Public Health Commons^™

Exploring The Experience Of Healthcare-Related Epistemic Injustice Among People With Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, Joanne Hunt, Jessica Runacres, Daniel Herron, David Sheffield

The Qualitative Report

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a chronic, disabling yet clinically “contested” condition, previously theorised through a lens of epistemic injustice. Phenomena conceptually close to epistemic injustice, including stigma, are known to have deleterious consequences on a person’s health and life-world. Yet, no known primary studies have explored how people with ME/CFS experience healthcare through a lens of epistemic injustice, whilst a dearth of research explicitly exploring healthcare-related injustice from a patient perspective has been noted. This qualitative study seeks to address this gap. Semi-structured interviews and interpretative phenomenological analysis (IPA) were used to explore the experiences of …

How To Develop A Qualitative Evaluation Plan For A Complex National Intervention: Key Steps And Reflections From The Radx-Up Program, Shelly A. Maras, Josephine Mckelvy, Kelley Milligan, Allyson Kelley, Valerie A. Lucas, Tara Carr, Abisola Osinuga, Leah Frerichs, Gaurav Dave

The Qualitative Report

This article describes the formative process of developing and implementing a Qualitative Evaluation Plan (QEP) for a large-scale, National Institute of Health (NIH) supported program: Rapid Acceleration of Diagnostics — Underserved Populations (RADx-UP). RADx-UP includes over 137 projects in the United States that aim to ensure that all Americans have access to timely, accurate diagnostics for COVID-19, with a specific focus on populations the pandemic disproportionately affects. As part of a comprehensive, mixed-methods strategic evaluation plan, our team developed the QEP. We employed qualitative methods to understand RADx-UP academic and community partners’ experiences implementing community-engaged research strategies, and to understand …

Pastoral Leaders’ Perception Of Obesity And Their Role Within Faith-Based Organizations, Darren D. Moore, Clinton E. Cooper, Charles Williams

The Qualitative Report

The purpose of this study was to explore the perspectives of pastoral leaders regarding obesity and health within faith-based organizations (FBOs). In this study, the authors focused on gaining additional insight regarding how pastoral leaders conceptualize and make sense of their roles in terms of health promotion within FBOs. Utilizing a qualitative research methodological approach, specifically Qualitative Description, authors administered a qualitative survey to 12 participants which yielded three emerging themes: (1) perceived scope, (2) understanding and use of resources, and (3) defining obesity through pastoral leaders’ perspectives. In the study, investigators discuss clinical implications and provide recommendations.

Family Caregivers Of Older Adults With Physical Disabilities In Rural Thailand, Denis Tuttle, Jiranan Griffiths, Anuchart Kaunnil

The Qualitative Report

Thailand is one of many countries experiencing changes in the demographics of its population. People are living longer and having fewer children resulting in an increasing percentage of older adults in the general population. This presents a challenge in providing care for older adults, especially in countries where there is a culture of family caregiving. This study aims to investigate the experience of family caregivers, exploring the problems of caring for older people with physical disabilities and the needs of family caregivers. This is done to better understand ways to support caregivers. Using a descriptive qualitative approach, 15 family caregivers …

Experiences And Concerns Of Female Hotel Housekeepers In The First Stages Of The Covid-19 Lockdown In The Balearic Islands (Spain): A Qualitative Study, Xenia Chela-Alvarez, Cristian Sanchez-Rodriguez, Oana Bulilete, Mclara Vidal-Thomàs, Joan Llobera

The Qualitative Report

Strongly enforced mobility restrictions to deter the spread of COVID-19 severely impacted tourism, a pivotal economic sector of the Balearic Islands. Little is known about the experiences of the most economically affected groups, such as hotel housekeepers. This study aimed to explore the experiences and concerns of hotel housekeepers (approximately 13,000 worked in the Balearic Islands before the pandemic) during the first stages of the COVID-19 lockdown. Semi-structured interviews were conducted by telephone in April of 2020. Thematic analysis was used for interpretation. Eighteen hotel housekeepers were interviewed. Main experiences and concerns identified were: (a) distress due to employment status …

“We Live On An Island:” Perspectives On Rural Family Caregiving For Adults With Alzheimer’S Disease And Related Dementias In The United States, Heather J. Williamson, Andria B. Begay, Dorothy J. Dunn, Rachel Bacon, Mark Remiker, Yolanda E. Garcia, Michael J. Mccarthy, Julie A. Baldwin

The Qualitative Report

As the United States’ aging population grows, there will be increased prevalence of individuals living with Alzheimer’s Disease and related dementias (ADRD), who largely rely on the support of their family caregivers. Family caregivers residing in rural areas face additional challenges with managing caregiving responsibilities and navigating support services. The purpose of this multilevel phenomenological qualitative study was to explore the assets, unique needs, and resources of rural-residing ADRD caregivers from the caregiver, provider, and policy influencers’ perspectives. The study took place between 2019 through 2021 in northern Arizona, a largely rural and geographically vast area home to caregivers from …

Access To Health Care By Foreign Children With Special Needs In An International Border Municipality, Gabriela Dominicci De Melo Casacio, Adriana Zilly, Rosane Meire Munhak Da Silva

The Qualitative Report

This qualitative study aimed to analyze access to health by foreign children with special needs in an international border municipality. Grounded on hermeneutics-dialectics, this research was conducted through in-depth interviews with 26 professionals who treat foreign children with special health care needs and thematic analysis for data analysis was adopted. One central theme emerged: Vulnerability of foreign children and the health access in a border area Brazil-Argentina-Paraguay, organized by six sub-themes. High demand of children, overload in the health services, problems with documentation and language, insufficient articulation between the countries, and lack of funding represent restrictions for the access, especially …

Attempting To Close The Evidence-Practice Gap In Physical Activity Intervention Research: Strategies And Outcomes Of A Co-Creative Qualitative Study, Andrew Powell, Charlotte Coward

The Qualitative Report

It is argued that a gap exists between research evidence and “real-world” physical activity (PA) intervention practice. One potential way to aid the translatability of evidence in this field is for researchers to work actively with the public health practitioners and organisations that run PA interventions to engage in co-creative research. This paper reports the process and strategies used to underpin research co-creation during a recent qualitative PA intervention study, and the outcomes of the co-creative approach from the perspective of the public health organisation involved in the research in terms of providing them with translatable evidence. A range of …

The Lived Experience Of Postpartum Anxiety During Covid-19: A Hermeneutic Phenomenological Study, Walker Ladd Phd, Jenny De Decker

The Qualitative Report

The experience of pregnancy and postpartum anxiety disorders results in adverse birth outcomes and the disrupted development of infants and children. Since the COVID-19 Pandemic, the Centers for Disease Control and Prevention (CDC) has designated pregnant and postpartum women as more vulnerable to COVID-19 (CDC, 2021), and perinatal mood and anxiety disorders rates have increased. However, research regarding the lived experience of women with postpartum anxiety (PPA) during a global pandemic remains lacking. Using van Manen’s hermeneutic phenomenological research method, we interviewed eight women self-identifying as having had PPA during the COVID-19 pandemic. Analysis revealed five themes describing the lived …

Arab Health Promoters’ Perspectives On Religious/Cultural Challenges To Adopt Healthy Lifestyle Behaviours Among Arab Immigrants In Canada, Hussein Baharoon, Judy King

The Qualitative Report

Despite the importance of faith and cultural background in Arab immigrants’ lives, little is known about their role in preventing cardiovascular diseases. To understand the challenges among Arab immigrants related to acculturation and religiosity in adopting healthy lifestyle behaviours and managing stress, we conducted three face-to-face focus groups with 17 Arab health promoters who were members of the Canadian Arab Health Coalition. Averaging 80 minutes in length, the focus groups were conducted in Ottawa, Canada, in February and March 2018. Data were analyzed with an inductive thematic analysis approach; we identified four themes: “Culture first!”: dominant influence of home country …

Examining Newcomer Women’S Experiences With Perinatal Care In Ontario, Canada: An Application Of Carspecken’S Critical Ethnographic Method, Jessica Pimienta, Oona St-Amant, Sepali Guruge, Corinne Hart, Cristina Catallo

The Qualitative Report

This article provides a practical description of Carspecken’s (1996) five-stage critical ethnographic approach entitled “Critical Qualitative Research (CQR).” Situated epistemologically and ontologically in the critical paradigm, this article is an exploration of critical ethnography as an important methodology for shedding light on the discursive culture of perinatal care for newcomer women during the three-month health insurance waiting period in Ontario, Canada. We argue that Carspecken’s approach to critical ethnography is especially instrumental in illuminating the social structures that contribute to health inequities.

African-American Lay Pastoral Care Facilitators’ Perspectives On Dementia Caregiver Education And Training, Nik M. Lampe, Nidhi Desai, Tomeka Norton-Brown, Alexandra C. H. Nowakowski, Robert L. Glueckauf

The Qualitative Report

The African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS 2) is a faith-integrated, skills-training and support program for distressed African American family caregivers of persons living with dementia across Florida. Caregivers participate in a 12-week, telephone-based, skills-building and support program led by faith community workers (i.e., lay pastoral care facilitators) who provide volunteer services to their denominations. In this case study, we examined facilitators’ perspectives and recommendations for supplementary audiovisual and written training materials to optimize group process and goal-setting skills. Utilizing a qualitative approach, we explored facilitators’ needs, experiences in using current training materials, and recommendations for supplementary …

“If I Were To Suffer A Stroke Right Now, The First Place That I Should Be Taken To Is The Traditional Healer”: Community Beliefs And Health-Seeking Practices For Noncommunicable Diseases In Rural Kwazulu-Natal, South Africa, Herbert Chikafu, Innocent Tinashe Mutero Dr., Moses John Chimbari Prof.

The Qualitative Report

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The burden of chronic noncommunicable diseases in rural South Africa is exacerbated by delayed health-seeking. This study explored awareness, beliefs and health-seeking behaviour relating to diabetes, hypertension and cardiovascular diseases in Ingwavuma, a poor rural community in the uMkhanyakude district of KwaZulu-Natal, South Africa. Eight gender and age-stratified Focus Group Discussions (FGD) were conducted in isiZulu using a pre-tested FGD guide with seventy-six participants. Thematic analysis was done to discern views on access to care for noncommunicable diseases. Findings revealed limited awareness of hypertension, diabetes, and cardiovascular-related disease burden. The community practices medical plurality, and consultation with traditional healers …

Challenges In Conducting Online Videoconferencing Qualitative Interviews With Adolescents On Sensitive Topics, Salima Moez Meherali, Samantha Louie-Poon

The Qualitative Report

In the wake of COVID-19, researchers are seeking innovative data-collection methods. Computer-mediated communication platforms have played a pivotal role among these pursuits. However, conducting online interviews present challenges to both researchers and participants. Online data-collection forces researchers to give up control over the study environment due to the varying location participants partake in interviews. Consequently, researchers can no longer fully guarantee the confidentiality and privacy of the researcher-participant conversations. Participants may face difficulties if being asked to disclose private information in the presence of family members. These challenges are heightened when conducting online interviews with adolescents on sensitive topics. Thus, …

The Importance Of Explicit And Timely Knowledge Exchange Practices Stemming From Research With Indigenous Families, Elizabeth J. Cooper, S Michelle Driedger

The Qualitative Report

Ethical research practice within community-based research involves many dimensions, including a commitment to return results to participants in a timely and accessible fashion. Often, current Indigenous community-based research is driven by a partnership model; however, dissemination of findings may not always follow this approach. As a result, products may not be as useful to participants who were motivated to be involved in the research process. We conducted a seven-week workshop on three occasions with different First Nations and Metis women and girls (age 8-12) in Winnipeg, Manitoba. The workshop explored participants’ perspectives around health, safety, and family wellbeing using a …

The Lived Experience Of Syrian Refugees In Canada: A Phenomenological Study, Khaldoun Aldiabat, Enam Alsrayheen, Catherine Aquino-Russell, Michael Clinton, Roger Russell

The Qualitative Report

Health care providers in Canada are expected to take care of people from a variety of cultural backgrounds, and it is difficult for health care providers to deeply understand the lived experiences of some individuals to provide them with culturally sensitive care. Syrian refugees comprise one such group of newcomers to Canada. This phenomenological study aimed to uncover the meaning of the lived experiences of Syrian refugees using Giorgi’s (2009) method. Seven participants’ descriptions were viewed through the lens of the social determinants of health model. Seven essences of the general structural description or the meaning Syrian refugees gave to …

Use Of Mobile Health In Infant And Young Child Nutrition: A Formative Study In Rural Maharashtra, Samreen Sadaf Khan Dr., Archana Patel Dr., Amrita Puranik Ms., Priyanka Kuhite Dr., Yamini Pusdekar Dr., Michael J. Dibley Dr., Ashraful Alam Dr.

The Qualitative Report

Undernutrition is a major public health problem for under 5 years of age children in India. Approximately 41% and 21% of under 5 years of age children are stunted and wasted respectively. Despite the known importance of age appropriate infant and young child feeding practices for child nutrition, the rates of these practices remain poor in India. The major determinants for inappropriate IYCF practices are beliefs and knowledge of parents and caregivers. These can be effectively addressed through counselling by mobile Health technology as mobile phones are widely available and have a high penetration across the country. This formative research …

Access To Eye Care Before And After Vision Loss: A Qualitative Study Investigating Eye Care Among Persons Who Have Become Blind, Tosha Zaback, Stephanie Lam, Joan Randall, Teresa Field, Mitchell V. Brinks

The Qualitative Report

Navigating access to eye care requires that patients recognize the need for screening and care, employ limited financial and social resources, manage complex health insurance policies, and access specialty clinical care. We investigated the experience of patients through the progression of vision loss to blindness, utilizing qualitative methods. We conducted structured telephone interviews with 28 persons with blindness throughout Oregon. Utilizing closed and open-ended questions, we explored patient experience on the events preceding avoidable blindness. Coding for emergent themes was conducted independently by two researchers using a constant comparative method. Participants described important barriers to accessing eye care: at the …

Application Of Rigour And Credibility In Qualitative Document Analysis: Lessons Learnt From A Case Study, Leanne M. Wood, Bernadette Sebar, Nerina Vecchio

The Qualitative Report

This paper probes functions and processes of qualitative document analysis (QDA), a method widely used in case study research. It firstly demonstrates the application of a QDA framework to inform a case study of women entrepreneurs in rural Australia; and provides insights into the lessons learnt, including strengths and limitations of QDA. Secondly, the paper provides guidelines for novice researchers seeking to use thematic analysis in a QDA process, arguing for rigour in naming assumptions and explicitness about the procedures employed. The paper contributes to discussion in the literature that positions QDA not only as a convenient tool, but as …

Healthy Older Adults’ Motivation And Knowledge Related To Food And Meals, Kai Victor Hansen

The Qualitative Report

The population over 60 years old is growing rapidly in Norway and in many other countries, and researchers often focus on elderly people and various diseases. This article examines the healthy elderly who are active in their daily lives to understand their motivation and knowledge about food and meals. The method used was CurroCus® group interviews, or fast focus groups. Nine CurroCus® groups were conducted, lasting for 37 to 56 minutes (average = 45 minutes). Altogether, 76 persons participated, ranging in age from 60 to 87 years; participants were predominantly female (>80%). The article discusses two areas: motivation and …

Conflict Between Religious Beliefs And Sexuality: An Autoethnography, Carlos E. Gerena

The Qualitative Report

Despite the shift in attitudes in religious institutions toward homosexuals in the United States, there are some religions that continue to view same-sex behavior as a deviant and damning sin. For many, religious beliefs and values provide meaning and impact personal identity. Using autoethnography, I will explicate my own experiences with religious institutions and the ongoing conflict between religious beliefs and sexuality. I will discuss messages received from the Pentecostal church, family, and Latino community, and how these messages influenced my human development and emotional well-being. I show that internalization of the principles taught by the Pentecostal Church triggered a …

Hope, Courage, And Resilience In The Lives Of Transgender Women Of Color, Nadine Ruff, Amy B. Smoyer, Jean Breny

The Qualitative Report

There is a lack of qualitative and strengths-based knowledge about the lived experience of transgender women of color in the US. To address this research gap, a Photovoice project was undertaken with five transgender women living in a small urban area. Thematic analysis of the participants’ discussion of their photographs identified three major themes: hope, courage, and resilience. Analysis suggests a framework for understanding these women’s lived experiences and the psychosocial tools that they use to negotiate their daily lives and persevere in the face of interpersonal and structural oppression.

Clinic Exploration Of Care Processes To Promote Colorectal Cancer Screening In Rural Accountable Care Organization Clinics: A Qualitative Case Study, Sarbinaz Bekmuratova, Jungyoon Kim, Hongmei Wang, Lufei Young, Daniel J. Schober, Li-Wu Chen

The Qualitative Report

It is essential to have an effective care process to promote colorectal cancer (CRC) screening particularly in rural areas. Primary care health care providers may have a significant impact on improving CRC screening rates among rural residents through systematic screening processes in their clinics. In this qualitative study, we aimed to explore the whole clinic processes of recommending and referring CRC screening in the rural accountable care organization (ACO) primary care clinics. We collected qualitative data through 21 semi-structured in-depth interviews with healthcare providers in rural primary care ACO clinics in Nebraska. We audio recorded and transcribed the interviews and …

“Do I Need Exercise?” A Qualitative Study On Factors Affecting Leisure-Time Physical Activity In India, Shalini Garg, V Raman Kutty

The Qualitative Report

Physical activity can reduce the risk of premature mortality from various chronic diseases. Previous research in Kerala, India indicates several barriers which can impact physical activity levels. Perceptions about the importance of health-promoting physical activity were examined among adults in Kerala and various facilitators, motivators and barriers to physical activity were identified using focus group discussions and interviews with key informants. At present, the attitude of people and health professionals is that physical activity has to be taken up when diagnosed with a disease (obesity, diabetes) and advised by a health professional. Men were more likely to start exercising after …

A Qualitative Metasynthesis Of Published Research Exploring The Pregnancy And Resettlement Experience Among Refugee Women, Diana M. Kingsbury, Sheryl L. Chatfield

The Qualitative Report

The number of refugees and asylum seekers throughout the world continues to increase, leading to increasing challenges in meeting healthcare needs of these individuals. Women’s antenatal health is of particular concern due to their vulnerability to sexual violence and the substantial proportion of refugees consisting of women and girls of or nearing reproductive age. The purpose of this qualitative metasynthesis was to integrate and interpret findings from previously published research reports in which authors explored aspects of pregnancy among resettled refugee women. Following a systematic search process, we used Dedoose qualitative data analysis software to manage the process of extracting …

One-Sentence, One-Word: An Innovative Data Collection Method To Enhance Exploration Of The Lived Experiences, Shannon L. Sibbald, Dylan Brennan, Aleksandra Zecevic

The Qualitative Report

Experienced-based methods are growing in popularity and are increasingly being utilized in a variety of research programs and investigations. They enable researchers and participants to co-design research strategies and outcomes and subsequently propose solutions to potential problems in the partnership. By applying an experience-based methods lens, we sought to augment traditional qualitative interviewing methodologies by using a novel method we named “one-sentence, one-word” (1S1W). To apply our 1S1W method, we used a phenomenological study that examined the relationship between the risk of falling and the desire of master athletes to engage in competitive sports. Participants reflected and recorded their subjective …

“My Determination Is To Live”: Narratives Of African-American Women Who Have Lived With Hiv For 10 Or More Years, Sabrina Cherry, Kathleen Demarrais, Cheryl Keita, Marsha Davis, Joel Lee

The Qualitative Report

Exploring the experiences of African-American women who have lived with HIV for many years can inform public health practice on how to better serve high-risk populations along the care continuum. To understand the experiences of African-American women who are HIV positive, the researchers used a narrative approach to guide repeat interviews. Under a theoretical framework of Womanism, we interviewed six African-American women ages 48-66 (M=57) who have lived with HIV for 10 years or longer and conducted analyses of narrative to identify key themes. The primary themes were: recollecting early hardships, HIV infection, and diagnosis; embracing social support; surviving and …

Barriers To Pregnancy Spacing In Women Living With Hiv: A Series Of Informational Interviews, Rachel K. Scott, Piyapa Praditpan, Patricia Tanjutco, Elizabeth Laidlaw, Regina Zopf, Manon M. Schladen

The Qualitative Report

For reproductive-age women living with HIV, birth spacing allows for optimization of maternal health and viral suppression to prevent mother-to-child transmission of HIV. We conducted semi-structured informational interviews to explore use of contraception for birth spacing. Interviews were transcribed and analyzed. Audio files were reviewed to capture non-explicit data. We interviewed 18 multiparous HIV positive women. All described experiences with at least one contraceptive method. Six themes emerged: Burden of contraception, Failure of birth control, Impact of youth and lack of life experience, Community beliefs about birth control, Lack of partner cooperation, and Altruism. Women viewed birth spacing favorably. Young …

Reaction To Safety Equipment Technology In The Workplace And Implications: A Study Of The Firefighter’S Hood, Brian W. Ward

The Qualitative Report

In the 1990s the firefighter’s hood became a standard article of safety equipment worn by municipal firefighters, eliciting a negative reaction among many of these firefighters. I used data from interviews with 42 firefighters to explain why this reaction occurred. Data analysis revealed that negative reactions ultimately stemmed from the hood’s disruption of autonomy, repudiation of the complex mental and physical skill needed to perform tasks required of firefighters, and hindrance in negotiating the life-threatening environment created by a fire. These findings indicate that when introducing new safety equipment technology to emergency response workers, their reaction to this equipment, and …

Journal Conversations: Building The Research Self-Efficacy Of An Aboriginal Early Career Academic, Michelle L. Dickson

The Qualitative Report

This paper shows how I used my research journal mainly as a reflective tool throughout the process of applying for and completing a PhD. Embarking on a PhD can be daunting for anyone and I was challenged by my lack of academic self-efficacy. In the absence of a formal academic mentor my research journal became my confidante, a tool that helped me make progress at times when barriers to research seemed insurmountable. It helped me decrease the cognitive dissonance I was experiencing about issues of subjectivity/objectivity and the positioning of my self in the research. This paper shares research journal …