SSM. Qualitative research in health最新文献

{"title":"Bridging work: Community health workers’ role as a continuum of building, guiding, sustaining and transforming the path to health equity","authors":"Melina Michelen ,&nbsp;John Billimek ,&nbsp;Salvador Zarate ,&nbsp;Patricia J. Cantero ,&nbsp;Noraima Chirinos ,&nbsp;Rocio Salazar ,&nbsp;Mary Anne Foo ,&nbsp;Samantha Peralta ,&nbsp;Gloria I. Montiel ,&nbsp;Brittany N. Morey ,&nbsp;Sora P. Tanjasiri ,&nbsp;Alana M.W. LeBrón","doi":"10.1016/j.ssmqr.2025.100693","DOIUrl":"10.1016/j.ssmqr.2025.100693","url":null,"abstract":"<div><div>Community Health Workers (CHW) are commonly conceptualized as a ‘bridge’ that connects the community to health-related systems and resources for which they have historically and contemporarily experienced systemic barriers to accessing. Nonetheless, the nuances of the bridge role remain underexamined. The bridge metaphor, by the static nature of a bridge, can overlook the dynamic and relational aspects of CHWs' work beyond simple liaison functions. This qualitative study shows CHWs' work goes beyond liaison roles, expanding on the bridge metaphor. We evaluated narratives from CHWs from Orange County, California and across California (n = 77), as well as Orange County institutional representatives and policy makers (n = 15) regarding CHWs roles as bridges through interviews and focus groups conducted between February 2023–January 2024. Interviews and focus group discussions were recorded, transcribed, and analyzed following a flexible coding approach. Participants provided nuanced details to expand on the CHW role as bridges, well beyond liaising or connecting. Their narratives illuminate the full arc of CHW bridging work, highlighted in three themes: 1) Building: involving working with the community to identify the need for a bridge and building responsive and adaptable bridges accessible to the community, 2) Guiding: encompasses accompanying and guiding the community to access and cross these bridges, and 3) Sustaining and transforming: comprising maintaining a responsive and accessible bridge while working to reduce the structural gaps necessitating such bridges. Such an understanding of CHW roles can provide insights into the efforts needed to sustain this workforce, critical to public health and community wellbeing.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100693"},"PeriodicalIF":2.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924982","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":"“Implementing a policy is something else”. Governance of a complex health management information system and its digitalization in Tanzania: A qualitative study","authors":"Regine Unkels ,&nbsp;Elibariki Mkumbo ,&nbsp;Ntuli A. Kapologwe ,&nbsp;Fatuma Manzi ,&nbsp;Claudia Hanson ,&nbsp;Helle Mølsted Alvesson ,&nbsp;Andrea B. Pembe","doi":"10.1016/j.ssmqr.2025.100695","DOIUrl":"10.1016/j.ssmqr.2025.100695","url":null,"abstract":"<div><h3>Introduction</h3><div>Health management information systems are crucial for a country's health service planning and monitoring. Research findings indicate however that data produced within this system is often of low quality or not used for decision-making in low-resource settings like Tanzania. Policymaking and -implementation towards efficient data processes and use take place in an environment challenged by limited availability of human and other resources, low levels of supervision and feedback on data quality despite national and international guidance. To better understand how this complexity affects system governance, it is crucial to analyse perceptions and practices of national policymakers and subnational healthcare managers responsible for policy implementation. We therefore aimed to understand how policymakers and health care managers perceive and practice governance of health management information data systems and processes including the introduction of digital technology in Tanzania.</div></div><div><h3>Methods</h3><div>We conducted 16 interviews with policymakers and healthcare managers experienced in governance and use of health management information systems in two districts, two regions and at national level in Tanzania between October 2022 and January 2023. Reflexive thematic analysis grounded in constructivism was used. Themes were developed through reflexive sessions underpinned by complexity theory and Lipsky's theory of street-level bureaucracy.</div></div><div><h3>Results</h3><div>Health management information system governance took place in a complex environment characterized by unpredictable funding and human capacity impairing policy agenda setting and its implementation. Policymakers at national level and healthcare managers at subnational level resorted to different power practices to ensure implementation of national policies and agendas. While policymakers mainly governed data processes using institutionalized means, e.g. international tools and guidance or formal communication platforms, healthcare managers governed implementation by making discrete, contextualized choices on managing relations with other actor groups through negotiation and connection.</div><div>This led to transformed agendas in some cases but also allowed for innovations to make policies work.</div></div><div><h3>Conclusions</h3><div>A new perspective may be needed to understand how governance of routine health information, which is central to health system strengthening, is implemented in policy environments characterized by unpredictability, where governments strive for efficient data use. Drawing on the concept of complex adaptive systems, we propose expanding the definition of Health Management Information System governance to include not only process management but also the relationship management of interdependent actor groups, especially healthcare providers, the primary data collectors.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100695"},"PeriodicalIF":2.5,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924974","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":"Framing video consultations in Danish general practice: An ethnographic study of problematizations underpinning digital integration","authors":"Ditte Bonde Stanek ,&nbsp;Ulrik Bak Kirk ,&nbsp;Michal Frumer","doi":"10.1016/j.ssmqr.2025.100694","DOIUrl":"10.1016/j.ssmqr.2025.100694","url":null,"abstract":"<div><div>Video consultations between patients and healthcare professionals have become an established part of Danish general practice. Initially introduced hastily during the COVID-19 pandemic, their use declined afterwards but remained a political priority. In January 2022, video consultations were formalised as a permanent consultation type, and since late 2024, all general practices in Denmark have been required to offer them. While previous research has explored the early adoption of video consultations during the pandemic, little is known about how general practices sustain and routinize their use in everyday care. This study addresses this gap through ethnographic fieldwork conducted in high-use practices in a post-pandemic context. Drawing on Foucault's concept of problematization, it examines the underlying rationalities and framings that shape the use of video consultations. Our findings show that general practitioners and practice staff primarily framed video consultations as tools for efficiency and time management, particularly in follow-up and acute care. They also described video consultations as providing flexibility that helps to ease busy practice schedules and potentially reduce burnout. These findings suggest that, in digitally mature practices, video consultations function as organisational strategies to balance limited resources with increasing demand.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100694"},"PeriodicalIF":2.5,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924972","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":"“Do you belong in my circle?” – a retrospective reflexive thematic analysis of the particularity and price of solidarity for socioculturally diverse communities in Switzerland during the COVID-19 pandemic","authors":"Gia Thu Ly ,&nbsp;Cristopher I.Kobler Betancourt ,&nbsp;Balthasar L. Hug ,&nbsp;Annika Frahsa","doi":"10.1016/j.ssmqr.2025.100697","DOIUrl":"10.1016/j.ssmqr.2025.100697","url":null,"abstract":"<div><div>During the COVID-19 pandemic, calls for solidarity were widespread, yet its practice proved fragile and uneven. This study explores how individuals from socio-culturally diverse and often marginalized communities in the canton of Bern (Switzerland) experienced and enacted solidarity. Drawing on the conceptual works by Prainsack &amp; Buyx and Komter, we conducted reflexive thematic analysis of seven focus group discussions with 53 participants and identified two central themes: (1) “<em>Commonality, gratitude and reciprocity as particularities of solidarity”</em>, highlighting how shared values and mutual recognition shaped solidaristic practices; and (2) <em>“Barriers, challenges and costs: the ticket to enter solidarity”</em>, capturing affective labour, limitations of institutional solidarity, and conditions under which solidarity was withheld. Focusing on participants' lived experiences, findings concentrate on three key insights: first, participants experienced positive aspects of solidarity—such as shared purpose and commonality—but these were often offset by emotional and social burdens; second, sociocultural and socioeconomic contexts fundamentally shaped who could afford the costs asscociated with solidaristic engagement; and third, institutional appeals to solidarity were insufficient to sustain collective action, failing to meet participants’ diverse needs and capacities. Solidarity was thus enacted in deeply situated and contingent ways, motivated by ethical and emotional imperatives, yet constrained by structural inequalities. The study underscores the need to consider both affective and socio-structural dimensions when fostering solidaristic practices, offering insights for developing context-specific and culturally responsive strategies to support collective action and social cohesion in times of crisis.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100697"},"PeriodicalIF":2.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976546","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":"Do-it-yourself hormones: constructing credible knowledge in an online transgender forum","authors":"Natasa Stoli,&nbsp;Klasien Horstman,&nbsp;Olga Zvonareva","doi":"10.1016/j.ssmqr.2025.100692","DOIUrl":"10.1016/j.ssmqr.2025.100692","url":null,"abstract":"<div><div>On the continuum of patient participation between ‘‘informed patients'’ and ‘‘patients in control’‘, DIY pharmaceuticals are considered the most radical because they are produced outside regular medical professional and regulatory contexts. While some see DIY pharmaceuticals as an important contribution to making pharmaceuticals more accessible, others are concerned because they circumvent established procedures for assessing safety and efficacy. We studied a particular case of DIY pharmaceuticals: citizen drug developers who enable access to hormone therapy in transgender health care through the home production of hormones. By studying an online community of DIY hormone producers, we aimed to gain insight into how they strive to develop knowledge practices that are credible and safe. Theoretically, we drew from science and technology studies scholarship on knowledge credibility and patient participation in knowledge production. We relied on a qualitative study of an online forum to generate our data. The analysis shows how citizen drug developers constructed and performed standards of safety and efficacy in sharing knowledge within their community and how these standards were ensured. DIY pharmaceuticals can be an unconventional but important pathway for citizen participation in biomedical knowledge production, employing strategies for performing credible knowledge outside formal laboratory spaces and in the absence of external supervision.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100692"},"PeriodicalIF":2.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924977","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":"Beyond access: Racial and socioeconomic disparities in device use among youth with type 1 diabetes","authors":"Cassidy Puckett ,&nbsp;Jenise C. Wong ,&nbsp;Berty D.C. Arreguín ,&nbsp;Jennifer K. Raymond ,&nbsp;Stephanie S. Crossen ,&nbsp;Kevin Yen","doi":"10.1016/j.ssmqr.2025.100690","DOIUrl":"10.1016/j.ssmqr.2025.100690","url":null,"abstract":"<div><div>Racial and socioeconomic disparities in medical device use among youth with type 1 diabetes (T1D) are well documented. Inequities in access can arise in the unequal prescription of insulin pumps and continuous glucose monitoring (CGM) devices. Once prescribed, challenges to device use can also create inequities, but less is known about racial and socioeconomic disparities in post-access challenges such as barriers to use at school. Using focus group data from three mixed-method studies of youth with T1D (N = 50) and their caregivers (N = 56), we compare the experiences of higher-income and majority White youth to lower-income and predominantly Latinx and Black youth. We find many similarities, along with two striking differences. First, lower-income and majority Latinx and Black youth express more fear and victimization from bullying at school, which can lead to device discontinuation. Second, these youth and their caregivers report few connections to other families managing T1D but many connections to those with T2D. This social network configuration promotes the typicality assumption that these youth have T2D, which carries significant stigma and limits diabetes-related social capital that might otherwise support device use. Overall, our findings extend health inequities research by identifying unique challenges faced by lower-income and majority Latinx and Black youth with T1D in utilizing medical innovation.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100690"},"PeriodicalIF":2.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924973","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":"Institutional objection to abortion care in Australia: Exploring the perspectives and experiences of key interest-holders","authors":"Casey M. Haining ,&nbsp;Bronwen Merner ,&nbsp;Lindy Willmott ,&nbsp;Louise A. Keogh ,&nbsp;Julian Savulescu","doi":"10.1016/j.ssmqr.2025.100685","DOIUrl":"10.1016/j.ssmqr.2025.100685","url":null,"abstract":"<div><div>Each Australian jurisdiction has decriminalised abortion. Despite this, abortion-seekers face multiple barriers to access, among them is encountering objection by individual health practitioners (conscientious objection) or institutions (institutional objection). This article reports on a qualitative interview study that examined 41 key interest-holders’ perspectives and experiences of institutional objection to abortion. Framework analysis resulted in the generation of four themes: (1) institutional variation in different aspects of abortion care; (2) impacts of institutional objection affected multiple interest-holders; (3) attitudes towards accommodating institutional objection; and (4) suggestions for reimagining institutional objection regulation. Our findings suggest that institutional objection manifests in different ways across settings and results in harm to both patients and health practitioners. Consequently, current approaches to regulating institutional objection should be revisited. Such approaches should consider minimum levels of transparency, information provision, and explore other opportunities for service provision and de-stigmatisation.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100685"},"PeriodicalIF":2.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924979","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":"The silence of reason: Ethnography of the management of secrecy among young people living with HIV in Kinshasa","authors":"Emilia Brazy-Nancy,&nbsp;Elysée Manziasi Sumbi,&nbsp;Petros Isaakidis,&nbsp;Gisèle Mucinya,&nbsp;Umberto Pellecchia","doi":"10.1016/j.ssmqr.2025.100687","DOIUrl":"10.1016/j.ssmqr.2025.100687","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100687"},"PeriodicalIF":2.5,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925103","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":"Eviction as structural community violence: Qualitative focus group findings from the social epidemiology to combat unjust residential evictions (SECURE) study","authors":"Shawnita Sealy-Jefferson ,&nbsp;Loretta J. Ross ,&nbsp;Tamika Anderson-Mays ,&nbsp;Cassy Jones-McBryde ,&nbsp;Kyra Sanders ,&nbsp;Roquesha Oneal ,&nbsp;JoAnn M. Booth ,&nbsp;Jacqueline Brown ,&nbsp;Tamika Anderson ,&nbsp;Maria Hill ,&nbsp;Scarlett Bellamy","doi":"10.1016/j.ssmqr.2025.100691","DOIUrl":"10.1016/j.ssmqr.2025.100691","url":null,"abstract":"<div><h3>Background</h3><div>While growing quantitative evidence documents spillover effects of neighborhood eviction on the health of community members, limited qualitative data exists to identify specific mechanisms of these associations.</div></div><div><h3>Objective</h3><div>To understand how Black women experience living in neighborhoods where other people are evicted from their homes.</div></div><div><h3>Methods</h3><div>As part of the Social Epidemiology to Combat Unjust Residential Evictions (SECURE) Study, we conducted n = 16 focus groups among n = 86 Black reproductive age women from Wayne, Oakland, and Macomb Counties in Michigan (2021–2024). The study was informed by several theoretical frameworks including reproductive justice and intersectionality. We used a semi-structured facilitation guide for focus group discussions. We used a grounded theory approach for data analysis, with line-by-line, open coding of professionally transcribed transcripts, using Atlas.ti software. Themes and subthemes emerged based on density of codes in the data.</div></div><div><h3>Results</h3><div>Thematic analysis revealed several negative impacts specific to the community violence of eviction (n = 209 quotes) including: (1) understanding housing instability caused by eviction, (2) observing belongings removed, (3) eviction and community degradation, (4) mental and emotional responses to witnessing eviction, and (5) neighborhood gentrification.</div></div><div><h3>Significance</h3><div>Findings emphasize that landlord business practices and behaviors before, during, and after residential evictions should be considered an important source of structural community violence. Future policy solutions, social activism, and intervention studies are warranted.</div></div><div><h3>Impact</h3><div>This is the first qualitative study to document potential mechanisms of associations between neighborhood evictions and adverse health among Black communities, and data suggests that evictions are an underacknowledged source of neighborhood structural violence.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100691"},"PeriodicalIF":2.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790651","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":"Using metaphor analysis to understand personal and familial experiences with behavioral variant frontotemporal dementia","authors":"Makenna May ,&nbsp;Ying Zhang ,&nbsp;Laynie Dratch ,&nbsp;William M.P. Klein ,&nbsp;Weiyi Mu ,&nbsp;Megan T. Cho ,&nbsp;Jill Owczarzak","doi":"10.1016/j.ssmqr.2025.100686","DOIUrl":"10.1016/j.ssmqr.2025.100686","url":null,"abstract":"<div><div>Frontotemporal dementia (FTD) is a progressive neurodegenerative condition that causes changes in behavior, personality, and language. As researchers better understand the genetic components of FTD, the number of people pursuing genetic testing, either due to their own symptoms of FTD or their family history, is increasing, making it important to understand the impact of genetic diagnosis on lived experience. Individuals may use metaphors to describe, process, and make sense of their experiences with illness. This qualitative study explores how individuals use metaphors to describe personal and familial experiences with behavioral variant FTD (bvFTD) in order to understand what themes may arise in genetic counseling sessions and to accordingly tailor clinical care. The data for this analysis comes from two study populations: asymptomatic individuals with confirmed genetic risk for bvFTD (n = 16) and individuals diagnosed with bvFTD (n = 9). A secondary analysis of 25 semi-structured interviews was completed. Abductive analysis and metaphor analysis were used to identify the primary metaphors through which participants described their experiences with bvFTD. Two of the main themes expressed by metaphors – (1) lack of control over the disease and (2) uncertainty about inheritance and symptoms – consistently conveyed that participants were grappling with how to understand their lives in the past, present, and future. This study suggests that metaphors can provide valuable insight into how clients are revising their life narratives when bvFTD causes biographical disruption. These findings have important implications for genetic counselors working with individuals who have neurodegenerative conditions.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100686"},"PeriodicalIF":2.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790602","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}