Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework

Background: The Theoretical Domains Framework (TDF) was developed to investigate determinants of specific clinical behaviors and inform the design of interventions to change professional behavior. This framework was used to explore the beliefs of chiropractors in an American Provider Network and two Canadian provinces about their adherence to evidence-based recommendations for spine radiography for uncomplicated back pain. The primary objective of the study was to identify chiropractors’ beliefs about managing uncomplicated back pain without xrays and to explore barriers and facilitators to implementing evidence-based recommendations on lumbar spine xrays. A secondary objective was to compare chiropractors in the United States and Canada on their beliefs regarding the use of spine x-rays. Methods: Six focus groups exploring beliefs about managing back pain without x-rays were conducted with a purposive sample. The interview guide was based upon the TDF. Focus groups were digitally recorded, transcribed verbatim, and analyzed by two independent assessors using thematic content analysis based on the TDF. Results: Five domains were identified as likely relevant. Key beliefs within these domains included the following: conflicting comments about the potential consequences of not ordering x-rays (risk of missing a pathology, avoiding adverse treatment effects, risks of litigation, determining the treatment plan, and using x-ray-driven techniques contrasted with perceived benefits of minimizing patient radiation exposure and reducing costs; beliefs about consequences); beliefs regarding professional autonomy, professional credibility, lack of standardization, and agreement with guidelines widely varied (social/professional role & identity); the influence of formal training, colleagues, and patients also appeared to be important factors (social influences); conflicting comments regarding levels of confidence and comfort in managing patients without x-rays (belief about capabilities); and guideline awareness and agreements (knowledge). Conclusions: Chiropractors’ use of diagnostic imaging appears to be influenced by a number of factors. Five key domains may be important considering the presence of conflicting beliefs, evidence of strong beliefs likely to impact the behavior of interest, and high frequency of beliefs. The results will inform the development of a theorybased survey to help identify potential targets for behavioral-change strategies

Language attitudes, linguistic authority and independence in 21st century Catalonia

peer-reviewedIn a context of increasing linguistic and cultural diversity and political uncertainty in Catalonia, this article reports on a research project which set out to explore the attitudes of members of independence organisations operating in the city of Girona toward the Catalan and Spanish languages. This study approaches language attitudes through the theoretical lens of linguistic authority, in particular, the concepts of anonymity and authenticity. The data, gathered from six focus groups, provide an insight on the nature of linguistic authority in contemporary Catalonia. Two themes emerge in the informants’ discussion of Catalan and Spanish: ‘twenty-first Century Catalanisme’ and ‘Embracing Linguistic Diversity’. The comments of the respondents indicate that, against the backdrop of the independence process in the region, bilingualism and multilingualism have become highly valued in the territory. In addition, this study suggests that a fuller understanding of the situation in Catalonia may be facilitated by qualitative approaches, which explore attitudes in-depth

User Evaluation of Neonatology Ward Design: An Application of Focus Group and Semantic Differential

[EN] Objective: The object of this article is to identify the set of affective and emotional factors behind users assessments of a space in a neonatology unit and to propose design guidelines based on these. Background: The importance of the neonatology service and the variety of users place great demands on the space at all levels. Despite the repercussions, the emotional aspects of the environment have received less attention. Methods: To avoid incurring limitations in the user mental scheme, this study uses two complementary methodologies: focus group and semantic differential. The (qualitative) focus group methodology provides exploratory information and concepts. The (quantitative) semantic differential methodology then uses these concepts to extract the conceptual structures that users employ in their assessment of the space. Of the total 175 subjects, 31 took part in focus groups and 144 in semantic differential. Results: Five independent concepts were identified: privacy, functionality and professional nature, spaciousness, lighting, and cleanliness. In relation to the importance of the overall positive assessment of the space, the perception of privacy and sensations of dominance and pleasure are fundamental. Six relevant design aspects were also identified: provide spacious surroundings, facilitate sufficient separation between the different posts or cots, use different colors from those usually found in health-care centers, as some aversion was found to white and especially green, design areas with childhood themes, use warm artificial light, and choose user-friendly equipment. Conclusions: Results provide design recommendations of interest and show the possibilities offered by combining both systems to analyze user response.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Ministerio de Economia y Competitividad, Spain (Project TIN2013-45736-R).Higuera-Trujillo, JL.; Montañana I Aviñó, A.; Llinares Millán, MDC. (2017). User Evaluation of Neonatology Ward Design: An Application of Focus Group and Semantic Differential. HERD Health Environments Research & Design Journal. 10(2):23-48. https://doi.org/10.1177/1937586716641275S234810

The use of focus group discussion methodology: Insights from two decades of application in conservation

This is the final version of the article. Available from Wiley via the DOI in this recordFocus group discussion is frequently used as a qualitative approach to gain an in-depth understanding of social issues. The method aims to obtain data from a purposely selected group of individuals rather than from a statistically representative sample of a broader population. Even though the application of this method in conservation research has been extensive, there are no critical assessment of the application of the technique. In addition, there are no readily available guidelines for conservation researchers. Here, we reviewed the applications of focus group discussion within biodiversity and conservation research between 1996 and April 2017. We begin with a brief explanation of the technique for first-time users. We then discuss in detail the empirical applications of this technique in conservation based on a structured literature review (using Scopus). The screening process resulted in 170 articles, the majority of which (67%, n = 114,) were published between 2011 and 2017. Rarely was the method used as a stand-alone technique. The number of participants per focus group (where reported) ranged from 3 to 21 participants with a median of 10 participants. There were seven (median) focus group meetings per study. Focus group discussion sessions lasted for 90 (median) minutes. Four main themes emerged from the review: understanding of people's perspectives regarding conservation (32%), followed by the assessment of conservation and livelihoods practices (21%), examination of challenges and impacts of resource management interventions (19%) and documenting the value of indigenous knowledge systems (16%). Most of the studies were in Africa (n = 76), followed by Asia (n = 44), and Europe (n = 30). We noted serious gaps in the reporting of the methodological details in the reviewed papers. More than half of the studies (n = 101) did not report the sample size and group size (n = 93), whereas 54 studies did not mention the number of focus group discussion sessions while reporting results. Rarely have the studies provided any information on the rationale for choosing the technique. We have provided guidelines to improve the standard of reporting and future application of the technique for conservation.N.T.O. was funded by Cambridge Overseas Trusts, The Wildlife Conservation Society, Wildlife Conservation Network and WildiZe Foundation. NM was funded by the NERC grant (NE/R006946/1), Fondation Wiener Anspach and the Scriven post doctoral fellowships. K.W. was sup-ported by the Australian Research Council Centre of Excellence for Environmental Decisions (CE11001000104) and Future Fellowship (FT100100413) programs and funded by the Australian Government