Explanatory Sequential Mixed Methods Design Research Articles

Insights into Health Program Implementation and Evaluation in Iran: A Brief Review of National Healthcare Programs in Iran

Background: Healthcare program monitoring can play a key role in evaluating their implementation and identifying their strengths and weaknesses. Methods: This study was performed with the exploratory sequential mixed methods design in 2023 at Tehran, Iran. The information was categorized into indicators, refining, analysis, interpretation, reporting, and proposed challenges and recommendations. Results: Medical Sciences Department of Public Health (TUMSDoPH) evaluation of its public health programs revealed a comprehensive approach covering a wide spectrum from disease management to health promotion, emphasizing electronic health records, targeted disease interventions, and strategies for non-communicable diseases, alongside efforts to enhance community health. Conclusion: There is a need for initiating “the monitoring committee” under the supervision of the deputy chancellor for public health to monitor key performance indicators and policies to discover the problems of each part of the health system and provide recommendations.

Perception of caregivers on ITNs utilisation and its effectiveness among children under 5years of age in Chikwawa district, Malawi.

In 2020, Malawi had 6.9 million malaria cases and 2551 deaths, mainly in children under five years of age. The 2017-2022 Malawi malaria control strategic plan promoted the consistent use of insecticide-treated nets through free distribution and mass campaigns. Despite widespread availability of the control strategy plan, Chikwawa District continues to suffer from high malaria burden especially among under five children, due to inconsistent insecticide-treated (ITN) net usage. For this reason, this study aimed at exploring caregivers' perceptions on insecticide-treated net utilisation and also find out about its effectiveness among those who consistently use them. This study used a sequential exploratory mixed methods design. The data used for quantitative analysis was drawn from the population of under-five children's caregivers within the catchment area of Chikwawa district hospital. The sample size was 96 participants, as determined by Cochran's formula. The data collection lasted from December 2023 to April 2024 and included four in-depth interviews and three focus group discussions to address the objectives qualitatively. The study revealed that 91.67% of households used ITNs, with 87.50% using them daily. The significant factors influencing ITN utilisation included the number of nets, user satisfaction, perceived impact, user habits, acquisition method, and usage frequency (all p values < 0.001). Under-five malaria cases were also significant (p = 0.025). The odds of the perceived net impact influencing utilisation were 4.956 times greater. Non-usage was due to heat, quality concerns, limited access, breathing difficulties, health conditions such as asthma, and misconceptions about net treatment. The study revealed a strong belief in insecticide-treated net efficacy. However, some challenges such as access, durability, and misinformation of insecticide-treated nets were discovered. These challenges affected utilisation of insecticide-treated nets in agreement with some literature reviewed. The insights found in this study will help policymakers in addressing health interventions for the reduction of malaria cases in Malawi.

Emotion and cognition in customer experience: a mixed-method study on loyalty formation in the hospitality sector

PurposeThis study investigates the dual roles of emotion and cognition in shaping customer experiences within the hospitality sector, examining their distinct impacts on the formation of customer loyalty.Design/methodology/approachEmploying a sequential exploratory mixed-method design, this research integrates qualitative interviews with eighteen hospitality managers and a quantitative survey involving 595 customers to develop and validate a new instrument measuring affective and cognitive experiential states for general hospitality consumers.FindingsThe study's results reveal that emotional experiences strongly correlate with affective loyalty, while cognitive experiences significantly influence cognitive loyalty. The study contributes to the existing literature by introducing a robust instrument that effectively captures the experiential dimensions, offering insights into customer loyalty formation.Research limitations/implicationsThe reliance on retrospective self-reporting in the quantitative phase may introduce recall bias, potentially limiting the precision of the findings. Future research should seek to mitigate this by employing real-time data capture methods.Practical implicationsThe newly developed measurement tool presents a practical solution for industry professionals aiming to enhance customer experience management by focusing on both affective and cognitive aspects, thus facilitating targeted strategies to cultivate customer loyalty. The implications for service design suggest that both emotional and cognitive elements must be considered to optimize customer experiences and drive loyalty.Originality/valueThis work advances the theoretical understanding of customer experience by distinguishing between its affective and cognitive dimensions and their respective contributions to loyalty. It offers a validated empirical tool, setting a foundation for future investigations.

Comparing the psychological impact of the Shanghai lockdown on local and non-local college students: an explanatory sequential mixed method approach.

In 2022, the Shanghai municipal government enforced strict COVID-19 lockdown measures. Lockdown experiences for college students varied. Local students normally returned home and had familial support while non-local students relied more on institutional support when quarantining in dormitories. The difference could profoundly impact their access to necessary material resources and emotional support, affecting their mental health. This study compared the psychological effects of the Shanghai Lockdown on local and non-local college students using an explanatory-sequential mixed methods design. Quantitative analyses of data from 327 college students examined local and non-local students' mental health outcomes during the lockdown. Follow-up qualitative interviews (N = 12) contextualized their sources of stress and group differences. Higher prevalences of probable anxiety (34.6%), depression (45.1%), and poor subjective mental well-being (65.4%) are found among non-local students compared to local students (23.7% anxiety, 29.4% depressive symptoms, and 47.9% poor well-being). Suicidal ideation was higher among local students (8.6% prevalence difference). Being a non-local college student was associated with increased odds of probable anxiety, depression, and poor well-being. Interviews identified group differences such that non-local students received more school support (i.e., food and financial) and perceived emotional support but faced poorer quarantine living environments compared to local peers. Non-local college students were more vulnerable to the impact of lockdown. Our findings also provide insights into the impact of familial versus institutional support on student mental health during times of crisis.

Development and Validation of the Decisions to use Opioids Measure

BackgroundMillions experience inadequately managed acute pain each year. Opioids are an important tool for managing pain; however, recent reductions in opioid prescriptions have exacerbated preexisting challenges in pain management. Moreover, patient expectations and desires for pain management may drive additional opioid use. There is an important need to characterize patient motivations for using opioids in order to develop promising interventions. The aim of this study was to develop the Decisions To use Opioids (DTO) measure. MethodsWe used an exploratory sequential mixed methods design to create items for the DTO measure. Qualitative data from patient interviews and focus groups informed the development of items for the DTO. We evaluated the content validity of candidate items with nine experts using the content validity index (CVI) and conceptual significance. Face validity was assessed via cognitive interviews with five emergency department (ED) participants who experienced acute pain. ResultsWe generated an initial pool of 52 items. Expert ratings provided evidence of content validity on 40 items, as indicated by an item CVI score of 0.83 or higher. Nine items with CVI scores of <0.83 were retained and revised due to the conceptual significance. The remaining three items were discarded. ConclusionsThis study provided evidence of content and face validity of the DTO measure for ED patients. Further psychometric evaluation is needed to gather data regarding the DTO's internal consistency, construct validity, and criterion validity.

The privilege to play: race, gender, & SES advantages in boys’ high school athletic opportunities

ABSTRACT In this study, with an exploratory sequential mixed-methods design, we considered the components and implications of a habitus that (re)produces racial/ethnic, social class, and gender differences in US interscholastic sport participation. We drew from independently collected qualitative (N = 19 men and 47 total college athletes) and quantitative (N = 4,097 high school boys) data and noted and investigated dynamic links between individual choices; family, community, and school contexts; and power structures that inform interscholastic athletics. Findings positioned sports as offering valuable institutionalized cultural capital but being rife with reproductive struggles. Schools serve as fields that co-construct unequal athletic opportunity structures by nurturing and rewarding a cultivated athletic habitus associated with masculinity, whiteness, and affluent dispositions. These processes situate athletic advantages and successes as purely meritorious but restrict who is most likely to receive the individual and social benefits of high school sports participation.

Exploring the role of packaging in the formation of brand images: a mixed methods investigation of consumer perspectives

Purpose This study aims to explore consumers’ perspectives on how packaging plays a role in their consumption experience and how it contributes to the formation of brand images. By adopting a consumer’s perspective, the authors identify the criteria that consumers apply to evaluate packaging and reveal how packaging relates to consumers’ overall brand associations. Design/methodology/approach Through a sequential exploratory mixed methods design, the authors explore brand packaging of chocolate bars as emotionally laden, well-known fast-moving consumer goods. First, the authors conduct a qualitative focus group study to explore how consumers perceive package design, and how it relates to their brand impressions. Second, the authors test the constructs and attributes with an independent sample through a quantitative survey. Findings The qualitative findings reveal the different roles of packaging and highlight how packaging provides value for consumer experiences not only at the point-of-sale but also during later consumption. More specifically, the authors identify 12 main criteria that consumers use to evaluate packaging. The authors unwrap how packaging is embedded in consumers’ brand image networks by mapping out its connections to other brand associations pertaining to product attributes, the brand itself and personality impressions. The quantitative findings confirm the importance of practical and symbolic packaging criteria and the brand image comparisons. Originality/value Taking a consumer’s perspective, this study contributes to a more holistic understanding of how packaging supports brand building as we reveal the various ways in which packaging relates to consumers’ overall brand image associations. This study further directs attention to the roles that consumers themselves assign to packaging and how they evaluate packaging based on its practical, symbolic and social value.

How does Learning Differentiate with The Socio-Scientific Issue (SSI) Climate Change Improving Environmental Literacy?

Climate change is a complex global problem that requires understanding and action from students. Natural and Social Sciences projects can integrate climate change learning with social and scientific contexts. The preliminary study show that students do not yet have the environmental literacy skills needed to support science and technology projects learning. It also shows that students have difficulty understanding the concept of climate change and its implications for the environment. This research aims to determine the effect of differentiated learning with SSI to increase students ' understanding of climate change. The research method used is mixed methods research using the Exploratory Sequential Mixed Methods Design method. The research results show that implementing climate change differentiation learning with SSI can improve students ' environmental literacy skills. The results of the one-way ANOVA test have a significance value less than 0.05, where there is an increase after implementing differentiation learning. The findings of this research can integrate climate change learning with social and scientific contexts. SSI can help students understand complex issues that have significant social and scientific impact. This can motivate students to take action to overcome problems as an aspect of environmental literacy skills.

Self-Leadership and Associated Factors in Nursing Students

Background: Nurse leaders face high pressure, but self-leadership can help them thrive. Nursing students, therefore, should develop this skill before graduation. Purpose: To investigate nursing students’ self-leadership perceptions and associated factors, and to reveal when and how self-leadership strategies are utilized. Methods: An explanatory sequential mixed-methods design with interpretative description; 943 nursing students were surveyed and 13 were selected for qualitative analysis. Descriptive data were collected, and self-leadership was assessed using the Revised Self-Leadership Questionnaire. Focus group interviews were analyzed through thematic and content analysis. Results: Students who were employed, were involved in student clubs or organizations, held managerial roles, and had career goals exhibited higher self-leadership perceptions. Qualitative findings revealed that staying in comfort zones, overthinking, and procrastination hinder self-leadership, while self-respect, self-awareness, and self-determination enhance it. Conclusions: Nurse educators should design interventions that enable students to take on planning roles, advance at their own pace, and engage in opportunities to develop their self-leadership skills.

Beyond Empathy: Examining the Complexities of Outpatient Satisfaction in a Resource-Constrained Setting

Patient satisfaction is a critical indicator of healthcare quality, particularly in resource-constrained settings where efficient and effective care is paramount. This study aimed to explore the multifaceted nature of outpatient satisfaction at a private Indonesian hospital, moving beyond the traditional focus on empathy to understand the interplay of various service quality dimensions. A mixed-methods sequential explanatory design was employed. The quantitative phase involved a survey of 400 outpatients, measuring their satisfaction with five service quality dimensions: tangibles, reliability, responsiveness, empathy, and assurance. Data were analyzed using descriptive statistics, Importance-Performance Analysis (IPA), and gap analysis (suitability index). The qualitative phase utilized in-depth interviews and focus group discussions with patients, staff, and management to provide context and depth to the quantitative findings. While overall patient satisfaction was 82.9%, a gap analysis revealed substantial discrepancies between patient expectations and perceptions across several service quality dimensions. Tangibles, reliability, and responsiveness emerged as key areas requiring improvement. Qualitative findings highlighted extended wait times, inconsistent staff communication, and concerns about the physical environment as significant contributors to patient dissatisfaction. Achieving high levels of patient satisfaction in resource-constrained environments necessitates a comprehensive approach that addresses systemic inefficiencies and communication gaps alongside interpersonal factors like empathy. These findings underscore the need for targeted interventions to optimize resource allocation, streamline processes, and enhance staff communication skills to improve the patient experience.

Giving children permission for risky play: teacher variables and reported practices

ABSTRACT This study aimed to examine (a) whether preschool teachers’ risky play attitudes differed in relation to school type, number of children, presence of teachers’ aides, professional experience, age groups, and/or duration of time outdoors, and (b) preschool teachers’ self-reported practices regarding risky play outdoors. An explanatory sequential mixed method design was utilized. 484 preschool teachers were completed the Scale for the Attitudes Towards Risky Play at Early Childhood-Teacher Form. Semi-structured interviews were conducted with 21 preschool teachers. Quantitative results unveiled significant differences in teachers’ risky play attitudes regarding preschool type, presence of teachers’ aides, and daily time spent outdoors. Qualitative results shed light on the way parents and administrators perceived risky play impacted teachers’ practices for allowing or prohibiting children’s risky play outdoors. This study underscores a need for professional training and continuous collaboration among teachers, parents, and administrators to support risky play in educational settings.

Assessing Age-Friendly Community Initiatives: Developing a Novel Survey Tool for Assessment and Evaluation.

Age-Friendly Community Initiatives (AFCIs) have gained recognition as essential responses to the needs of aging populations. Despite their growing significance, there is a notable lack of effective measurement tools to assess the planning, implementation, and sustainability of AFCIs. The purpose of this study was to develop and validate a survey tool for evaluating AFCIs. A sequential exploratory mixed-method design was used in two phases. First, we identified key themes from interviews with AFCI leads to generate AFCI survey items and regional workshops. Then, we conducted a pilot of the survey and assessed its measurement properties. Thematic analysis of interviews with 68 key informants from 58 AFCIs revealed four main themes: AFCI priorities, enablers, challenges, and benefits. These themes, combined with feedback from AFCI stakeholders at the regional workshops and a AFCI conference, informed the development and refinement of a reliable and valid AFCI survey in 2019, supported by a high Cronbach's Alpha value (α = 0.881). Steps were identified to maintain and sustain the AFCI survey over time. The survey accommodates AFCIs' diverse demographics, governance structures, and priorities with a standardized and flexible approach for effective measurement. This research contributes to the academic understanding of AFCIs and aids community leaders and policymakers in planning, implementing, and evaluating AFCIs.

Which one? AI-assisted language assessment or paper format: an exploration of the impacts on foreign language anxiety, learning attitudes, motivation, and writing performance

In recent years, language practitioners have paid increasing attention to artificial intelligence (AI)’s role in language programs. This study investigated the impact of AI-assisted language assessment on L2 learners’ foreign language anxiety (FLA), attitudes, motivation, and writing skills. The study adopted a sequential exploratory mixed-methods design. Divided between an experimental group (receiving AI-assisted assessment) and a control group (receiving paper-format assessment), the participants were 70 intermediate English learners from two intact university classes in Bangladesh. The TOEFL iBT writing section measured writing skills, while the study also investigated perceptions and experiences of FLA, attitudes, and motivation using narrative frames. Thematic analysis of the narrative data showed that AI-assisted assessment greatly raised learners’ motivation, improved attitudes about language acquisition, and lowered FLA. According to quantitative analysis, the pretest writing abilities across groups showed no appreciable variation. Even though the difference was not statistically significant on the posttest, the experimental group exceeded the control group. The results of this study imply that AI-assisted assessments can generate a helpful learning environment, lower anxiety, improve attitudes, and increase motivation, thereby delivering useful information. Future studies should investigate long-term consequences, and further improvements to AI tools should optimize educational advantages—attitudes, motivation, and writing skills.

A Mixed Methods Study of Ethnic Identity and Mental Health Recovery Processes in Minoritized Young Adults.

Ethnic identity development is associated with positive mental health in young adults from ethnic minority groups. How a sense of belonging and attachment to one's ethnic culture is related to personal mental health recovery remains unexplained. This study examines the experiences of ethnic minority young adults in the U.S. to understand the aspects of culture and identity development that are relevant to their recovery processes. Young adults who were living with chronic mental disorders were recruited from four rehabilitation programs. Interviews produced quantitative and qualitative data. An explanatory sequential mixed methods design was used to integrate the qualitative findings from a sub-group of young adults (n = 44) with the results from the quantitative study. Directed content analysis was used to analyze the qualitative data, and the integrated data were analyzed in joint displays. The prominent themes characterizing ethnic identity development in personal recovery were (a) cultural history, traditions, and values; (b) mental illness stigma within the ethnic community; and (c) bias and discrimination in mental health services. Young adults with high ethnic identity development reported having more support from family, but they also described experiences with stigma and racism. The integrated results suggest that ethnic identity development promotes mental health recovery in minoritized young adults through social support and improved well-being and resilience. Experiences of intersectional stigma and structural racism associated with ethnic identity can interfere with self-determination and access to care among minoritized Hispanic/Latine, Black, and multiracial young adults in the U.S.

Preparing Graduate Registered Nurses for Independence in Aged Care.

Graduate registered nurses (RNs) start their careers working in a variety of clinical areas including aged care. However, they may not be fully prepared to work in aged care settings that often require them to work independently as the only RN on the premises. A list of essential clinical skills is crucial for supporting the development and effective transition of graduate nurses into aged care. To identify and rank a list of essential clinical skills for graduate RNs working in aged care settings on commencement of practice. An explanatory sequential mixed-methods design was applied and included a modified Delphi Study and semi-structured interviews. Five expert aged care RNs engaged in the three iterative Delphi rounds and five graduate aged care RNs were interviewed to confirm the clinical skills and ranking from their perspective. Quantitative data were presented through descriptive statistics. Qualitative data were analysed using thematic analysis. Thirty-six essential clinical skills for graduate RNs working in aged care settings were identified and ranked by the experienced aged care RNs. Graduate RNs supported this list of essential clinical skills on commencement and identified palliative care as an additional skill required by graduate RNs working in aged care. The derived essential skills offer aged care a guided approach to ensure that graduate RNs are work-ready, safe practitioners and supported to work independently. The study recommends the essential clinical skills for graduate nurses transitioning in their role as RNs in aged care that will support safe, quality clinical care.

Public Youth Services Librarians’ Perceptions Towards and Experiences in Promoting Teens’ Positive Mental Health: A Mixed Methods Study

Over the last decade, teen mental health has declined rapidly. In Florida, high rates of youth mental health concerns and lowered access to care led to its ranking as the 19th worst in the nation. To help address these issues, a “whole community” approach to mental health promotion has been advocated, with public libraries identified as potential partners. But research exploring public youth librarians’ perceptions and experiences related to this agenda is lacking. Informed by Seligman’s well-being theory, this study addresses that gap by exploring public youth librarians’ perceptions towards and experiences in promoting teens’ positive mental health through an explanatory sequential mixed-methods design consisting of surveys of and interviews with Florida public librarians responsible for teen services. Survey results (n=183) showed that most librarians viewed promoting teens’ positive mental health as an important part of their role and engaged in a variety of related activities. But challenges in carrying out these activities were identified as well as concerns related to professional boundaries and training. Interviews (n=30) further explored how librarians define the scope of their role and their experiences, including any training and support received and challenges related to promoting teens’ positive mental health. Findings provide greater understanding of what members of the profession are doing and what they perceive as their role in response to declining teen mental health, thus improving service provision by informing future education and training efforts and the development of new models for how to best promote teens’ mental health through a holistic lens.

Aiding Clinical Decision-Making at the Individual and Community Level Using Mobile Sensor Data: Study Protocol for an Experimental Design.

Background Mobile sensor data can provide vital information about patients' behavior and physical activity. In particular, the mobile accelerometer sensor data, if monitored effectively, can be used further for keeping watch on the physical activity of an individual and planning an intervention to improve it. These sensor data can also be used for improving clinical decision-making in sedentary lifestyle-related diseases. However, despite the availability of smartphone devices to the majority of the population, the sensor statistics captured by those devices are underused because of the lack of awareness about sensor metadata and the absence of clear-cut guidelines for using them. Objective The objective of this study is to study and encourage the use of the accelerometer sensor metadata of the mobile device in facilitating the delivery of interventions to enhance physical activity. At the end of the study, it should be able to lay down the basic guidelines for using the accelerometer sensor data of the mobile device for monitoring patients' activity and aiding the clinical decision monitoring. Methods A sequential explanatory mixed-method research design will be used between July 2023 and December 2024. Firstly, individuals between the ages of 30 and 45 visiting the clinic of healthcare workers and having lifestyle-related diseases will be screened for a sedentary lifestyle with the pre-tested sedentary lifestyle measuring tool. After enrolling patients with a sedentary lifestyle in the study, physical activity-related accelerometer sensor data will be collected from them. Based on the initial data recorded, an individualized activity plan will be created. Periodic monitoring of physical activity levels will be conducted over a three-month period. Participants will receive a message from clinicians based on their current physical activity levels to encourage them to adhere to the prescribed regimen suggested by clinicians. The improvement in physical activity over the period will be monitored, and feedback from clinicians to improve the mechanism will be recorded. Results The proposed research will help in exploring the role of remote monitoring of sensor data in improving adherence to physical activity plans as prescribed by their clinicians. It will also help in studying the variables that influence the monitoring of remote data collection. Conclusions This study will help create a protocol to bring improvement in the physical activity levels of patients with a sedentary lifestyle and with confirmed hypertension and type 2 diabetes through remote capturing and monitoring of mobile sensor data, ongoing messaging, and facilitation through clinical decision-making.

ICT in biology education: teachers’ readiness and implementation challenges in the context of Bangladesh

Information and Communication Technology (ICT) is commonly employed in biology classes to facilitate students' comprehensive comprehension of biological processes and enable them to see living phenomena. The purpose of the study was to explore the use of ICT in enhancing the teaching and learning process of biology in the secondary schools of Bangladesh. In our study, sequential explanatory mixed method design has been followed. Data was collected from purposively selected ten secondary schools of Dhaka city. The study reveals that teachers have a positive attitude towards incorporating ICT in biology lessons and possess operational understanding of data processing tools and online browsing. Nevertheless, it also emphasizes the fact that teachers are devoid of personal computers in their houses and have restricted availability to school computers. Furthermore, the existing curriculum and teachers' guides lack adequate instructions for integrating ICT into biology lectures. The study also suggests that the process of developing ICT-based curriculum is complicated, which deters teachers from incorporating ICT into their classes. Furthermore, there is a limited availability of educational materials related to ICT in the Bangla language. This study recommends continuous in-servicing training on ICT to teachers, interest free loan to teachers for purchasing laptops, developing interactive biology educational ICT contents in Bangla and include specific instructions in the curriculum and teachers’ guide on how to use ICT in biology classes. These findings have important implications for policy makers, educators, and researchers who are dedicated to expanding the use of ICT in education.

Pilot implementation study of a web-based men’s health screening app in primary care during COVID-19: a mixed-methods approach

BackgroundThe traditional delivery of healthcare services, including crucial preventive measures such as health screenings, faced significant disruption due to the COVID-19 pandemic. In response, eHealth technology emerged as a practical alternative for conducting screening services. This pilot study introduces ScreenMen, a web-based app for men’s health screening, implemented in a primary care setting. The study aims to assess patient uptake and healthcare provider’s acceptability and feasibility of implementing ScreenMen, emphasizing the importance of implementation science research in healthcare innovation.MethodsThis study employed a mixed-method explanatory sequential design, using a tailored implementation intervention to implement ScreenMen in an urban health clinic. Quantitative phase focused on patient uptake of ScreenMen and healthcare provider involvement, utilizing Google Analytics and provider questionnaires. Qualitative phase, using in-depth interviews with providers, explored factors influencing uptake and implementation. Data analysis employed means and percentages for quantitative data and framework analysis for qualitative data.ResultsWe invited 47 healthcare providers to attend the ScreenMen implementation workshop, with 26 participating, resulting in a 55.3% participation rate. Throughout the five-month study, there were 75 recorded accesses, with a completion rate of 20%. The primary way users accessed the app was through QR codes on buntings (38.7%), followed by postcards (12%). In qualitative interviews with three healthcare providers, it was found that the Identify and prepare champions strategy was helpful, as these champions led the implementation and encouraged other providers to promote ScreenMen. The use of QR codes on buntings, part of the Provide education and training strategy, was effective due to their visibility in patient waiting areas. However, the Mandate change strategy was considered ineffective, as providers felt obligated rather than motivated to implement ScreenMen.ConclusionThis study highlighted the uptake of ScreenMen and found barriers and facilitators during the pilot implementation. Two useful strategies were Identify and prepare champions and QR codes while Mandate change was not helpful. Further studies are needed to study the effectiveness of these implementation strategies to implement web-based apps.Trial registrationClinical Trial Number: NCT06388473 (Retrospectively registered 05/04/2024).

Practices and Perception of Paediatric Obstructive Sleep Apnea Among Orthodontists and Paediatric Dentists in Brazil: A Mixed-Methods Study.

To explore orthodontists' (OTs) and paediatric dentists' (PDs) practices and perceptions regarding the screening and management of paediatric obstructive sleep apnea (OSA). This explanatory sequential mixed methods design included OTs and PDs with active clinical practice in Brazil and encompassed a quantitative phase followed by a qualitative phase. In the quantitative phase, a survey assessing OSA screening and management practices was administered to OTs and PDs practicing in Brazil. Information-rich OTs and PDs were interviewed in the qualitative phase. Descriptive statistics and the chi-square test were used to analyse the survey data, while inductive content analysis was applied to the interview data. The results from both phases were integrated and reported narratively. Three hundred eighty-one OTs and PDs completed the survey, and ten of them were interviewed. Nearly half of OTs and PDs administered sleep questionnaires and demonstrated some knowledge about paediatric OSA signs and symptoms. PDs and OTs primarily offered rapid maxillary expansion and functional mandibular advancement for managing selected children with OSA, with OTs being more frequently involved in this task than PDs. OTs and PDs identified several barriers and expressed the need for support regarding access to reliable screening tools and interprofessional care. Brazilian OTs and PDs were aware of the main signs and symptoms of paediatric OSA and were somewhat involved in offering oral appliance management options. To further define the role of these professionals, increasing support for dental professionals in OSA management and updating existing clinical guidelines is warranted.