Fatemeh Rabiee

Focus-group interview and data analysis

In recent years focus-group interviews, as a means of qualitative data collection, have gained popularity amongst professionals within the health and social care arena. Despite this popularity, analysing qualitative data, particularly focus-group interviews, poses a challenge to most practitioner researchers. The present paper responds to the needs expressed by public health nutritionists, community dietitians and health development specialists following two training sessions organised collaboratively by the Health Development Agency, the Nutrition Society and the British Dietetic Association in 2003. The focus of the present paper is on the concepts and application of framework analysis, especially the use of Kruegers framework. It provides some practical steps for the analysis of individual data, as well as focus-group data using examples from the authors own research, in such a way as to assist the newcomer to qualitative research to engage with the methodology. Thus, it complements the papers by Draper (2004) and Fade (2004) that discuss in detail the complementary role of qualitative data in researching human behaviours, feelings and attitudes. Draper (2004) has provided theoretical and philosophical bases for qualitative data analysis. Fade (2004) has described interpretative phenomenology analysis as a method of analysing individual interview data. The present paper, using framework analysis concentrating on focus-group interviews, provides another approach to qualitative data analysis.

A Question of Access: An exploration of the factors that influence the health of young males aged 15 to 19 living in Corby and their use of health care services

Objective To explore the factors that influence young mens access to health services with a view to identifying the potential for health promotion interventions in this area. Design A qualitative study using a semi-structured interview schedule with small groups of young men. Setting Interviews were carried out in the field within school and youth settings. Method A series of three focus group interviews were used as a means of gathering qualitative data. Results It was found that participants consistently equated health to physical fitness, and help-seeking behaviour was dictated by social norms. These demanded that a problem should be both physical and sufficiently severe to justify needing help. General Practitioners (GPs) were not a popular choice for confiding because of discomfort associated with communication issues, unfamiliarity and feelings of vulnerability. In some cases this was expressed using homophobic comments. Participants were more likely to confide in female key workers with whom they had an established relationship. Conclusion The complex factors influencing help-seeking and access to services require that health promotion interventions embrace a social model of health. Clients attitudes and beliefs about health and health services need to be considered within a cultural context taking into account the sociological and environmental conditions in which they live. When providing health service to young men, issues such as com munication, and vulnerability should be considered and it should not be assumed that young men would prefer to see male health professionals.

Experiences of using a memory aid to structure and support daily activities in a small-scale group accommodation for people with dementia

Background Use of technology to structure and support the daily activities of the residents in a small-scale group accommodation (SSGA) for dementia is a new innovation in the Netherlands. This paper presents the process of development of this new way of structuring activities and the findings of a pilot study looking at the experiences of using this device in people with dementia. Method A qualitative method was chosen, data were collected using individual interviews with the residents (n = 6), focus groups interviews with informal carers (n = 5) and members of staff (n = 6). Data were analysed using Ritchie & Spencer’s framework (1994). Findings Three main themes emerged: issues regarding the implementation, needs for further development and the learning experiences acquired during the development. The majority of the residents were happy with the use and function of the memory aid. However, the occurrence of installation errors, limited ease of use and a lack of knowledge regarding the function and use of the memory aid were issues that prevented a successful implementation. Findings highlighted shared views about ways of improving through adaptation of the software program and additional technological applications; internet connectivity, improving its accessibility by using a remote control and adding videos and photos. Conclusion Lessons are learned about the use and transferability of this innovation in people with dementia and other vulnerable target groups including those with learning disabilities as well as its limitation and the needs for further development.

Black and Minority Ethnic Groups’ Perception and Experience of Early Intervention in Psychosis Services in the United Kingdom:

In the United Kingdom, Black and minority ethnic (BME) service users experience adverse pathways into mental health care. Ethnic differences are evident even at first-episode psychosis; therefore, contributory factors must operate prior to first presentation to psychiatric services. This study examines the cultural appropriateness, accessibility, and acceptability of the Early Intervention (EI) for Psychosis Services in Birmingham (the United Kingdom) in improving the experience of care and outcomes for BME patients. Thirteen focus groups were conducted with EI service users (n = 22), carers (n = 11), community and voluntary sector organizations (n = 6), service commissioners (n = 10), EI professionals (n = 9), and spiritual care representatives (n = 8). Data were analyzed using a thematic approach and framework analysis. Findings suggest that service users and carers have multiple, competing, and contrasting explanatory models of illness. For many BME service users, help-seeking involves support from faith/spiritual healers, before seeking medical intervention. EI clinicians perceive that help-seeking from faith institutions in Asian service users might lead to treatment delays. The value of proactively including service user’s religious and spiritual perspectives and experiences in the initial assessment and therapy is recognized. However, clinicians acknowledge that they have limited spiritual/religious or cultural awareness training. There is little collaborative working between mental health services and voluntary and community organizations to meet cultural, spiritual, and individual needs. Mental health services need to develop innovative collaborative models to deliver holistic and person-centered care.

Non-Communicable Disease Risk Factors among Employees and Their Families of a Saudi University: An Epidemiological Study

Objectives To assess the prevalence of noncommunicable disease (NCD) risk factors among Saudi university employees and their families; to estimate the cardiovascular risk (CVR) amongst the study population in the following 10years. Methods The NCD risk factors prevalence was estimated using a cross-sectional approach for a sample of employees and their families aged ≥ 18 years old, in a Saudi university (Riyadh in Kingdom of Saudi Arabia; KSA). WHO STEPwise standardized tools were used to estimate NCD risk factors and the Framingham Coronary Heart Risk Score calculator was used to calculate the CVR. Results Five thousand and two hundred subjects were invited, of whom 4,500 participated in the study, providing a response rate of 87%. The mean age of participants was 39.3±13.4 years. The majority of participants reported low fruit/vegetables consumption (88%), and physically inactive (77%). More than two thirds of the cohort was found to be either overweight or obese (72%), where 36% were obese, and 59% had abdominal obesity. Of the total cohort, 22–37% were found to suffer from dyslipidaemia, 22% either diabetes or hypertension, with rather low reported current tobacco use (12%). One quarter of participants was estimated to have >10% risk to develop cardiovascular disease within the following 10-years. Conclusion The prevalence of NCD risk factors was found to be substantially high among the university employees and their families in this study.

Gym for Free: The short-term impact of an innovative public health policy on the health and wellbeing of residents in a deprived constituency in Birmingham, UK

Background: This paper describes the process, impact and outcomes of an innovative health policy project entitled Gym for Free in Birmingham, UK. Objectives: To explore the short-term effectiveness of the pilot scheme in relation to access, utilisation, perceived benefits and sustainability. Design: Cross-sectional study using survey and focus group interviews. Setting: Community-based physical activity intervention programme. Methods: Data were collected using a validated questionnaire (n = 257) and focus group interviews (n = 9). Descriptive and inferential analyses were conducted where appropriate. Focus group interviews were recorded, transcribed and analysed thematically. Results: Findings showed that the pilot scheme increased the uptake of exercise particularly for women in an economically deprived inner city area. The use of leisure facilities also increased markedly (p < .05). Thus, the Gym for Free scheme was a step towards addressing health inequality by increasing access to and widening participation in exercise with multiple physical, mental and emotional benefits. Conclusion: Based on the findings of this pilot research project, Gym for Free won numerous national awards for its policy innovation, and, through the support and advocacy of the research team, was extended so as to be available to the whole population of Birmingham, between 9 a.m. and 5 p.m., 7 days a week.

Being understood, being respected: an evaluation of mental health service provision from service providers and users' perspectives in Birmingham, UK

This paper examines the views and experiences of using and providing mental health services from the perspectives of black African and black African Caribbean mental health service users, their carers, voluntary services and a range of statutory mental health professionals and commissioners in Birmingham, UK. Using a qualitative approach, data were collected through telephone interviews (n = 15), individual face-to-face (n = 20) and focus group interviews (n = 12), and analysed using Kruegers framework and Rabiees guidelines. Findings showed differences in the experiences of mental health services amongst African Caribbean and their African counterparts, the impact of social inequality on mental health and the needs of asylum seekers and refugees. It highlighted the important role of voluntary organizations in provision of care and support, insufficient provision of psychological therapies and concerns about high dosage of medication. The implications for practice are discussed, particularly the role of health beliefs in help-seeking behaviour and barriers to accessibility of mental health services.