Preventive Practices of Hantavirus in a Rural Community in Panama: An Explanatory Sequential Mixed Methods Study.

INTRODUCTION: Preventive care practices are a challenge in community care. This study examined hantavirus preventive practices and their relationship with personal and social factors, lifestyle, and cultural beliefs. METHOD: An explanatory sequential mixed methods design, guided by Leininger's Theory of Culture Care Diversity and Universality, was used in two phases: (a) a cross-sectional relational design (n = 109) and (b) ethnonursing research (n = 30), in an endemic community in Panama. Univariate and bivariate analyses were used to analyze the quantitative data, whereas the Leininger's analysis model was used to analyze the qualitative data. RESULTS: In the quantitative phase, the most frequent preventive practice was household hygiene, and the least frequent was vector control. Two of the eight preventive practices were associated with personal factors and two were associated with social factors. In the qualitative phase, lifestyle, beliefs, and context were found to influence the adoption of hantavirus preventive practices and help explain the quantitative findings. DISCUSSION: Knowledge and understanding of the social and cultural contexts are essential for hantavirus prevention.

Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation tool for rigor in mixed methods implementation research.

BACKGROUND: Implementation science helps generate approaches to expedite the uptake of evidence in practice. Mixed methods are commonly used in implementation research because they allow researchers to integrate distinct qualitative and quantitative methods and data sets to unravel the implementation process and context and design contextual tools for optimizing the implementation. To date, there has been limited discussion on how to ensure rigor in mixed methods implementation research. PURPOSE: To present Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation (PEARL) as a practical tool for understanding various components of rigor in mixed methods implementation research. DATA SOURCES: This methodological discussion is based on a nurse-led mixed methods implementation study. The PEARL tool was developed based on an interpretive, critical reflection, and purposive reading of selected literature sources drawn from the researchers' knowledge, experiences of designing and conducting mixed methods implementation research, and published methodological papers about mixed methods, implementation science, and research rigor. CONCLUSION: An exemplar exploratory sequential mixed methods study in nursing is provided to illustrate the application of the PEARL tool. The proposed tool can be a useful and innovative tool for researchers and students intending to use mixed methods in implementation research. The tool offers a straightforward approach to learning the key rigor components of mixed methods implementation research for application in designing and conducting implementation research using mixed methods. CLINICAL RELEVANCE: Rigorous implementation research is critical for effective uptake of innovations and evidence-based knowledge into practice and policymaking. The proposed tool can be used as the means to establish rigor in mixed methods implementation research in nursing and health sciences.

Missed opportunities in mixed methods EdTech research? Visual joint display development as an analytical strategy for achieving integration in mixed methods studies.

Mixed methods research is becoming more prevalent in educational technology due to its potential for addressing complex educational problems by integrating qualitative and quantitative data and findings. At the same time, a growing chorus of researchers laments the quality and rigor of research in this field. Mixed methods studies which demonstrate explicit integration in educational technology research are scarce, and even fewer apply integration strategies recommended in the literature, such as visual joint displays. Failure to address the challenge of comprehensive integration may result in missed opportunities for deeper insights. To address this methodological problem, the purpose of this paper is to shed light on the procedures, opportunities, and practical challenges associated with mixed methods integration through the use of visual joint displays as an analytical tool for data interpretation and reporting in these types of designs. Using an exploratory sequential mixed methods multiple case study design as an illustrative example, we will (1) provide step-by-step guidance on how to develop a visual joint display to conduct an integrated analysis in a complex mixed methods design; (2) demonstrate how to use a display of this type to integrate meta-inferences previously generated through a series of interconnected joint displays; and (3) illustrate the benefits of integrating at the literature review, theoretical, analysis, interpretation, and reporting levels in mixed methods studies. This methodological article aims to advance knowledge in educational technology research by addressing the integration challenge in mixed methods studies and assisting researchers in this field in achieving comprehensive integration at multiple levels.

A Smartphone Intervention to Promote a Sustainable Healthy Diet: Protocol for a Pilot Study.

BACKGROUND: Changing current dietary patterns into sustainable healthy diets (ie, healthy diets with low environmental impact and socioeconomic fairness) is urgent. So far, few eating behavior change interventions have addressed all the dimensions of sustainable healthy diets at once and used cutting-edge methods from the field of digital health behavior change. OBJECTIVE: The primary objectives of this pilot study were to assess the feasibility and effectiveness of an individual behavior change intervention toward the adoption of a more environmentally sustainable healthy diet as a whole and changes in specific relevant food groups, food waste, and obtaining food from fair sources. The secondary objectives included the identification of mechanisms of action that potentially mediate the effect of the intervention on behaviors, identification of potential spillover effects and covariations among different food outcomes, and identification of the role of socioeconomic status in behavior changes. METHODS: We will run a series of ABA n-of-1 trials over a year, with the first A phase corresponding to a 2-week baseline evaluation, the B phase to a 22-week intervention, and the second A phase to a 24-week postintervention follow-up. We plan to enroll 21 participants from low, middle, and high socioeconomic statuses, with 7 from each socioeconomic group. The intervention will involve sending text messages and providing brief individualized web-based feedback sessions based on regular app-based assessments of eating behavior. The text messages will contain brief educational messages on human health and the environmental and socioeconomic effects of dietary choices; motivational messages to encourage the adoption of sustainable healthy diets by participants, providing tips to achieve their own behavioral goals; or links to recipes. Both quantitative and qualitative data will be collected. Quantitative data (eg, on eating behaviors and motivation) will be collected through self-reported questionnaires on several weekly bursts spread through the study. Qualitative data will be collected through 3 individual semistructured interviews before the intervention period, at the end of the intervention period, and at the end of the study. Analyses will be performed at both the individual and group levels depending on the outcome and objective. RESULTS: The first participants were recruited in October 2022. The final results are expected by October 2023. CONCLUSIONS: The results of this pilot study will be useful for designing future larger interventions on individual behavior change for sustainable healthy diets. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/41443.

Examining the influence of group diversity on the functioning of community-based participatory research partnerships: A mixed methods study.

Public health has endorsed the use of community-based participatory research (CBPR) to address health inequities involving diverse and marginalized communities. However, few studies have examined how group diversity among members of CBPR partnerships influenced how well the partnerships achieve their goals of addressing health inequities through equitable collaboration. We conducted secondary, convergent, mixed methods analysis to (1) evaluate the association between group diversity and participatory decision-making within CBPR partnerships, and (2) identify the perceived characteristics, benefits, and challenges of group diversity within CBPR partnerships. Using data from a cross-site study of federally funded CBPR partnerships, we analyzed and integrated data from surveys of 163 partnerships (n = 448 partners) and seven in-depth case study interviews (n = 55 partners). Quantitatively, none of the measured characteristics of group diversity was associated with participatory decision-making within the partnerships. Qualitatively, we found that partnerships mainly benefited from membership differences in functional characteristics (e.g., skillset) but faced challenges from membership differences in sociocultural characteristics (e.g., gender and race). The integrated findings suggest the need to further understand how emergent group characteristics and how practices that engage in group diversity contribute to collective functioning of the partnerships. Attention to this area can help promote health equity achievements of CBPR partnerships.

Interventions to increase young people's interest in STEM. A scoping review.

The underrepresentation of young people and particularly young women in many STEM fields has inspired various intervention programmes and research intended to boost their interest in these areas. The purpose of this scoping review is to examine the characteristics and effectiveness of interventions designed to encourage interest in STEM among secondary school students, particularly female students, over the past 20 years. A systematic search of the literature in five databases and additional search strategies resulted in identifying 215 studies evaluating interventions in different disciplinary fields. Data extraction and synthesis of these studies were carried out, focusing on the methodologies and theoretical foundations used. Twenty-five exemplars were selected to illustrate best practices in designing and evaluating interventions that address the various facets of young people's lack of interest in STEM. These interventions attempt to modify and/or manipulate multiple environmental and school factors to impact students' personal factors associated with STEM interest, such as achievement, self-perception of ability, and self-efficacy. Implications for the design of future interventions and potential outcomes are then discussed.

Consensus-building around the conceptualisation and implementation of sustainable healthy diets: a foundation for policymakers.

BACKGROUND: Healthy and sustainable diets need to be adopted to reduce the negative impact of food consumption on human and planetary health. Food systems account for a third of greenhouse gas emissions. "Dietary Patterns for Health and Sustainability" is a World Health Organization (WHO) project that aims to build consensus among international food, health, and sustainability experts and policymakers on how to conceptualise healthy and sustainable diets and on the actions and policies that could be implemented in the WHO European Region to promote these diets. METHODS: A qualitative study among European food, health, and sustainability experts and policymakers to elicit their views on multiple dimensions of food sustainability and health was carried out using a three-phase process, including semi-structured interviews, a Nominal Group Technique, and focus groups during a participatory WHO workshop held in Copenhagen. Thematic analysis was used to analyse the three data sources. RESULTS: The workshop resulted in a shared understanding of the interconnected components of sustainable healthy eating habits. As a result of this understanding, a variety of potential solutions were identified, including actions across different policy domains, tools, strategic guidelines, needs, and pathways for sustainable healthy diets. The pathways included the need for a multi-stakeholder approach, as well as the simultaneous execution of an aligned and coherent mix of policies at the local and national levels. CONCLUSIONS: The prioritised actions should be aimed at helping government policymakers promote sustainable healthy diets and make decisions on improving dietary patterns for citizens' health and wellbeing in line with the United Nations Sustainable Development Goals in the European Region.

Mixed methods intervention studies in children and adolescents with emotional and behavioral disorders: A methodological review.

BACKGROUND: Mixed methods intervention studies can improve the accuracy of interventional evaluations in the field of emotional and behavioral disorders by helping researchers gain a more nuanced understanding of how a particular intervention works. However, no studies to date have systematically examined the ways in which this type of studies have been carried out and reported. AIM: To examine the methodological features and reporting practices found in mixed methods intervention studies in children and adolescents with emotional and behavioral disorders. METHOD: Methodological review based on a systematic search from inception to July 2021 in Embase, Medline, PsycINFO, and SCOPUS, and a hand search in seven journals. RESULTS: We found 30 studies, most of them published since 2019. These studies reported several patterns of mixed methods use which illustrated the unique insights that researchers can gain by using this approach. We identified several ways that authors could more clearly report the justification for using a mixed methods approach, the description of the design used, and the evidence of integration of the quantitative and qualitative components. CONCLUSION: We make recommendations for improving the reporting quality of mixed methods intervention studies in the field of emotional and behavioral disorders.

Providing English and native language quotes in qualitative research: A call to action.

BACKGROUND: When publishing qualitative research in international journals, researchers studying non-English-speaking participants provide quotes in English language. This is an issue of increasing concern given the need to be rigorous to represent a diversity of participants within their context, beyond how language (alone) situates them. AIM: To argue for providing English and native language quotes in qualitative research reports. DESIGN: Discussion. METHODS: This paper is based on the literature on use of quotes and translation in qualitative research and authors' experiences of publishing qualitative research. RESULTS: Provision of native and English language quotes may allow for greater transparency of findings, thereby reflecting that the researchers adequately captured the socially and culturally dependent experiences of participants. CONCLUSIONS: Presentation of findings with eloquent quotes serves as the gateway into the sociocultural experiences of individuals. We argued against the norm of providing translated quotes in qualitative reports and build a case for the provision of native as well as English language quotes to promote cross-cultural understanding.

Use of mixed methods research in intervention studies to increase young people's interest in STEM: A systematic methodological review.

Introduction: Mixed methods research intervention studies integrate quantitative evaluation approaches, such as randomized controlled trials and quasi-experimental designs, with qualitative research to evaluate the effectiveness, efficacy, or other results of an intervention or program. These types of studies, which have attracted growing attention in recent years, enhance the scope and rigor of the evaluation. While various frameworks that summarize the justifications for carrying out these types of studies and provide implementation guidance have been published in the last few years in the health sciences, we do not know whether such frameworks have been properly implemented in the social and educational sciences. This review examined the methodological features and reporting practices of mixed methods intervention studies aimed at increasing young people's interest in STEM. Methods: A systematic search was carried out in APA PsycNET, ERIC, ProQuest, Scopus, and Web of Science, and a hand search in 20 journals. We included peer-reviewed English-language articles that reported intervention studies with a quantitative component measuring outcomes specific to increasing secondary school students' interest in STEM fields, a qualitative component conducted before, during, or after the quantitative component, and evidence of integration of both components. Qualitative content analysis and ideal-type analysis were used to synthesize the findings. Results: We found 34 studies; the majority published in the last ten years. Several patterns of mixed methods application were described in these studies, illustrating the unique insights that can be gained by employing this methodology. The reporting quality of the included studies was generally adequate, especially regarding the justification for using a mixed methods intervention design and the integration of the quantitative and qualitative components. Nonetheless, a few reporting issues were observed, such as a lack of detail in the presentation of the mixed methods design, an inadequate description of the qualitative sampling and analysis techniques, and the absence of joint displays for representing integration. Discussion: Authors must pay attention to these issues to ensure that the insights obtained by the use of mixed methods research are effectively communicated.

Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa.

Eat Better South Africa (EBSA) is an organization that provides low-carbohydrate, high-fat (LCHF) nutrition and health education programs for women from under-resourced South African communities. Community assessments are essential to explore participants' potential facilitators and challenges of adhering to new dietary behaviours and should be implemented before any dietary interventions. This study is a qualitative community assessment to enable the EBSA program to better meet potential participants' needs and explore their willingness to enrol in the EBSA program. Sixty women from two communities in the Western Cape were interviewed through six focus group discussions. A thematic analysis was conducted using NVivo 12 software, and four themes were developed around the women's (1) role within the households; (2) dietary behaviour; (3) health perceptions; and (4) willingness to participate in an LCHF program. Women mentioned that they were responsible for cooking and shopping for their households. They expressed their understanding of healthy and unhealthy behaviours and their dietary patterns. Some women showed concerns about LCHF diets, but others wanted to learn more due to their knowledge of other people's positive experiences with the diet. There was a general desire to become healthy. However, the women anticipated dietary behaviour change to be challenging. Those challenges mostly revolved around their socioeconomic environments. The findings are intended to inform EBSA (or other nutrition interventions) on what to consider when implementing their interventions in these communities.

Taking a critical stance towards mixed methods research: A cross-disciplinary qualitative secondary analysis of researchers' views.

Recent growth and institutionalization in the field of mixed methods research has provided fertile ground for a wide range of thoughtful criticism of how this research approach has been developed and conceptualized by some members of the mixed methods community. This criticism reflects the increasing maturity of the field as well as the different theoretical perspectives and methodological practices of researchers in different disciplines. While debates addressing these criticisms are likely to lead to valuable insights, no empirical studies have been carried out to date that have investigated researchers' critical views on the development and conceptualization of mixed methods research. This study examines the criticisms of the mixed methods field raised by a cross-national sample of researchers in education, nursing, psychology, and sociology. We carried out a secondary analysis of semi-structured interviews with 42 researchers and identified 11 different criticisms, which we classified in four domains: essence of mixed methods, philosophy, procedures, and politics. The criticisms related to the procedures domain were equally distributed among the four disciplines, while those related to the essence, philosophy and politics domains were more common among sociologists. Based on our findings, we argue that the divergence of views on foundational issues in this field reflects researchers' affiliation to different communities of practice, each having its own principles, values, and interests. We suggest that a greater awareness of this divergence of perspectives could help researchers establish effective collaboration and anticipate potential challenges when working with researchers having different methodological approaches.

Family Meals, Conviviality, and the Mediterranean Diet among Families with Adolescents.

Two aspects that characterize the Mediterranean diet (MD) are "what" and "how" we eat. Conviviality relates to "how" we eat and to the pleasure of sharing meals with significant people. The most studied concept is "family meals", which includes conviviality, which involves "enjoying" family meals. Given the lack of research on convivial family meals in Mediterranean countries, the purpose of this qualitative study was to analyze the family meal representations and practices of families with 12- to 16-year-old adolescents to assess whether they responded to a pattern of conviviality, and to examine their association with MD adherence. Twelve semi-structured interviews were conducted and food frequency and family meal questionnaires were administered. A food pattern analysis was carried out and digital photos of meals were analyzed to examine eating habits and meal composition, respectively. The findings showed that parents believed family meals are a space for socialization and communication. Items relating to the conviviality of family meals identified in the study were meal frequency, meals at the table, lack of digital distractions, pleasant conversations, and time spent on family meals. Attention should be paid to conviviality in Mediterranean families when designing multi-approach strategies to promote healthy eating among adolescents.

Exploring the gender gap in the Spanish Wikipedia: Differences in engagement and editing practices.

Wikipedia's significant gender bias is widely acknowledged. In this paper we analyze the Spanish Wikipedia with the aim of estimating the percentage of women editors and measuring their engagement and editing practices with respect to their men counterparts. To identify the gender of Wikipedia registered users, we analyzed both the information contained in their user profile and the information provided by users about themselves on their personal user pages. Using our own coding procedure, it is possible to identify a greater number of women than by relying only on the gender reported in their user profile. Combining both methods, our results show that the percentage of women is small, a meagre 11.6% of all analyzed editors, though there is still a significant percentage of users whose gender cannot be determined by either method. Men outnumber women in all Wikipedia namespaces in a ratio that is always equal to or greater than 3:1. This fact can be partially explained by the lesser persistence of women editors, who tend to leave Wikipedia much more quickly. There is, however, a small group of veteran women editors who, in some cases, surpass men editors in terms of their editing practices and participation in different Wikipedia namespaces.

Using the Very Short Form of the Children's Behavior Questionnaire for Spanish-Speaking Populations in Low- and Middle-Income Countries: A Psychometric Analysis of Dichotomized Variables.

While the psychometric properties of the Spanish version of the Very Short Form of the Children's Behavior Questionnaire (CBQ-VSF) have been assessed in the US and Europe in samples composed of middle- and high-income parents with high levels of education, no studies have tested the instrument in low-income Spanish-speaking populations living in low- and middle-income countries. To fill this gap, our cross-sectional study assessed the psychometric properties of the Spanish version of the CBQ-VSF version in a sample of 315 low-income and low-educated parents with preschool children living in the Caribbean Region of Colombia. While our findings revealed problems that were similar to those identified in previous assessments of the CBQ-VSF Spanish version, they also showed unique problems related to the sociodemographic characteristics of our sample, containing many individuals with a low income and low educational level. Most of the participants gave extreme responses, resulting in a notable kurtosis and skewness of the data. This article describes how we addressed these problems by dichotomizing the variables into binary categories. Additionally, it demonstrates that merely translating the CBQ-VSF is insufficient to be able to capture many of the underlying latent constructs associated with low-income and low-educated Latino/Hispanic populations.

Male-On-Male Child and Adolescent Sexual Abuse in the Caribbean Region of Colombia: A Secondary Analysis of Medico-Legal Reports.

Child and adolescent sexual abuse (CSA) is an important global health problem, especially in non-Western low- and middle-income countries. A number of studies have indicated that, in Latin American countries, male CSA is phenomenon of great concern. However, research on this topic is seriously lacking, and more specifically, on male-on-male CSA. We carried out a qualitative and quantitative secondary analysis of 680 cases of alleged male-on-male CSA that occurred between the years 2017 and 2018 in the Caribbean Region of Colombia. We analyzed the contents of forensic interviews with the alleged victims, conducted by professionals working at the Colombian Institute of Legal Medicine and Forensic Sciences. Our findings indicated a high prevalence of cases of alleged male-on-male CSA among young minors. Most of these cases were allegedly perpetrated by offenders known to the victim and involved high levels of violence. Evidence-based and culturally grounded preventative actions, such as training-based programs for teachers and parents among other public health initiatives are needed to address this type of CSA. Further research is also required to gain a more fine-grained understanding of the cultural and social context of CSA in the Caribbean Latin American countries.

Parent and Teacher Depictions of Gender Gaps in Secondary Student Appraisals of Their Academic Competences.

The present study examines a group of secondary teachers' and parents' appraisals of gender gaps in secondary students' self-assessment of competence in Science, Technology, Engineering, and Mathematics (STEM) and non-STEM domains. Eight focus groups with 39 parents and 34 secondary teachers were conducted for this purpose. In light of the observed gender gaps in students' performance and self-perception of ability in the different subject areas, the participants were particularly surprised by girls' underestimation of their abilities in STEM subjects, compared with boys' tendency to overestimate their abilities in STEM. Most participants agreed on the need for measures to combat these inaccuracies and discussed possible causes. Some participants associated these gender disparities in students' self-assessment of ability with gender gaps in their choices of subject areas and occupations. The role played by school, teachers, families, and other socialization agents in reinforcing gender stereotypes about academic competence was also discussed in most of the focus groups. Interestingly, some teachers questioned why gender attainments obtained in schools do not serve as an example when it comes to neutralizing the sexism and gender inequality messages offered by the media and society. Likewise, technology teachers proposed changes in school practices to close gender gaps in certain areas (i.e., boys' appropriation of the playground, or the reproduction of gender roles in the classroom). Few parents acknowledged their unconscious reproduction of gender roles and stereotypes in raising their children.

A Methodological Review of Mixed Methods Research in Palliative and End-of-Life Care (2014-2019).

Mixed methods research has been increasingly recognized as a useful approach for describing and explaining complex issues in palliative care and end-of-life research. However, little is known about the use of this methodology in the field and the ways in which mixed methods studies have been reported. The purpose of this methodological review was to examine the characteristics, methodological features and reporting quality of mixed methods articles published in palliative care research. The authors screened all articles published in eight journals specialized in palliative care between January 2014 and April 2019. Those that reported a mixed methods study (n = 159) were included. The Good Reporting of a Mixed Methods Study (GRAMMS) criteria were used to assess reporting quality. Findings showed that 57.9% of the identified studies used a convergent design and 82.4% mentioned complementarity as their main purpose for using a mixed methods approach. The reporting quality of the articles generally showed a need for improvement as authors usually did not describe the type of mixed methods design used and provided little detail on the integration of quantitative and qualitative methods. Based on the findings, recommendations are made to improve the quality of reporting of mixed methods articles in palliative care.