Bridging the digital divide: Reflections on using WhatsApp instant messenger interviews in youth research

Interpersonal conflicts in nursing through the lens of senior nursing students: A qualitative study

BACKGROUND

Unmanaged interpersonal conflicts emerge as significant obstacles for the nursing team during daily duties. Observations and discussions with nursing undergraduate students determined the need to explore their perspectives on conflict management in greater depth.

OBJECTIVE

To investigate the perspectives of senior undergraduate nursing students on conflicts experienced by nurses during clinical practice, as well as the strategies employed to manage these conflicts.

DESIGN

This is a qualitative descriptive study.

PARTICIPANTS

The study involved written interviews with 31 senior undergraduate nursing students from a university in Istanbul, Türkiye.

METHODS

Data were collected between November 23, 2023, and December 4, 2023. Thematic analysis was used.

RESULTS

Four themes emerged: (1) Causes of conflicts, (2) Methods for resolving conflicts, (3) Nurse managers' approaches, and (4) Student learning through observation. The themes were organized under 13 sub-themes: ineffective communication, absence of a singular goal, misunderstanding in role boundaries, and lack of professionalism (first theme); transparent communication, absolute loss, integration, and softening (second theme); autonomy in conflict resolution and seeking other professionals to manage conflicts (third theme); positive side of the conflict, negative side of the conflict, and how I would act if I were the nurse manager (fourth theme).

CONCLUSIONS

Nursing students know that staff nurses and nurse managers play crucial roles in conflict management. Communication issues were identified as significant causes of conflicts. Open communication and the active involvement of nurse managers were determined as essential for effective conflict resolution. Positive outcomes of conflicts included changes in attitudes; however, conflicts were also acknowledged as contributors to workplace stress. The study underscores the importance of equipping nurses with conflict resolution skills through practical educational approaches.

Early mental health intervention and supported self-care for LGBTQ+ young people in the UK: a mixed-methods study

Background

Lesbian, gay, bisexual, trans, queer/questioning, plus young people have a higher risk of poor mental health in comparison to cisgendered heterosexual young people, and they underutilise mental health services and support. In addition, there is a paucity of research conducted in United Kingdom examining mental health early intervention provision for lesbian, gay, bisexual, trans, queer/questioning, plus young people.

Objectives

To produce a model of what works for early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people and increase understanding of lesbian, gay, bisexual, trans, queer/questioning, plus young people's access to, navigation of, and engagement with mental health support.

Method

This was a multi-methods theory-led case study evaluation with three distinct stages: (1) a meta-narrative review of existing literature to develop a theoretical framework to explain effective mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people; (2) an online and offline service mapping exercise to locate current mental health early intervention support for lesbian, gay, bisexual, trans, queer/questioning, plus young people in the United Kingdom in order to produce a service typology; and (3) a theory-led case study evaluation of 12 case study sites selected from the service typology produced in stage 2, to establish the components of appropriate quality, early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people.

Results

Stage 1 produced an interdisciplinary theoretical framework indicating that early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus youth must prioritise addressing normative environments that marginalise youth, lesbian, gay, bisexual, trans, queer/questioning, plus identities and mental health problems. Stage 2 mapping found 111 services, the majority in urban settings in England. There was an absence of mainstream National Health Service support that specifically addressed the needs of lesbian, gay, bisexual, trans, queer/questioning, plus young people. The majority of lesbian, gay, bisexual, trans, queer/questioning, plus youth mental health support was provided by voluntary/community organisations. Stage 3 case study evaluation found that an intersectional, youth-rights approach is the most appropriate way to deliver early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people. Youth rights should underpin mental health support to address the multiple marginalisation, isolation and stigmatisation that lesbian, gay, bisexual, trans, queer/questioning, plus young people may experience and to enable them to make informed independent decisions about their own bodies and lives, and for the right to freedom of safe self-expression to be upheld. The model that we have produced contains 13 principles that are necessary to the provision of mental health support, and to improve access to, engagement with, and navigation of mental health services.

Conclusions

In the United Kingdom, a rights-based approach to mental health service provision is not prominent. In addition, at the time of writing, lesbian, gay, bisexual, trans, queer/questioning, plus young people are facing active legislative and policy attacks on their human rights. This study provides the first large-scale theory-led evaluation of early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people with common mental health problems. The resulting intersectional, youth-rights approach provides evidence on ways of improving lesbian, gay, bisexual, trans, queer/questioning, plus young people's mental health. Further research on the implementation of an intersectional, youth-rights approach to early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people with mental health problems is required.

Study registration

This study is registered as PROSPERO CRD42019135722.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/09/04) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 47. See the NIHR Funding and Awards website for further award information.

Engagement in rapid public health research among young people from underserved communities: maximising opportunities and overcoming barriers

BACKGROUND

Inclusion in public health research of young people from low-income households and those from minority ethnic groups remains low. It is recognised that there is a need to change the way in which research is conducted so that it becomes more inclusive. The aim of this work was to identify novel and innovative ways to maximise recruitment and inclusion of diverse participants when doing co-production within very short time frames for emergency responses.

METHOD

We conducted interviews with young people from low-income and minority ethnic backgrounds, and members or leaders of groups or organisations supporting or representing young people from underserved communities.

RESULTS

A total of 42 participants took part in an interview. This included 30 young people from low income or minority ethnic backgrounds and 12 community leaders/service providers. Of the 30 young people, 26 participants identified as female and 12 participants identified as being from a minority ethnic background. Participants discussed a number of interrelated barriers to research involvement and identified ways in which barriers may be reduced. Prejudice and discrimination experienced by young people from underserved communities has led to substantial mistrust of educational and governmental establishments. Rigid and unfamiliar research practices further limit the involvement of young people. Four themes were identified as ways of supporting involvement, including: making opportunities available for young people, adaptations to research governance, understanding and acknowledging challenges faced by young people, and ensuring reciprocal benefits.

CONCLUSION

This research explored barriers to engagement in rapid public health co-production. Working with communities to co-produce rapid recruitment and research procedures to suit the needs and the context in which young people live is necessary.

Digital mental health strategies used by young people in Aotearoa New Zealand during the COVID-19 pandemic: 'Just do it yourself, DIY'

Objective

With rising rates of mental health distress amongst youth during the COVID-19 pandemic, digital resources have been identified as a valuable tools for delivering support to young people. However, many of the websites and apps developed by professionals to support the youth do not take account of the importance young people place on exercising their own agency in managing their mental health. This article investigates how young people in Aotearoa New Zealand used digital resources to manage their mental health needs during the COVID-19 pandemic.

Methods

The study gathered information from semi-structured interviews with 34 young people aged 16-22 years. The data was analysed using reflexive thematic analysis.

Results

Six themes were identified including: searching for online information about mental health; evaluating digital mental health resources; controlling mood through online activity; looking for escape in the virtual world; staying connected online; and giving and receiving support.

Conclusion

Young people's practices demonstrated their investment in their own agency, a general reluctance to engage with professional resources and recognition of the need to balance the risks and benefits of the informal strategies they preferred. Young people appeared sceptical of professionally-designed mental health resources and interventions and preferred to adapt and re-purpose the wide range of platforms and networks available in their informal digital worlds.

"It's really hard to strike a balance": The role of digital influencers in shaping youth mental health

Objective

Social media influencers have enormous sway with youth; however, little is known about how they communicate about mental health and how young people respond to this content.

Methods

This study used semi-structured, remote interviews with 31 participants aged 16 to 24 years to explore how young people feel about the way social media influencers discuss mental health online. Thematic analysis and member-checking processes were used to identify five themes, each reflecting a tension in how participants viewed a specific aspect of influencer content.

Results

Themes included the style (casual or serious), volume (inadequate or excessive), focus (distress or solutions), source (lived experience or professional advice), and sponsorship status (persuading or exploitative) of influencer content.

Conclusion

Young people appear to hold widely varying, nuanced preferences regarding influencer mental health content. Notwithstanding some risks and limitations, influencers can generate engaging mental health content-their potential role in shaping youth mental health and other health communication efforts warrants further exploration.

Global research on digital divide during the past two decades: a bibliometric study of Web of Science indexed literature

Purpose

This study aims to examine the research output on digital divide from 2001 to 2020 and measure the qualitative and quantitative growth of literature during the stated period by using required bibliometric measures for identifying the types of documents, yearly growth, country productivity, citation network of collaborative countries, authorship pattern, top authors, cocitation networks and assorted facets.

Design/methodology/approach

Web of Science database was used to retrieve the required data for this study. Keeping the objectives of this study in mind, the keyword “Digital Divide” was used as the search term. Moreover, the retrieved data were limited from the year 2001 to 2020 for two decades. A total of 5,518 publications were filtered and focused for subsequent facet-wise analysis and interpretation. Required bibliometric indicators like types of documents, yearly growth, authorship pattern, degree of collaboration (DC), country productivity, h-index and citation impact were used to study various dimensions of publication trends. VOSviewer software was used to visualize the authorship network, bibliographic coupling and keyword occurrences.

Findings

This study finds a total of 5,518 publications on the topic digital divide contributed by 14,277 authors from 130 countries across the world published through 2,843 source titles in 13 global languages during the past two decades (2001–2020). The annual growth of publications (AGP) on the topic digital divide shows 38.43% AGP globally. Journal articles have been identified as the preferred type of document with 73.11% of the literature. The DC indicates a healthy trend of collaborative research with a mean value of 0.70. The USA is the table topper with the contribution of 1,933(35.03%) publications and 77 h-index and James J., from Tilburg University, The Netherlands, is identified as top amongst the most productive authors with the highest number of 34 publications (h-index 14).

Research limitations/implications

This study restricts its scope on research productivity to the theme “digital divide” regarding authorship pattern, DC, most productive authors, most productive countries, most published sources and other key facets. This study exclusively refers to the Web of Science database in retrieving the required data. Moreover, this study takes global research into account with no geographical or language limitations and comprehends literature on digital divide for two decades ranging from the years 2001 to 2020.

Practical implications

Teachers and research scholars interested in bibliometric studies can benefit from insights into the scholarly documents published on the topic digital divide from 2001 to 2020.

Originality/value

This study yields some interesting findings on published literature on the digital divide during the past two decades relating to the most striking contributions, highly cited journals, the most prolific authors, country productivity, keyword cooccurrence and assorted parameters.

Understanding How School-Based Interventions Can Tackle LGBTQ+ Youth Mental Health Inequality: A Realist Approach

Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison with their cisgender heterosexual peers. The school environment is a major risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ young people. The aim of this UK study was to develop a programme theory that explained how, why, for whom, and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ young people, through participation with key stakeholders. Online realist interviews were conducted in the UK with (1) LGBTQ+ young people aged between 13-18 years attending secondary schools (N = 10); (2) intervention practitioners (N = 9); and (3) school staff (N = 3). A realist retroductive data analysis strategy was employed to identify causal pathways across different interventions that improved mental health outcomes. The programme theory we produced explains how school-based interventions that directly tackle dominant cisgender and heterosexual norms can improve LGBTQ+ pupils' mental health. We found that context factors such as a 'whole-school approach' and 'collaborative leadership' were crucial to the delivery of successful interventions. Our theory posits three causal pathways that might improve mental health: (1) interventions that promote LGBTQ+ visibility and facilitate usualising, school belonging, and recognition; (2) interventions for talking and support that develop safety and coping; and (3) interventions that address institutional school culture (staff training and inclusion polices) that foster school belonging, empowerment, recognition, and safety. Our theoretical model suggests that providing a school environment that affirms and usualises LGBTQ+ identities and promotes school safety and belonging can improve mental health outcomes for LGBTQ+ pupils.

Using Web-Based Content to Connect Young People With Real-life Mental Health Support: Qualitative Interview Study

BACKGROUND

Young people experience high rates of mental health problems but make insufficient use of the formal services available to them. As young people are heavy users of the internet, there may be an untapped potential to use web-based content to encourage this hard-to-reach population to make better use of face-to-face mental health services. However, owing to the vast range of content available and the complexities in how young people engage with it, it is difficult to know what web-based content is most likely to resonate with this age group and facilitate their engagement with professional support.

OBJECTIVE

This study aimed to identify the types of web-based content young people identified as more likely to prompt youth engagement with mental health services.

METHODS

This study used a qualitative design conducted within a social constructionist epistemology that recognized the importance of youth empowerment in mental health. Digital interviews using WhatsApp instant messenger were conducted with 37 young people aged 16-23 years who participated as "expert informants" on the priorities and practices of youth in web-based spaces. The data were analyzed using reflexive thematic analysis to identify the types of web-based content that participants believed would encourage young people to reach out to a face-to-face mental health service for support.

RESULTS

The analysis generated 3 main themes related to the research question. First, participants noted that a lack of information about available services and how they worked prevented young people from engaging with face-to-face mental health services. They proposed web-based content that provided clear information about relevant mental health services and how to access them. They also suggested the use of both text and video to provide young people with greater insight into how face-to-face counseling might work. Second, participants recommended content dedicated to combating misconceptions about mental health and negative portrayals of mental health services and professionals that are prevalent in their web-based spaces. They suggested content that challenged the stigma surrounding mental health and help seeking and highlighted the value of mental health services. Finally, participants suggested that young people would be more likely to respond to "relatable" digital stories of using mental health services, recounted in the context of a personal connection with someone they trusted.

CONCLUSIONS

This study offers recommendations for professionals and service providers on how to better engage young people with real-life mental health support using web-based content. Web-based content can be used to challenge some of the barriers that continue to prevent young people from accessing face-to-face mental health services and underlines the importance of including young people's voices in the design of web-based mental health content.

Measuring entrepreneurial orientation and institutional theory for informal enterprises: scale validation

The importance of institutional factors and entrepreneurial orientation is widely recognized in the study of entrepreneurship development, leading to the development of different measurement scales. Using the sample of 45 informal enterprises, we examined the factor structure, reliability, convergent and discriminant validity of the selected constructs adapted to measure these constructs in the context of informal enterprises in Nigeria. We examined 45 items that measure institutional factors (political, cognitive, cultural, and corruption) and entrepreneurship orientation (innovativeness, proactiveness, and risk-taking). An assessment of Cronbach's alpha and composite reliability shows that the items measuring risk-taking, proactiveness, uncertainty avoidance, and masculinity are internally consistent. However, some of the items measuring other constructs have lower loading, highlighting their lack of internal consistency. The results also evidence convergent and discriminant validity of the measures used. We conclude that most of the items are reliable measurements of the corresponding constructs, and the constructs adapted to measure these constructs correlate positively with the alternative measure of the constructs. Thus, the measures evaluated in this study can be used to assess these constructs across informal enterprises. The paper contributes to validating the measurement scales and indices of institutional theory and theory of entrepreneurial orientation in the context of informal enterprises.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11135-022-01357-1.

Research behind a webcam: an exploration of virtual interviewing with children and young people

BACKGROUND

Societal use of digital technology rapidly increased during the COVID-19 pandemic. Face-to-face services converted to online provision where possible. This affected many nurse researchers.

AIM

To explore conducting research interviews online with children and young people (CYP) about sensitive topics.

DISCUSSION

This article considers digital inclusion, as well as ethical issues surrounding safety, support and consent, along with choosing tools for collecting data. It also presents a discussion of physical proximity in qualitative interviews with this population and its role in data quality. The authors investigate benefits in the context of researchers' personal experiences. They acknowledge the disadvantages of conducting interviews online and discuss ways to mitigate these.

CONCLUSION

The advantages for researchers include cost-effectiveness, time-efficiency and greater geographical reach of participants. However, CYP's perspectives are unknown and the specific ethical issues of using this method with CYP need careful consideration.

IMPLICATIONS FOR PRACTICE

More research is needed to examine virtual interviews from the perspectives of CYP as participants. Virtual acquisition of consent and assent should be investigated to standardise good research practices.

"Don't let anybody ever put you down culturally…. it's not good…": Creating spaces for Blak women's healing

Research has highlighted the importance of Indigenous knowledge and cultural practice in healing from ongoing histories of trauma, dispossession, and displacement for Indigenous peoples in Australia and elsewhere. Connection with culture, Country, and kinship has been identified as protective factors for Aboriginal social and emotional well-being and as facilitating cultural healing. This paper draws on stories mediated through cultural practice specifically, Wayapa and bush-dyeing workshops, to explore how women resignified experiences and engaged in "healing work." Our collaborative analysis of the stories shared resulted in three main themes that capture dialogs about the need for culturally safe spaces, vulnerability and identity, and culture, Country, and place. Centering Aboriginal knowledge, our analysis shows the meanings of Country, spirituality, and the coconstitution of people, culture, and the natural environment. Through Indigenous cultural practice, the women "grew strength in relationship" as they engaged in the psychosocial processes of deconstruction, reclamation, and renarrating personal and cultural identities.

Using Empathy Interviews and Qualitative Evidence to Improve Human Resource Development Practice and Theory

Scholars have long advocated the use of evidence, particularly quantitative evidence, to guide program improvement efforts in the field of human resource development. Yet, there is also widespread recognition that quantitative data has limitations and that new sources of information are useful. The purpose of this article is to consider the use of qualitative evidence to support program improvement efforts within the field of human resource development (HRD). Specifically, the article describes how HRD professionals might design and conduct empathy interviews, a technique widely used in improvement research, to produce a compelling theory of practice that can be used to support program improvement activities. Empathy interviews are thus positioned as a valuable but under-utilized form of qualitative data in the field. As such, the article describes a design process that considers how to select a perspective, structure the conversation, and analyze data. The completion of this process has implications for the development of HRD theory because it shifts the focus from a program-to user-centered understanding of practice.

'Today Was Probably One of the Most Challenging Workdays I've Ever Had': Doing Remote Qualitative Research with Hospital Doctors During the COVID-19 Pandemic

In this article we outline how a team of qualitative researchers responded to the challenging circumstances of the COVID-19 pandemic, describing how we successfully and speedily adopted remote/digital methods to research the experiences of hospital doctors. In 2020, we used Zoom to conduct qualitative interviews with 48 hospital doctors; in 2021, we used Zoom and WhatsApp to conduct a Mobile Instant Messaging Ethnography with 28 hospital doctors. We explain how we adapted to a virtual setting and provide clear insights (case study vignettes) into the additional demands on researchers and respondents, in particular, the impact on the research team. Finally, we analyse the positive and negatives of using remote qualitative methods and highlight the potential of hybrid data collection models that combine remote and face-to-face methods. We also highlight our success in communicating findings to a policy audience, important in time-critical situations, such as the COVID-19 pandemic.

Using WhatsApp Focus Group Discussions to Collect Qualitative Data Collection During a Pandemic: Exploring Knowledge, Attitudes, and Perceptions of COVID-19 in Singapore

This qualitative study aimed to explore Singapore residents' knowledge, attitudes, perceptions, and behaviors around COVID-19 as shaped by different information sources. Through utilizing WhatsApp as a means of conducting digital focus group discussions (FGDs), participants were involved in five consecutive days of discussions through both synchronous and asynchronous means. We found that the use of WhatsApp as a means of conducting FGDs not only served as a means of generating essential, time-sensitive data in the community, but also advanced the quality and quantity of data generated, democratized, and enhanced the participatory nature of FGDs, and facilitated the communication of potential issues around data privacy between facilitators and participants. Although challenges around privacy and confidentiality remain, this means of collecting data is novel in terms of providing timely and relevant data during a pandemic and would be appropriate to be further utilized in the context of other health-related research beyond a public health emergency.

Youth Information Interaction Research in the Pandemic: Adjustments, Innovations, Implications

For over a year, the pandemic has forced youth to alter their routines and rely almost exclusively on technology to learn, play and connect with family and friends. Although some alterations in youth's routine seem to be temporary, some adaptations and appropriations resulting from interactions with technology will likely be forever altered. As this scenario develops, we must reflect on how these permanent changes will affect our approaches and inquiries on youth information interaction. This 90‐minute panel will convene scholars and members of the ASIS&T community interested in discussing the present and the future of digital youth research. Panelists will mediate focused conversations with participants to generate a collective account of experiences and reflections based on challenges and research plans for after the pandemic. As the implications of a global pandemic are unfolding, youth information interaction research will be critical to inform policies and programs in education and reduce digital divides.

'I'm Gonna Tell You about How Mrs Rona Has Affected Me'. Exploring Young People's Experiences of the COVID-19 Pandemic in North East England: A Qualitative Diary-Based Study

Children and young people risk being 'disproportionately harmed' by the COVID-19 pandemic. Whilst an evolving body of literature focuses on the impact of the pandemic on the mental health and wellbeing of children and young people, less attention has been paid to the collection of qualitative, exploratory data. The aim of this study was to examine young people in North East England's experiences of COVID-19 and associated control measures. Flexible, qualitative diaries were collected with 31 young people aged 13-17 for six weeks between July and October 2020. Diary extracts were curated using Instagram Direct Messaging (DM), email and text messaging. At the end of this study, participants took part in a follow-up interview (conducted by telephone or Zoom), asking them to reflect on their diary entries. Thematic analysis of diaries and interviews yielded three central themes: (1) impacts upon mental health and emotional wellbeing; (2) disruptions and changes to education and school life; and (3) frustration, burden and responsibility. These findings highlight acute mental health impacts (loneliness, isolation, anxiety) as well as longer-term repercussions from disrupted education (missed parts of curriculum, home schooling, cancelled exams, periods of isolation) on young people aged 13-17 as a result of the COVID-19 pandemic.

The unintended consequences of COVID-19 mitigation measures matter: practical guidance for investigating them

BACKGROUND

COVID-19 has led to the adoption of unprecedented mitigation measures which could trigger many unintended consequences. These unintended consequences can be far-reaching and just as important as the intended ones. The World Health Organization identified the assessment of unintended consequences of COVID-19 mitigation measures as a top priority. Thus far, however, their systematic assessment has been neglected due to the inattention of researchers as well as the lack of training and practical tools.

MAIN TEXT

Over six years our team has gained extensive experience conducting research on the unintended consequences of complex health interventions. Through a reflexive process, we developed insights that can be useful for researchers in this area. Our analysis is based on key literature and lessons learned reflexively in conducting multi-site and multi-method studies on unintended consequences. Here we present practical guidance for researchers wishing to assess the unintended consequences of COVID-19 mitigation measures. To ensure resource allocation, protocols should include research questions regarding unintended consequences at the outset. Social science theories and frameworks are available to help assess unintended consequences. To determine which changes are unintended, researchers must first understand the intervention theory. To facilitate data collection, researchers can begin by forecasting potential unintended consequences through literature reviews and discussions with stakeholders. Including desirable and neutral unintended consequences in the scope of study can help minimize the negative bias reported in the literature. Exploratory methods can be powerful tools to capture data on the unintended consequences that were unforeseen by researchers. We recommend researchers cast a wide net by inquiring about different aspects of the mitigation measures. Some unintended consequences may only be observable in subsequent years, so longitudinal approaches may be useful. An equity lens is necessary to assess how mitigation measures may unintentionally increase disparities. Finally, stakeholders can help validate the classification of consequences as intended or unintended.

CONCLUSION

Studying the unintended consequences of COVID-19 mitigation measures is not only possible but also necessary to assess their overall value. The practical guidance presented will help program planners and evaluators gain a more comprehensive understanding of unintended consequences to refine mitigation measures.

Selfie consents, remote rapport, and Zoom debriefings: collecting qualitative data amid a pandemic in four resource-constrained settings

In-person interactions have traditionally been the gold standard for qualitative data collection. The COVID-19 pandemic required researchers to consider if remote data collection can meet research objectives, while retaining the same level of data quality and participant protections. We use four case studies from the Philippines, Zambia, India and Uganda to assess the challenges and opportunities of remote data collection during COVID-19. We present lessons learned that may inform practice in similar settings, as well as reflections for the field of qualitative inquiry in the post-COVID-19 era. Key challenges and strategies to overcome them included the need for adapted researcher training in the use of technologies and consent procedures, preparation for abbreviated interviews due to connectivity concerns, and the adoption of regular researcher debriefings. Participant outreach to allay suspicions ranged from communicating study information through multiple channels to highlighting associations with local institutions to boost credibility. Interviews were largely successful, and contained a meaningful level of depth, nuance and conviction that allowed teams to meet study objectives. Rapport still benefitted from conventional interviewer skills, including attentiveness and fluency with interview guides. While differently abled populations may encounter different barriers, the included case studies, which varied in geography and aims, all experienced more rapid recruitment and robust enrollment. Reduced in-person travel lowered interview costs and increased participation among groups who may not have otherwise attended. In our view, remote data collection is not a replacement for in-person endeavours, but a highly beneficial complement. It may increase accessibility and equity in participant contributions and lower costs, while maintaining rich data collection in multiple study target populations and settings.

Project OPUS: Development and evaluation of an electronic platform for pain management education of medical undergraduates in resource-limited settings

INTRODUCTION

Pain is a very frequent symptom that is reported by patients when they present to health professionals but remains undertreated or untreated, particularly in low-resource settings including Nigeria. Lack of training in pain management remains the most significant obstacle to pain treatment alongside an inadequate emphasis on pain education in undergraduate medical curricula, negatively impacting on subsequent care of patients. This study aimed to determine the effect of a 12-week structured e-Learning course on the knowledge of pain management among Nigerian undergraduate medical students.

METHODS

Prospective, multisite, pre-post study conducted across five medical colleges in Nigeria. Structured modules covering aspects of pain management were delivered on an e-Learning platform. Pre- and post-test self-assessments were carried out in the 12-week duration of the study. User experience questionnaires and qualitative interviews were conducted via instant messaging to evaluate user experiences of the platform. User experience data was analysed using the UEQ Data Analysis Tool and Framework Analysis.

RESULTS

A total of 216 of 659 eligible students completed all sections of the e-Learning course. Participant mean age was 23.52 years, with a slight female predominance (55.3%). Across all participants, an increase in median pre- and post-test scores occurred, from 40 to 60 (Z = 11.3, p<0.001, effect size = 1.3), suggestive of increased knowledge acquisition relating to pain management. Participants suggested e-Learning is a valuable approach to delivering pain education alongside identifying factors to address in future iterations.

CONCLUSION

e-Learning approaches to pain management education can enhance traditional learning methods and may increase students' knowledge. Future iterations of e-Learning approaches will need to consider facilitating the download of data and content for the platform to increase user uptake and engagement. The platform was piloted as an optional adjunct to existing curricula. Future efforts to advocate and support integration of e-Learning for pain education should be two-fold; both to include pain education in the curricula of medical colleges across Nigeria and the use of e-Learning approaches to enhance teaching where feasible.