A qualitative exploration of whether lesbian and bisexual women are 'protected' from sociocultural pressure to be thin

Heterosexual women in Western cultures are known to experience body image concerns, dieting and disordered eating as a result of intense social pressures to be thin. However, it is theorised that lesbian and bisexual women belong to a subculture that is ‘protective’ of such demands. Fifteen non-heterosexual women were interviewed about their experiences of social pressure. Thematic analysis of their accounts suggests that such theorising may be inaccurate, because these lesbian and bisexual women did not feel ‘protected’ from social pressures and experienced body dissatisfaction. While they might attempt to resist thin idealisation, resistance is not centred around their sexuality

‘We have to wait in a queue for our turn quite a bit’ Examining children’s physical activity during primary physical education lessons

The overall purpose of this study was to examine children’s physical activity (PA) during primary physical education (PE). This was achieved through the following two research objectives: (1) to measure children’s PA, lesson context and teacher promotion of PA during PE lessons; and (2) to explore teachers’ and children’s perspectives on PA levels during PE lessons. Evidence suggests that children’s PA during PE is below recommended levels and further research is required to understand the reasons why. Through a mixed method design, 138 children were observed using the System for Observing Fitness and Instruction Time, 80 children participated in group interviews, and 13 teachers were interviewed, across three primary schools in England. Findings indicated that the mean percentage of lesson time allocated to moderate to vigorous PA (MVPA) was 42.4% and the average lesson length was 35.3 minutes. Qualitative themes identified were: ‘knowledge and beliefs’; ‘teacher pedagogy’; and ‘teacher development’. The findings indicate that a change in perspective is needed, which includes a focus on PA during primary PE lessons. Intervention work is required that targets teachers’ knowledge and beliefs towards PE along with the development of effective teaching strategies. However, this needs to be grounded in an ecological approach which will allow researchers and schools to target the various levels of influence. It is strongly recommended that interventions are grounded in behaviour change theory, as this study indicates that sharing knowledge about pedagogical strategies to increase children’s MVPA does not necessarily produce changes in teachers’ behaviours

"Am iz kwiin" (I'm his queen): Combining interpretative phenomenological analysis with a feminist approach to work with gems in a resource-constrained setting

This article focuses on working with gems using a feminist approach to interpretative phenomenological analysis (IPA) in a resource-constrained setting. The research explores the experiences of maternal disclosure of HIV to children of HIV positive mothers in Kingston, Jamaica. A feminist approach helps recognise power imbalances within research relationships and the women’s lived experiences. We present three “gems” which illuminate women’s lived experiences and explore how popularised representations of women’s sexuality and mothering influence disclosure discourses. We use emotion work as a conceptual resource to structure the women’s narratives and challenge existing policy discourses, which arguably represent disclosure within a binary, rationalist, decision-making framework. This article adds to global literature on maternal HIV disclosure and problematises policy discourses by bringing into relief the emotion work women engage in when deciding if and how to communicate their HIV status to their children. It adds to the body of research using IPA, particularly in resource-constrained settings where IPA has thus far had little application

A method for studying decision-making by guideline development groups

Background: Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making.Methods: A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis.Results: Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG.Conclusion: This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups

The experience of living with knee osteoarthritis: exploring illness and treatment beliefs through thematic analysis

Purpose: Knee osteoarthritis (OA) is a major cause of disability in older adults. However, there is limited research on the daily experience of living with knee OA. We aimed to offer insight into the beliefs of patients with knee OA about their illness and treatment. Method: Twenty-four semi-structured interviews were conducted with 17 women and 7 men with physician-diagnosed knee OA, aged between 48 and 84 years (mean 1/4 62, SD 1/4 7). The audio-taped interviews lasted from 30 min to 1 h, and were transcribed verbatim. The data were subjected to thematic analysis. The transcripts were independently coded by two researchers to increase reliability of coding. Results: Six themes were developed and two of these are examined in further detail: (i) Illness representation and (ii) Beliefs about the medical and surgical control of pain. Illness representation comprised beliefs about people’s understanding of OA and their pain experience, as well as expectations about the course of illness. The second theme presented experiences of limited pain relief and concerns about the use of drugs and surgery. Conclusion: Exploring illness representations and beliefs about medical and surgical control of pain may provide the basis for initiating psychological interventions for people with knee OA

Barriers to Treatment for Female Problem Gamblers: A UK Perspective

There is a paucity of research in the UK which examines problem gambling and that which does exist is mainly quantitative, focuses on male samples and fails to look at treatment seeking populations or obstacles preventing problem gamblers from seeking treatment. This paper presents findings from part of a larger qualitative study that explored the experience of treatment for female problem gamblers. Data were collected using semi-structured interviews with eight women who had received individual cognitive-behavioural therapy in the National Health Service for their gambling problem. An interpretative phenomenological analysis approach was applied in the research process, identifying three main themes, of which the subtheme ‘Barriers to Treatment’ is examined here. Internal and external barriers to treatment organically emerged in all female participants’ accounts and appear to have an impact on service utilisation. Input directly from gamblers can be combined with findings from other studies to devise better ways of reaching female problem gamblers. A better understanding of barriers to treatment can also provide valuable direction for future research and suggest applications in clinical service provision and treatment planning

"Arabic is the language of the Muslims–that's how it was supposed to be": exploring language and religious identity through reflective accounts from young British-born South Asians

This study explores how a group of young British-born South Asians understood and defined their religious and linguistic identities, focusing upon the role played by heritage languages and liturgical languages and by religious socialisation. Twelve British-born South Asians were interviewed using a semi-structured interview schedule. Interview transcripts were subjected to interpretative phenomenological analysis. Four superordinate themes are reported. These addressed participants' meaning-making regarding "the sanctification of language" and the consequential suitability of "the liturgical language as a symbol of religious community"; the themes of "ethnic pride versus religious identity" and "linguistic Otherness and religious alienation" concerned potential ethno-linguistic barriers to a positive religious identity. Findings are interpreted in terms of concepts drawn from relevant identity theories and tentative recommendations are offered concerning the facilitation of positive religious and ethnic identities

Shared decision-making – Rhetoric and reality: Women’s experiences and perceptions of adjuvant treatment decision-making for breast cancer

This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women’s experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women’s desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients’ subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor–patient power dynamics within shared decision-making for breast cancer

A practical guide to analysing online support forums

As the number of online support forums continues to grow and the amount of user-generated content increases, analysing forum messages can provide researchers and others working in health-related fields with important new insights into the needs, opinions and experiences of individuals who use them. There has been a lack of guidance regarding how to make the best use of user-generated content within forums as a data source in research studies, so this paper explains the practical, ethical and methodological issues associated with this type of research. It describes the benefits of forum research, the organisational structure of forums, how forums are selected for research, approaches to sampling, preparing data for analysis, and methods of analysis that can be used. The decisions that researchers need to make during each stage of the research process are explained, describing the options available and the ethical dilemmas that need to be considered to successfully develop, carry out and complete a research project

The Potential Economic Value of a Trypanosoma cruzi (Chagas Disease) Vaccine in Latin America

The substantial burden of Chagas disease, especially in Latin America, and the limitations of currently available treatment and control strategies have motivated the development of a Trypanosoma cruzi (T. cruzi) vaccine. Evaluating a vaccine's potential economic value early in its development can answer important questions while the vaccine's key characteristics (e.g., vaccine efficacy targets, price points, and target population) can still be altered. This can assist vaccine scientists, manufacturers, policy makers, and other decision makers in the development and implementation of the vaccine. We developed a computational economic model to determine the cost-effectiveness of introducing a T. cruzi vaccine in Latin America. Our results showed vaccination to be very cost-effective, in many cases providing both cost savings and health benefits, even at low infection risk and vaccine efficacy. Moreover, our study suggests that a vaccine may actually “pay for itself”, as even a relatively higher priced vaccine will generate net cost savings for a purchaser (e.g., a country's ministry of health). These findings support continued investments in and efforts toward the development of a human T. cruzi vaccine