Healthcare providers balancing norms and practice : challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study

BACKGROUND: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. OBJECTIVE: This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. DESIGN: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. RESULTS: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. CONCLUSIONS: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

"Beyond number crunching" : applying qualitative techniques in sport marketing research

Valid and reliable research is pivotal to successful sport marketing strategy. Market research may be gathered via either quantitative or qualitative means. This paper explores the theoretical background and practical applications of qualitative research techniques. It explains the appropriate context for qualitative approaches, and discusses sampling procedures with particular emphasis on the powerful but simple technique known as theoretical sampling. In addition, it clarifies and explores data analysis procedures. The purpose of this paper is to provide sport market research practitioners with a model for implementing qualitative methodologies in sport marketing campaigns.

Recovery after stroke : a qualitative perspective

The purpose of this study was to determine the impact of stroke on survivors of the condition and to identify their physical and psychosocial needs in rural and regional settings. Data were collected via focus group interviews with stroke survivors, carers and key informants. Data were managed using NUD*IST and analysed using a content analysis method identifying major themes related to the impact of living in the community after having a stroke. It was found that stroke survivors suffered severe physical and emotional effects. The findings also identified the vulnerability of this group and a lack of organised, on-going psychosocial and rehabilitative support. Recommendations are made to enhance the current management of stroke after the acute and subacute phases.

Recruiting in public places : A strategy to increase diversity in qualitative research samples

For some research projects, recruiting in public places is an invaluable addition to sampling strategies. It complements the more traditional recruitment strategies by providing researchers with' opportunities to include people in the research who would otherwise be excluded. One of the limitations of selective and snowball sampling is that participants often come from the same social group. Participants from these social groups often share similar experiences and ways of thinking about those experiences. The aim of recruiting in public places is to move beyond this 'in group' to ensure a wider perspective. This paper illustrates how recruiting in public places can provide greater sample diversity for theoretical strength. The paper begins with a brief overview of recruiting in public places. It then describes the theoretical considerations associated with this recruiting strategy. The paper demonstrates how recruiting in public places facilitates grounded theory by providing comparisons that are informed by diverse experiences. Using examples and a case study, we illustrate how recruiting in public places can complement selective, snowball and theoretical sampling to ensure a more comprehensive sample.

Fattening foods - perceptions and misconceptions: a qualitative and quantitative exploration

Describes adults' perceptions and beliefs about foods that are considered "fattening". Use of qualitative and quantitative methods to determine the prevalence of the perceptions among adults; Range of factors that are considered when judging foods as "fattening"; Limitations in the public's understandings of "fattening foods" which are inconsistent with dietary recommendations.

Police perceptions of interviews involving children with intellectual disabilities: a qualitative inquiry

This study employed a qualitative method to explore the experiences of 20 police officers when interviewing children with intellectual disabilities. Three main themes were interpreted as representing challenges to the officers when interviewing special-needs children: police organizational culture, participants' perceptions of these children as interviewees, and prior information. Participants in this inquiry mentioned poor organizational priority within the police force for child abuse cases and children with intellectual disabilities, as well as inadequate support for interviewing skills development and maintenance. Participants also attempted to equalize these children by interviewing them in the same way as their mainstream peers. Finally, participants viewed interview preparation as influential in determining an interview's successful outcome, but recognized that preparedness could bias their interviewing techniques. Increased attention towards these issues will provide a basis for developing strategies to minimize such challenges and thus improve the quality of interviews with children with intellectual disabilities.

Why do women of low socioeconomic status have poorer dietary behaviours than women of higher socioeconomic status? A qualitative exploration

In developed countries, persons of low socioeconomic status (SES) are generally less likely to consume diets consistent with dietary guidelines. Little is known about the mechanisms that underlie SES differences in eating behaviours. Since women are often responsible for dietary choices within households, this qualitative study investigated factors that may contribute to socioeconomic inequalities in dietary behaviour among women. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low- SES women, recruited from Melbourne, Australia, using an area-level indicator of SES. An ecological framework, in which individual, social and environmental level influences on diet were considered, was used to guide the development of interview questions and interpretation of the data. Thematic analysis was undertaken to identify the main themes emerging from the data. Several key influences varied by SES. These included food-related values such as health consciousness, and a lack of time due to family commitments (more salient among higher SES women), as well as perceived high cost of healthy eating and lack of time due to work commitments (more important for low SES women). Reported availability of and access to good quality healthy foods did not differ strikingly across SES groups. Public health strategies aimed at reducing SES inequalities in diet might focus on promoting healthy diets that are low cost, as well as promoting time-efficient food preparation strategies for all women.

Children's perceptions of their home and neighborhood environments, and their association with objectively measured physical activity: A qualitative and quantitative study

Environmental factors may have an important influence on children’s physical activity, yet children’s perspectives of their home and neighborhood environments have not been widely assessed. The aim of this study was to investigate children’s perceptions of their environments, and to examine associations between these perceptions and objectively measured physical activity. The sample consisted of 147, 10-year-old Australian children, who drew maps of their home and neighborhood environments. A subsample of children photographed places and things in these environments that were important to them. The maps were analyzed for themes, and for the frequency with which particular objects and locations appeared. Physical activity was objectively measured using accelerometers. Six themes emerged from the qualitative analysis of the maps and photographs: the family home; opportunities for physical activity and sedentary pursuits; food items and locations; green space and outside areas; the school and opportunities for social interaction. Of the 11 variables established from these themes, one home and two neighborhood factors were associated with children’s physical activity. These findings contribute to a broader understanding of children’s perceptions of their environment, and highlight the potential importance of the home and neighborhood environments for promoting physical activity behavior.

Understanding parental motivators and barriers to uptake of child poison safety strategies: a qualitative study

Objectives: To develop an understanding of factors acting as barriers and motivators to parental uptake of child poison safety strategies.

Design: A qualitative study involving semistructured interviews and focus groups. A grounded theory approach was used for the collection and analysis of data.

Participants: Sixty five parents of children under 5 years of age, some of whom had experienced an unintentional child poisoning incident.

Results: A range of knowledge based, environmental, and behavioral barriers to comprehensive parental uptake of poison safety practices were identified. As a result there tended to be only partial implementation of safety initiatives in the home. Selection of safety practices was often guided by the interests and behaviors of the child. This made the child vulnerable to changes in the home environment, inadequate supervision, and/or shifts in their own behavior and developmental ability. Personal or vicarious exposure of a parent to a child poisoning incident was a significant motivator for parental review of safety practices.

Conclusion: Environmental measures targeting child resistant containers, warning labels, and lockable poisons cupboards will support parents’ efforts to maintain poison safety. Additional education campaigns using stories of actual poisoning incidents may help to increase awareness of risk and encourage increased uptake.

Beliefs about genetically modified foods : a qualitative and quantitative exploration

This study is aimed to examine consumers' beliefs about genetically modified foods. Ten focus group interviews of community members and a random questionnaire-based mail survey of 500 Australian (Victorian) adults were conducted (58% response). Participants were generally negative about genetically modified foods, with concerns being raised about them being unnatural, difficult to identify, and having unknown long-term health and environmental effects. Many participants were unaware of or disagreed with the benefits of genetically modified foods that are promoted by its advocates and there were some misconceptions present. These findings provide information for both advocates and opponents of genetically modified foods and a basis for future larger-scale research.

Australian adult consumers' beliefs about plant foods: a qualitative study

This exploratory qualitative study examined consumers’ perceived barriers and benefits of plant food (fruits, vegetables, grains, legumes, nuts, seeds) consumption and views on the promotion of these foods. Ten focus groups were conducted in Melbourne, Australia. Groups consisted of employees of various workplaces, community group members, university students, and inner-city residents. Health-related benefits predominated, particularly relating to the properties of plant foods (e.g., vitamins). Taste, variety, versatility, and environmental benefits were also considered important. The main barriers to eating plant foods were lack of knowledge and skills and length of preparation time. The poor quality of plant foods was also an issue for consumers. Awareness of the promotion of plant foods was generally high. Participants noted that promotions require a stronger practical emphasis with a focus on quick, easy-to-prepare foods and meals. These findings provide insight into effective ways to promote a higher consumption of plant foods

Towards Qualitative Approaches to Bayesian Evidential Reasoning

A crucial aspect of evidential reasoning in crime investigation involves comparing the support that evidence provides for alternative hypotheses. Recent work in forensic statistics has shown how Bayesian Networks (BNs) can be employed for this purpose. However, the specification of BNs requires conditional probability tables describing the uncertain processes under evaluation. When these processes are poorly understood, it is necessary to rely on subjective probabilities provided by experts. Accurate probabilities of this type are normally hard to acquire from experts. Recent work in qualitative reasoning has developed methods to perform probabilistic reasoning using coarser representations. However, the latter types of approaches are too imprecise to compare the likelihood of alternative hypotheses. This paper examines this shortcoming of the qualitative approaches when applied to the aforementioned problem, and identifies and integrates techniques to refine them.

On Qualitative Probabilities for Legal Reasoning about Evidence

A crucial aspect of evidential reasoning in crime investigation involves comparing the support that evidence provides for alternative hypotheses. Recent work in forensic statistics has shown how Bayesian Networks (BNs) can be employed for this purpose. However, the specification of BNs requires conditional probability tables describing the uncertain processes under evaluation. When these processes are poorly understood, it is necessary to rely on subjective probabilities provided by experts. Accurate probabilities of this type are normally hard to acquire from experts. Recent work in qualitative reasoning has developed methods to perform probabilistic reasoning using coarser representations. However, the latter types of approaches are too imprecise to compare the likelihood of alternative hypotheses. This paper examines this shortcoming of the qualitative approaches when applied to the aforementioned problem, and identifies and integrates techniques to refine them.

Where do children usually play? A qualitative study of parents' perceptions of influences on children's active free-play

This study explored the perceptions of 78 parents from low, mid and high socio-economic areas in Melbourne, Australia to increase understanding of where children play and why. Using an ecological model interviews with parents revealed that safety and social factors emerged as key social themes, facilities at parks and playgrounds, and urban design factors emerged as important physical environment themes. The children's level of independence and attitudes to active free-play were considered to be important individual level influences on active free-play. The study findings have important implications for future urban planning and children's opportunities for active free-play.

How can socio-economic differences in physical activity among women be explained? A qualitative study

This qualitative study investigated why women of low socio-economic status (SES) are less physically active than women of higher-SES. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low-SES women. A social-ecological framework, taking into account intrapersonal, social and environmental level influences, was adopted to guide the development of interview questions and interpretation of data. Thematic analysis identified a number of key influences on physical activity that varied by SES. These included negative early life/family physical activity experiences (a consistent theme among those of low-/mid-SES); participation in a wider range of physical activities in leisure time (high-SES); greater priority given to television viewing (low-SES); lack of time due to work commitments (low-SES); lack of time due to family commitments (high-SES); and neighbourhood-level barriers (low-SES). Financial costs were not perceived as a key barrier by women in any SES group. Public health strategies aimed at reducing SES