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The aim of this study was to explore and identify why young adults aged between 18 and 30 years in the UK and France do or do not consume dairy products. Several studies have associated dairy products with a healthy diet, and the production of soft dairy, i.e. milk, yoghurt, and soft cheese, as more environmentally friendly than some other animal-based products. Yet recent reports highlight that dairy intake is lower than recommended for health, especially among young adults. Using a qualitative methodology, forty-five participants aged 18–30 years (UK: n = 22; France: n = 23) were asked about their reasons for (non)consumption of a wide range of dairy products. Audio-recorded focus groups and individual interviews were conducted in English in the UK and in French in France, transcribed and coded. A thematic analysis found four themes and sixteen sub-themes (theme product-related: sub-themes sensory, non-sensory, composition; theme individual-related: sub-themes mode of consumption, preferences, personal reasons, knowledge, attitudes and concerns, needs or cravings; theme cultural aspects: sub-themes product categorization, social norms, use; theme market offering: sub-themes alternative, packaging, value for money, availability) to influence participants’ dairy (non)consumption in both countries. A seventeenth sub-theme (theme cultural aspects: sub-theme structure of the meal) was found to influence dairy consumption only in France. Further studies are needed to investigate these themes within larger samples, but these findings contribute to understanding dairy (non)consumption in young adults in the UK and France and may aid the development of strategies to improve young adults’ diets.
Prognosticating outcomes for traumatic brain injury (TBI) patients is challenging due to the required specialized skills and variability among clinicians. Recent attempts to standardize TBI prognosis have leveraged machine learning (ML) methodologies. This study evaluates the necessity and influence of ML-assisted TBI prognostication through healthcare professionals’ perspectives via focus group discussions.
Methods:
Two virtual focus groups included ten key TBI care stakeholders (one neurosurgeon, two emergency clinicians, one internist, two radiologists, one registered nurse, two researchers in ML and healthcare and one patient representative). They answered six open-ended questions about their perceptions and potential ML use in TBI prognostication. Transcribed focus group discussions were thematically analyzed using qualitative data analysis software.
Results:
The study captured diverse perceptions and interests in TBI prognostication across clinical specialties. Notably, certain clinicians who currently do not prognosticate expressed an interest in doing so independently provided they had access to ML support. Concerns included ML’s accuracy and the need for proficient ML researchers in clinical settings. The consensus suggested using ML as a secondary consultation tool and promoting collaboration with internal or external research resources. Participants believed ML prognostication could enhance disposition planning and standardize care regardless of clinician expertise or injury severity. There was no evidence of perceived bias or interference during the discussions.
Conclusion:
Our findings revealed an overall positive attitude toward ML-based prognostication. Despite raising multiple concerns, the focus group discussions were particularly valuable in underscoring the potential of ML in democratizing and standardizing TBI prognosis practices.
It is important to limit statistical testing of context–mechanism–outcome configurations (CMOCs) to those which are most plausible. This is because testing too many hypotheses will lead to some false positive conclusions. Qualitative research conducted within process evaluations is a useful way to inform refinement of CMOCs before they are tested using quantitative data. Process evaluations aim to examine intervention implementation and the mechanisms that arise from this. They involve a mixture of quantitative (for example, logbooks completed by intervention providers) and qualitative (for example, interviews or focus groups with recipients) research. Qualitative research can be useful in assessing and refining CMOCs because intervention providers and recipients will have insights into how intervention mechanisms might interact with context to generate outcomes. These insights might be explored directly (for example, by asking participants how they think the interventions works) or indirectly (for example, by asking participants about their experiences of an interventions, and the conditions and consequences of this). Sampling for such qualitative research should ensure that a diversity of different participant accounts is explored. Analyses of these accounts can draw on grounded theory approaches which aim to build or refine theory based on qualitative data.
Veterinarians and animal scientists can provide leadership on issues relevant to farm animal welfare, but perceptions of these stakeholders regarding societal expectations for welfare are underexplored. This study involved five focus groups of veterinarians and animal scientists (n = 50 in total), recruited at a European meeting focused on cattle welfare. Participants were invited to discuss topics related to cattle welfare and were prompted with questions to elicit their perspectives of public concerns and how the participants felt public input should be included when developing solutions. Discussions were moderated by trained facilitators, audio-recorded and transcribed, and transcripts analysed using reflexive thematic analysis. Ultimately, four primary themes were developed: (1) The public as concerned; (2) The public as ignorant; (3) The public as needing education; and (4) The public as helper or hindrance. Groups identified specific farming practices viewed as concerning to the public, including lack of pasture access, behavioural restriction, and painful procedures. Discussions about these concerns and the role of the public were often framed around the assumption that the public was ignorant about farming, and that this ignorance needed to be rectified through education. Participants were generally ambivalent in their beliefs regarding public contributions to solutions for farm animal welfare but suggested that consumers should pay more for products to help shoulder any costs of welfare improvements.
Intimate partner violence against women (IPVAW) is a public health problem that affects women worldwide. Consequently, victims frequently go to healthcare centers, usually with a cover reason. To address this problem, national and autonomic protocols to respond to IPVAW in health systems have been developed in Spain. In this regard, the role of primary care physicians (PCPs) will be essential for addressing IPVAW, but they could encounter obstacles in doing so. The purpose of this study was to explore how IPVAW is addressed in healthcare centers in Spain. This study synthesized the information available in the protocols to address IPVAW among health care workers in Spain and analyzed it according to World Health Organization (WHO) guidelines. Additionally, PCPs’ perspectives on these protocols and the nature of IPVAW attention from healthcare centers were explored through a focus group. The findings displayed that, although the protocols mostly conform to WHO guidelines, they are insufficient to address IPVAW. Generally, PCPs were unaware of the existence of the protocols and referred to the lack of training in IPVAW and protocol use as one of the main obstacles to intervening, along with a lack of time and feelings as well as cultural, educational, and political factors. The adoption of measures to ensure that PCPs apply these protocols correctly and to approach PCPs’ obstacles for addressing IPVAW in consultations will be crucial for the care of victims.
On March 11, 2004, Madrid suffered one of the worst terrorist attacks in the history of Spain, leaving more than 190 dead and 2,000 injured. For years, the psychological consequences of the attacks have been studied; however, its long-term effects on symptomatology and especially on well-being remains unknown. This study aims to explore, through a qualitative approach, pathways and obstacles to the well-being of those affected directly or indirectly by the attacks of March 11 in Madrid. Two focus groups were held, one for indirect victims and one for direct victims. Subsequently, a thematic analysis of the materials obtained was carried out. More than 10 years after the attacks, most of the participants reported great difficulty in achieving well-being. Acceptance and victims’ associations seemed to act as key facilitators, while symptoms, political institutions and the media were the main obstacles. Direct and indirect victims presented similar data although aspects such as guilt and family relationships played a different role in their well-being.
Using the Theoretical Domains Framework (TDF) and COM-B model, this study aimed to determine the facilitators to a support tool for adolescent non-traumatic knee pain in general practice.
Background:
Many children and adolescents with non-traumatic knee pain consult their general practice. Currently, there are no tools to support general practitioners in the diagnosis and management of this group. There is a need to identify behavioural targets that would facilitate further development and implementation of such a tool.
Methods:
This study was designed as a qualitative study using focus group interviews with 12 medical doctors working in general practice. The semi-structured focus group interviews conducted online and followed an interview guide based on the TDF and COM-B model. Data were analysed via thematic text analysis.
Findings:
One of the biggest challenges from the general practitioner’s perspective was how to manage and guide adolescents with non-traumatic knee pain. The doctors had doubts in their capability to diagnose knee pain and saw opportunity to help structure the consultation. The doctors felt motivated to use a tool but considered access a potential barrier. Increasing opportunity and motivation by creating access in the community among general practitioners was considered important. We identified several barriers and facilitators for a support tool for the management of adolescent non-traumatic knee pain in general practice. To align with user needs, future tools should support diagnostic workup, structure the consultation and be easily available among doctors working in general practice.
Studies that measure environmental exposures in biological samples frequently provide participants their results. In contrast, studies using personal air monitors do not typically provide participants their monitoring results. The objective of this study was to engage adolescents who completed personal air sampling and their caregivers to develop understandable and actionable report-back documents containing the results of their personal air sampling.
Methods:
Adolescents and their caregivers who previously completed personal air sampling participated in focus groups to guide the development of report-back materials. We conducted thematic analyses of focus group data to guide the design of the report-back document and convened experts in community engagement, reporting study results, and human subjects research to provide feedback. Final revisions to the report-back document were made based on follow-up focus group feedback.
Results:
Focus groups identified critical components of an air-monitoring report-back document to include an overview of the pollutant being measured, a comparison of individual personal sampling data to the overall study population, a guide to interpreting results, visualization of individual data, and additional information on pollution sources, health risks, and exposure reduction strategies. Participants also indicated their desire to receive study results in an electronic and interactive format. The final report-back document was electronic and included background information, participants’ results presented using interactive maps and figures, and additional material regarding pollution sources.
Conclusion:
Studies using personal air monitoring technology should provide research participants their results in an understandable and meaningful way to empower participants with increased knowledge to guide exposure reduction strategies.
This paper presents an account of a Welfare Quality® assessment of 92 dairy farms carried out by seven experienced assessors. The aim was to evaluate the potential of the Welfare Quality® assessment protocol with respect to its uptake by UK farm assurance schemes. Data collection, and measure aggregation were performed according to the Welfare Quality® protocol for dairy cows. This study examined the data itself, by the testing of how hypothetical interventions might be reflected in changes in the aggregated scores, and also investigated human-related aspects, through inter-assessor standardisation sessions to evaluate reliability, and an assessor focus group to collect feedback. Overall, three main ‘challenges’ were identified. The first challenge related to the large amount of missing data. Unexpectedly, this was such that it was only possible to calculate an overall classification for 7% of farms. The second challenge concerned the way in which aggregated scores did not always reflect hypothetical interventions. The final challenge was inter-assessor reliability, where not all assessors were found to achieve acceptable levels of agreement on a number of outcome measures by the third training session. Suggestions for managing these challenges included, follow-up to assessor training, the use of multiple imputation methods to fill in missing data, and, where applicable, not aggregating the scores. The conclusion of the study was that the protocol provided useful information from which to make an informed selection of measures, but that the challenges, combined with the lengthy assessment time, were too great for its use as a certification tool.
This chapter presents the multi-scale co-creation methodology used in SURE-Farm to involve stakeholders with the aim of assessing the resilience of European farming systems. This methodology resulted in a wide range of valuable insights and allowed to identify convergent and divergent stakeholders’ perceptions with possible policy implications.
This study aimed to examine the intrapersonal, interpersonal, environmental and macrosystem influences on dietary behaviours among primary school children in Singapore.
Design:
A qualitative interpretive approach was used in this study. Focus group discussions guided by the socio-ecological model (sem), of which transcripts were analysed deductively using the sem and inductively using thematic analysis to identify themes at each sem level.
Setting:
Two co-educational public primary schools in Singapore.
Participants:
A total of 48 children (n 26 girls) took part in the semi-structured focus group discussions. Their mean age was 10·8 years (sd = 0·9, range 9–12 years), and the majority of the children were Chinese (n 36), along with some Indians (n 8) and Malays (n 4).
Results:
Children’s knowledge of healthy eating did not necessarily translate into healthy dietary practices and concern for health was a low priority. Instead, food and taste preferences were pivotal influences in their food choices. Parents had a large influence on children with regards to their accessibility to food, their attitudes and values towards food. Parental food restriction led to some children eating in secrecy. Peer influence was not frequently reported by children. Competitions in school incentivised children to consume fruits and vegetables, but reinforcements from teachers were inconsistent. The proximity of fast-food chains in the neighbourhood provided children easy access to less healthy foods. Health advertisements on social media rather than posters worked better in drawing children’s attention.
Conclusions:
Findings highlighted important factors that should be considered in future nutrition interventions targeting children.
Socio-relational aspects are essential for mental wellbeing (MWB), especially in the oldest old age. Our study aims to explore the socio-relational aspects related to MWB in accordance with the experiences of the oldest old of four European countries; and to examine how these differ between Mediterranean and Nordic people. A total of 117 participants aged 80+ years old were recruited, and 23 focus groups were performed. Qualitative content analysis identified five main themes. Family seemed to be the most important driver of the MWB of the oldest old, followed by relationships with close friends. Participants felt better when they had a sense of being needed, cared for, and connected. Loneliness and isolation negatively affected MWB, although solitude was appreciated. Differences appeared between Mediterranean and Nordic regions. Initiatives to promote positive interactions with family and friends, as well as social activities within the community, may contribute to strengthening MWB in the oldest old.
The purpose of this study was to investigate how old persons perceived their life to be, how they viewed the ageing process and their need of health care and societal support.
Background:
The purpose of WHO’s Healthy Ageing strategy and development of age-friendly environments is to support physiological and psychosocial changes in old persons by facilitating basic needs. Interventions to operationalize these needs in older people living at home are often developed from a professional perspective and to a small extent involves the perceptions, experience and expectations of the older persons.
Method:
This qualitative study has an explorative design using focus group discussions to collect data. In all, 34 persons between 69 and 93 years of age participated in seven group discussions. The interviews were analyzed using inductive manifest content analysis.
Findings:
The main results suggest that most old persons enjoyed life and wished it to continue for as long as possible. Important was to sustain networks and to feel useful. Unexpected changes were described as threats and the need to use health care services was associated with illness and being dependent. The result is presented in three categories with sub-categories: ‘Embracing life’, ‘Dealing with challenges’ and ‘Considering the future’.
Retirement timing can have important health implications. Little is known, however, about older adults’ views on this issue and whether they consider it better to retire later, earlier, on time or anytime. This knowledge gap about older adults’ views is particularly true outside North America and Europe. This qualitative study aims to examine older Chileans’ ideas about the relationship between retirement timing and health and to explore gender and class patterns in qualitative themes identified, knowledge which may strengthen quantitative population-based approaches. Framework analysis was conducted on qualitative accounts from a purposive, non-random sample of 40 older Chileans in six focus groups, stratified by gender and class as marked by lifetime occupation. Transcriptions were coded by two independent reviewers (inter-coder reliability = 81%) according to four deductive categories of retirement timing as well as inductive coding of emergent themes. The content and sequence of codes were visually represented in MAXQDA's document portraits and illustrated with descriptive quotes. Results indicate that participants’ views about when to retire in order to maximise health did not highlight retirement age or timing (later, earlier, on time, anytime). Instead, these older Chileans emphasised that the optimal retirement age depends on other conditions, such as employment quality, retirement income and gender. These views were patterned: lower occupational-class participants emphasised income and job hazards, higher-class males emphasised job satisfaction and higher-class females emphasised gendered patterns. Women and lower-class participants were relatively more favourable to earlier retirements than men and higher-class participants. Overall, qualitative analyses of lay perspectives from understudied country contexts complement and extend population-based models focused on timing or retirement age, suggest specific characteristics of retirement transitions that may moderate health consequences, and highlight class and gender differences in views of retirement timing. More research is needed using mixed-methods approaches and leveraging both purposive and random samples.
Alcohol misuse is common in bipolar disorder and is associated with worse outcomes. A recent study evaluated integrated motivational interviewing and cognitive behavioural therapy for bipolar disorder and alcohol misuse with promising results in terms of the feasibility of delivering the therapy and the acceptability to participants.
Aims:
Here we present the experiences of the therapists and supervisors from the trial to identify the key challenges in working with this client group and how these might be overcome.
Method:
Four therapists and two supervisors participated in a focus group. Topic guides for the group were informed by a summary of challenges and obstacles that each therapist had completed at the end of therapy for each individual client. The audio recording of the focus group was transcribed and data were analysed using thematic analysis.
Results:
We identified five themes: addressing alcohol use versus other problems; impact of bipolar disorder on therapy; importance of avoidance and overcoming it; fine balance in relation to shame and normalising use; and ‘talking the talk’ versus ‘walking the walk’.
Conclusions:
Findings suggest that clients may be willing to explore motivations for using alcohol even if they are not ready to change their drinking, and they may want help with a range of mental health problems. Emotional and behavioural avoidance may be a key factor in maintaining alcohol use in this client group and therapists should be aware of a possible discrepancy between clients’ intentions to reduce misuse and their actual behaviour.
Pervez Ghauri, University of Birmingham,Kjell Grønhaug, Norwegian School of Economics and Business Administration, Bergen-Sandviken,Roger Strange, University of Sussex
In business studies most researchers need to collect some primary data to answer their research question. This entails deciding what kind of data collection method to use, which depends upon an overall judgement on which type of data is needed for a particular research problem. One important aspect is to identify the scope of the study and unit of analysis and what type of analysis is needed. After looking briefly at the chief differences between quantitative and qualitative approaches, the chapter looks at different qualitative methods and when to use them.
Pervez Ghauri, University of Birmingham,Kjell Grønhaug, Norwegian School of Economics and Business Administration, Bergen-Sandviken,Roger Strange, University of Sussex
In business studies most researchers need to collect some primary data to answer their research question. This entails deciding what kind of data collection method to use, which depends upon an overall judgement on which type of data is needed for a particular research problem. One important aspect is to identify the scope of the study and unit of analysis and what type of analysis is needed. After looking briefly at the chief differences between quantitative and qualitative approaches, the chapter looks at different qualitative methods and when to use them.
To gain insight in Dutch food bank recipients’ perception on the content of the food parcels, their dietary intake and how the parcels contribute to their overall dietary intake.
Design:
Eleven semi-structured focus group discussions were conducted. Focus group topics were based on Andersons food insecurity definition: the lack of availability of nutritionally adequate foods and the assured ability to acquire foods in socially acceptable ways. Data were coded and analysed with Atlas.ti 7.0 software, using the framework approach.
Setting:
Seven food banks throughout the Netherlands.
Participants:
A total of 44 Dutch food bank recipients.
Results:
Food bank recipients were not always satisfied with the amount, quality, variation and type of foods in the food parcel. For the participants who could afford to, supplementing the food parcel was reported as main reason for buying foods, and price was the most important aspect in selecting these foods. Participants were not satisfied with their dietary intake; they mainly reported not having enough to eat. The content of the food parcel importantly influenced participants’ overall dietary intake. Finally, participants reported struggling with their feelings of dissatisfaction, while also being grateful for the foods they receive.
Conclusions:
This study suggests that, despite their best efforts, food banks are not meeting food bank recipients’ needs. Our results provide valuable directions for improving the content of the food parcels by increasing the quantity, quality and variation in the foods supplied. Whether this also improves the dietary intake of recipients needs to be determined.
To explore the concepts of healthy eating and to identify the barriers and facilitating factors for dietary behaviour change in adolescents.
Design:
A qualitative study involving twelve focus groups.
Setting:
Two secondary schools in the district of Hulu Langat in Selangor, Malaysia.
Participants:
Seventy-two adolescents aged 13–14 years.
Results:
Adolescents had some understanding regarding healthy eating and were able to relate healthy eating with the concepts of balance and moderation. The adolescents’ perceptions of healthy and unhealthy eating were based on food types and characteristics, cooking methods and eating behaviours. Facilitators for healthy eating were parents’ control on adolescents’ food choices, feeling concern about own health and body, being influenced by other’s health condition, and knowledge of healthy or unhealthy eating. On the other hand, barriers for healthy eating were the availability of food at home and school, taste and characteristics of foods, and lack of knowledge on healthy or unhealthy foods.
Conclusions:
The findings contribute to a better understanding of the adolescents’ concept of healthy eating, as well as the facilitators and barriers to practising healthy eating. Future interventions should include a method of promoting the immediate benefits of healthy eating, the way to cope with environmental barriers for healthy eating, and increasing the availability of healthy food choices at home and in the school environment. The health and nutrition education programmes should also focus on educating parents, as they can be role models for adolescents to practise more healthful behaviours.