What\u27s Rapport Got To Do With It? The Practical Accomplishment of Fieldwork Relations Between Young Female Researchers and Socially Marginalised Older Men

Drawing on field notes, interview transcripts and personal reflections, this paper describes an ethnographic research project as a practical accomplishment. The project has employed two young female fieldworkers in negotiating and documenting the social worlds of socially disadvantaged and marginalised older men in inner city Sydney, Australia. We provide a rich description of the various processes involved in this kind of research such as gaining entry, recruiting participants, obtaining consent and conducting interviews. Our analytical and interpretive focus is on the social relationships of fieldwork and the problematic role of rapport as the ideal (or only) basis for such relationships. We show how these relationships and the information they generate have been variably and situationally accomplished in our project. Our findings suggest that communicative relationships in field research can take a variety of forms that produce useful data but that these are not necessarily illustrative of rapport between researcher and researched. We conclude by arguing the need for the methodological literature of ethnography to develop a new analytical vocabulary for describing research practice and a conceptual framework that moves beyond neo-positivist and normative prescriptions for doing \u27good\u27 fieldwork

Ethnicity or cultural group identity of pregnant women in Sydney, Australia: is country of birth a reliable proxy measure?

Background: Australia has one of the most ethnically and culturally diverse maternal populations in the world. Routinely few variables are recorded in clinical data or health research to capture this diversity. This paper explores and how pregnant women, Australian-born and overseas-born, respond to survey questions on ethnicity or a cultural group identity, and whether country of birth is a reliable proxy measure. Methods: Frequency tabulations and inductive qualitative analysis of data from two questions on country of birth, and identification with an ethnicity or cultural group from a larger survey of pregnant women attending public antenatal clinics across four hospitals in Sydney, Australia. Results: Responses varied widely among the 762 with 75 individual cultural groups or ethnicities and 68 countries of birth reported. For Australian-born women (n=293), 23% identified with a cultural group or ethnicity, and 77% did not. For overseas-born women (n=469), 44% identified with a cultural group or ethnicity and 56% did not. Responses were coded under five emerging themes. Conclusions: Ethnicity and cultural group identity are complex concepts; women across and within countries of birth identified differently. Over three quarters of Australian-born, and over half of over-seas born women, reported no ethnicity or cultural group identity, indicating country of birth is not a reliable measure for identifying diversity. Researchers should scrutinise research questions and data usage, policy makers consider the complexity of ethnicity or cultural group identity, and the limitations of a single variable measure to identify ethnically and culturally diverse pregnant women and deliver woman-centred care.NHMR

Testing a health research instrument to develop a statewide survey on maternity care

Partnerships between researchers and end users are an important strategy for research uptake in policy and practice. This paper describes how collaboration between an academic research organisation (the Kolling Institute) and a government performance reporting agency (the NSW Bureau of Health Information (BHI)), contributed to the development of a new statewide maternity care survey for NSW.NHMR

Supporting research translation through partnership

This paper provides a brief introduction to research translation in health care and three essential building blocks that support the process of using evidence to inform health policy and practice: partnerships, system readiness and diversity of evidence. We then describe a ‘live’ example of research translation currently underway between a research group and policy makers working together to support maternity care in NSW, and the important facilitating role of a shared knowledge broker.NSW Population Health and Health Services Research Support Program (PHHSRSP) gran

Pre-notification letter type and response rate to a postal survey among women who have recently given birth

Background: Surveys are commonly used in health research to assess patient satisfaction with hospital care. Achieving an adequate response rate, in the face of declining trends over time, threatens the quality and reliability of survey results. This paper reports on a postal satisfaction survey conducted with women who had recently given birth, and explores the effect of two strategies on response rates. Methods: A sample of 2048 Australian women who had recently given birth were invited to participate in a postal survey about their recent experiences with maternity care. The study design included two different strategies intended to increase response rates: a randomised controlled trial testing two types of pre-notification letter (with or without the option of opting out of the survey), and a request for consent to link survey data with existing routinely collected health data (omitting the latter data items from the survey reduced survey length and participant burden). Results: The survey had an overall response rate of 46%. Women receiving the pre-notification letter with the option of opting out of the survey were more likely to actively decline to participate than women receiving the letter without this option, although the overall numbers of women were small (27 versus 12). Letter type was not significantly associated with the return of a completed survey. Among women who completed the survey, 97% gave consent to link their survey data with existing health data. Conclusions: Seeking consent for record linkage was highly acceptable to women who completed the survey, and represents an important strategy to add to the arsenal for designing and implementing effective surveys. In addition to aspects of survey design, future research should explore how to more effectively influence personal constructs that contribute to the decision to participate in surveys.NHMR

Woman-centred maternity care: what do women say? Protocol for a survey of women receiving maternity care in NSW

Background: Over the past decade or so, recommendations for improvements in maternity care have emphasised the importance of providing woman-centred care. Feedback from women about existing maternity services can help to identify whether services are currently meeting women’s needs. The present study aims to capture women’s expectations of, and experiences with maternity care, and to explore whether maternal and birth characteristics are associated with those experiences. Methods: A survey will be undertaken with a sample of approximately 2,000 women who have given birth over a 3-month period at seven public maternity units in two neighbouring health districts in New South Wales (NSW), Australia. The survey will be mailed out three-four months after birth. The study will also examine two strategies intended to increase survey response rates: use of two types of pre-notification letters, and request for consent from women to link survey responses with health information recorded at the time of birth. Data analysis will examine response rate, evidence of sample bias and effect of pre-notification letters; describe expectations and experiences with maternity care and associations with maternal and/or health characteristics; and where possible, compare results with maternity satisfaction data reported by others. Discussion: This study will provide, for the first time in NSW, comprehensive information about women’s expectations, experiences and satisfaction with maternity services in two local health districts. It will identify aspects of care that are meeting women’s needs, and areas where care and service provision may be improved in line with the aspirations of Towards Normal Birth. The survey tool may also prove to be appropriate for use by other health districts and/or state-wide.NHMR

Woman-centred maternity care: what do women say? Protocol for a survey of women receiving maternity care in NSW

Background: Over the past decade or so, recommendations for improvements in maternity care have emphasised the importance of providing woman-centred care. Feedback from women about existing maternity services can help to identify whether services are currently meeting women’s needs. The present study aims to capture women’s expectations of, and experiences with maternity care, and to explore whether maternal and birth characteristics are associated with those experiences. Methods: A survey will be undertaken with a sample of approximately 2,000 women who have given birth over a 3-month period at seven public maternity units in two neighbouring health districts in New South Wales (NSW), Australia. The survey will be mailed out three-four months after birth. The study will also examine two strategies intended to increase survey response rates: use of two types of pre-notification letters, and request for consent from women to link survey responses with health information recorded at the time of birth. Data analysis will examine response rate, evidence of sample bias and effect of pre-notification letters; describe expectations and experiences with maternity care and associations with maternal and/or health characteristics; and where possible, compare results with maternity satisfaction data reported by others. Discussion: This study will provide, for the first time in NSW, comprehensive information about women’s expectations, experiences and satisfaction with maternity services in two local health districts. It will identify aspects of care that are meeting women’s needs, and areas where care and service provision may be improved in line with the aspirations of Towards Normal Birth. The survey tool may also prove to be appropriate for use by other health districts and/or state-wide.NHMR

Maternity Care in NSW - Having Your Say 2013-14. A survey about women’s views of their maternity care

This report details the findings of a survey with women about their expectations and experiences of maternity care in public hospitals in New South Wales (NSW), Australia. The report provides background information about the survey project, and a summary of the responses from the women participating in the survey. The survey and this report have been structured around the three main maternity care periods: antenatal (pregnancy); birth; and postnatal (the first days and weeks after birth). All women who gave birth between 1 May and 31 July 2013 at seven public maternity units in NSW were eligible to participate in the survey. These seven maternity units account for approximately 11% of births in public hospitals in NSW, and represent a mixture of urban and regional, and tertiary and smaller health services. A total of 2048 women were mailed a survey. Survey packs were returned as undeliverable for 59 women, and 913 women returned a completed survey, representing a response rate of 46% (913/1989).NHMR

Maternity Care in NSW - Having Your Say 2013-14. A survey about women’s views of their maternity care

This report details the findings of a survey with women about their expectations and experiences of maternity care in public hospitals in New South Wales (NSW), Australia. The report provides background information about the survey project, and a summary of the responses from the women participating in the survey. The survey and this report have been structured around the three main maternity care periods: antenatal (pregnancy); birth; and postnatal (the first days and weeks after birth). All women who gave birth between 1 May and 31 July 2013 at seven public maternity units in NSW were eligible to participate in the survey. These seven maternity units account for approximately 11% of births in public hospitals in NSW, and represent a mixture of urban and regional, and tertiary and smaller health services. A total of 2048 women were mailed a survey. Survey packs were returned as undeliverable for 59 women, and 913 women returned a completed survey, representing a response rate of 46% (913/1989).NHMR

Adrift in time:The subjective experience of circadian challenge during COVID-19 amongst people with mood disorders

Social distancing/lockdown policies during the coronavirus (COVID-19) pandemic may alter social rhythms of people through imposition of restrictions on normal daily activities. This may in turn challenge circadian function, particularly in people with mood disorders. Although objective data describing the relationship between circadian disturbances and mood disorders exist, data regarding the subjective experience of circadian challenge is sparse, and its association with mood symptoms is unclear. The present qualitative study was one component of a mixed-methods multi-national project, which took advantage of widespread disruption to daily routines due to Government COVID-related lockdowns during 2020. The Behavior Emotion and Timing during COVID-19 (BEATCOVID) survey study included three open questions generating qualitative data on participants' subjective experience of social disruption due to social distancing/lockdown policies, two of which asked about the barriers and opportunities for stabilizing routines. Responses were coded and analyzed using Thematic Analysis. A total of N = 997 participants responded to at least one of the free-text questions. Four themes were identified: 1) loss of daily timed activities, 2) role of social interaction, 3) altered time perception and 4) disruption to motivation and associated psychological effects. Themes were organized into a provisional heuristic map, generating hypotheses for future research centered on the new concept of 'psychological drift.