Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field

Barriers experienced by visually impaired rugby players when undertaking concussion assessment: a qualitative investigation

Previous work has conjectured that visually impaired athletes may face barriers when attempting concussion assessments because they can present with signs of concussion as part of their condition. The present study aimed to explore the qualitative experiences of visually impaired players undertaking the Sport Concussion Assessment Tool 5 (SCAT5). Four visually impaired Physical Disability Rugby League players completed the SCAT5 neurological assessment (i.e. read aloud and visual tracking sections) prior to attending an online focus group discussion. Thematic analysis was performed, revealing numerous barriers and consequent additional needs experienced by the athletes. The present results support the removal of the read aloud section from the SCAT5 and suggest that the SCAT6 may thus be a more appropriate assessment tool for visually impaired athletes. Clinicians using the SCAT6 may want to make adjustments to meet the additional needs of visually impaired athletes when completing the visual tracking section.

Staying isolated indoors means that nobody sees me": ontological (in)security and living with significant appearance concerns before, during, and 'since' COVID-19

PURPOSE

Though a worldwide period of uncertainty (COVID-19) has 'ended', there exists a legacy of maladaptive experiences among people with significant appearance concerns (SAC) that requires care and attention.

METHODS

Using Giddens' concept of ontological security, we explored how people experienced their SAC before, during and "since" COVID-19. Qualitative surveys allowed us to capture diverse perspectives from individuals transnationally, analysed with deductive reflexive thematic analysis using ontological security as our theoretical foundation.

RESULTS

Themes named "More Mirror(ed) Time" and "Locked Out, Shut Down, and Shut Out" gave a contextual grounding for the embodied experiences of this group through times of social restrictions, and the theme "Redefining Relevance" explored the continued legacy of COVID-19 - and continued global uncertainties such as economic hardship and warfare - that impact the wellbeing of people with SAC.

CONCLUSIONS

People with SAC are still 'locked out' from essential healthcare support as those providing healthcare are overworked, under-resourced and rely on efficient interactive methods such as tele-health that may be triggers for people with SAC. Care providers may consider expanding appearance concerns verbiage, look to involve trusted others in the care-seeking process, and utilize modalities beyond digital health to support people with SAC.

Australian parents' perceptions of the risks posed by harmful products to the health of children

Cigarettes, alcohol, vaping and gambling products can cause significant harm to children and young people. The industries that make these products employ a range of tactics that aim to normalize their products and resist policy and regulatory reform. This includes 'responsibility' framing, in which parents are often held responsible for educating their children about the risks of these products. However, there has been very little research, which has investigated parents' perceptions of these industries. A qualitatively led online panel survey was conducted with n = 455 Australian parents who had at least one child aged between 11 and 17 years. Participants were asked questions relating to concerns about harmful products; what they talked about with their children; other potential sources of risk information; and who were responsible for protecting young people from these industries. Four themes were constructed. (i) Parents identified that parental influence, peer pressure, social media and advertising influenced children's attitudes towards these products. (ii) They had concerns about the short- and long-term consequences of these products. (iii) Parents actively engaged in educating their children about these products but recognized that it was difficult to counter industry messages. (iv) Parents emphasized the need for a collective approach, advocating for increased information and government regulations, particularly relating to marketing. This study demonstrates that parents are concerned about these industries and do their best to protect their children from harm but recognize that they need more support. Evidence-based education and comprehensive regulations particularly around marketing are needed to de-normalize products and protect young people.

COVID-19 pandemic: Ghana and the geographies of blame

The emergence and the rapid spread of the novel Coronavirus (COVID-19) have resulted in a global public health crisis. The debilitating social and economic impact of the COVID-19 pandemic on vulnerable societies has given rise to questionings, blames, and accusations about how the pandemic has been managed at the national level. This study uses the concept of 'Geographies of blame' to investigate how the national government, citizenry and other stakeholders have blamed each other for the rise in COVID-19 cases in Ghana. The study employs a qualitative research approach and administered 45 online surveys to the residents of Accra Metropolis, Ghana, that inquired about who is to be blamed for the rising COVID-19 cases in Ghana. Our results revealed that while the government of Ghana must share the blame due to how they poorly handled the pandemic, the citizens are more to blame for the spread and continued increase of the COVID-19 cases in the country. Based on the results, the study highlights the need for a pro-active and continuous analysis of the 'babel of blame' as a useful guide to create public awareness and help governments develop and implement strategic plans to tackle the COVID-19 pandemic.

"Aussies love a bet": Gamblers discuss the social acceptance and cultural accommodation of gambling in Australia

OBJECTIVE

This study aimed to explore regular gamblers' perceptions of the social acceptance and cultural accommodation of gambling in Australia, which are two dimensions of the normalisation of gambling.

METHODS

Qualitatively focused online survey with 363 adults in New South Wales and Victoria who gambled in a typical month. Open-text responses about the link between gambling and Australian culture were interpreted using reflexive thematic analysis to construct themes from the data.

RESULTS

Gambling was perceived to be a culturally significant part of Australian life due to existing traditions, the perception that gambling was central to the Australian identity, and perceived economic benefits. Participants considered that gambling was a common and socially accepted activity that was embedded in the activities of social networks. Participants also stated that gambling products, venues and marketing were embedded in everyday environments, although some believed that the embedding of gambling in society was harmful. Conclusion and public health implications: This study demonstrated that regular gamblers largely viewed gambling as being a socially accepted and culturally accommodated activity in Australia. There is scope for governments to develop comprehensive programs to denormalise gambling, including learning from research, evidence and experience in other areas of public health.

Reiterating a Need for Antiracism Praxis in Nursing and Psychiatric Nursing Education

BACKGROUND

The reemergence of the Black Lives Matter movement in 2020 reinforced the need for antiracist and decolonizing praxis in all areas, including nursing education, the burden for which has fallen predominantly on visible minorities. To enact the needed change within health care systems and nursing education, White nurses must recognize their privilege and become active participants in the conversations and change.

METHOD

This two-phase qualitative study explored nursing and psychiatric nursing students' experiences of racism and antiracism education at a small western Canadian university.

RESULTS

Anonymous qualitative surveys (n = 24) and structured interviews (n = 9) with nursing and psychiatric nursing students highlighted the difficulties and complexities of recognizing racism and a present lack of antiracism praxis in educational and health care settings.

CONCLUSION

Nursing educators must reevaluate structural and behavioral aspects of nursing education to support genuine antiracism praxis. [J Nurs Educ. 2022;61(8):439-446.].

Gamblers' perceptions of responsibility for gambling harm: a critical qualitative inquiry

BACKGROUND

Gambling has traditionally been conceptualised as an issue of addiction and personal responsibility. While there are now clear public health models that recognise that gambling harm is caused by a range of socio-cultural, environmental, commercial and political determinants, government and industry messages about gambling are still largely personal responsibility focused. Given the well-recognised issues associated with personal responsibility paradigms, this study sought to understand how gamblers themselves conceptualised responsibility for gambling harm.

METHODS

A qualitatively led online panel survey was conducted with 363 adult gamblers in New South Wales and Victoria, Australia. Participants were asked to respond to what they thought were the causes of gambling harm, and what could be done to prevent harm. A reflexive thematic analysis was conducted.

RESULTS

Six common tropes were constructed from gamblers' responses: (1) Gambling in moderation; (2) Personal responsibility for rational behaviour; (3) Character flaws; (4) Personal responsibility to seek help; (5) More education is needed; and (6) Governments are responsible for action - but motivation and efficacy are questioned. Gamblers primarily understood gambling harm as being a matter of personal responsibility, and government responsibility was generally seen as limited to providing information to facilitate informed gambling choices.

CONCLUSIONS

This study demonstrates that gamblers' perceptions of gambling harm are similar to the personal responsibility framings and tropes present in industry and government messaging strategies. Refocusing public communication strategies away from 'responsible gambling' messaging, and towards evidence-based approaches, will be an important part of addressing the harms associated with gambling.

Challenges with text-based messaging platform to perform social needs assessments of patients presenting with COVID-19-like illness at an urban academic emergency department

Objectives

To evaluate the challenges encountered when using technology-based recruitment and electronic consenting to conduct social needs assessment of patients presenting with COVID-19-like illness at an urban academic emergency department.

Methods

COVID-19 Testing Registry (CTR) was established in the emergency department of UI Health in Chicago, Illinois. An online survey platform REDCap (Research Electronic Data Capture) was used, through which a standardized text message was sent to the mobile devices of eligible patients who tested positive for COVID-19. Patients were first provided with information on social services (e.g., health, food, transportation, housing). After e-consent, they were then asked to complete a social and health needs assessment on the first day and 14th day after COVID-19 testing.

Results

Out of 153 patients invited to participate in the survey, 32 (21%) opened the link and accessed the survey, 13 (8%) accessed the information on resources, 22 (14%) replied to the question on interest in research participation, while 17 (11%) expressed interest in learning about CTR. Ultimately, only 6 (4%) consented and only 1 (0.6%) eventually completed both surveys. The mean age for the total invited pool was 39 (±16), while mean age for those who consented was 37 (±11).

Conclusions

In our urban, mostly minority population, technology-based recruitment and electronic consent proved to be significantly low yield. In the future, CTR aims to further analyze predictors of lower patient engagement and widening disparity when using digital tools. Further data collection will be conducted using phone-call based procedures in patients who contracted COVID-19 in the first 6 months of the pandemic.

Experiences and attitudes toward aesthetic procedures in East Asia: a cross-sectional survey of five geographical regions

Background

The demand for aesthetic procedures continues to grow globally, particularly in East Asian countries. The popularity of specific aesthetic procedures varies, however, depending on the particular East Asian geographical region being studied. This study aimed to evaluate the experiences of and attitudes toward aesthetic procedures in five East Asian countries/regions, including China, Japan, South Korea, Hong Kong, and Taiwan.

Methods

To recruit participants, an online questionnaire was designed and distributed on social media networks between May 2015 and March 2016. The statistical analysis was conducted using SPSS software, version 22.0.

Results

A total of 3,088 people responded (approximately 600 in each country/region). Of these, 940 participants (47.8%) responded that they had experienced at least one aesthetic procedure in the past. Taiwan had the highest number of participants who had experienced at least one procedure (264/940, 41%), with primarily non-surgical experiences. Only in South Korea did surgical cosmetic experiences exceed non-surgical cosmetic experiences (55.9% vs. 44.1%). The popularity of particular procedures and the motivation for undergoing aesthetic procedures varied by country.

Conclusions

The popularity of aesthetic procedures continues to evolve. Similar trends were observed across the East Asian regions; however, each country had its unique demands and preferences. The information provided by this study can help aesthetic plastic surgeons further understand the patients in their corresponding region, customize their practice, and develop the requisite skills.

"Not having a minute of self-distancing during the social distancing is exhausting": a qualitative study on the perspective of caregivers of youth with type 1 diabetes during the COVID-19 pandemic

OBJECTIVE

To investigate the impact of the COVID-19 pandemic on caregivers of youth with type 1 diabetes.

METHODS

We performed a qualitative research based on an open-ended questionnaire that was conducted through an online platform for primary caregivers of children and adolescents with type 1 diabetes. Participants were asked to describe the impact of the COVID-19 outbreak on their caring for youth with diabetes, as well as the emotional burden that it has brought to their personal lives. Interview responses were coded and stratified by youth age: ≤ 12 years (youth aged ≤ 12 years) and between 13 and 18 years (youth aged > 12 years). The connections between the responses were identified based on either positive or negative content of the reported experience. Data were analyzed in accordance with an inductive reasoning methodology.

RESULTS

A total of 318 participants (mean age of 40.3 ± 8.1 years old) were included, representing caregivers of youth aged 11.7 ± 4.3-year-old with diabetes duration of 5.1 ± 3.8 years. The preponderance of negative feelings was noteworthy. Regarding diabetes care, more than 80% of participants reported concern and anxiety about the changes in habits that accompanied the pandemic. Also, more than half of caregivers regretted the isolation of their youth, factors that were associated with greater difficulty in achieving good glycemic control. Regarding the personal burden experienced, the negative impact of uncertainties and concerns about the COVID-19 were present in almost all participants.

CONCLUSION

The period of pandemic may lead to exhaustion in caregivers of youths with type 1 diabetes, which reflects the need for mental health support strategies to help those families.

Online HIV Self-Testing (HIVST) Dissemination by an Australian Community Peer HIV Organisation: A Scalable Way to Increase Access to Testing, Particularly for Suboptimal Testers

HIV self-testing (HIVST) introduces opportunities for screening in non-conventional settings, and addresses known testing barriers. This study involved the development and evaluation of a free online HIVST dissemination service hosted by a peer-led, community-based organisation with on-site, peer-facilitated HIV testing, and established referral and support programs for people newly diagnosed with HIV to determine whether this model was feasible and acceptable for engaging MSM, particularly among infrequent and naive HIV-testers, or those living in remote and rural areas. Between December 2016 and April 2018, 927 kits were ordered by 794 individuals, the majority of whom were men who have sex with men (MSM) (62%; 494), having condomless sex (50%; 392), or living outside a major city (38%; 305). Very few (5%; 39) sought the available pre-test peer contact, despite 45% (353) being naive HIV-testers. This study demonstrates that online HIVST dissemination is acceptable and feasible for engaging at-risk suboptimal testers, including those unwilling to test elsewhere (19%; 47/225). With half (50%; 403) unwilling to buy a kit, our study suggests that HIVST will need to be subsidized (cost-neutral to users) to enhance population coverage and access.

Conducting Qualitative Research Online: Challenges and Solutions

What ways of thinking and concrete strategies can assist qualitative health researchers to transition their research practice to online environments? We propose that researchers should foreground inclusion when designing online qualitative research, and suggest ethical, technological and social adaptations required to move data collection online. Existing research shows that this move can aid in meeting recruitment targets, but can also reduce the richness of the data generated, as well as how much participants enjoy participating, and the ability to achieve consensus in groups. Mindful and consultative choices are required to prevent these problems. To adapt to ethical challenges, researchers should especially consider participant privacy, and ways to build rapport and show appropriate care for participants, including protocols for dealing with distress or disengagement, managing data, and supporting consent. To adapt to technological challenges, research plans should choose between online modalities and platforms based on a clear understanding of their particular affordances and the implications of these. Finally, successful research in virtual social environments requires new protocols for engagement before data collection, attention to group numbers and dynamics, altered moderator teams and roles, and new logistical tasks for researchers. The increasing centrality of online environments to everyday life is driving traditional qualitative research methods to online environments and generating new qualitative research methods that respond to the particularities of online worlds. With strong design principles and attention to ethical, technical and social challenges, online methods can make a significant contribution to qualitative research in health.

Mechanisms of impact and experiences of a person-centred transition programme for adolescents with CHD: the Stepstones project

Background

During the past decade there has been some evaluation of transition programmes for adolescents with chronic conditions. However, this has rarely involved process evaluations focusing on mechanisms leading to outcomes, thus hampering implementation of these complex interventions. Our aim was to (I) describe adolescents’ and parents’ experiences of participating in a person-centred transition programme aiming to empower them in transition to adulthood and (II) explore the mechanisms of impact.

Methods

A qualitative process evaluation was performed, embedded in a randomized controlled trial evaluating the effectiveness of a transition programme for adolescents with congenital heart disease in Sweden. A purposive sample of 14 adolescents and 12 parents randomized to the intervention group were interviewed after participation in the programme. Data were analysed deductively and inductively in NVivo v12.

Results

Experiences of participation in the transition programme were generally positive. Meeting a transition coordinator trained in person-centred care and adolescent health and embarking on an educational process based on the adolescents’ prerequisites in combination with peer support were considered key change mechanisms. However, support to parents were not sufficient for some participants, resulting in ambivalence about changing roles and the unmet needs of parents who required additional support.

Conclusions

Participants experienced increased empowerment in several dimensions of this construct, thus demonstrating that the transition programme was largely implemented as intended and the evidence-based behaviour-change techniques used proved effective in reaching the outcome. These findings can inform future implementation of transition programmes and illuminate challenges associated with delivering a complex intervention for adolescents with chronic conditions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06567-1.

When face-to-face interviews are not possible: tips and tricks for video, telephone, online chat, and email interviews in qualitative research

Face-to-face interviews have long been the norm for conducting qualitative interviews in healthcare research. However, the Covid-19 pandemic has accelerated the need to explore alternative methods. This, along with the swift digitalization of healthcare, has led to video, telephone, and online interactions becoming increasingly used. The use of new techniques to carry out interviews through video, telephone, and online applications all come with benefits and drawbacks. In this article, three ways of collecting data through qualitative interviews are described and their uses exemplified through a project investigating the impact of a transition program for adolescents with congenital heart disease.

Feasibility of a Web-Based Psychoeducation Course and Experiences of Caregivers Living With a Person With Schizophrenia Spectrum Disorder: Mixed Methods Study

BACKGROUND

Schizophrenia is a severe mental illness that burdens both patients and caregivers.

OBJECTIVE

The aim of this study is to examine the feasibility of a web-based psychoeducation course targeted at caregivers of persons with schizophrenia spectrum disorders (SSDs) and to describe their experiences of living with a person with SSD based on the material caregivers produced during the web-based course.

METHODS

A convergent, parallel, mixed methods study design was used. First, caregivers' engagement in the course was evaluated quantitatively. Second, the overview of the course feedback was evaluated using quantitative and qualitative methods. Third, the experiences of being a caregiver to a person with SSD were analyzed qualitatively with the thematic analysis of the writings caregivers produced during the web-based course.

RESULTS

A total of 30 caregivers participated in the study and a web-based psychoeducation course. Less than two-thirds (18/30, 60%) completed the course. Content was most often logged for the first module, Orientation (3465 log-ins), and the lowest number of log-ins was recorded for the Daily life module (1061 log-ins). Feedback on the course varied; over half (10/17, 59%) of the caregivers considered the content to be very good or good, about half (9/17, 53%) considered the website layout to be good, only 6% (1/17) felt that the usability of the website was poor, and no one felt that it was very poor. From the reported experiences of being a caregiver to a person with SSD, 3 themes were formed: the caregiver's own well-being, relationship with the person with SSD, and experience of health care services.

CONCLUSIONS

The web-based psychoeducation course for caregivers living with a person with SSD seems to be especially suitable for those who have little experience as a caregiver. In the future, more planning and the consideration of aspects related to the needs of specific target groups, course content, practical arrangements, and scheduling should be taken into account. In addition, although caregivers can improve their own well-being in different ways, they need regular support and cooperation from health care professionals.

Positive Psychological Impacts of Cooking During the COVID-19 Lockdown Period: A Qualitative Study

This study aims to explore the positive psychological effects of culinary experiences during the COVID-19 lockdown days. Qualitative research methods adopted to provide a deeper understanding. Data was collected through a structured online survey from 30 participants in Turkey. This occurred between April 10th and June 3rd, 2020 when the strict confinement measures were applied. Content analysis was deductively applied according to the Stebbins's Theory of Casual vs. Serious Leisure which classifies the well-being according to characteristics of leisure experiences. The results revealed that at the first stage people went into the kitchen with the motivation of pure happiness and relaxation indicating hedonic well-being. However, people who intended to spend time with culinary activities with the expectations of pure happiness left the kitchen with eudaimonic outcomes by gaining special skills and knowledge, self-actualization and self-enrichment. When these outcomes are evaluated based on the Stebbins's theoretical framework, culinary activities have both casual and serious leisure experience characteristics in terms of psychological well-being. It is understood that culinary activities have versatile leisure characteristics. Thanks to the culinary activities, people do not only obtain pure happiness and relaxation but can draw wider inferences about their life by realizing their own potential during the psychologically challenging COVID-19 lockdown days.

Factors affecting adolescents' participation in randomized controlled trials evaluating the effectiveness of healthcare interventions: the case of the STEPSTONES project

Background

Recruitment of adolescents to intervention studies is a known challenge. For randomized controlled trials (RCT) to be generalizable, reach must be assessed, which means ascertaining how many of the intended population actually participated in the trial. The aim of this study was to evaluate the reach and representativeness of an RCT evaluating the effectiveness of a complex intervention for adolescents with chronic conditions.

Methods

A mixed methods sequential explanatory design was employed. Firstly, quantitative cross-sectional data from the RCT, patient registries and medical records were collected and analysed regarding baseline differences between participants and non-participants in the trial. Secondly, qualitative data on their reasons for participating or not were collected and analysed with content analysis to explain the quantitative findings.

Results

Participants showed larger differences in effect sizes and a significantly more complex chronic condition than non-participants. No other statistically significant differences were reported, and effect sizes were negligible. Reasons for declining or accepting participation were categorized into three main categories: altruistic reasons, personal reasons and external reasons and factors.

Conclusions

Integration of quantitative and qualitative findings showed that participation in the RCT was affected by disease complexity, the perceived need to give back to healthcare and research and the adolescents’ willingness to engage in their illness. To empower adolescents with chronic conditions and motivate them to participate in research, future intervention studies should consider developing tailored recruitment strategies and communications with sub-groups that are harder to reach.

Understanding the Lexicon of Fatigue in Parkinson's Disease

Background:

Fatigue in Parkinson’s disease (PD) is multifaceted and associated with reduced quality of life. In turn, the language used by people with PD to describe fatigue is variable and poorly understood. We sought to elucidate the lexicon of fatigue using a qualitative grounded theory approach.

Objective:

The objective of this study was to understand how patients with PD describe fatigue.

Methods:

A pre-study phase of online journaling (Phase 1) provided information regarding topics of importance to patients. Following this, two independent samples of fatigued subjects were studied. Individuals with PD participated in a telephone interview (Phase 2); interview transcripts were analyzed to develop a detailed codebook. To ensure trustworthiness of the findings, an online survey (Phase 3) was administered to individuals with self-reported PD participating in the online study Fox Insight. The survey included the following question: “How do you define fatigue? Please provide your definition in the space below.” The codebook developed from Phase 2 was applied to the Phase 3 responses.

Results:

Fifteen individuals participated in Phase 2 and 413 individuals completed Phase 3. Fatigue was subdivided into three domains: cognitive, emotional, and physical. Nearly all individuals experienced more than one domain of fatigue. The most common themes included tiredness, lack of energy, and negative motivation.

Conclusion:

Fatigue in PD is multidimensional. Questionnaires that only assess the physical impact of fatigue may not be adequate to capture the broad range of experiences of fatigue among people with PD.

Restricted mobility and unheard voices: perceptions of accessibility and inclusion expressed on Romanian disability-specific blogs and forums

Purpose: Concerning psychosocial aproaches to disability, Romania is characterized by significant discrepancies between the Disability Rights legislation and reality, while the input of people with disabilities regarding the matter is largely overlooked. This study aims to explore perceptions regarding Romania's built and sociocultural environment, as they are expressed by bloggers with disabilities and users of disability-specific forums.Materials and methods: Data were collected from four personal blogs and three discussion forums on the topic of physical disabilities. Thematic analysis was performed.Results: Four major themes emerged from the analysis: the disabling built environment; the isolating sociocultural environment; blaming others and the past; self-empowerment and the movement towards independent living.Conclusions: The resistance of disabled people to negative perceptions of disability and their calls to action in this regard may foster positive changes in social attitudes towards disability.Implications for RehabilitationRomanians with physical disabilities perceive that the adaptation and implementation of inclusion and accessibility regulations are superficial.They promote a proactive defence of their rights, independence, and dignity, to resist against discrimination and stigma resulting from the medicalization of disability.Education regarding disability, its evaluation, and the development of inclusion policies should stop focusing on "incapacity" as an individual attribute and focus more on the disabling roles of environmental factors.Responsible authorities should understand and enforce the implementation of inclusion and accessibility regulations accordingly.

Recruiting Research Participants via Traditional Snowball vs Facebook Advertisements and a Website

This article describes the use of Facebook, a website targeting nurses, and snowball sampling for recruitment of registered nurse participants in a qualitative study exploring measurement-driven clinical behavior and metric-driven harm. Previous studies suggest that social media can be a successful and cost-effective sampling strategy, increasing the numbers of participants, their diversity, and their representativeness of the population of interest. This study, however, found traditional snowball sampling to be far more effective than advertisements via Facebook and a professional website. Lessons learned are detailed, including cost and technical issues encountered. Suggestions for nurse researchers considering using Facebook for participant recruitment are described. Methodological research that could enhance the empirical-base supporting effective social media recruitment of research participants is offered for consideration by nurse researchers.

Stuttering as Defined by Adults Who Stutter

Purpose Numerous frameworks and definitions have sought to differentiate what behaviors and experiences should be considered as a part of stuttering. Nearly all of these efforts have been based on the perspectives and beliefs of conversational partners and listeners. This outside-in approach to defining stuttering lacks validation from people who live with the condition. Method In this study, 430 adults who stutter participated in a qualitative exploration of the term stuttering. Data were analyzed thematically to determine speakers' perspectives about moment of stuttering and the overall experience of stuttering in their lives. Results To adults who stutter, the term stuttering signifies a constellation of experiences beyond the observable speech disfluency behaviors that are typically defined as stuttering by listeners. Participants reported that the moment of stuttering often begins with a sensation of anticipation, feeling stuck, or losing control. This sensation may lead speakers to react in various ways, including affective, behavioral, and cognitive reactions that can become deeply ingrained as people deal with difficulties in saying what they want to say. These reactions can be associated with adverse impact on people's lives. This interrelated chain of events can be exacerbated by outside environmental factors, such as the reactions of listeners. Discussion Data from this survey provide novel evidence regarding what stuttering means to adults who stutter. These data are used to update the adaptation of the World Health Organization's International Classification of Functioning, Disability and Health as it applies to stuttering (Yaruss & Quesal, 2004) to better account for the complex and individualized phenotype of stuttering and to develop a definition of the experience of stuttering that is based not only on the observations of listeners but also on the impact of stuttering on the lives of adults who stutter.

"I am a Runner": A qualitative analysis of women-runners' pregnancy experiences

BACKGROUND

Women runners are a group with potential for health maintenance and health promotion in pregnancy. When providers counsel women to discontinue or cut back on running without cause, an opportunity for health benefits to both woman and baby may be lost.

AIM

This study aims to explicate the experience women runners have in pregnancy to further providers' understanding of this population's unique needs.

METHODS

An online, qualitative inquiry was employed to explore the experiences of an online community of women runners in pregnancy (N=22). The Doing Pregnancy framework provided guidance for final stages of the analysis.

FINDINGS

Four themes emerged, explicating a process for "Doing Pregnancy" as a woman-runner: (1) I am a runner; (2) running tunes me into my pregnant body; (3) adjusting to pregnancy's changes; and (4) trusting my instincts & knowledge vs. listening to others.

DISCUSSION

Women's sense of embodiment caused them to feel strongly tuned into the needs of their maternal-fetal dyad and to trust that they knew what was healthy regarding running during pregnancy. When provider advice was conflicting or was not evidence-based, women lost trust in their providers.

CONCLUSION

Providers caring for women runners should recognize running as a key piece of their identities and enter into shared partnership as women navigate changes in pregnancy. Women have a strong sense of embodiment and are tuned into the needs of their body as well as the needs of their baby.

The use of Facebook for virtual asynchronous focus groups in qualitative research

The Internet and the development of more user-engaging applications have opened a whole new world for researchers as a means of recruitment and data collection source. This paper describes the methodological approach of a research study that explored the experiences of Australian military spouses who packed up their family and home to accompany their spouse on an overseas posting. The study used Facebook as a recruitment tool and then as a data source through the conduct of an asynchronous virtual focus group. This paper outlines the advantages and disadvantages of this unique data source as a means of capturing the voices of a hard-to-reach population.