Monique Hennink

Verbatim transcription in qualitative research is hugely time consuming, yet critical for data validity. The rise in artificial intelligence tools for transcription provides new opportunities for researchers. We assessed the accuracy and efficiency of two widely accessible AI tools and human transcription to provide empirical guidance for researchers. We compared 10 verbatim transcripts generated via three transcription modes: human, Otter.ai and MAXQDA. We compared transcription time, cost, errors (volume and type), and correction time. Results show that the AI tools were highly time/cost efficient but had 2-3 times more errors than human transcription. Accounting for average correction time, AI tools generated a transcript in 1.25 - 2.5 hours for USD31-38 per transcript; thus 3–6 times faster and 3 times cheaper than human transcription. However, human review of AI transcription remains critical for data validity; thus, AI tools can assist in the transcription process versus generating the final product. We develop recommendations for each phase of the research process to maximize the benefits of using AI transcription tools.

Background: Malnutrition and antimicrobial-resistant infections are major causes of morbidity and mortality in low-income countries. These conditions have been associated with the gut microbiome, although little is known about the acceptability of microbiota therapies such as fecal microbiota transplantation (FMT). We explored the acceptability of FMT among health care providers (HCPs) and patients in Addis Ababa, Ethiopia. Methods: In this qualitative study, we purposively sampled patients with bacterial infections and acute malnutrition, caregivers, and HCPs at two hospitals. Eight focus group discussions were held. Amharic and English discussion guides covered knowledge of FMT and perceived barriers or facilitators for uptake. Data were transcribed and translated into English when necessary. MAXQDA software was used for a thematic analysis, with trained researchers closely reading transcripts to identify issues, develop a codebook, iteratively code data, and assess intercoder agreement. Description, comparison, and categorization were conducted to discern core themes, and validity checks ensured that findings were grounded in the data. Results: HCPs indicated a general willingness to prescribe FMT, provided that there was sufficient evidence supporting its efficacy and safety and they were confident on patient adherence. Patient acceptability of FMT was categorized along a continuum from those who were unconvinced, persuadable, amenable, and accepting of salvage treatment. Conclusions: FMT may be acceptable for HCPs and patients in Addis Ababa, although interventions are needed to enhance acceptance among some groups, such as marketing it as standard medication, obtaining endorsement by religious leaders, providing multiple formulations, and/or providing thoughtful health communication.

: The optimal global health (GH) workforce should be racially and ethnically diverse, yet few persons from historically underrepresented minority (URM) groups in the United States participate in GH training programs. We conducted a study to explore barriers and facilitators for URM individuals to participate in the NIH Fogarty International Center’s GH Program for Fellows and Scholars (FGHFS), which offers yearlong international research training opportunities. We used an exploratory sequential mixed methods study design that used qualitative in-depth interviews (n = 18) to inform a subsequent quantitative online survey (n = 82). We assessed URM interest and engagement in GH training at three stages of FGHFS (applicants, alumni, and eligible persons who had not applied). Most participants in both phases were female, Black or African American, aged between 31 and 39 years, and had completed graduate or postgraduate training; a third or less were Hispanic. We identified four principal barriers to participation in GH training programs including lack of exposure to GH, lack of mentorship or support, challenges of global travel and work, and finances. The barriers compounded across training stages. Principal facilitators of training engagement included encouraging mentors and supportive families. Recommendations for increasing the participation of URM individuals in GH research training programs included increased financial support and exposure to GH in academic studies, as well as exposure to role models and mentors who can provide career advising in GH. Our findings suggest that early exposure, mentorship, and sufficient financial support will facilitate URMs’ entry into GH.

: Qualitative research methods are central to understanding many public health problems. However, capacity building for qualitative research is globally skewed toward high-income countries, with a significant skills deficit in low- and middle-income countries (LMICs). To address this imbalance and provide a model program, we developed the Qualitative Research Leaders (QRL) program, a pipeline program to increase qualitative research capacity in LMIC institutions and foster leadership in qualitative research. The QRL program is a collaboration between Emory University and Vanderbilt University in the United States and two LMIC institutions Kilimanjaro Christian Medical College in Tanzania and the Public Health Foundation of India. The program had five phases conducted over 12 months: 1) mentored study design sessions, 2) an in-country skill-building workshop, 3) mentored proposal development sessions, 4) a residential grant writing program in the United States, and 5) mentor matching for field implementation. Program evaluation results showed that the QRL program was effectively designed, and scholars valued the program components, learning formats, and session content. The program increased scholars’ knowledge, skills, and confidence as mentors in qualitative research. Furthermore, scholars demonstrated leadership in initiating postprogram research, mentoring, and teaching in qualitative research. Overall, scholars felt that the program could be extended to enable more time to internalize new knowledge and develop skills, and the role of in-country mentors could be expanded to further support scholars during fieldwork. In this article, we describe the components of the QRL program and its implementation, results of our program evaluation, and lessons learned for developing similar pipeline training programs.

The principle of saturation guides adequate sample size estimation in qualitative research. It is based on assessing data adequacy for a study rather than the number of participants per se. This lesson provides guidance on estimating an adequate sample size for a research proposal using the characteristics of the study.

Bangladesh is historically a patriarchal society, but has made recent strides in increasing educational and economic opportunities for women. Yet men continue to perpetrate economic coercion and other forms of intimate partner violence against women in Bangladesh. This study examines how men in rural Bangladesh shape the economic activities of their wives within the context of changing norms around women’s involvement in economic domains. Men’s perspectives are not often explored in the literature and can provide valuable insight into how and why economic coercion persists. 25 in-depth interviews were conducted with men in rural Bangladesh and analyzed using thematic analysis. Men engaged in economically coercive practices, both implicitly and explicitly. Three themes captured how men perpetrated economic coercion: they held gendered expectations about how and if women should participate in economic activities, they monitored women’s activities to ensure they conformed to the men’s gendered expectations, and they placed explicit restrictions on women’s economic activities to align with and maintain gender inequitable norms. These findings call attention to how men continue to see themselves as dominant over women in rural Bangladesh, despite the progress made in expanding educational and economic opportunities for women. The analysis points to the need for interventions that go beyond increased access to educational and economic programs for women to address the persistence of gender inequitable norms within patriarchal societies.

Background: Women in rural Bangladesh face multiple, inter-related challenges including food insecurity, malnutrition, and low levels of empowerment. We aimed to investigate the pathway towards empowerment experienced by women participating in a three-year nutrition-sensitive homestead food production (HFP) program, which was evaluated through the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized controlled trial. Methods: We conducted 44 in-depth interviews and 12 focus group discussions with men and women in both intervention and control communities of the FAARM study site in rural, north-eastern Bangladesh. Using a modified grounded theory approach to data collection and analysis, we developed a framework to explain the pathway towards empowerment among HFP program participants. Results: The analysis and resulting framework identified seven steps towards empowerment: 1) receiving training and materials; 2) establishing home gardens and rearing poultry; 3) experiencing initial success with food production; 4) generating social or financial resources; 5) expanding agency in household decision-making; 6) producing renewable resources (e.g. farm produce) and social resources; and 7) sustaining empowerment. The most meaningful improvements in empowerment occurred among participants who were able to produce food beyond what was needed for household consumption and were able to successfully leverage these surplus resources to gain higher bargaining power in their household. Additionally, women used negotiation skills with their husbands, fostered social support networks with other women, and developed increased self-efficacy and motivation. Meanwhile, the least empowered participants lacked support in critical areas, such as support from their spouses, social support networks, or sufficient space or time to produce enough food to meaningfully increase their contribution and therefore bargaining power within their household. Conclusions: This study developed a novel framework to describe a pathway to empowerment among female participants in an HFP intervention, as implemented in the FAARM trial. These results have implications for the design of future nutrition-sensitive agriculture interventions, which should prioritize opportunities to increase empowerment and mitigate the barriers identified in our study. Trial registration: FAARM is registered with ClinicalTrials.gov (NCT02505711).

Mental health issues among school-age children are variable yet consistently prevalent worldwide; the implications can be debilitating and long-lasting. Due to their regular interactions with students, school staff members are well poised to identify issues and implement in-school mental health interventions. In this qualitative study, we examine how staff in public elementary schools in Jeddah, Saudi Arabia perceived, assessed, and responded to mental health challenges among their students. We conducted semi-structured interviews with school staff members (n = 16) including teachers (n = 8), counselors (n = 4), and principals (n = 4) from public elementary all-female schools. Using a thematic analysis, we outlined the school staff’s perceptions of the causes and identifiers of students’ mental health problems, their approach to managing students with mental health problems, and the perceived barriers to improving students’ mental health with suggested solutions. Public health implications and future recommendations were discussed.