Sequential Mixed Methods Design Research Articles

Student engagement and concerns on studies and future professions: exploratory research in a Palestinian higher education context

PurposeStudent engagement evaluation is considered to be connected to many aspects of the management of higher education, but outside Western higher education, research and evaluation on student engagement and experiences has been limited so far. Our study focuses on the underexplored aspects of Palestinian higher education with the aim of gaining an actionable understanding from the overall student engagement situation to enhance the management and development of local teaching and learning practices.Design/methodology/approachA quantitatively oriented, sequential mixed-methods design was adopted. With the applied and validated engagement measurement we collected 946 engagement questionnaire responses from Palestinian university students. Quantitative data were analysed using structural equation modelling, K-means cluster analysis and chi-squared tests. Inductive and deductive thematic analysis was employed for the open answers.FindingsWith the three validated student engagement dimensions, the applied cluster analysis allowed three different engagement profile groups to be distinguished: strongly, moderately and loosely engaged. In the subsequent statistical and qualitative thematic analyses, these three engagement clusters differ in the degree to which they had a clear vision of a future profession or in their academic engagement with their studies. Moreover, qualitative analysis brought up many shared concerns regarding theoretically oriented studies and uncertain professional and career prospects in the Palestinian higher education context.Originality/valueThis study is one of the first attempts to develop tools for student engagement management in Palestinian higher education. The study findings are particularly significant for developing micro- and meso-level management practices in Palestinian higher education institutions.

Identifying and understanding digital exclusion: a mixed-methods study

ABSTRACT Many of our transactions and interactions are now exclusively online; however, whilst we live in a world which is becoming ubiquitously digital, digital exclusion remains a complex societal issue. This study aimed to identify the scale and characteristics of ‘digitally excluded’ individuals in one borough in North East England and investigate factors influencing experiences of digital exclusion. A two-phase, sequential explanatory mixed-methods design was used. Phase One utilised a survey which was sent to every household in the borough (N = >98,000). The surveys (N = 9181) were analysed using exploratory univariate analysis, followed by a two-staged regression model. Of those responses, 1130 individuals (12.3%) were identified as digitally excluded. Older adults with disability, no or low-level education, and residing in specific (micro) geographical areas, were at higher risk of digital exclusion. Smaller household sizes and lower income also contributed to digitally exclusion. To further enhance inclusivity, three focus groups were conducted with groups who were identified as being at higher risk of digital exclusion (N = 10). Discussions highlighted the complexities of digital exclusion and digital use across communities and within individual circumstances. Digital exclusion is multi-factored and complex. It requires regional institutions and local communities to collaborate in an integrated governance framework to improve digital inclusion.

Rethinking the implications of sprawl for sustainable urban development: Insights from the Ejisu Municipality of Ghana between 2003 and 2023

Urban sprawl has been the focus of substantial academic discussion due to its intricate nature. The dominant narrative of this phenomenon, particularly in the global south, points to its adverse implications on cities, despite its positive outcomes. This study contributes to this discourse by examining the positive implications of sprawl — essentially spatial expansion and urban growth — from the perspectives of households and local planning officials within the Ejisu Municipality of Ghana. Employing an explanatory sequential mixed methods design, satellite images were used to assess the nature and spatial extent of Ejisu Municipality between 2003 and 2023. Additionally, 500 households and four relevant agencies were interviewed to discuss the positive implications of sprawl on the area's development and suggest measures to promote sustainable urban sprawl and development. The results showed significant horizontal expansion in the built-up areas over the period - from 34.51 km2 (16.6%) in 2003 to 44.92 km2 (21.61%) in 2013 and 76.46 km2 (36.78%) in 2023 with a projected increase to 100.80 km2 in 2033. Macroeconomic factors, demography, housing preferences, transportation, and regulatory frameworks were reported to influence the nature and extent of sprawl. Sprawl was reported to have resulted in economic diversification and viability, improved quality of life, improved access to public services, affordable housing, and expanded road networks, among others. The study proposes implementing sustainable measures for urban sprawl, and effective land-use planning, coupled with the enforcement of well-designed regulatory frameworks.

Construction and validation of a Computerized Formative Assessment Literacy (CFAL) questionnaire for language teachers: an exploratory sequential mixed-methods investigation

The contributions of Computerized Formative Assessment (CFA) to teachers’ instructional practices and students’ learning outcomes necessitate the development of valid and reliable instruments for measuring teachers’ literacy. To address this necessity, this study adopted an exploratory sequential mixed-methods design via drawing on a dual deductive–inductive approach to develop and validate a Computerized Formative Assessment Literacy (CFAL) questionnaire for language teachers. The participants comprised 489 Iranian male and female English as a Foreign Language (EFL) teachers teaching from elementary to advanced levels at different language institutes in eight big cities across the country. The results of Exploratory Factor Analysis (EFA) revealed that CFAL consisted of six factors including practical, theoretical, socio-affective, critical, identity-related, and developmental. The results of Cronbach’s alpha demonstrated that the questionnaire and its six components had satisfactory levels of reliability. The findings are discussed and implications for developing professional programs aiming at determining and promoting teachers’ CFAL are presented.

Psychological Well-Being, Curiosity and Perfectionism among Filipino Young Professionals with Quarter Life Crisis: Basis for Existential Positive Psychology Wellness Plan

Quarter Life Crisis is a difficult encounter in the life transition from adolescence to early adulthood. This crisis revolves around social comparison, work satisfaction, intimate relationships, career consolidation, preoccupations and fears, struggle from transition, social isolation, and frustration and disappointments. This study examined the psychological well-being, curiosity, and perfectionism among young professionals with a quarter-life crisis. There were 318 participants in this study from two different cities in one province of Region IV-A in the Philippines. The study used a sequential explanatory mixed method design that combines qualitative and quantitative research. Based on the result, the research found that young professionals with quarter-life crises have low psychological well-being, low curiosity, and high perfectionism. The themes, low disposition, poor mindset, and weak personality were extracted from the texts to fully support the respective variables. Furthermore, the research proposed a psychological intervention plan for young professionals experiencing the crisis: the existential positive psychology wellness plan.

Indoor environment sensor systems for healthier homes: a feasibility study in social housing

ABSTRACT This study examines the feasibility of using an indoor environment sensor system to improve property management and health in social housing. Over a 6-year period, sensors were installed and maintained in 280 homes to monitor temperature, humidity, and air quality, with the sensor data provided to residents and the Housing Association (HA) through co-designed dashboards. Employing a mixed method sequential research design, feasibility was evaluated using the RE-AIM model. From the residents’ perspective, monitoring the indoor environment was acceptable, but adoption rates of the dashboard were low and there was minimal evidence of its effectiveness in prompting changes in behavior. From the HA perspective, the system proved effective in identifying high-risk homes, prompting the HA to reach out to vulnerable residents, and provide more timely support and maintenance. The system also facilitated long-term monitoring, planning, and helped the HA achieve its social objectives and legislative responsibilities. Despite initial technical challenges, HA staff expressed a desire to continue using the system, integrate it with existing infrastructure, and expand its deployment to more homes. However, scaling the intervention would require careful planning. In conclusion, sensor systems are a feasible intervention that holds promise in helping to address health risks in underserved communities.

Faculty Online Teaching Effectiveness Scale (FOTES): Instrument development and content validation

This study aimed to develop and psychometrically test the Faculty Online Teaching Effectiveness Scale (FOTES) based upon both student and faculty perspectives of online teaching and learning in higher education. Online teaching effectiveness is a crucial component of quality education, but it has not been well-defined conceptually, and few studies have been conducted, using relevant domains, to accurately measure online teaching effectiveness. The impact of online course delivery on teaching effectiveness remains unclear. An exploratory sequential mixed methods design was employed with three phases of instrument development and psychometric testing. The FOTES comprises 50 items in seven domains: teaching philosophy, self-efficacy, relationships, course content, learning activities, teaching practices, and satisfaction. The instrument underwent initial testing, yielding positive expert appraisals with good-excellent psychometrics. All domains of the scale were significantly correlated, except for teaching philosophy. The preliminary results of the FOTES provide the empirical evidence to advance additional psychometric validation. This newly developed instrument has the potential to enhance faculty capacity and skill in self-evaluating their teaching effectiveness in online courses, providing a valid and reliable measure. The resulting instrument is poised to promote outcome evaluation and strengthen teaching and learning processes.

The link between patient safety competence and adverse event among master of nursing students: a cross-sectional mixed-methods study

BackgroundPatient safety (PS) is a core competency for registered nurses. However, there is a gap between the PS competence of nursing students and their clinical experience in PS. This study explored the effect of PS competence levels on the occurrence of adverse events (AEs) among nursing master’s students in China.MethodsA sequential mixed methods design was used, with a purposive sample across seven colleges. A total of 327 graduate nursing students, aged 22 to 38, participated in the survey, and 15 participated in qualitative interviews. The Health Professional Education in Patient Safety Survey (H-PEPSS) assessed the students’ competence levels in PS. The respondents also reported any AEs that they had been involved in over the past year.ResultsA total of 78 AEs occurred in the past year, with 17.7% of the participants involved 1 to 3 AEs. The most common AEs were medication administration errors (30.77%) and improper use of medical equipment/supplies (28.20%). Students acquired more competencies from the clinical setting than from the classroom setting. Three competencies learned from classroom settings were associated with clinical AEs: low clinical safety skills [OR = 0.61], inappropriate identify, response to and disclosing AE and close calls [OR = 0.454], and low confidence in working in teams with other health professionals [OR = 2.168]. Qualitative data analysis revealed five themes: recognizing AEs, reducing harm by addressing immediate risks to patients and others involved, promoting safe medication and clinical practice, managing members’ authority and team dynamics, and dealing with inter-professional conflict.ConclusionsThe quantitative and qualitative data align, supporting the enhancement of students’ PS competence.

Clear Masks Do Not Prevent Gains During Dynamic Temporal and Tactile Cueing Treatment: An Explanatory Sequential Mixed Methods Pilot Study

Purpose: This study aimed to determine the outcomes and impact of Dynamic Temporal and Tactile Cueing (DTTC) treatment when clear vinyl masks were worn. DTTC is one of the few evidence-based treatments for children with childhood apraxia of speech (CAS). Given that DTTC relies on visual, auditory, and tactile cues, it was unknown if treatment gains would be demonstrated when masks were worn and how masking would impact the therapy experience for clinicians and caregivers. Method: A sequential mixed methods design was used to study the efficacy of DTTC treatment in children with CAS when clear masks were worn. The quantitative phase used a multiple-baseline across-participants design. Four children (each 4 years of age) participated in the treatment protocol in which 24 sessions of DTTC were provided over 8 weeks while clear vinyl face masks were worn by participants and clinicians. Whole word accuracy on treated items and generalization to easy and hard untreated items were assessed during baseline, treatment, and follow-up. Semistructured interviews were conducted with clinicians and caregivers following treatment to explore the experience of masks being worn during treatment. Qualitative data were analyzed using descriptive thematic analysis. Results: Three children completed the treatment protocol. Visual and statistical analyses revealed that two participants demonstrated significant treatment effects, with one also demonstrating generalization. The remaining participant demonstrated marginal treatment gains. Qualitative findings revealed two main themes: “mask wearing was inconvenient but did not prevent therapy gains” and “in-person therapy with face masks was preferable to teletherapy.” Conclusions: Masks did not prohibit treatment gains during DTTC therapy, with treatment effects of varying degrees shown for the three participants who completed the protocol. Together, quantitative and qualitative results indicate that mask wearing was, for most, a minor inconvenience that did not substantially interfere with the efficacy of DTTC treatment. Supplemental Material: https://doi.org/10.23641/asha.26408854

Understanding the physical literacy development of 8- to 12-year-old children living with chronic medical conditions: A comprehensive, mixed methods inquiry.

Physical literacy is a concept used to describe the combined physical, affective and cognitive capacities facilitating an active lifestyle. Physical activity participation is essential for children living with chronic medical conditions, but knowledge of physical literacy among this group is scarce. An explanatory, sequential mixed methods design was used to comprehensively describe the physical literacies of children with chronic medical conditions (CMCs). Participants were recruited from paediatric cardiology, respirology/cystic fibrosis, neurology, haematology and endocrinology outpatient clinics. All participants completed the Canadian Assessment of Physical Literacy (2nd Edition), and those with higher and lower scores were invited to a semi-structured interview. A deductive-inductive thematic analysis was applied using Margaret Whitehead's conceptualization of physical literacy. Using normative strata, 80.0% of the 99 children assessed (mean age = 9.97 ± 1.3years, 48% girls) were considered beginning or progressing in their overall physical literacy (mean score = 56.5 ± 13.8/100). Meanwhile, physical literacy informed participants' approach to new, active experiences and may have contributed to a strong sense of self. There was a significant difference between endocrinology and haematology patients on total physical literacy score (p = 0.03) but not domain scores. Participants scored high on motivation/confidence (mean = 22.9 ± 5.0/30) but obtained low physical competence (mean = 11.8 ± 5.6/30) and daily behaviour scores (n = 72, mean = 15.5 ± 7.1/30). Main themes represent salient experiences of children with CMCs within the domains of physical literacy, including their need to evaluate active contexts, self-regulate activity intensity and manage physical limitations. Children with CMCs can achieve recommended levels of physical literacy without meeting normative standards for physical competence. Participants would benefit from a physical literacy intervention that targets the development of bodily self-regulation skills and risk evaluation in active settings.

Evaluating the Impact of the Language Mindset Toolkit among Thai Undergraduate Students

This study reports the impact of a language mindset toolkit in influencing the language mindsets of Thai undergraduate students. An explanatory sequential mixed method design was used to determine how language mindset changes and know the students’ language learning insights through a focused mindset intervention. Data from 67 students chosen from convenience sampling completed language mindset surveys, journal entries, and semi-structured interviews were analyzed. Descriptive statistics was used to analyze the survey data, while thematic and content analyses were utilized for journal entries and interview data. Key findings revealed a notable shift from a fixed to a growth mindset, particularly in language learning abilities. While mindsets related to intelligence and age sensitivity remained relatively stable, there was a marked change in participants’ belief in the malleability of their language learning abilities, underpinned by the principles of effort and persistence. Thematic analysis of journals supports these findings, with themes such as knowing about language mindset in learning, putting effort into language learning, setting goals in language learning, using strategies in language learning, and regulating emotions in language learning. Meanwhile, the content analysis of individual interviews revealed insights such as appreciating self, motivating self in language learning, and gaining self-efficacy. Growth mindset-oriented interventions could transform the students’ beliefs in language learning.

'A Meaningful Difference, but Not Ultimately the Difference I Would Want': A Mixed-Methods Approach to Explore and Benchmark Clinically Meaningful Changes in Aphasia Recovery.

Outcome measurement instruments (OMIs) are used to gauge the effects of treatment. In post-stroke aphasia rehabilitation, benchmarks for meaningful change are needed to support the interpretation of patient outcomes. This study is part of a research programme to establish minimal important change (MIC) values (the smallest change above which patients perceive themselves as importantly changed) for core OMIs. As a first step in this process, the views of people with aphasia and clinicians were explored, and consensus was sought on a threshold for clinically meaningful change. Sequential mixed-methods design was employed. Participants included people with post-stroke aphasia and speech pathologists. People with aphasia were purposively sampled based on time post-stroke, age and gender, whereas speech pathologists were sampled according to their work setting (hospital or community). Each participant attended a focus group followed by a consensus workshop with a survey component. Within the focus groups, experiences and methods for measuring meaningful change during aphasia recovery were explored. Qualitative data were transcribed and analysed using reflexive thematic analysis. In the consensus workshop, participants voted on thresholds for meaningful change in core outcome constructs of language, communication, emotional well-being and quality of life, using a six-point rating scale (much worse, slightly worse, no change, slightly improved, much improved and completely recovered). Consensus was defined a priori as 70% agreement. Voting results were reported using descriptive statistics. Five people with aphasia (n = 4, > 6 months after stroke; n = 5, < 65 years; n = 3, males) and eight speech pathologists (n = 4, hospital setting; n = 4, community setting) participated in one of four focus groups (duration: 92-112 min). Four themes were identified describing meaningful change as follows: (1) different for every single person; (2) small continuous improvements; (3) measured by progress towards personally relevant goals; and (4) influenced by personal factors. 'Slightly improved' was agreed as the threshold of MIC on the anchor-rating scale (75%-92%) within 6 months of stroke, whereas after 6 months there was a trend towards supporting 'much improved' (36%-66%). Our mixed-methods research with people with aphasia and speech pathologists provides novel evidence to inform the definition of MIC in aphasia rehabilitation. Future research will aim to establish MIC values for core OMIs. This work is the result of engagement between people with lived experience of post-stroke aphasia, including people with aphasia, family members, clinicians and researchers. Engagement across the research cycle was sought to ensure that the research tasks were acceptable and easily understood by participants and that the outcomes of the study were relevant to the aphasia community. This engagement included the co-development of a plain English summary of the results. Advisors were remunerated in accordance with Health Consumers Queensland guidelines. Interview guides for clinicians were piloted by speech pathologists working in aphasia rehabilitation.

Livestreamed tourism shopping: consumers’ attitudes and behaviors

Purpose This study aims to investigate how source attractiveness (including platform credibility, product appeal and streamer attractiveness) and information quality impact viewers’ cognition and flow state. Additionally, it examines how these factors influence the development of consumer attitudes and behaviors toward livestreamed tourism shopping, as well as the moderating roles of perceived risk and personal characteristics. Design/methodology/approach A sequential mixed-methods research design was used. In addition to a literature review, 15 interviews were conducted to identify measurement items for the subsequent questionnaire survey. Sample 1 (n = 209) was used to refine these measurement items, whereas Sample 2 (n = 227) was used to evaluate the measurement model and test the proposed hypotheses. Findings Findings reveal that source attractiveness (streamer attractiveness, tourism product attractiveness and platform credibility) and information quality significantly influence customers’ behavior formation, with cognition and flow state acting as mediators. Findings further confirm the moderating effect of perceived risk in a livestreamed shopping environment. Practical implications The findings provide new insights into how consumers select livestreamed shopping platforms. As viewers assess the credibility and trustworthiness of each component to form their perception of the overall platform’s credibility, companies should market their products through credible platforms, studios and stores with extensive reach. It is also critical to collaborate with streamers who are sincere, trustworthy, knowledgeable and professional. Since perceived risk lowers consumer behavioral intentions, live streamers, platforms and merchants should offer convincing and credible arguments to alleviate viewers’ perceived risks. Originality/value This study advances the literature on livestreamed shopping by broadening the conceptualization of source attractiveness to include three dimensions: streamer attractiveness, product attractiveness and platform attractiveness. Furthermore, it differentiates itself from existing studies by integrating and adopting multidimensional measurements of cognition (perceived usefulness and ease of use) and flow state (control, enjoyment, curiosity and concentration).

Mathematical communication of preservice mathematics teachers in solving gender-biased higher-order thinking skills problems

Mathematical communication is a crucial 21st-century skill related to achievement and other skills. This study aims to analyze the differences in mathematical communication abilities and describe the difficulties male preservice teachers (MPT) and female preservice teachers (FPT) face in solving gender-biased Higher-Order Thinking Skills (HOTS) problems. This research employs a sequential explanatory mixed-methods design. The respondents, selected through purposive sampling, consisted of 4 MPTs and 10 FPTs. Data on mathematical communication abilities were obtained through a gender-biased HOTS problem-solving test. The respondents' difficulties in solving the problems were gathered through interviews. The results indicate differences between MPT and FPT mathematical communication skills using symbols and mathematical notation in solving problems. Student's difficulties in solving gender-biased HOTS problems are unfamiliarity and disinterest in the context. This study implies that education should emphasize contextual understanding and utilize gender-neutral problems to enhance mathematical communication skills.

DIALECT PREFERENCES AMONG THE SYRIAN REFUGEES IN JORDAN: A MIXED-METHODS STUDY

Background and Purpose: Taking into account the scarcity of research on Syrian refugees from the perspective of sociolinguistics, this research explored Syrian refugees’ reasons for dialect preferences when they communicate in various domains of life in Jordan. Methodology: The study employed a sequential mixed-methods design, which involved collecting both quantitative and qualitative data. The quantitative data were collected using a questionnaire of 20 items. Qualitative data were collected using the semi-structured interviews which were conducted with 18 Syrian refugees. While the quantitative data analysis was done using descriptive statistics, the transcripts of the semi-structured interviews were coded and analysed thematically. Findings: The results of the study showed that the majority of Syrian refugees use the Syrian Dialect with family members, Syrian friends, and colleagues at work, and Syrian neighbours. Further, the results revealed that most of the Syrian refugees prefer to use the Jordanian Dialect when they communicate with Jordanian neighbours and friends, and with Jordanians at the workplace and in educational contexts. The study revealed that the major reasons for dialect preferences among Syrian refugees are a desire for integration, close connection to their families, a sense of cultural familiarity, comfort in communication, interlocutors, and the importance of the formal context. Contributions: The findings of this research can contribute to research in sociolinguistics in terms of understanding the Syrian refugees’ dialect preferences. Keywords: Syrian refugees, sociolinguistics, dialect preferences, Jordan, integration. Cite as: Samaher, F., &amp; Salasiah, C. L. (2024). Dialect preferences among the Syrian refugees in Jordan: A mixed-methods study. Journal of Nusantara Studies, 9(2), 106-130. http://dx.doi.org/10.24200/jonus.vol9iss2pp106-130

Promoting inclusion for disabled students in healthcare education: Using research-based theatre to enhance knowledge and empathy

AimThis study explores and compares the impact of in-person and online versions of a Research-based Theatre production named "Alone in the Ring," aimed at increasing knowledge and fostering positive attitudes towards persons with disabilities in healthcare professions. The study examines changes in attitudes towards disabled persons in healthcare professions, levels of engagement in the play and knowledge about the experiences and challenges of disabled individuals in healthcare professions. It also investigates possible actions to increase inclusion for disabled persons in healthcare education and practice. BackgroundDisabled students face numerous barriers in healthcare education and practice, many of which are rooted in stigma and negative attitudes. Research-based Theatre promotes experiential learning to address these attitudes and stereotypes. The performance "Alone in the Ring" is based on a comprehensive study of the experiences of disabled students and clinicians in health professions, aiming to promote inclusion for students with disabilities in these fields. DesignThis study uses a pre-test and post-test design with two comparison groups. MethodThe study employed an explanatory sequential mixed method design to explore the impact of online versus in-person Research-based Theatre teaching in healthcare education. Participants were graduate health students (N = 198); 100 watched the in-person version and 98 watched the online version. Surveys were administered before and after the performance. Participants were also invited to share their experiences in semi-structured interviews and their responses were analyzed using thematic analysis. ResultsResults indicated that students generally felt more comfortable with disabled persons in healthcare professions in the post-survey compared to the pre-survey, with online participants reporting greater comfort and higher engagement than those in-person. Knowledge of disabled persons' experiences and challenges, as well as possible actions to increase belonging and inclusion, improved significantly for both groups from pre- to post-performance, with online participants showing a greater change. Qualitative data revealed that online theatre was perceived as authentic and beneficial for accessibility, engagement and emotional impact on students, though challenges included potential distractions and technological issues. Positive correlations were found between changes in knowledge, positive attitude and engagement, suggesting that increased engagement and a shift in attitudes can promote knowledge and awareness of the inclusion of disabled persons in healthcare professions. ConclusionThese results support the use of online theatre-based academic teaching that experientially engages students, increases empathy and can promote more inclusive healthcare educational settings for disabled persons.

Parental involvement predicts Grade 4 learners’ reading literacy: an analysis of PIRLS data for students in Mpumalanga, South Africa

ABSTRACT The purpose of the study was to examine how parents’ involvement is associated with Grade 4 learners' reading literacy achievement in Mpumalanga. Selected variables from the PIRLS 2016 home and school questionnaires were used, and interviews were conducted with parents to gain a deeper understanding of parental involvement in their child’s education in terms of reading literacy. A sequential explanatory mixed-method design was used based on the pragmatism paradigm. The quantitative data (1,025 learners) was gathered before the qualitative data (ten parents). For the quantitative data, multi-level analysis showed that parents who read books with their child before the child went to primary school, parents who participated in their child’s reading outside school hours, and parents being included in their child’s education by the school are the best predictors of Grade 4 reading literacy achievement. For the qualitative data, the findings indicated that parents understand that promoting English as First Additional Language is of great importance; however, they lack the skills, time and resources to effectively teach English reading at home. This study suggests that more research should be conducted on effective parenting strategies at home to teach their children to read.

Intents and Actualities of Health Optimizing Physical Education (HOPE) Curriculum Implementation: A Sequential Exploratory

This study explores the implementation of the Health Optimizing Physical Education (HOPE) curriculum in senior high schools in Pasay City, Philippines. Utilizing an exploratory sequential mixed-method design, the research first employed validated questionnaires to quantitatively assess the implementation of HOPE 1, 2, 3, and 4. Subsequently, Focus Group Discussions (FGDs) with teachers provided qualitative insights into the challenges and experiences during the curriculum's initial three years. The study involved 428 private school students, 412 public school students, 27 private school teachers, and 38 public school teachers. Quantitative findings indicated a moderate to limited extent of curriculum implementation, with significant differences between public and private schools for HOPE 1 and 2, but not for HOPE 3 and 4. Qualitative data highlighted challenges related to curriculum content, facilities, equipment, and teacher training. Recommendations include targeted workshops, Learning Action Cell sessions, collaboration with community resources, and initiatives like the Family Activity Challenge. These interventions aim to enhance the curriculum's effectiveness, promoting physical activity and health literacy among students.

Assessment of infrastructure, behaviours, and user satisfaction of guardian waiting shelters for secondary level hospitals in southern Malawi.

Guardian Waiting Shelters (GWSs) are an essential component of the Malawi's health care system as they serve as a temporary home for patient guardians while taking care of their relatives admitted to the hospital, and expectant mothers. Although GWSs play a crucial role in Malawi's healthcare system, past studies have primarily concentrated on maternity waiting homes, neglecting the role and importance of GWSs. The study examines GWS management structures and conditions, as well as guardian satisfaction and perception of health risks related to GWS use. In this explanatory sequential mixed methods design, we assessed 12 GWSs from southern region of Malawi. Qualitative data included interviews (n = 149) and focus group discussions with patient guardians (n = 72), interviews with GWS caretakers (n = 5), representatives from Hospital Management (n = 12) and Hospital Advisory Committees (n = 11). Lack of guidelines and standards for GWSs resulted in creating a customized facility checklist to quantitatively assess infrastructure present at GWSs (n = 12). Descriptive statistics and qualitative thematic analysis were utilized for data analysis, and a problem tree analysis was used to triangulate and summarize the findings. A total of 249 participants participated in the study. Each GWS had an average of 100 users daily, primarily adult females (71%). No one was accountable for GWS operation and maintenance due to the lack of a management hierarchy. GWS infrastructure conditions were poor, with inadequate functional sleeping rooms, insufficient access to water, sanitation and hygiene facilities. Notably, 50% of the GWSs lacked water access, and a quarter had non-functional toilets. Guardians felt unsafe and at risk of disease transmission when staying within GWS. Study findings highlight lack of clear, consistent GWS ownership as a root cause of challenges in GWSs. Clear policy and operational standards must be established for effective management and smooth functioning of GWSs.

Narrative based online career group counseling program: an explanatory sequential design

AbstractThe aim of this study is to determine the effect of the Narrative Based Online Career Group Counseling Program on the career exploration, career and talent development self-efficacy, and career development of fourth grade primary school students. An explanatory sequential mixed-method design was used in the study. A 2 × 3 quasiexperimental design was used in the quantitative part, and a focus group interview was used in the qualitative part. The results showed that the program had a significant impact and could support career development in children. Thus, a career program with proven effectiveness that can be implemented in schools has been emerged.