Pub Date : 2025-12-04DOI: 10.1016/j.ssmqr.2025.100682
Harry Barbee , Jordan Ramnarine , Nik M. Lampe , Marci Exsted , Ellesse-Roselee Akré
{"title":"Forced to adapt: Structural constraints and healthcare trade-offs among transgender and gender-diverse populations in the United States","authors":"Harry Barbee , Jordan Ramnarine , Nik M. Lampe , Marci Exsted , Ellesse-Roselee Akré","doi":"10.1016/j.ssmqr.2025.100682","DOIUrl":"10.1016/j.ssmqr.2025.100682","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100682"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.1016/j.ssmqr.2025.100684
Carolin Auschra, Jörg Sydow
Introducing new technologies is a challenge to organizations that strive for reliability. With the help of practice theory and a special focus on resourcing practices, we conducted a qualitative case study on the introduction of two technologies in two German hospitals: one introducing a digital anesthesia documentation software, the other one a robot-assisted knee arthroplasty. Our findings illustrate that, to introduce such technologies, the organizations involved enacted specific practices, among them resourcing practices, in order to increase reliability during all steps of the introduction process. Our study also reveals that, throughout all phases, it is important to collaborate with the technology provider in order to acquire knowledge not only about the new technology, but also about the introduction process and to maintain reliability.
{"title":"Introducing new technologies while maintaining high reliability: Comparison of two hospitals","authors":"Carolin Auschra, Jörg Sydow","doi":"10.1016/j.ssmqr.2025.100684","DOIUrl":"10.1016/j.ssmqr.2025.100684","url":null,"abstract":"<div><div>Introducing new technologies is a challenge to organizations that strive for reliability. With the help of practice theory and a special focus on resourcing practices, we conducted a qualitative case study on the introduction of two technologies in two German hospitals: one introducing a digital anesthesia documentation software, the other one a robot-assisted knee arthroplasty. Our findings illustrate that, to introduce such technologies, the organizations involved enacted specific practices, among them resourcing practices, in order to increase reliability during all steps of the introduction process. Our study also reveals that, throughout all phases, it is important to collaborate with the technology provider in order to acquire knowledge not only about the new technology, but also about the introduction process and to maintain reliability.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100684"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.1016/j.ssmqr.2025.100680
Tim Sedgley , Joanne Alexander , Laurence Lessard-Phillips , Aisha Macgregor , Liz Forbat
Background
Having a terminal illness is associated with an increased risk of living in poverty and destitution at end of life. This is more pronounced for migrants who may not have the same social and cultural capital, or local family support, that established citizens have. This paper explores the financial challenges for migrants with a terminal illness.
Methodology
Qualitative interviews were conducted with healthcare staff, and legal and migration specialists supporting migrants with a terminal illness in the UK. A total of 22 people were interviewed, comprising 14 working within health/palliative care settings, four in legal/policy settings, and four in migrant support.
Findings
Thematic analysis identified that having a terminal illness as a migrant accompanies severe financial and material challenge. Migrants continued to work while receiving chemotherapy and used unregulated money lenders to stave off poverty. The expense of visa applications, insecure visa terms, and exclusion from statutory and healthcare support combined to produce enormous financial, emotional and physical strain on terminally ill migrants. Interviewees situated these challenges as both impediments to their work supporting migrants, and as constituting a form of bureaucratic violence.
Conclusion
Financial precarity for migrants with terminal illness was exacerbated by bureaucratic systems and processes (e.g., immigration policy and welfare exclusion). There is urgent need for systemic reform to ensure that good quality of living and dying is not a privilege of the financially secure. However, this is predicated on a political will and interest to improve the lives and deaths of migrants with terminal illness.
{"title":"Bureaucratic violence: Professionals’ views of the financial experiences of terminally ill migrants","authors":"Tim Sedgley , Joanne Alexander , Laurence Lessard-Phillips , Aisha Macgregor , Liz Forbat","doi":"10.1016/j.ssmqr.2025.100680","DOIUrl":"10.1016/j.ssmqr.2025.100680","url":null,"abstract":"<div><h3>Background</h3><div>Having a terminal illness is associated with an increased risk of living in poverty and destitution at end of life. This is more pronounced for migrants who may not have the same social and cultural capital, or local family support, that established citizens have. This paper explores the financial challenges for migrants with a terminal illness.</div></div><div><h3>Methodology</h3><div>Qualitative interviews were conducted with healthcare staff, and legal and migration specialists supporting migrants with a terminal illness in the UK. A total of 22 people were interviewed, comprising 14 working within health/palliative care settings, four in legal/policy settings, and four in migrant support.</div></div><div><h3>Findings</h3><div>Thematic analysis identified that having a terminal illness as a migrant accompanies severe financial and material challenge. Migrants continued to work while receiving chemotherapy and used unregulated money lenders to stave off poverty. The expense of visa applications, insecure visa terms, and exclusion from statutory and healthcare support combined to produce enormous financial, emotional and physical strain on terminally ill migrants. Interviewees situated these challenges as both impediments to their work supporting migrants, and as constituting a form of bureaucratic violence.</div></div><div><h3>Conclusion</h3><div>Financial precarity for migrants with terminal illness was exacerbated by bureaucratic systems and processes (e.g., immigration policy and welfare exclusion). There is urgent need for systemic reform to ensure that good quality of living and dying is not a privilege of the financially secure. However, this is predicated on a political will and interest to improve the lives and deaths of migrants with terminal illness.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100680"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Longitudinal reflections on family caregiving experiences: Insights from solicited diaries of caregivers of people living with dementia in British Columbia, Canada","authors":"Kishore Seetharaman , Lucy Kervin , Koushambhi Khan , Heather Cooke , Jennifer Baumbusch","doi":"10.1016/j.ssmqr.2025.100677","DOIUrl":"10.1016/j.ssmqr.2025.100677","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100677"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.1016/j.ssmqr.2025.100681
Beth St. Jean , Katherine F. Raymond , Brooke Fisher Liu , Duli Shi , Miranda Downey , Twanna Hodge , Jane Behre , Nicole Miller
COVID long-haulers face a great deal of uncertainty and information-related challenges that can impede their ability to cope with and manage this serious chronic health condition. We conducted an explanatory sequential mixed-methods study involving an online survey (n = 135) and follow-up interviews (n = 29) to investigate the information-related experiences of COVID long-haulers. In this paper, we share the strategies they used to navigate uncertainty and to assess the trustworthiness of COVID-19-related information. We found that participants experienced a great deal of uncertainty, often relating to the fear, anxiety, and depression they felt as they were unsure whether they would ever recover. Nearly all participants shared strategies they used to deal with uncertainty, which included seeking, sharing, and/or avoiding information; using information to manage one's health; taking control of what they can and/or giving up control over things they cannot; and accepting their situation. With specific regard to information management, participants shared several strategies they used to assess the trustworthiness of COVID-19-related information. These included looking into the source and/or authors of the information, making sure that the authors provided evidence and citations for their claims, investigating why the information was being shared, making sure that the source/authors acknowledged remaining gaps or uncertainty in our knowledge, and checking multiple sources to cross-verify the information they had found. Our findings have important implications for the design of optimal approaches that can help to support and facilitate COVID long-haulers’ uncertainty management and information assessment efforts.
{"title":"“I'm staying as informed as I can and trying to make nutritional & lifestyle amendments”: COVID long-haulers’ strategies for managing uncertainty and assessing the trustworthiness of COVID-19-related information","authors":"Beth St. Jean , Katherine F. Raymond , Brooke Fisher Liu , Duli Shi , Miranda Downey , Twanna Hodge , Jane Behre , Nicole Miller","doi":"10.1016/j.ssmqr.2025.100681","DOIUrl":"10.1016/j.ssmqr.2025.100681","url":null,"abstract":"<div><div>COVID long-haulers face a great deal of uncertainty and information-related challenges that can impede their ability to cope with and manage this serious chronic health condition. We conducted an explanatory sequential mixed-methods study involving an online survey (<em>n</em> = 135) and follow-up interviews (<em>n</em> = 29) to investigate the information-related experiences of COVID long-haulers. In this paper, we share the strategies they used to navigate uncertainty and to assess the trustworthiness of COVID-19-related information. We found that participants experienced a great deal of uncertainty, often relating to the fear, anxiety, and depression they felt as they were unsure whether they would ever recover. Nearly all participants shared strategies they used to deal with uncertainty, which included seeking, sharing, and/or avoiding information; using information to manage one's health; taking control of what they can and/or giving up control over things they cannot; and accepting their situation. With specific regard to information management, participants shared several strategies they used to assess the trustworthiness of COVID-19-related information. These included looking into the source and/or authors of the information, making sure that the authors provided evidence and citations for their claims, investigating why the information was being shared, making sure that the source/authors acknowledged remaining gaps or uncertainty in our knowledge, and checking multiple sources to cross-verify the information they had found. Our findings have important implications for the design of optimal approaches that can help to support and facilitate COVID long-haulers’ uncertainty management and information assessment efforts.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100681"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.1016/j.ssmqr.2025.100679
Saba Rouhani , Bradley E. Silberzahn , Laura N. Sisson , Abigail K. Winiker , Jinwoo Kim , Leanne Zhang , Kristin E. Schneider , Susan G. Sherman
Drug decriminalization aims to reduce the harms of punitive enforcement while improving police-community relations. Baltimore City implemented de facto decriminalization in 2020, declining to prosecute simple drug possession cases. We examined perspectives of 26 people who use drugs (PWUD) and 22 police officers on policy impacts using semi-structured interviews conducted in 2023–2024. Using post-structural policy analysis, we explored support for criminalization, experiences of and support for the decriminalization policy, and perceptions of persistent or emerging challenges after its implementation. Both PWUD and police criticized criminalization of drug possession as ineffective and inefficient, agreeing that policing should focus on more serious and violent crime rather than personal drug use. Reflecting on decriminalization, PWUD reported persistent distrust and fear of police despite reduced risk of arrest and described encounters as unpredictable. Police officers described the policy as compromising their ability to maintain public order or respond effectively to community complaints about drug activity. Both groups identified police inaction as problematic but framed it differently—PWUD perceived intentional negligence on the part of police, while police perceived the policy to fundamentally constrain their ability to fulfill their role. Participants from both groups highlighted underlying neighborhood disinvestment and absence of social services as key challenges to improving public health and safety. Effective drug policy reform requires comprehensive approaches that couple non-punitive policies with clearly refocused policing protocols and robust community investment.
{"title":"Experiences of a drug decriminalization policy among police and people who use drugs in Baltimore City: a post-structural policy analysis","authors":"Saba Rouhani , Bradley E. Silberzahn , Laura N. Sisson , Abigail K. Winiker , Jinwoo Kim , Leanne Zhang , Kristin E. Schneider , Susan G. Sherman","doi":"10.1016/j.ssmqr.2025.100679","DOIUrl":"10.1016/j.ssmqr.2025.100679","url":null,"abstract":"<div><div>Drug decriminalization aims to reduce the harms of punitive enforcement while improving police-community relations. Baltimore City implemented <em>de facto</em> decriminalization in 2020, declining to prosecute simple drug possession cases. We examined perspectives of 26 people who use drugs (PWUD) and 22 police officers on policy impacts using semi-structured interviews conducted in 2023–2024. Using post-structural policy analysis, we explored support for criminalization, experiences of and support for the decriminalization policy, and perceptions of persistent or emerging challenges after its implementation. Both PWUD and police criticized criminalization of drug possession as ineffective and inefficient, agreeing that policing should focus on more serious and violent crime rather than personal drug use. Reflecting on decriminalization, PWUD reported persistent distrust and fear of police despite reduced risk of arrest and described encounters as unpredictable. Police officers described the policy as compromising their ability to maintain public order or respond effectively to community complaints about drug activity. Both groups identified police inaction as problematic but framed it differently—PWUD perceived intentional negligence on the part of police, while police perceived the policy to fundamentally constrain their ability to fulfill their role. Participants from both groups highlighted underlying neighborhood disinvestment and absence of social services as key challenges to improving public health and safety. Effective drug policy reform requires comprehensive approaches that couple non-punitive policies with clearly refocused policing protocols and robust community investment.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100679"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.ssmqr.2025.100609
Vlas Nikulkin, Catharina Margaretha van Leersum, Alexander Peine
{"title":"Corrigendum to “Key users and the creation of everyday relations with digital technologies in care” [SSM - Qualitative Research in Health 7C (2025) 100547]","authors":"Vlas Nikulkin, Catharina Margaretha van Leersum, Alexander Peine","doi":"10.1016/j.ssmqr.2025.100609","DOIUrl":"10.1016/j.ssmqr.2025.100609","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100609"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.ssmqr.2025.100675
Chadwick K. Campbell , Hannah E. Reynolds , Kirstin Kielhold , Daniel E. Siconolfi , Stephen D. Ramos , Susan M. Kegeles , Erik D. Storholm
While much research has focused on individual (e.g., mental health, substance use) and structural factors (e.g., stigma, institutional racism) driving HIV inequities, less studied are the macro-structural factors like policies governing healthcare and transportation. Using the framework of structural intersectionality, we explore how transportation barriers and administrative burden – the experience of accessing safety net services as burdensome – interfered with sustained HIV care engagement among Black sexual minority men living with HIV (BSMM+) in the US South. Between July 2022 and September 2023, we conducted qualitative interviews with 27 BSMM+. Interviews averaged 60 min, and data were analyzed using codebook thematic analysis. Transportation barriers included limited bus routes, reduced capacity during COVID-19, and long travel times. Administrative burden included: not knowing how to access benefits; inconsistent benefit eligibility, required frequent renewals of public insurance; and waiting in long lines for services. Most barriers existed prior to, and were exacerbated by, COVID-related restrictions. Further, barriers intersected such as when reduced capacity on public transit overlapped with changing clinic hours. Individual-level factors have long been the focus of HIV prevention and care interventions. Our findings offer important insights into how macro-structural barriers influence HIV care engagement. Importantly, macro-structural barriers do not impact all people equally. The need for, and access to transportation and safety net services vary by factors such as race, class, and geography, with the most marginalized being the most likely to face these hurdles. Additional research and policy changes are needed to address macro-structural factors and achieve equitable HIV outcomes.
{"title":"Transportation, administrative burden, and COVID-19: A structural intersectional analysis of barriers to HIV care among Black sexual minority men living with HIV in the US South","authors":"Chadwick K. Campbell , Hannah E. Reynolds , Kirstin Kielhold , Daniel E. Siconolfi , Stephen D. Ramos , Susan M. Kegeles , Erik D. Storholm","doi":"10.1016/j.ssmqr.2025.100675","DOIUrl":"10.1016/j.ssmqr.2025.100675","url":null,"abstract":"<div><div>While much research has focused on individual (e.g., mental health, substance use) and structural factors (e.g., stigma, institutional racism) driving HIV inequities, less studied are the macro-structural factors like policies governing healthcare and transportation. Using the framework of structural intersectionality, we explore how transportation barriers and administrative burden – the experience of accessing safety net services as burdensome – interfered with sustained HIV care engagement among Black sexual minority men living with HIV (BSMM+) in the US South. Between July 2022 and September 2023, we conducted qualitative interviews with 27 BSMM+. Interviews averaged 60 min, and data were analyzed using codebook thematic analysis. Transportation barriers included limited bus routes, reduced capacity during COVID-19, and long travel times. Administrative burden included: not knowing how to access benefits; inconsistent benefit eligibility, required frequent renewals of public insurance; and waiting in long lines for services. Most barriers existed prior to, and were exacerbated by, COVID-related restrictions. Further, barriers intersected such as when reduced capacity on public transit overlapped with changing clinic hours. Individual-level factors have long been the focus of HIV prevention and care interventions. Our findings offer important insights into how macro-structural barriers influence HIV care engagement. Importantly, macro-structural barriers do not impact all people equally. The need for, and access to transportation and safety net services vary by factors such as race, class, and geography, with the most marginalized being the most likely to face these hurdles. Additional research and policy changes are needed to address macro-structural factors and achieve equitable HIV outcomes.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100675"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.ssmqr.2025.100656
Anja M.B. Jensen, Sif Sofie Vange, Signe Smith Jervelund, Anne Sofie Borsch
{"title":"Corrigendum to “On-screen medicine. How patients present themselves to medical specialists in video consultations” [SSM - Qualitative Research in Health 8C (2025) 100643]","authors":"Anja M.B. Jensen, Sif Sofie Vange, Signe Smith Jervelund, Anne Sofie Borsch","doi":"10.1016/j.ssmqr.2025.100656","DOIUrl":"10.1016/j.ssmqr.2025.100656","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100656"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-28DOI: 10.1016/j.ssmqr.2025.100671
Margaret M. Palmer
Young Adult Literature (YAL) provides adolescents with cultural scripts for understanding gender, sexuality, and power, making it essential to examine portrayals of sexual violence and its aftermath. They can normalize sexual harm by suggesting that girls must manage violence on their own and that institutions will not intervene, or they can challenge rape culture by modeling resistance and accountability. This paper analyzes 20 popular YAL novels published between 2005 and 2013 using iterative inductive content analysis (ICA), an approach involving repeated cycles of reading, coding, and refining categories. I find that characters employ six tactics: saying no, joking, threatening violence, creating space, relocation, and violence, both independently and in combination when responding to sexual violence. Schools are portrayed as failing girls, treating sexual harassment as misunderstandings and dismissing girls as “divas” when they protest; notably, school discipline disproportionately targets Latino boys as perpetrators while excusing white boys, who more frequently commit sexual violence in this sample. Police are almost entirely absent, responding to sexual violence in only two texts. Collectively, these patterns demonstrate how young adult romance novels reproduce central assumptions of rape culture: that sexual violence is an individual rather than institutional issue, that resistance is constrained by gender, and that institutional accountability is not reliable.
{"title":"“Stop acting like a diva”: Responses to sexual violence in young adult romance novels","authors":"Margaret M. Palmer","doi":"10.1016/j.ssmqr.2025.100671","DOIUrl":"10.1016/j.ssmqr.2025.100671","url":null,"abstract":"<div><div>Young Adult Literature (YAL) provides adolescents with cultural scripts for understanding gender, sexuality, and power, making it essential to examine portrayals of sexual violence and its aftermath. They can normalize sexual harm by suggesting that girls must manage violence on their own and that institutions will not intervene, or they can challenge rape culture by modeling resistance and accountability. This paper analyzes 20 popular YAL novels published between 2005 and 2013 using iterative inductive content analysis (ICA), an approach involving repeated cycles of reading, coding, and refining categories. I find that characters employ six tactics: saying <em>no</em>, joking, threatening violence, creating space, relocation, and violence, both independently and in combination when responding to sexual violence. Schools are portrayed as failing girls, treating sexual harassment as misunderstandings and dismissing girls as “divas” when they protest; notably, school discipline disproportionately targets Latino boys as perpetrators while excusing white boys, who more frequently commit sexual violence in this sample. Police are almost entirely absent, responding to sexual violence in only two texts. Collectively, these patterns demonstrate how young adult romance novels reproduce central assumptions of rape culture: that sexual violence is an individual rather than institutional issue, that resistance is constrained by gender, and that institutional accountability is not reliable.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100671"},"PeriodicalIF":2.5,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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