no rural-specific facilitators. ConclusionsNext steps include increasing awareness of pharmacy-based patient care services, researching further to identify the extent to which facilitators and barriers influence the ability to initiate and sustain pharmacy services in rural and urban areas, and providing support to pharmacies to overcome barriers and leverage facilitators.

Enhancing nurse practitioner research through reflexivity.

This article highlights the essential role of reflexivity in research, using a qualitative project involving interviews with nurse practitioners during the COVID-19 pandemic as an example. It discusses the potential biases inherent in research, particularly when the researcher's experiences closely align with those of the participants. Drawing on the perspective of a nurse practitioner engaged in both research and health care provision, this article explores the importance of reflexivity in addressing these biases. Examining the lead author's experiences conducting interviews with fellow nurse practitioners, the article illustrates how reflexivity was used, particularly in data collection and analysis, to enhance transparency and minimize subjectivity. By advocating for the integration of reflexivity in qualitative research, this article emphasizes the significance of shared experiences between nurse practitioner researchers and participants in reducing biases and improving research outcomes. It demonstrates how reflexivity contributes to a more authentic and comprehensive methodology, especially when researchers share similar experiences with participants. Furthermore, this article offers practical suggestions to assist nurse practitioners in enhancing reflexivity throughout the research process, thereby contributing to ongoing discussion and strategy development in the field.

Co-Design of a Digital Health Tool for Use by Individuals With Opioid Use Disorder: App4Independence (A4i-O).

Opioid use disorder (OUD) has arguably the highest mortality rate of mental health conditions; opiate-related deaths are identified as the number one cause of accidental deaths in Canada and the United States. Specialized care for OUD is often described as lacking, fractured, and with frequent periods of disengagement. Digital health strategies may support connection to evidence-based resources even during periods of disengagement. However, sustained engagement in digital interventions remains a barrier, and as such, experts recommend using co-design approaches to develop interventions. The current study outlines the results from a qualitative co-design project that engaged 6 lived experts and 8 clinical experts in a series of focus groups and interviews to adapt an existing intervention for use in OUD. Focus groups and interviews were recorded and transcribed before undergoing thematic analysis. This co-design process is the first stage of a larger project that will lead to the development of a novel digital health intervention for OUD populations. Transcripts underwent thematic analysis, and themes were divided into Crosscutting Themes, Feasibility and Engagement, and Specific Features. Each theme was divided into specific subthemes, which were reviewed by the design team and informed the design of the digital health platform. Key resulting directions included creating a psychologically safe digital space, curating resources for OUD as a multifaceted condition, and being mindful of barriers to implementation from both lived and clinical expert perspectives. Specific features are discussed in detail in the article. Lived experts and clinicians strongly supported integrating digital tools into OUD care. Ongoing work is needed to better understand the role of technology in existing OUD structures as well as the implementation of key features such as digital peer support and creating effective and safe social connections. This study also validates co-design as an essential step in digital health development.

Liberal policies does not mean equitable policies: Latinx families' experiences navigating social policies in Oregon and California.

The United States government has implemented various social policies (e.g., Medicare) to support children and families (U.S. Department of Health and Human Services, 2023). An emerging body of research seems to indicate that many of these programs are being underutilized by Latinx families even though they are sorely needed. Latinx families are often framed as undeserving, taking advantage of social policies, and as a criminal threat to the United States (Baranauskas & Stowell, 2022). Drawing on cultural stress theory (Salas-Wright & Schwartz, 2019), the present study explores how the deficit framing of Latinx families influences how they navigate social policies. This study draws on data from four qualitative projects across Oregon and California that explored the experiences of Latinx families accessing services to support their families. Findings indicate that Latinx families experience multiple stressors when navigating social policies or programs (e.g., shame/fear and racism) for their families. These stressors discourage Latinx families from accessing social programs, which exacerbates disparities in the health, development, and learning of Latinx children and families. Findings from this study can further inform advocacy efforts to create meaningful systemic changes that reduce inequities and call out discrimination/racism within our policy system. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Keeping young researchers out of harm's way: conducting youth participatory action research with young people experiencing homelessness.

Youth Participatory Action Research (YPAR) is an approach to conducting research with youth populations in order to effectively engage youth in research that impacts their lives. Young people experiencing homelessness (YEH) are vulnerable to power and social environments in ways that call attention to their experiences in research. The context for this paper was a qualitative YPAR project to incorporate youth voice into the operations of a larger research study that hired youth as researchers. Participant-researchers provided feedback and consultation with senior staff in order to improve their access to resources, safety, and stability. Themes that emerged from thematic analysis of reflections, discussions, and meetings showed the need for consistent access to food, the risk of environmental violence targeting youth researchers, the structural and experiential barriers to professional engagement, and the benefits that young researchers experienced as part of their work in the study. Recommendations and lessons learned are described, notably to ensure that youth are paid and provided food, to construct effective safety plans during fieldwork, and to provide a flexible, inclusive, trauma-responsive approach to supervision of project tasks.

Bridging an Education Gap: Ultrasound-guided Peripheral IVs

PurposeTo provide ultrasound (US) education to anesthesia providers to increase usage for peripheral intravascular (IV) cannulation on difficult IV access patients. DesignThis project reflects a qualitative descriptive quality improvement project with outcomes measured. Data in this project include the overall knowledge and competency scores from the provider’s US survey before and after education and training were provided. MethodsA presentation was developed and provided to 38 certified registered nurse anesthetists (CRNA) via the hospital’s online platform. Next, in-person simulations were conducted to facilitate the skills of US utilization. Each CRNA participating in simulations successfully performed the skill. The impact and success of the education bundle were collected via the disbursement of a Likert-scale survey via an automated data collection software. FindingsSeventeen of the 38 (45%) participants responded to the survey. Of these respondents, 88% of providers indicated that their US skills and confidence had increased following the intervention, and 100% of participants stated that the intervention was helpful in learning US-guided peripheral IV insertion. ConclusionsEducation and hands-on skills sessions increased provider confidence in US use. While this project focused on educational training of CRNAs, this is applicable to all health care providers who are responsible for IV cannulation. The project team members will disseminate these findings and plan to improve perioperative nurses’ confidence in US-guided peripheral IV insertions; thus, improving efficiency in the operative setting.

Client and family experiences with telehealth-delivered early psychosis services.

The COVID-19 pandemic prompted a significant shift to delivering early psychosis services using telehealth. Little is known about the experience of using telehealth in early psychosis services. This quality improvement qualitative project investigated the experiences of program participants and family members with telehealth services in OnTrackNY, an early intervention program for psychosis in New York State during the COVID-19 pandemic. The project team conducted individual interviews and focus groups. Data analyses used a matrix approach. Nineteen OnTrackNY program participants and nine family members participated in five focus groups and nine individual interviews. Data were organized into five themes (a) accessibility: most individuals had a device and internet access and challenges were related to connectivity, such as image freezing and sound breaking; (b) convenience/flexibility: benefits included the reduced commute and costs; (c) levels of comfort/privacy with telehealth: program participants felt less judged and less anxiety leading up to in-person appointments while also expressing privacy concerns; (d) sense of connectedness: in-person social connections were deemed important and not replaceable by telehealth; and (e) suggestions: program participants expressed a preference for in-person group activities and suggested hybrid options, highlighting the importance of in-person visits to establish rapport at the beginning of treatment before transitioning to telehealth. Telehealth services were generally well accepted. Suggestions for future service delivery include offering a combination of telehealth and in-person services based on program participants' preferences and prioritizing in-person services during the early phase of treatment.

Effects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: a meta-analysis study.

To identify the impact of redox imbalance on the clinical evolution of patients with polycystic ovary syndrome and carry out a qualitative and quantitative projection of the benefits of vitamin D supplementation. Combinations of the keywords polycystic ovary syndrome, vitamin D, oxidative stress, reactive oxygen species, antioxidant, and free radicals were used in PubMed, Cochrane Library, LILACS, EMBASE, and Web of Science databases. The last search was conducted on August 22, 2023.Selection of studies: Based on the inclusion and exclusion criteria, studies were selected considering a low risk of bias, published in the last 5 years in English, which investigated the effects of vitamin D supplementation in women with PCOS, focusing on oxidative stress markers. Of the 136 articles retrieved, 6 intervention studies (445 women) were included. The risk of bias in included studies was assessed using the Jadad scale, and analysis and visualization of continuous data were performed using Review Manager 5.4.1, summarized as standardized mean differences (SMD) with confidence intervals (CI) of 95%. Vitamin D effectively reduced malondialdehyde (P=0.002) and total testosterone (P=0.0004) levels and increased total antioxidant capacity levels (P=0.01). Although possible improvements in the modified Ferriman-Gallwey hirsutism score, levels of sex hormone-binding globulin, and free androgen index were identified and the results were not statistically significant. Vitamin D is a promising alternative for the treatment of PCOS with a positive influence on the oxidative, metabolic, and endocrine disorders of this syndrome.

“We rely on each other”: A qualitative exploration of rural Eastern Region Native American experiences during the COVID-19 pandemic

BackgroundNative American communities suffered disproportionately negative effects during the COVID-19 pandemic, yet no research has explored the experiences of rural Eastern Region Native Americans. MethodsInformed by the Native Reliance Model and Indigenous Standpoint Theory, we conducted a qualitative descriptive project in the Spring and Summer of 2022; data included semi-structured interviews and focus groups with 24 individuals representing five South Carolina tribal groups. FindingsThematic analysis yielded four emergent themes: 1) “Let's just finish the Indians off”: Pandemic distrust rooted in historical and contemporary Native American experiences; 2) “We have been misled”: Making sense of conflicting public health information; 3) “I'm not giving it to some innocent person”: COVID-19 mitigation behaviors as Native American cultural practice; and 4) “We put the plan in place”: Self-advocacy and action as a source of Native American pride and responsibility. InterpretationThese participants demonstrated resiliency grounded in family and tribal ties, even in the face of personal losses, economic struggles, and healthcare barriers. To strike a balance between cultural traditions and public health recommendations, public health practitioners should 1) build partnerships with community leaders, elders, and tribal health authorities to facilitate the development of culturally respectful interventions that address specific health concerns in the context of historical traumas; and 2) implement alternative methods of communication and engagement to ensure equitable access to healthcare services in rural locations, such as collaborating with community organizations, deploying mobile health units, and utilizing traditional channels of communication within these communities.

Home-based primary care providers' perspectives on the unique challenges of working with late life posttraumatic stress disorder within their population of Veterans.

Posttraumatic stress disorder (PTSD) is more prevalent in medically ill older Veterans in Home-Based Primary Care (HBPC) settings than in the general population, raising unique considerations. The aim of this qualitative project was to explore HBPC mental health providers' perceptions of the presentation and treatment of PTSD and trauma-related symptoms in this population of older Veterans, many of whom face additional barriers to treatment due to living in rural settings. Five focus groups and one one-on-one interview were conducted with 23 HBPC mental health providers serving rural or rural/urban mixed communities across the United States. We applied qualitative content analysis to the data. Three themes were found: (1) Presentation of Trauma-Related Symptoms and PTSD in HBPC Population; (2) Treatment Challenges in HBPC; and (3) PTSD Treatment Strategies. Each theme had multiple subthemes which illustrate unique issues in this population. Results of this project contribute to key insights surrounding the unique presentation of PTSD and trauma-related processes and treatment considerations in a medically, cognitively, and psychosocially complex group of veterans. Efforts to improve access to care should consider the specific needs of veterans who are homebound, live in rural settings and identify with rural cultural norms, and have difficulty engaging in specialized PTSD treatment due to the convergence of these factors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring Learning experiences of Black Asian and Minority Ethnic (BAME) students in a Public Health Undergraduate Degree.

Whilst university data highlights that BAME students are awarded up to 33% lower assessment outcomes than their white counterparts, there is limited contextual information to explain why the situation arises. A small scale qualitative project sought to explore the barriers and enablers to Public Health students' learning experiences through semi-structured interviews. Emerging themes included the role of the family in their learning; the influence of peer groups and others in their motivation to study and becoming an independent student and these themes are viewed from a critical intercultural and intersectional perspective.

Researching local public health priorities in the locked down city using online community focus groups: Reflections and recommendations

In this commentary paper we reflect on our experiences of conducting two qualitative public health projects in Leicester UK around health inequalities and marginalised groups during the Covid 19 pandemic in 2020 and 2021. To contextualise the commentary, we first provide information about Leicester and how and why it was disproportionately affected by the pandemic, as well as describing the origins, aims, and methodologies of the two projects. In the second half, we describe and evaluate some of the adaptations we made to our studies and conclude with suggestions for future qualitative community health research as we adapt to the post-pandemic research landscape.

Artificial intelligence-based pre-conception stage construction budget decision-making model and tool for residential buildings

PurposeDeveloping a reliable cost estimate at the early stage of construction projects is challenging due to inadequate project information. Most of the information during this stage is qualitative, posing additional challenges to achieving accurate cost estimates. Additionally, there is a lack of tools that use qualitative project information and forecast the budgets required for project completion. This research, therefore, aims to develop a model for setting project budgets (excluding land) during the pre-conceptual stage of residential buildings, where project information is mainly qualitative.Design/methodology/approachDue to the qualitative nature of project information at the pre-conception stage, a natural language processing model, DistilBERT (Distilled Bidirectional Encoder Representations from Transformers), was trained to predict the cost range of residential buildings at the pre-conception stage. The training and evaluation data included 63,899 building permit activity records (2021–2022) from the Victorian State Building Authority, Australia. The input data comprised the project description of each record, which included project location and basic material types (floor, frame, roofing, and external wall).FindingsThis research designed a novel tool for predicting the project budget based on preliminary project information. The model achieved 79% accuracy in classifying residential buildings into three cost_classes ($100,000-$300,000, $300,000-$500,000, $500,000-$1,200,000) and F1-scores of 0.85, 0.73, and 0.74, respectively. Additionally, the results show that the model learnt the contextual relationship between qualitative data like project location and cost.Research limitations/implicationsThe current model was developed using data from Victoria state in Australia; hence, it would not return relevant outcomes for other contexts. However, future studies can adopt the methods to develop similar models for their context.Originality/valueThis research is the first to leverage a deep learning model, DistilBERT, for cost estimation at the pre-conception stage using basic project information like location and material types. Therefore, the model would contribute to overcoming data limitations for cost estimation at the pre-conception stage. Residential building stakeholders, like clients, designers, and estimators, can use the model to forecast the project budget at the pre-conception stage to facilitate decision-making.