In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The second article focused on context, research questions and designs, and referred to publications for further reading. This third article addresses FAQs about sampling, data collection and analysis. The data collection plan needs to be broadly defined and open at first, and become flexible during data collection. Sampling strategies should be chosen in such a way that they yield rich information and are consistent with the methodological approach used. Data saturation determines sample size and will be different for each study. The most commonly used data collection methods are participant observation, face-to-face in-depth interviews and focus group discussions. Analyses in ethnographic, phenomenological, grounded theory, and content analysis studies yield different narrative findings: a detailed description of a culture, the essence of the lived experience, a theory, and a descriptive summary, respectively. The fourth and final article will focus on trustworthiness and publishing qualitative research.
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Background: A paradigm shift in health care from illness to wellbeing requires new assessment technologies and intervention strategies. Self-monitoring tools based on the Experience Sampling Method (ESM) might provide a solution. They enable patients to monitor both vulnerability and resilience in daily life. Although ESM solutions are extensively used in research, a translation from science into daily clinical practice is needed. Objective: To investigate the redesign process of an existing platform for ESM data collection for detailed functional analysis and disease management used by psychological assistants to the general practitioner (PAGPs) in family medicine. Methods: The experience-sampling platform was reconceptualized according to the design thinking framework in three phases. PAGPs were closely involved in co-creation sessions. In the ‘understand’ phase, knowledge about end-users’ characteristics and current eHealth use was collected (nominal group technique – 2 sessions with N = 15). In the ‘explore’ phase, the key needs concerning the platform content and functionalities were evaluated and prioritized (empathy mapping – 1 session with N = 5, moderated user testing – 1 session with N = 4). In the ‘materialize’ phase, the adjusted version of the platform was tested in daily clinical practice (4 months with N = 4). The whole process was extensively logged, analyzed using content analysis, and discussed with an interprofessional project group. Results: In the ‘understand’ phase, PAGPs emphasized the variability in symptoms reported by patients. Therefore, moment-to-moment assessment of mood and behavior in a daily life context could be valuable. In the ‘explore’ phase, (motivational) functionalities, technological performance and instructions turned out to be important user requirements and could be improved. In the ‘materialize’ phase, PAGPs encountered barriers to implement the experience-sampling platform. They were insufficiently facilitated by the regional primary care group and general practitioners. Conclusion: The redesign process in co-creation yielded meaningful insights into the needs, desires and daily routines in family medicine. Severe barriers were encountered related to the use and uptake of the experience-sampling platform in settings where health care professionals lack the time, knowledge and skills. Future research should focus on the applicability of this platform in family medicine and incorporate patient experiences.
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Residential burglaries often go unsolved, as collected DNA traces and fingermarks frequently originate from residents rather than the offender. It is therefore important to know how to target sampling locations that specifically relate to the burglary event. However, data that aid in assessing the likelihood of a burglar touching certain surfaces, and, consequently leaving trace evidence, is unavailable. Instead, forensic examiners rely primarily on their personal experience and expertise to determine where burglary-related traces are most likely to be found.The current study aims to identify specific areas that are contacted during different types of interactions with points of entry. An experiment was conducted at a Dutch music festival, where participants simulated both a legitimate and burglary scenario. Using paint, the points of contact between the participants’ hands and the experimental set-up were recorded. The contact locations of all participants were combined using heatmaps to reveal the patterns of contact. We found that different burglary methods lead to distinct contact patterns, indicating specific areas where traces are most likely to be deposited. Our findings can support forensic examiners in making evidence-based decisions during search strategies in burglary investigations.
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World globalisation drives companies to undertake international expansion with the aim of retaining or growing their businesses. When companies globalize, managers encounter new challenges in making international marketing strategy (IMS) decisions, which are influenced by perceived cultural and business distance between their home- and foreign country. Telkom Indonesia International (Telin) was formed by Telkom Indonesia (i.e. the state-owned company in the telecommunication industry in Indonesia) to engage in international business within a global market. The central question in this study is to what extent do managers’ perceived cultural and business distance between home- and foreign country influence their IMS decisions? A mixed research strategy will be employed by applying qualitative and quantitative methods concurrently. The data collection will involve interviews with CEOs and managers, alongside a web survey to 55 managers of Telkom's. Results suggest important consequences for IMS decisions and emphasizes the need for dialogue on perceptions of cultural and business characteristics of countries.
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Background The gait modification strategies Trunk Lean and Medial Thrust have been shown to reduce the external knee adduction moment (EKAM) in patients with knee osteoarthritis which could contribute to reduced progression of the disease. Which strategy is most optimal differs between individuals, but the underlying mechanism that causes this remains unknown. Research question Which gait parameters determine the optimal gait modification strategy for individual patients with knee osteoarthritis? Methods Forty-seven participants with symptomatic medial knee osteoarthritis underwent 3-dimensional motion analysis during comfortable gait and with two gait modification strategies: Medial Thrust and Trunk Lean. Kinematic and kinetic variables were calculated. Participants were then categorized into one of the two subgroups, based on the modification strategy that reduced the EKAM the most for them. Multiple logistic regression analysis with backward elimination was used to investigate the predictive nature of dynamic parameters obtained during comfortable walking on the optimal modification gait strategy. Results For 68.1 % of the participants, Trunk Lean was the optimal strategy in reducing the EKAM. Baseline characteristics, kinematics and kinetics did not differ significantly between subgroups during comfortable walking. Changes to frontal trunk and tibia angles correlated significantly with EKAM reduction during the Trunk Lean and Medial Thrust strategies, respectively. Regression analysis showed that MT is likely optimal when the frontal tibia angle range of motion and peak knee flexion angle in early stance during comfortable walking are high (R2Nagelkerke = 0.12). Significance Our regression model based solely on kinematic parameters from comfortable walking contained characteristics of the frontal tibia angle and knee flexion angle. As the model explains only 12.3 % of variance, clinical application does not seem feasible. Direct assessment of kinetics seems to be the most optimal strategy for selecting the most optimal gait modification strategy for individual patients with knee osteoarthritis.
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Purpose: Employer branding (EB) has become a powerful tool for organizations to attract employees. Recruitment communication ideally reveals the image that companies want to portray to potential employees to attract talents with the right skills and competences for the organization. This study explores the impact of EB on employer attractiveness by testing how pre-existing employee preferences interact with EB and how this interaction affects employer attractiveness. Design/methodology/approach: A quasi-experiment among 289 final-year students was used to test the relationships between EB, perceived employer image, person-organization (P-O) fit and employer attractiveness, and the potential moderating variables of pre-existing preferences, in this case operationalized as locational preferences. Students are randomly assigned to four vacancies: one with and one without EB cues in two different locations: Groningen and Amsterdam. The authors used standard scales for attractiveness, perceptions of an employer and person-organization fit. The authors test the relationships using a regression analysis. Findings: Results suggest that if respondents have previous predispositions, then their preference can be enhanced using an EB-targeted strategy. Based on these results, the authors can conclude that EB and related practices can be successful avenues for organizations in the war for talent, particularly if they reaffirm previous preferences of potential employees. Originality/value: The research is original in the way it provides empirical evidence on the relationship between EB and attractiveness, particularly when previous employee preferences exist. This is of value to employers using EB as a tool to influence employer attractiveness.
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In this article, we describe a study on the impact of an ethics program aimed at strengthening the ethical agency of 15 social workers of three welfare organizations. The goal of the study was to make an inventory of the impact of the program, and to evaluate the relevance of this impact with the help of several stakeholders. The most significant change (MSC) approach was used as a research strategy, though some changes to the approach were made with a view to our research goal. We explain the MSC approach and how we used it in our study design. Further, we describe the research process, answering the question whether our adaptation of the MSC was helpful to inventory the impact of our ethics program and the evaluation of its relevance. The implications of MSC's focus on "most significant" changes and the need for a thorough feedback of the results of the evaluation process in the participating organizations are discussed.
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Twitter timelines are increasingly populated with brand tweets that are linked to public events, a practice that is also known as real-time marketing (RTM). In two studies, we examine whether RTM is an effective strategy to boost sharing behavior, and if so, what event- and content-related characteristics are likely to contribute to its effectiveness. A content analysis of brand tweets from Nielsen’s top-100 advertisers (n=1500) shows that not all events are equally effective. RTM is only a more effective strategy (vs. no real-time marketing), when brand messages are linked with unpredictable events but not when brand messages are linked with predictable events. In a follow-up study, we examined what content characteristics improve the shareability of predictable RTM messages. A content analysis of RTM messages (n=143) from the Forbes top-100 brands showed that predictable events yield more retweets when the event is visually integrated in the brand tweet (vs. not visually integrated). The presence of event-driven hashtags did not lead to more retweets. Implications for theory and practice are discussed.
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Patients with coronary artery disease (CAD) are more sedentary compared with the general population, but contemporary cardiac rehabilitation (CR) programmes do not specifically target sedentary behaviour (SB). We developed a 12-week, hybrid (centre-based+home-based) Sedentary behaviour IntervenTion as a personaLisEd Secondary prevention Strategy (SIT LESS). The SIT LESS programme is tailored to the needs of patients with CAD, using evidence-based behavioural change methods and an activity tracker connected to an online dashboard to enable self-monitoring and remote coaching. Following the intervention mapping principles, we first identified determinants of SB from literature to adapt theory-based methods and practical applications to target SB and then evaluated the intervention in advisory board meetings with patients and nurse specialists. This resulted in four core components of SIT LESS: (1) patient education, (2) goal setting, (3) motivational interviewing with coping planning, and (4) (tele)monitoring using a pocket-worn activity tracker connected to a smartphone application and providing vibrotactile feedback after prolonged sedentary bouts. We hypothesise that adding SIT LESS to contemporary CR will reduce SB in patients with CAD to a greater extent compared with usual care. Therefore, 212 patients with CAD will be recruited from two Dutch hospitals and randomised to CR (control) or CR+SIT LESS (intervention). Patients will be assessed prior to, immediately after and 3 months after CR. The primary comparison relates to the pre-CR versus post-CR difference in SB (objectively assessed in min/day) between the control and intervention groups. Secondary outcomes include between-group differences in SB characteristics (eg, number of sedentary bouts); change in SB 3 months after CR; changes in light-intensity and moderate-to-vigorous-intensity physical activity; quality of life; and patients’ competencies for self-management. Outcomes of the SIT LESS randomised clinical trial will provide novel insight into the effectiveness of a structured, hybrid and personalised behaviour change intervention to attenuate SB in patients with CAD participating in CR.
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This article proposes a strategy for Switzerland to change the goal from HIV control to HIV elimination. In Switzerland, HIV treatment is well organized and available for all with good access. An important challenge that obstructs prevention is the new infections originating from people who are unaware of their status. Since the majority of new infections in Switzerland are within the group of men who have sex with men (MSM), this strategy targets MSM who do not know their HIV status and engage in risky sexual behavior.
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