Supporting population mental health and wellness during the COVID-19 pandemic in Canada: protocol for a sequential mixed-method study.
TL;DR: In this paper, a two-way text messaging service for mental health was used to connect individuals with appropriately suited digital mental health interventions through the use of text messaging services during the COVID-19 pandemic.
Abstract: Introduction The global COVID-19 pandemic has reported to have a negative impact on the mental health and well-being of individuals around the world. Mental health system infrastructure, primarily developed to support individuals through in-person care, struggled to meet rising demand for services even prior to COVID-19. With public health guidelines requiring the use of physical distancing during the pandemic, digital mental health supports may be one way to address the needs of the population. Despite this, barriers exist in promoting and supporting access to existing and emerging digital resources. Text messaging may address some of these barriers, extending the potential reach of these digital interventions across divides that may separate some vulnerable or disadvantaged groups from essential mental health supports. Building on an existing knowledge synthesis project identifying key digital resources for improved mental health, this research will establish low-tech connections to assess need and better match access to services for those who need it most. The aim of this study is to codesign a customised two-way texting service to explore need and better align access to mental health supports for Canadians located in Saskatchewan during the COVID-19 pandemic. Methods and analysis This study will be completed in Saskatchewan, Canada. For this project, the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will be used to support three phases of a sequential mixed-method study. An advisory committee of Saskatchewan residents will guide this work with the study team. A 10-week service will be launched to connect individuals with appropriately suited digital mental health interventions through the use of text messaging. In phase 1, implementation and prototyping will be conducted with collaborative codesign for key elements related to features of an enrolment survey and initial messaging content. Phase 2 will focus on advancing the effectiveness of the service using quantitative user data. In phase 3, an embedding approach will be used to integrate both qualitative and quantitative data collected to understand the overall acceptability, satisfaction and perceived benefit of the text messaging service. Thematic analysis and descriptive statistics will be used as analytic methods. Ethics and dissemination This study has received approval from the Research Ethics Board at the University of Saskatchewan. A knowledge dissemination plan has been developed that includes traditional academic approaches such as conference presentations, and academic publications, as well as mainstream approaches such as social media, radio and dissemination through the advisory committee.
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01 Apr 2022
TL;DR: In this article , the authors presented evidence-informed consensus statements to guide the creation of ICU visitation policies during the current COVID-19 pandemic and future pandemics and to identify barriers and facilitators to their implementation and sustained uptake in Canadian ICUs.
Abstract: Hospital policies forbidding or limiting families from visiting relatives on the intensive care unit (ICU) has affected patients, families, healthcare professionals, and patient- and family-centered care (PFCC). We sought to refine evidence-informed consensus statements to guide the creation of ICU visitation policies during the current COVID-19 pandemic and future pandemics and to identify barriers and facilitators to their implementation and sustained uptake in Canadian ICUs. We created consensus statements from 36 evidence-informed experiences (i.e., impacts on patients, families, healthcare professionals, and PFCC) and 63 evidence-informed strategies (i.e., ways to improve restricted visitation) identified during a modified Delphi process (described elsewhere). Over two half-day virtual meetings on 7 and 8 April 2021, 45 stakeholders (patients, families, researchers, clinicians, decision-makers) discussed and refined these consensus statements. Through qualitative descriptive content analysis, we evaluated the following points for 99 consensus statements: 1) their importance for improving restricted visitation policies; 2) suggested modifications to make them more applicable; and 3) facilitators and barriers to implementing these statements when creating ICU visitation policies. Through discussion, participants identified three areas for improvement: 1) clarity, 2) accessibility, and 3) feasibility. Stakeholders identified several implementation facilitators (clear, flexible, succinct, and prioritized statements available in multiple modes), barriers (perceived lack of flexibility, lack of partnership between government and hospital, change fatigue), and ways to measure and monitor their use (e.g., family satisfaction, qualitative interviews). Existing guidance on policies that disallowed or restricted visitation in intensive care units were confusing, hard to operationalize, and often lacked supporting evidence. Prioritized, succinct, and clear consensus statements allowing for local adaptability are necessary to guide the creation of ICU visitation policies and to optimize PFCC.
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TL;DR: Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology as mentioned in this paper, and it offers an accessible and theoretically flexible approach to analysing qualitative data.
Abstract: Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.
103,789 citations
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18 Aug 2006TL;DR: This book discusses writing and Evaluating Mixed Methods Research, and the importance of knowing the structure of the writing so that it Relates to the Designs Evaluating a Mixed Methods Study Within Designs.
Abstract: List of Tables List of Figures Preface Purpose of This Book Audience for the Book Book Features Acknowledgments Chapter 1: Understanding Mixed Methods Research Purpose and Organization Clarifying Terms What Is Mixed Methods Research? The Importance of Mixed Methods Research Summary Activities Additional Resources to Examine Chapter 2: Examining Preliminary Considerations Consider Worldview Stances The Basics of Quantitative and Qualitative Research Research Problems Addressed by Mixed Methods Summary Activities Additional Resources to Examine Chapter 3: Locating and Reviewing Mixed Methods Studies Searching for and Reviewing Mixed Methods Studies A Mixed Methods Notation System and Visual Diagrams Four Examples of Mixed Methods Studies Summary Activities Additional Resources to Examine Chapter 4: Choosing a Mixed Methods Design Classifications of Mixed Methods Designs The Four Major Types of Mixed Methods Designs Selecting a Type of Mixed Methods Design Implementing the Design Decisions Writing a Paragraph to Identify a Study's Design Summary Activities Additional Resources to Examine Chapter 5: Introducing a Mixed Methods Study Writing a Mixed Methods Title Stating the Problem in the Introduction The Purpose Statement Research Questions and Hypotheses Summary Activities Additional Resources to Examine Chapter 6: Collecting Data in Mixed Methods Research Procedures in Qualitative and Quantitative Data Collection Data Collection in Mixed Methods Design Summary Activities Additional Resources to Examine Chapter 7: Analyzing Data in Mixed Methods Research Procedures in Quantitative and Qualitative Data Analysis Data Analysis With Mixed Methods Designs Summary Activities Additional Resources to Examine Chapter 8: Writing and Evaluating Mixed Methods Research General Guidelines for Writing Organize the Structure of the Writing So That It Relates to the Designs Evaluating a Mixed Methods Study Within Designs Summary Activities Additional Resources to Examine Chapter 9: Questions Often Raised About Mixed Methods Research Anticipate Mixed Methods Questions What Is Mixed Methods Research? Is Mixed Methods Research Accepted? Is Mixed Methods Research Realistic? Summary Activities Additional Resources to Examine Chapter 10: Future Directions for Mixed Methods Research Needed Developments in Mixed Methods Research Summary Activities Additional Resources to Examine Appendix A. A Triangulation Design Appendix B. An Embedded Design Appendix C. An Explanatory Design Appendix D. An Exploratory Design References Index About the Authors
23,221 citations
TL;DR: In this paper, the authors examined how the field of mixed methods currently is being defined and discussed the criteria of demarcation in mixed methods research, and concluded that mixed methods are one of the three major research paradigms.
Abstract: The purpose of this article is to examine how the field of mixed methods currently is being defined. The authors asked many of the current leaders in mixed methods research how they define mixed methods research. The authors provide the leaders' definitions and discuss the content found as they searched for the criteria of demarcation. The authors provide a current answer to the question, What is mixed methods research? They also briefly summarize the recent history of mixed methods and list several issues that need additional work as the field continues to advance. They argue that mixed methods research is one of the three major “research paradigms” (quantitative research, qualitative research, and mixed methods research). The authors hope this article will contribute to the ongoing dialogue about how mixed methods research is defined and conceptualized by its practitioners.
6,049 citations
TL;DR: The descriptive epidemiology revealed that males, older adults, more educated individuals, and married adults were more likely to be mentally healthy and flourishing and moderate mental health were associated with superior profiles of psychosocial functioning.
Abstract: This paper introduces and applies an operationalization of mental health as a syndrome of symptoms of positive feelings and positive functioning in life. Dimensions and scales of subjective well-being are reviewed and conceived of as mental health symptoms. A diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, is applied to data from the 1995 Midlife in the United States study of adults between the ages of 25 and 74 (n = 3,032). Findings revealed that 17.2 percent fit the criteria for flourishing, 56.6 percent were moderately mentally healthy, 12.1 percent of adults fit the criteria for languishing, and 14.1 percent fit the criteria for DSM-III-R major depressive episode (12-month), of which 9.4 percent were not languishing and 4.7 percent were also languishing. The risk of a major depressive episode was two times more likely among languishing than moderately mentally healthy adults, and nearly six times greater among languishing than flourishing adults. Multivariate analyses revealed that languishing and depression were associated with significant psychosocial impairment in terms of perceived emotional health, limitations of activities of daily living, and workdays lost or cutback. Flourishing and moderate mental health were associated with superior profiles of psychosocial functioning. The descriptive epidemiology revealed that males, older adults, more educated individuals, and married adults were more likely to be mentally healthy. Implications for the conception of mental health and the treatment and prevention of mental illness are discussed.
3,275 citations
TL;DR: The fit of integration describes the extent the qualitative and quantitative findings cohere and can help health services researchers leverage the strengths of mixed methods.
Abstract: Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs—exploratory sequential, explanatory sequential, and convergent—and through four advanced frameworks—multistage, intervention, case study, and participatory. Integration at the methods level occurs through four approaches. In connecting, one database links to the other through sampling. With building, one database informs the data collection approach of the other. When merging, the two databases are brought together for analysis. With embedding, data collection and analysis link at multiple points. Integration at the interpretation and reporting level occurs through narrative, data transformation, and joint display. The fit of integration describes the extent the qualitative and quantitative findings cohere. Understanding these principles and practices of integration can help health services researchers leverage the strengths of mixed methods.
2,165 citations