Jeff Breckon

Using QSR‐NVivo to facilitate the development of a grounded theory project: an account of a worked example

This paper demonstrates how the software package QSR‐NVivo can be used to faciitate a grounded theory approach. Recent research evidence has questioned the methodological quality of many studies that claim to utilise grounded theory. This paper argues that qualitative data analysis software can be used to encourage good quality grounded theory research by facilitating many of the key processes and characteristics associated with this approach. To achieve this, the paper identifies a number of grounded theory characteristics, common to all revisions of the methodology. It then describes the development of a recent study, which examined how people successfully maintain long‐term physical activity behaviour change. The purpose of this is to demonstrate how different functions of QSR‐NVivo may be used in conjunction with the key grounded theory characteristics. In summary, QSR‐NVivo is a powerful tool that, if used appropriately, can facilitate many aspects of the grounded theory process from the design and early sampling procedures, through to the analysis of data, theoretical development and presentation of findings.

Physical Activity Behavior Change Interventions Based on the Transtheoretical Model: A Systematic Review:

This review critically examines Transtheoretical Model (TTM)—based interventions for physical activity (PA) behavior change. It has been suggested that the TTM may not be the most appropriate theoretical model for applications to PA behavior change. However, previous reviews have paid little or no attention to how accurately each intervention represents the TTM. Findings comprise two sections: sample characteristics of each intervention reviewed and a summary outlining the use of the TTM to develop the interventions. Results reveal numerous inconsistencies regarding the development and implementation/application of TTM-based interventions. Specifically, the majority of interventions reported to be based on the TTM fail to accurately represent all dimensions of the model. Therefore, until interventions are developed to accurately represent the TTM, the efficacy of these approaches and the appropriateness of the underpinning theoretical model cannot be determined.

Key stakeholders’ perspectives towards childhood obesity treatment: A qualitative study:

Over the past three decades, there has been a dramatic global increase in childhood obesity. A better understanding of stakeholders’ perceptions of intervention requirements could contribute to developing more effective interventions for childhood obesity. This study provides a qualitative, in-depth, analysis of stakeholders’ (children, parents and health professionals) perspectives toward the efficacy of childhood obesity treatment interventions. Twenty-six stakeholders were recruited using purposive sampling; semi-structured interviews were adopted to explore stakeholders’ perceptions with data analysed using a framework approach. Stakeholders concurred that treatment should be family-based incorporating physical activity, nutrition and psychological components, and be delivered in familiar environments to recipients. However, incongruence existed between stakeholders towards the sustainability of obesity treatment interventions. Parents and children reported needing ongoing support to sustain behavioural changes made during treatment, while health professionals suggested interventions should aim to create autonomous individuals who exit treatment and independently sustain behaviour change. This study provides an insight into issues of stakeholder involvement in the obesity intervention design and delivery process. To promote long-term behaviour change, there needs to be increased congruence between the delivery and receipt of childhood obesity treatment interventions. Interventions need to incorporate strategies that promote autonomous and self-regulated motivation, to enhance families’ confidence in sustaining behaviour change independent of health professional support.

A review of telephone coaching services for people with long-term conditions

In one-to-one telephone coaching, the patient receives regular telephone calls from a health professional. We have reviewed the evidence for one-to-one telephone coaching. Following a literature search we retrieved 41 articles which reported on the development and the efficacy of 34 separate telephone coaching interventions for LTC management. Telephone coaching for LTC management has only occurred in the last ten years, is becoming increasingly prevalent, and is dominated by interventions in North America and Europe. Twenty-seven (79%) of the studies reported on randomised designs involving at least one control or comparison group/condition. Of the 34 interventions reviewed, 17 (50%) were aimed at diabetes management and 17 (50%) were designed to manage chronic cardiovascular conditions. Most studies (32 or 94%) reported outcomes in favour of the telephone coaching intervention, although few (15%) employed any form of cost-benefit analysis (CBA). In order to obtain a better impression of overall service efficacy, more clearly defined service outcomes are required in future.

Grounded Theory-Based Research within Exercise Psychology: A Critical Review

This article critically reviews the current body of grounded theory research within exercise psychology. Previous evidence has questioned the quality of grounded theory research within this academic domain. Guidelines for assessing grounded theory research are presented based on the common defining characteristics of the methodology and other published recommendations for assessing qualitative research. The review identified 21 articles that report on grounded theory studies conducted between 1999 and 2008. Findings comprise two sections: summary demographic characteristics and descriptive sample characteristics relating to the proposed assessment criteria. Results demonstrate that within exercise psychology, grounded theory is an increasingly popular methodological approach. However, many studies demonstrate a poor understanding of the grounded theory methodology or fail to present an adequate account of the research process. To further legitimise grounded theory as a form of enquiry within exercise psychology and to encourage greater research rigour in all grounded theory applications, it is crucial that both authors and reviewers understand the tenets of this approach and the limitations associated with a number of previous studies.

A phenomenological exploration of exercise mental toughness: perceptions of exercise leaders and regular exercisers

Although elite sport has provided an ideal context for exploring mental toughness (MT), currently, there is scant research examining how this construct might be equally applicable in exercise settings, where high rates of attrition have been reported. The present research, therefore, aimed to address this gap, and to understand and conceptualise exercise mental toughness (EMT) through in-depth phenomenological interviews with a range of exercise leaders and exercise participants. Seven qualified and experienced exercise leaders and seven regular and frequent exercisers from formal exercise environments (i.e. gym and fitness classes) were interviewed. Interviews were digitally recorded, transcribed verbatim and analysed independently by members of the interdisciplinary research team. Key themes were agreed and member checking was used to promote trustworthiness of interpretations. MT was recognisable in exercise settings, with 10 general dimensions found to be relatively consistent with conceptualisations derived from elite sport (e.g. commitment, focus, emotional control, etc.). Importantly, present findings reveal how mentally tough exercisers think and behave in exercise settings. Some negative consequences were also reported such as over-training and training with injuries. The article also discusses how components of EMT may be valuable in terms of exercise maintenance and relapse prevention during exercise behaviour change.

A grounded theory of successful long-term physical activity behaviour change

This paper presents a grounded theory of successful long-term physical activity (PA) behaviour change. Currently, a range of theoretical frameworks are available to guide researchers and practitioners in the development and implementation of PA behaviour change interventions. However, none of these theoretical approaches are specifically intended to account for PA-related behaviours. In addition, there is limited evidence to support the efficacy of current intervention strategies, particularly in the long term. To obtain a more ecologically valid explanation of successful PA behaviour change, this study describes the development of an explanatory model of successful PA behaviour change, grounded in relevant ‘real life’ experiences. To achieve this, a grounded theory methodology was adopted. Twenty-one adult participants, who had previously led sedentary lifestyles and had successfully completed a physical activity referral scheme to increase their PA participation, took part in in-depth interviews. All participants had been maintaining an increase in levels of PA participation for between four and seven years. An explanatory model of PA behaviour change is presented, which identifies individual core beliefs or values alongside various situational/informational cues, as key behavioural determinants. The results are discussed based on their contribution to the advancement of theoretical insights and applied practices within exercise psychology.

Embedding Physical Activity in the Heart of the NHS: The Need for a Whole-System Approach

AbstractSolutions to the global challenge of physical inactivity have tended to focus on interventions at an individual level, when evidence shows that wider factors, including the social and physical environment, play a major part in influencing health-related behaviour. A multidisciplinary perspective is needed to rewrite the research agenda on physical activity if population-level public health benefits are to be demonstrated. This article explores the questions that this raises regarding the particular role that the UK National Health Service (NHS) plays in the system. The National Centre for Sport and Exercise Medicine in Sheffield is put forward as a case study to discuss some of the ways in which health systems can work in collaboration with other partners to develop environments and systems that promote active lives for patients and staff.

Determinants and Strategies for Physical Activity Maintenance in Chronic Health Conditions: A Qualitative Study.

BACKGROUND Physical activity is promoted to help adults manage chronic health conditions, but evidence suggests that individuals relapse after intervention cessation. The objective of this study was to explore the determinants and strategies for successful and unsuccessful physical activity maintenance. METHODS A qualitative study using semistructured interviews was conducted with 32 participants. Purposive sampling was used to recruit 20 successful and 12 unsuccessful maintainers. Adults with chronic health conditions were recruited having completed a physical activity referral scheme 6 months before study commencement. The IPAQ and SPAQ were used to categorize participants according to physical activity status. Data were analyzed using framework analysis. RESULTS Eleven main themes emerged: 1) outcome expectations, 2) experiences, 3) core values, 4) trial and error, 5) social and practical support, 6) attitudes toward physical activity, 7) environmental barriers, 8) psychological barriers, 9) physical barriers, 10) cognitive-behavioral strategies for physical activity self-management (eg, self-monitoring), and 11) condition management (eg, pacing). CONCLUSIONS The findings identified determinants and strategies for successful maintenance and highlighted the processes involved in physical activity disengagement. Such findings can guide the development of physical activity maintenance interventions and increase activity engagement over the long-term in adults with chronic health conditions.

Evaluation of a new mental health liaison team in a general hospital. Part 2: exploring the themes and their effect on practice

Hospitals and emergency departments (EDs) are caring for increasing numbers of patients who present with underlying mental health issues. Managing these patients can be challenging for clinical staff who often lack the specialist knowledge and skills required to provide appropriate care. This article, part two of two on the evaluation of a newly formed mental health liaison team (MHLT) working in a general hospital, focuses on the perceptions and experiences of the MHLT participants, and explores three sub-themes derived from the interview data. The article considers the effect of these themes on practice, and the relationship between MHLT members and staff in EDs and the wider hospital.