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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., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

South Africa faces a dual burden of non-communicable diseases (NCDs) and communicable diseases, exacerbated by the high consumption of processed foods. The Eat Better South Africa (EBSA) program implements community-based low-carbohydrate, high-fat (LCHF) interventions to address these issues. This study evaluated the impact of EBSA's 6-week program on the metabolic health and well-being of 32 women from underserved communities. It assessed outcomes before, immediately after, and six months post-intervention (n = 21). Quantitative findings showed significant improvements in key health markers. After six months, participants experienced an average weight loss of 5.6 kg (+- 5.5), a BMI reduction of 2 kg/m 2 , and a waist circumference decrease of 6.6 cm. Blood pressure dropped by 10.7 mmHg on average, and fasting glucose levels decreased significantly. Reductions were also observed in triglycerides and HbA1c, indicating better glycemic control. Liver function markers (GGT, ALT) and inflammation markers (CRP) improved as well. Qualitative analysis highlighted several key themes: participants were motivated by a desire to improve their health and lose weight but faced challenges such as social pressures, community violence, and scepticism about the diet's affordability and sustainability. Despite these barriers, positive experiences like increased energy and better hunger control were reported. Participants expressed the need for ongoing support to maintain these changes, both from the program and from their community. These findings suggest that LCHF diets can effectively manage metabolic conditions, but long-term adherence is challenged by socio-economic factors. The study highlights the importance of community-based interventions and highlights the need for further research to develop sustainable health strategies in low-income settings., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

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., (© 2024 Sigma Theta Tau International.)

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., (© The Author(s) 2023.)

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., (© 2022 The Authors. American Journal of Community Psychology published by Wiley Periodicals LLC on behalf of Society for Community Research and Action.)

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.

Competing Interests: Competing interests: None declared.

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., (© 2022. The Author(s).)

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., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

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., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

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., Competing Interests: The authors have declared that no competing interests exist.

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.

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., Competing Interests: The authors have declared that no competing interests exist.

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.

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.

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., (Copyright © 2020 Sáinz, Fàbregues and Solé.)

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.

Scientific evidence suggests that low-carbohydrate high-fat (LCHF) diets may be effective for managing non-communicable diseases (NCDs). Eat Better South Africa (EBSA) is an organization that runs LCHF nutrition education programs for women from low-income communities. Three focus group discussions (FGDs) were held with 18 women who had taken part in an EBSA program between 2015 and 2017, to explore their perceptions and to identify the facilitators and barriers they faced in implementing and sustaining dietary changes. Thematic analysis of the focus groups was conducted using NVivo 12 software. Women reported that they decided to enroll in the program because they suffered from NCDs. Most women said that the EBSA diet made them feel less hungry, more energetic and they felt that their health had improved. Most women spoke of socioeconomic challenges which made it difficult for them to follow EBSA's recommendations, such as employment status, safety issues in the community, and lack of support from relatives and doctors. Hence, women felt they needed more support from EBSA after the program. The social determinants that affected these women's ability to change their health behavior are also NCD risk factors, and these should be assessed to improve the program for other communities., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Objective: The mixed methods appraisal tool (MMAT) was developed for critically appraising different study designs. This study aimed to improve the content validity of three of the five categories of studies in the MMAT by identifying relevant methodological criteria for appraising the quality of qualitative, survey, and mixed methods studies., Study Design and Setting: First, we performed a literature review to identify critical appraisal tools and extract methodological criteria. Second, we conducted a two-round modified e-Delphi technique. We asked three method-specific panels of experts to rate the relevance of each criterion on a five-point Likert scale., Results: A total of 383 criteria were extracted from 18 critical appraisal tools and a literature review on the quality of mixed methods studies, and 60 were retained. In the first and second rounds of the e-Delphi, 73 and 56 experts participated, respectively. Consensus was reached for six qualitative criteria, eight survey criteria, and seven mixed methods criteria. These results led to modifications of eight of the 11 MMAT (version 2011) criteria. Specifically, we reformulated two criteria, replaced four, and removed two. Moreover, we added six new criteria., Conclusion: Results of this study led to improve the content validity of this tool, revise it, and propose a new version (MMAT version 2018)., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Sensor-based data are becoming increasingly widespread in social, behavioral, and organizational sciences. Far from providing a neutral window on "reality," sensor-based big-data are highly complex, constructed data sources. Nevertheless, a more systematic approach to the validation of sensors as a method of data collection is lacking, as their use and conceptualization have been spread out across different strands of social-, behavioral-, and computer science literature. Further debunking the myth of raw data, the present article argues that, in order to validate sensor-based data, researchers need to take into account the mutual interdependence between types of sensors available on the market, the conceptual (construct) choices made in the research process, and the contextual cues. Sensor-based data in research are usually combined with additional quantitative and qualitative data sources. However, the incompatibility between the highly granular nature of sensor data and the static, a-temporal character of traditional quantitative and qualitative data has not been sufficiently emphasized as a key limiting factor of sensor-based research. It is likely that the failure to consider the basic quality criteria of social science measurement indicators more explicitly may lead to the production of insignificant results, despite the availability of high volume and high-resolution data. The paper concludes with recommendations for designing and conducting mixed methods studies using sensors.

The present qualitative study analyzes how a group of young people already involved in STEM fields perceive the prototypical person working in STEM. Gender differences between participants in technological and non-technological STEM fields were analyzed. A total of 27 young people (59.3% women) took part in the interviews (Mean Age = 25.48 years). Of them, 16 participants were working in STEM professions, and 11 were enrolled in the final courses of STEM degrees. The results of the content analysis were examined in light of social role theory and the multidimensional structure of gender stereotypes. Men in these fields were therefore attributed an unappealing and weird physical appearance. Some female participants linked STEM professionals' intellectual abilities to the stereotype that men have higher abilities in these fields. Whereas females attributed effort and perseverance to STEM professionals' intellectual aptitudes, males referred to the development of soft skills. Participants in technological STEM fields connected the stereotype of being a 'weirdo' to a boring job, whereas those in non-technological fields linked it to their unconventional character. Some participants were disappointed by a lack of correspondence between expectations and the actual job STEM professionals do. Moreover, females in technological STEM fields commented on the job's low social impact, while males mentioned low attainment of technical qualifications. Most referents in STEM fields were masculine, some of whom were present in the mass media. The practical implications of the findings are discussed.

The aim of this article is to introduce family medicine researchers to case study research, a rigorous research methodology commonly used in the social and health sciences and only distantly related to clinical case reports. The article begins with an overview of case study in the social and health sciences, including its definition, potential applications, historical background and core features. This is followed by a 10-step description of the process of conducting a case study project illustrated using a case study conducted about a teaching programme executed to teach international family medicine resident learners sensitive examination skills. Steps for conducting a case study include (1) conducting a literature review; (2) formulating the research questions; (3) ensuring that a case study is appropriate; (4) determining the type of case study design; (5) defining boundaries of the case(s) and selecting the case(s); (6) preparing for data collection; (7) collecting and organising the data; (8) analysing the data; (9) writing the case study report; and (10) appraising the quality. Case study research is a highly flexible and powerful research tool available to family medicine researchers for a variety of applications., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

While a growing number of works have been published about the use of mixed methods research in nursing, scarce attention has been devoted to the issue of the quality of mixed methods within the discipline. The quality appraisal of mixed methods research poses two problems to nursing science: first, current quality criteria are not nursing-specific and consequently, they might not facilitate the application of mixed methods research findings into nursing practice. Second, criteria were theoretically derived and as such, they might not faithfully account for the decisions that nurse researchers take when appraising mixed methods research studies. This qualitative, within-case study explored the views of nurse researchers about mixed methods research in general and, more specifically, the question of quality in mixed methods research. An international sample of 13 nurse researchers was interviewed via Skype and phone. Thematic analysis revealed that the participants favored universal, cross-disciplinary quality criteria, and not criteria specific to the nursing discipline, and a consensual and standardized approach to appraising the quality of mixed methods research. Recommendations are put forward to strengthen the quality appraisal of mixed methods research studies by nurse researchers, as well as future works on this topic within nursing science., (© 2018 John Wiley & Sons Ltd.)