A Quantum of Solace: An Exploratory Mixed Methods Study of Online Support in the Self-Management of Anxiety in HPV Positive Women

The implementation of human papillomavirus (HPV) DNA detection as the primary screening tool for screening and management of cervical intraepithelial neoplasia (CIN) proposed for roll-out in 2019-2020 will diagnose more women as HPV positive than are currently diagnosed with CIN due to the relative differences in prevalence between conditions (Sargent et al. 2008; Peto et al. 2004). At present there is no acceptable treatment for HPV (McRae et al. 2014). Anxiety over positivity (Friedman & Shepeard 2007), stigma (Kim 2012), and uncertainty (Kosenko et al. 2012) may constitute a biographical disruption. The stigmatised nature of HPV mean support from regular channels may be restricted due to fears of social rejection following disclosure (Kosenko et al. 2012; Crandall & Moriarty 1995). Online support might instead be utilised to allow access to disease information and social support. Methods: The study was a mixed methods study based on the follow-up explanations model, involving the administration of an online survey questionnaire (N = 107). Following descriptive data analysis, individuals were recruited for email interviews to describe their lived experiences of HPV positivity (N = 3). These narratives were then analysed using thematic analysis. Findings: Women responding to the questionnaire and the interviews reported anxiety over fears of transmission to loved ones. Interview narratives disclosed themes of anxiety caused by the mismanagement of information (too much/too little, conflicting or given at the wrong moment), uncertainty over viral clearance and residual issues of stigma. Women reported the use of online support to exchange information and experiences and provide emotional support. Conclusions: Both the questionnaire and the interview data indicate that uncertainty, anxiety over cancer development and guilt over transmission constitute a biographical disruption among women aware of their HPV positive status, and that the use of online support may be helpful in managing the uncertainty of HPV positivity

Computational Thematic Analysis of Online Communities

Public health researchers can use thematic analysis to develop human understandings of health topics from the lived experiences discussed in online communities. However, thematic analyses of online communities are difficult to conduct because large data sets amplify the resource intensity and complexity of the common phases: Data Collection, Data Familiarization, Coding, and Theme Review. Researchers can manage this amplification by integrating computational techniques that facilitate scalable interaction with large data sets when they converge with tasks completed during a thematic analysis. My thesis’ research explored barriers to integrating computational techniques into thematic analysis through three research questions: RQ1. Could computational techniques be used within a thematic analysis to assist with the analysis of online communities’ data? RQ2. How might tools be developed to not require programming expertise when integrating computational techniques as part of thematic analysis tasks? RQ3. How does a computational thematic analysis that integrates computational techniques compare with a traditional manual thematic analysis? To address these questions, I used a three-staged approach where I first piloted integrating techniques in a thematic analysis of addiction recovery. I then designed artifacts based on my pilot experience that allow qualitative researchers without programming expertise to integrate techniques. Finally, I deployed my artifacts with public health researchers to explore integration’s impact on their real-world thematic analyses. During my Pilot Stage, I conducted a topic-guided thematic analysis of two Reddit addiction recovery communities. Performing this analysis contributed a demonstration of integrating Latent Dirichlet Allocation topic modelling, a computational technique, to guide my reflexive thematic analysis by sampling interesting places in online discussion data sets for coding. Additionally, I discussed how integration benefited my data familiarization by facilitating the identification of patterns while being limited due to balancing metric optimization with interpretive usefulness when creating topic models. In my Design Stage, I created my Computational Thematic Analysis Workflow and Computational Thematic Analysis Toolkit to build upon my pilot stage experiences and support qualitative researchers. My workflow provides researchers with guidance on planning a reflexive thematic analysis of online communities that integrates computational techniques. Similarly, my toolkit supports qualitative researchers by implementing computational techniques as reusable tools in a graphic user interface that integrates into thematic analyses without requiring programmer expertise. My Deploy Stage investigated the impact of integrating computational techniques by collaborating with public health researchers studying COVID-19 news article comments.The researchers independently performed two inductive thematic analyses, one of which used my Computational Thematic Analysis Toolkit. I then work with the researchers to compare their processes and results. From this comparison, I identified that integrating computational techniques to facilitate multiple data interactions aided the analysis by enabling different interpretations. Additionally, despite both analyses developing a convergent set of themes, computational technique integration had subtle influences leading to divergent analysis processes and coding approaches. The contributions from my three stages have collective implications for qualitative research, human-computer interaction, and public health. My work provides qualitative researchers with demonstrations and tools that support integrating computational techniques to research online communities. My research created a base workflow and toolkit that human-computer interaction practitioners can support and extend to facilitate the integration of computational techniques into qualitative methods. Additionally, I addressed calls in human-computer interaction research to include qualitative perspectives in work that impacts qualitative researchers. Finally, public health researchers can use my guidance and toolkit to manage the amplification of resource intensity and complexity to perform thematic analyses on the lived experiences discussed in online communities. As researchers identify online communities’ perspectives on new and existing health issues, they can de- velop health interventions that impact people represented by online communities

Factors that influence HPV vaccinations in young women residing in Canada

The HPV vaccine was first made available to girls and women in 2006. Despite support for the vaccine from health care professionals and governments, vaccination rates remain lower than anticipated. This study had two goals: (1) To investigate factors that predict actual and intended vaccinations, and (2) to test a model of HPV vaccination intentions. An adapted Health Belief Model was used as the theoretical framework to guide this study. The model components assessed in this study were: Perceived severity, perceived susceptibility, perceived barriers, perceived benefits, cues to action, self-efficacy, knowledge, and subjective norms. Each model component was assessed by at least one variable, with some model components being assessed with multiple variables. Participants were 374 women, aged 18 to 30, residing in Canada. Data were collected using an online questionnaire. Logistic regression analyses revealed that actual vaccination decisions were directly influenced by the following model components and variables: Perceived severity (severity of treatment), perceived barriers (vaccine safety concerns, fear of doctor stigma, insurance coverage), and cues to action. Multiple regression analyses revealed that vaccination intentions were influenced by: Perceived benefits (vaccine positive beliefs, vaccine effectiveness), barriers (vaccine safety concerns), cues to action, self-efficacy, and subjective norms. A structural equation model to assess HPV vaccination intentions was tested. With a few modifications, support for the model was found. This model revealed that all of the theoretical components measured in this study contributed directly or indirectly to vaccination intentions. This study revealed that actual and intended HPV vaccinations are predicted by different variables. In addition, it also found support for a complex model of vaccination intentions. A unique contribution was the finding that women\u27s fear of experiencing stigma from doctors by asking for the vaccine impacted actual vaccination decisions. Vaccine safety concerns were also found to impact actual uptake. Finally, healthcare professionals may also benefit from understanding that cues to action were found to be predictive of behaviours, suggesting that women who are exposed to more cues are more likely to get vaccinated

Exploring perspectives of people with type-1 diabetes on goalsetting strategies within self-management education and care

Background. Collaborative goal-setting strategies are widely recommended for diabetes self-management support within healthcare systems. Creating self-management plans that fit with peoples’ own goals and priorities has been linked with better diabetic control. Consequently, goal-setting has become a core component of many diabetes selfmanagement programmes such as the ‘Dose Adjustment for Normal Eating (DAFNE) programme’. Within DAFNE, people with Type-1 Diabetes (T1D) develop their own goals along with action-plans to stimulate goal-achievement. While widely implemented, limited research has explored how goal-setting strategies are experienced by people with diabetes.Therefore, this study aims to explore the perspectives of people with T1D on theimplementation and value of goal-setting strategies within DAFNE and follow-up diabetes care. Furthermore, views on barriers and facilitators to goal-attainment are explored.Methods. Semi-structured interviews were conducted with 20 people with T1D who attended a DAFNE-programme. Following a longitudinal qualitative research design, interviews took place 1 week, and 6-8 months after completion of DAFNE. A recurrent cross-sectional approach is applied in which themes will be identified at each time-point using thematic analyses.Expected results. Preliminary identified themes surround the difference in value that participants place on goal-setting strategies, and the lack of support for goal-achievement within diabetes care.Current stage. Data collection complete; data-analysis ongoing.Discussion. Goal-setting strategies are increasingly included in guidelines for diabetes support and have become essential parts of many primary care improvement schemes. Therefore, exploring the perspectives of people with T1D on the value and implementation of goal-setting strategies is vital for their optimal application

HIV and adolescents: focus on young key populations

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/1/jia20076.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/2/jia20076-sup-0001.pd

Healthy snacks consumption and the Theory of Planned Behaviour. The role of anticipated regret

Two empirical studies explored the role of anticipated regret (AR) within the Theory of Planned Behavior (TPB) framework (Ajzen, 1991), applied to the case of healthy snacks consumption. AR captures affective reactions and it can be defined as an unpleasant emotion experienced when people realize or imagine that the present situation would be better if they had made a different decision. In this research AR refers to the expected negative feelings for not having consumed healthy snacks (i.e., inaction regret). The aims were: a) to test whether AR improves the TPB predictive power; b) to analyze whether it acts as moderator within the TPB model relationships. Two longitudinal studies were conducted. Target behaviors were: consumption of fruit and vegetables as snacks (Study 1); consumption of fruit as snacks (Study 2). At time 1, the questionnaire included measures of intention and its antecedents, according to the TPB. Both the affective and evaluative components of attitude were assessed. At time 2, self-reported consumption behaviors were surveyed. Two convenience samples of Italian adults were recruited. In hierarchical regressions, the TPB variables were added at the first step; AR was added at the second step, and the interactions at the last step. Results showed that AR significantly improved the TPB ability to predict both intentions and behaviours, also after controlling for intention. In both studies AR moderated the effect of affective attitude on intention: affective attitude was significant only for people low in AR