AbstractThe role of theory in qualitative health research is paramount for translation into practice and policy, since it moves beyond pure description of data, allowing interpretation of the social processes underpinning and potentially 'explaining' findings. However, the use of theory in empirical research proves challenging to undertake and subsequently articulate in theses and publications. This paper offers insight into how theory may be used in empirical research, drawing on both theory‐driven and grounded theory approaches. The approach described assists researchers in bridging the central criticisms of these two methodological approaches. Furthermore, if offers researchers and students a step‐by‐step guide for integrating theory within and throughout the research process. Within our step‐by‐step guide, we provide examples from our own research that we hope will help readers to map the difficult terrain of using theory within and throughout their own research. Think of this paper as a guide to working with theory and research in an interconnected and interdependent way – a pluralistic approach for theory verification and generation.
Abductive and retroductive inference are innovative tools of analysis which enable researchers to refine and redevelop social theory. This paper describes and demonstrates how to apply these tools to strengthen sociological theory-driven empirical research outputs. To illustrate how abductive and retroductive inference work for the benefit of enhanced qualitative analysis we present the findings of a qualitative study that investigated heart disease patients' trust in medical professionals (n=37). We outline the research process using a six-stage model developed by Danermark et al. (1997) that will guide researchers doing exploratory research in how to use abductive and retroductive inference in qualitative research design and analysis. A snapshot of the study findings are provided for illustration purposes. The reader will learn how the application of these under-utilized methodological tools provides a novel way of analyzing sociological research.
Knowledge stickiness often impedes knowledge transfer. When knowledge is complex and the knowledge seeker lacks intimacy with the knowledge source, knowledge sticks in its point of origin because the knowledge seeker faces ambiguity about the best way to acquire the needed knowledge. We theorize that, given the extent of that ambiguity, knowledge seekers will make a choice to either ask for needed knowledge immediately after deciding it is needed, or wait and ask for it at a later date. We hypothesize that when knowledge is sticky, knowledge seekers will delay asking for knowledge and, in the interim period, use an enterprise social networking site to gather information that can lubricate stuck knowledge, such as how, when, and in what way to ask for the desired knowledge. We propose that by doing this, knowledge seekers can increase their ultimate satisfaction with the knowledge once they ask for it. Data describing specific instances of knowledge transfer occurring in a large telecommunications firm supported these hypotheses, showing that knowledge transfer is made easier by the fact that enterprise social networking sites make other peoples' communications visible to casual observers such that knowledge seekers can gather information about the knowledge and its source simply by watching his or her actions through the technology, even if they never interacted with the source directly themselves. The findings show that simple awareness of others' communications (what we call ambient awareness) played a pivotal role in helping knowledge seekers to obtain interpersonal and knowledge-related material with which to lubricate their interactions with knowledge sources.
While gender-based differences in consumer behavior have been previously investigated within the context of gender-neutral or unisex retailers, men's behavior in women's retailers remains largely unexplored. Furthermore, most studies frame the retail environment as a passive platform through which essential gender differences yield setting-specific bifurcated behavior, and do not address the role the commercial establishment and men's shopping habits play in gender identity formation and maintenance. To address this gap, we analyzed men's behavior in women's retailers using interactionist and social constructionist theories of sex/gender. Data were collected through non-participatory observation at a series of large, enclosed shopping malls in South-Western Ontario, Canada and analyzed thematically. We found that men tend to actively avoid women's retailers or commercial spaces that connote femininity, while those who enter said spaces display passivity, aloofness, or reticence. We suggest the dominant cultural milieu that constitute hegemonic masculinity— disaffiliation with femininity, an accentuation of heterosexuality, and a prioritization of homosocial engagement—nform the dialectical relationship between individual and institutional gender practice that manifests through consumption.
Abstract Background Evidence suggests that there is a link between inequitable access to healthcare and inequitable distribution of illness. A recent World Health Organization report stated that there is a need for research and policy to address the critical role of health services in reducing inequities and preventing future inequities. The aim of this manuscript is to highlight disparities and differences in terms of the factors that distinguish between poor and good access to healthcare across six Asia-Pacific countries: Australia, Hong Kong, Japan, South Korea, Taiwan, and Thailand. Methods A population survey was undertaken in each country. This paper is a secondary analysis of these existing data. Data were collected in each country between 2009 and 2010. Four variables related to difficulties in access to healthcare (distance, appointment, waiting time, and cost) were analysed using binomial logistic regression to identify socio- and demographic predictors of inequity. Results Consistent across the findings, poor health and low income were identified as difficulties in access. Country specific indicators were also identified. For Thailand, the poorest level of access appears to be for respondents who work within the household whereas in Taiwan, part-time work is associated with difficulties in access. Within Hong Kong, results suggest that older (above 60) and retired individuals have the poorest access and within Australia, females and married individuals are the worst off. Conclusion Recognition of these inequities, from a policy perspective, is essential for health sector policy decision-making. Despite the differences in political and economic climate in the countries under analysis, our findings highlight patterns of inequity which require policy responses. Our data should be used as a means of deciding the most appropriate policy response for each country which includes, rather than excludes, socially marginalised population groups. These findings should be of interest to those involved in health policy, but also in policy more generally because as we have identified, access to health care is influenced by determinants outside of the health system.
Background: Marginalization is a multidimensional social construct that influences the mental health status of individuals and their use of psychiatric services. However, its conceptualization and measurement are challenging due to inconsistencies in definitions, and the lack of standard data sources to measure this construct. Aims: To create an index for screening marginalization based on an existing comprehensive assessment system used in inpatient psychiatry. Method: Items anticipated to be indicative of marginalization were identified from the Resident Assessment Instrument-Mental Health (RAI-MH) that is used in all inpatient mental health beds in Ontario, Canada. Principal Component Analysis (PCA) and cluster analysis of these items was performed on a sample of 81,232 patients admitted into psychiatric care in Ontario between 1 January 2011 and 31 December 2016 to identify dimensions being measured. Various weights and scoring methods were tested to assess convergent validity on multiple outcomes of marginalization. Receiver Operating Characteristic (ROC) curve analysis was utilized to determine optimal cut-offs for the index by modeling the likelihood of different marginalization outcomes, including homelessness. Results: Fifteen items were identified for the development of the Marginalization Index (MI). PCA and cluster analysis identified that the items measured five dimensions. ROC curve analysis among homeless individuals identified an Area Under the Curve of 0.76 and an optimal cut-off of five on the MI. Frequency analysis of the index by different characteristics identified homeless individuals, frequent mental health service users, persons with a history of violence and police intervention, and persons with addictions issues, as groups with the highest scores, confirming the convergent validity of the index. Conclusion: The MI is a valid measure of marginalization and is strong predictor of risk of homelessness among psychiatric inpatients. MI provides a resource that can be used for social and health policy, decision-support and evaluation.
Canadian post-secondary students are vulnerable to food insecurity, yet lack of examination of this issue has prevented identification of policy and program solutions. This mixed-methods study aimed to characterize the experience of food insecurity among undergraduate students by eliciting barriers to food security, strategies used to manage food and money shortages, and perceived implications for health and academic achievement. Surveys and in-depth interviews were conducted with 14 students who demonstrated compromised financial access to food. Students normalized experiences of food insecurity as typical of post-secondary education but expressed anxiety and frustration with financial inaccessibility to healthy food, and described negative implications for their physical and mental health and their ability to perform well in school. Ongoing attempts to adapt or adjust to food insecurity had limited success. Findings highlight the need to challenge the "starving student" ideology, which normalizes the lack of access to healthy food during higher education. ; Les étudiants de niveau postsecondaire canadiens sont vulnérables à l'insécurité alimentaire, pourtant ce problème esquive aux examens qui mèneraient aux politiques et programmes solutions. Cette étude aux méthodes mixtes tente de définir l'expérience des étudiants en situation d'insécurité alimentaire en suscitant ses entraves, les stratégies pour gérer les manques de nourriture et d›argent, et les impacts perçus sur la santé et la réussite académique. Des sondages et des entrevues ont été menés auprès de 14 étudiants en situation d'insécurité alimentaire. Pour eux, il s'agit d'une expérience normale propre à l›éducation. Mais quant à l'inaccessibilité à une saine alimentation, tous ont parlé d'anxiété et de frustration avec les barrières financières en plus des impacts négatifs sur leur état physique et sur leur performance en classe. Les tentatives courantes d'adaptation à l'insécurité alimentaire ont eu un succès limité. Les résultats démontrent la nécessité de critiquer l'idéologie de « l'étudiant famélique » qui normalise leur accès limité à une saine alimentation durant leurs études postsecondaire.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ; Background Building or maintaining institutional trust is of central importance in democratic societies since negative experiences (potentially leading to mistrust) with government or other institutions may have a much more profound effect than positive experiences (potentially maintaining trust). Healthy democracy relies on more than simply trusting the national government of the time, and is mediated through other symbols of institutional power, such as the legal system, banks, the media and religious organisations. This paper focuses on institutional trust–the level and predictors of trust in some of the major institutions in society, namely politics, the media, banks, the legal system and religious organisations. We present analyses from a consolidated dataset containing data from six countries in the Asia Pacific region–Australia, Hong Kong, Japan, South Korea, Taiwan and Thailand. Methods Cross-sectional surveys were undertaken in each country in 2009–10, with an overall sample of 6331. Analyses of differences in overall levels of institutional trust between countries were undertaken using Chi square analyses. Multivariate binomial logistic regression analysis was undertaken to identify socio-demographic predictors of trust in each country. Results Religious institutions, banks and the judicial system had the highest overall trust across all countries (70%, 70% and 67% respectively), followed by newspapers and TV (59% and 58%) and then political leaders (43%). The range of levels of higher trust between countries differed from 43% for banks (range 49% in Australia to 92% in Thailand) to 59% for newspapers (28% in Australia to 87% in Japan). Across all countries, except for Australia, trust in political leaders had the lowest scores, particularly in Japan and South Korea (25% in both countries). In Thailand, people expressed the most trust in religious organisations (94%), banks (92%) and in their judicial/legal system (89%). In Hong Kong, people expressed the highest level of trust in their judicial/legal system (89%), followed by religious organisations (75%) and banks (77%). Australian respondents reported the least amount of trust in TV/media (24%) and press/newspapers (28%). South Korea put the least trust in their political leaders (25%), their legal system (43%) and religious organisations (45%). The key predictors of lower trust in institutions across all countries were males, people under 44 years and people unsatisfied with the health and standard of living. Conclusion We interpreted our data using Fukuyama's theory of 'high/low trust' societies. The levels of institutional trust in each society did not conform to our hypothesis, with Thailand exhibiting the highest trust (predicted to be medium level), Hong Kong and Japan exhibiting medium trust (predicted to be low and high respectively) and Australia and South Korea exhibiting low trust (predicted to be high and medium respectively). Taiwan was the only country where the actual and predicted trust was the same, namely low trust. Given the fact that these predictors crossed national boundaries and institutional types, further research and policy should focus specifically on improving trust within these groups in order that they can be empowered to play a more central role in democratic vitality.
OBJECTIVE: Symptom checkers are potentially beneficial tools during pandemics. To increase the use of the platform, perspectives of end users must be gathered. Our objectives were to understand the perspectives and experiences of young adults related to the use of symptom checkers for assessing COVID-19-related symptoms and to identify areas for improvement. METHODS: We conducted semistructured qualitative interviews with 22 young adults (18–34 years of age) at a university in Ontario, Canada. Interviews were audio-recorded, transcribed, and analysed using inductive thematic analysis. RESULTS: We identified six main themes related to the decision of using a symptom checker for COVID-19 symptoms: (1) presence of symptoms or a combination of symptoms, (2) knowledge about COVID-19 symptoms, (3) fear of seeking in-person healthcare services, (4) awareness about symptom checkers, (5) paranoia and (6) curiosity. Participants who used symptom checkers shared by governmental entities reported an overall positive experience. Individuals who used non-credible sources reported suboptimal experiences due to lack of perceived credibility. Five main areas for improvement were identified: (1) information about the creators of the platform, (2) explanation of symptoms, (3) personalised experience, (4) language options, and (5) option to get tested. CONCLUSIONS: This study suggests an increased acceptance of symptom checkers due to the perceived risks of infection associated with seeking in-person healthcare services. Symptom checkers have the potential to reduce the burden on healthcare systems and health professionals, especially during pandemics; however, these platforms could be improved to increase use.
This article responds to calls for empirically grounded and critically analytical research on the sociology of happiness. We explore how 35 Australian women in midlife (45–64 years) navigate alcohol use in the context of gendered lifecourses. In response to emerging themes around happiness in and through alcohol consumption during inductive analysis, data were re-analysed using neo-Aristotlean notions of flourishing. This illuminated alcohol consumption for women in midlife vis-á-vis moment-in-time pleasure, lifecourse happiness and management of gendered constraints. Drawing on Ahmed's concepts of 'affective economies' and 'happiness and unhappiness archives' we contemporise Aristotle's notion of flourishing and argue that changing structures of feeling for women in midlife give rise to differing emotions that attach to alcohol use. Understanding the affective reasons for alcohol consumption among this population provides new avenues to think about how alcohol consumption is purposed by women to make and make do with (un)happiness during midlife.
