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Mixed methods research is essential to development of patient-reported outcome measures, digital technology, and endpoint selection for clinical drug trials and to advance clinical care when complex health-related experiences cannot be fully understood by quantitative or qualitative approaches alone. New technology and opportunities for remote data collection have changed the ways in which qualitative and quantitative data can be collected, enabling researchers to capture human experiences in ways not previously possible. This paper describes Perspective Mapping, a new online interviewing technique that uses mind mapping software to capture in-depth qualitative data inside a quantitative measurement framework to understand and measure individual experiences. The objective of this tutorial is to review the theoretical underpinnings, present instructions for study design and implementation, and address strengths, limitations, and potential applications of this technique in health and behavioral sciences. During videoconferencing interviews, mind-mapping software is used to visually depict experiences. Structured concept maps are cocreated in real time with participants, focusing on building detailed narrative descriptions about experiences and categorizing these within a predefined quantitative framework, such as the relative importance of different experiences relevant to a phenomenon. The approach combines semistructured interviewing with technology-enhanced card-sorting techniques, allowing participants to define and prioritize what matters most. This method ensures narrative richness alongside structured data collection, facilitating deeper understanding of phenomena. Perspective Mapping emphasizes participant engagement in data generation and analysis and enables the simultaneous collection of qualitative narratives and quantitative assessment of key concepts. The variations of the technique have been successfully applied in research on chronic illness, symptom burden, and digital health technology. Advantages of the approach include systematic collection of qualitative data, transparent and structured data outputs, real-time data validation, and the ability to return maps to participants as a form of reciprocity. Feasibility factors, such as interviewer capabilities, participant literacy, interview duration, and technology resources must be considered. Perspective Mapping offers an innovative and engaging way to gather complementary qualitative and quantitative data remotely. By blending qualitative depth with quantitative structure, the technique supports richer, more actionable insights for health research, policy, and beyond. This technique holds promise for applications in health, psychology, education, and other social sciences where comprehensive understanding of experiences is essential.

To determine risk factors for coronavirus disease (COVID-19) among US healthcare personnel (HCP), we conducted a case-control analysis. We collected data about activities outside the workplace and COVID-19 patient care activities from HCP with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test results (cases) and from HCP with negative test results (controls) in healthcare facilities in 5 US states. We used conditional logistic regression to calculate adjusted matched odds ratios and 95% CIs for exposures. Among 345 cases and 622 controls, factors associated with risk were having close contact with persons with COVID-19 outside the workplace, having close contact with COVID-19 patients in the workplace, and assisting COVID-19 patients with activities of daily living. Protecting HCP from COVID-19 may require interventions that reduce their exposures outside the workplace and improve their ability to more safely assist COVID-19 patients with activities of daily living.

Older adults use the emergency department (ED) at high rates, including for illnesses that could be managed by their primary care providers (PCP). Policymakers have implemented barriers and incentives, often financial, to try to modify use patterns but with limited success. This study aims to understand the factors that influence older adults' decision to obtain acute illness care from the ED rather than from their PCPs. We performed a qualitative study using a directed content analysis approach from February to October 2013. Fifteen community-dwelling older adults age≥65 years who presented to the ED of an academic medical center hospital for care and who were discharged home were enrolled. Semi-structured interviews were conducted initially in the ED and subsequently in patients' homes over the following six weeks. All interviews were audio-recorded, transcribed, verified, and coded. The study team jointly analyzed the data and identified themes that emerged from the interviews. The average age of study participants was 74 years (standard deviation ±7.2 years); 53% were female; 80% were white. We found five themes that influenced participants' decisions to obtain acute illness care from the ED: limited availability of PCP-based care, variable interactions with healthcare providers and systems, limited availability of transportation for illness care, desire to avoid burdening friends and family, and previous experiences with illnesses. Community-dwelling older adults integrate multiple factors when deciding to obtain care from an ED rather than their PCPs. These factors relate to personal and social considerations, practical issues, and individual perceptions based on previous experiences. If these findings are validated in confirmatory studies, policymakers wishing to modify where older adults receive care should consider person-centered interventions at the system and individual level, such as decision support, telemedicine, improved transport services, enhancing PCPs' capabilities, and enhancing EDs' resources to care for older patients.

Background: Healthcare facilities have experienced many challenges during the COVID-19 pandemic, including limited personal protective equipment (PPE) supplies. Healthcare personnel (HCP) rely on PPE, vaccines, and other infection control measures to prevent SARS-CoV-2 infections. We describe PPE concerns reported by HCP who had close contact with COVID-19 patients in the workplace and tested positive for SARS-CoV-2. Method : The CDC collaborated with Emerging Infections Program (EIP) sites in 10 states to conduct surveillance for SARS-CoV-2 infections in HCP. EIP staff interviewed HCP with positive SARS-CoV-2 viral tests (ie, cases) to collect data on demographics, healthcare roles, exposures, PPE use, and concerns about their PPE use during COVID-19 patient care in the 14 days before the HCP’s SARS-CoV-2 positive test. PPE concerns were qualitatively coded as being related to supply (eg, low quality, shortages); use (eg, extended use, reuse, lack of fit test); or facility policy (eg, lack of guidance). We calculated and compared the percentages of cases reporting each concern type during the initial phase of the pandemic (April–May 2020), during the first US peak of daily COVID-19 cases (June–August 2020), and during the second US peak (September 2020–January 2021). We compared percentages using mid- P or Fisher exact tests (α = 0.05). Results: Among 1,998 HCP cases occurring during April 2020–January 2021 who had close contact with COVID-19 patients, 613 (30.7%) reported ≥1 PPE concern (Table 1). The percentage of cases reporting supply or use concerns was higher during the first peak period than the second peak period (supply concerns: 12.5% vs 7.5%; use concerns: 25.5% vs 18.2%; p Conclusions: Although lower percentages of HCP cases overall reported PPE concerns after the first US peak, our results highlight the importance of developing capacity to produce and distribute PPE during times of increased demand. The difference we observed among selected groups of cases may indicate that PPE access and use were more challenging for some, such as nonphysicians and nursing home HCP. These findings underscore the need to ensure that PPE is accessible and used correctly by HCP for whom use is recommended. Funding: None Disclosures: None

Mixed methods research is essential to development of patient-reported outcome measures, digital technology, and endpoint selection for clinical drug trials and to advance clinical care when complex health-related experiences cannot be fully understood by quantitative or qualitative approaches alone. New technology and opportunities for remote data collection have changed the ways in which qualitative and quantitative data can be collected, enabling researchers to capture human experiences in ways not previously possible. This paper describes Perspective Mapping, a new online interviewing technique that uses mind mapping software to capture in-depth qualitative data inside a quantitative measurement framework to understand and measure individual experiences. The objective of this tutorial is to review the theoretical underpinnings, present instructions for study design and implementation, and address strengths, limitations, and potential applications of this technique in health and behavioral sciences. During videoconferencing interviews, mind-mapping software is used to visually depict experiences. Structured concept maps are cocreated in real time with participants, focusing on building detailed narrative descriptions about experiences and categorizing these within a predefined quantitative framework, such as the relative importance of different experiences relevant to a phenomenon. The approach combines semistructured interviewing with technology-enhanced card-sorting techniques, allowing participants to define and prioritize what matters most. This method ensures narrative richness alongside structured data collection, facilitating deeper understanding of phenomena. Perspective Mapping emphasizes participant engagement in data generation and analysis and enables the simultaneous collection of qualitative narratives and quantitative assessment of key concepts. The variations of the technique have been successfully applied in research on chronic illness, symptom burden, and digital health technology. Advantages of the approach include systematic collection of qualitative data, transparent and structured data outputs, real-time data validation, and the ability to return maps to participants as a form of reciprocity. Feasibility factors, such as interviewer capabilities, participant literacy, interview duration, and technology resources must be considered. Perspective Mapping offers an innovative and engaging way to gather complementary qualitative and quantitative data remotely. By blending qualitative depth with quantitative structure, the technique supports richer, more actionable insights for health research, policy, and beyond. This technique holds promise for applications in health, psychology, education, and other social sciences where comprehensive understanding of experiences is essential.

To describe nursing home staff experiences and perceptions of the factors that impact the sustainability of an antibiotic stewardship program (ASP). Using a qualitative descriptive design, semistructured interviews with staff at 9 not-for-profit nursing homes with an established ASP were conducted and audio recorded. De-identified transcriptions of the interviews were coded using a sustainability framework and were analyzed to identify themes. Interviews were conducted with 48 clinical and administrative staff to elicit their perceptions of the ASPs, and 7 themes were identified. ASPs were perceived to be resource intensive and \"data driven,\" requiring access to and interpretation of data that are not readily available at many nursing homes. Though motivated and committed, ASP champions felt that they could not single-handedly sustain the program. Attending to daily clinical needs (ie, \"fires\") made it hard to progress beyond implementation and to reach step 2 of sustainability. Longstanding treatment habits by external prescribers and regulations were believed to impede ASP efforts. Partnerships with an external consultant with antibiotic stewardship expertise were considered important, as was the need for internal leadership support and collaboration across disciplinary boundaries. Participants felt that consistent and ongoing education on antibiotic stewardship at all staff levels was important. Although many interconnected factors impact the sustainability of an ASP, nursing homes may be able to sustain an ASP by focusing on 3 critical areas: (1) explicit support by nursing home leadership, (2) external partnerships with professionals with antibiotic stewardship expertise and internal interprofessional collaborations, and (3) consistent education and training for all staff.

During the severe acute respiratory syndrome epidemic in 2002, HCWs experienced distress due to perceived stigma and fear of contagion.4 Lack of support and stigma contribute to distress, and those at higher risk for exposures experience greater post-traumatic stress disorder.5 Although the foremost fear is fear of developing COVID-19 and transmitting SARS-CoV-2,6 our participants were also afraid of not knowing how they got infected, of reinfection, and of transmitting the virus to their families (Table 1, Q8, Q9, and Q10). Despite physical exhaustion, anxiety, anger, guilt, and grief, these HCWs were the unsung heroes who continued to serve vulnerable older adults.3 It has been recommended that healthcare facilities prepare for pandemics by building individual and organizational resilience and by providing training and support to staff.4 Although COVID-19 is described as an “occupational disease” for which HCWs need social and psychological support,7 our participants felt unsupported and feared returning to work. Nursing homes need more resources, and COVID-19 may not be the last challenge of this magnitude that we will face. [...]it is imperative that nursing home HCWs are supported through measures such as (1) education and training on pandemics and disaster preparedness, (2) easy access and clear communication on infection control and appropriate use of PPE, (3) systems to cope physically under such circumstances such as rest breaks, and (4) systems to cope emotionally such as training on caring for the dying, and grief counseling to cope with death. With the continuous rise in the number of vulnerable older adults needing long-term care and the decrease in staff willing and needed to care for them, these measures may no longer be optional.

Despite recognition that spiritual concerns contribute to caregiver burden, little is known about spirituality, spiritual well-being, and spiritual distress in Parkinson’s disease caregivers. In this scoping review of the literature through October 2022, we searched PubMed, PsychINFO, Embase, and CINAHL. From an initial pool of 328 studies, 14 were included. Caregiver factors (e.g., depression, age) and patient factors (e.g., faith, motor function) affected caregiver spirituality and spiritual well-being. Caregivers experienced loss of meaning, existential guilt, and loneliness, and coped through acquiescence, cultural beliefs, prayer, and gratitude. Future research should focus on the specific spiritual needs of Parkinson’s disease caregivers and interventions to address them.

Abstract Studies of aging rarely include the older adults themselves in the process of conceptualizing questions, implementing the research, and evaluating the results. To provide opportunities for community members to become engaged in research, researchers and community stakeholders developed “Engaging Older Adult Learners as Health Researchers (ENGOAL).” This program educates older adults from underserved and underresourced communities about geriatric health and research methods, enabling them to become Research Partners. Two cohorts of African-American seniors (N=21) aged 53-79 have participated or are currently participating in six months of weekly classes followed by 4-6 months of research apprenticeships. Content and structure of classes (covering qualitative and quantitative research approaches and language, salient health themes, and developing a research proposal) will be described. Challenges and successes in providing research apprenticeships (interviewing for a study on vision, reviewing recruitment materials, evaluating a mentorship program, and testing a diabetes management program) will be discussed.

Although a substantial amount of research has been conducted in the field of religion, spirituality, and health, much still needs to be done. Training of researchers to conduct studies in the field of religion, spirituality, and health is essential for continued academic and methodological rigor. Such training should be globally oriented to ensure both representation and evidence from non-western cultures which is currently lacking. While little attention is given to this area in mainstream contemporary academic curricula, some researchers in the field have provided exceptional leadership in designing programs to train future researchers. In this commentary, the authors who participated in one such training program at Duke University, offer their insights based on a qualitative descriptive analysis of survey responses from a sample of participants. These insights relate to participants’ perceptions of the most valuable experiences from a workshop on religion, spirituality, and health, and include recommendations for future content in training programs in this field. The multicultural aspect of the program with researchers, clinicians, and other professionals from 17 different countries was the most enriching aspect of the workshop. One of the key recommendations for future training efforts is to dedicate workshop time for participants to work collaboratively in the design and plan for international and interdisciplinary research projects with guidance from faculty.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Tobias Anker] Last name [Stripp]. Also, kindly confirm the details in the metadata are correct.They are correct.