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      Piloting the informed health choices resources in Barcelona primary schools: A mixed methods study

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          Abstract

          Introduction

          The main objective of the Informed Health Choices (IHC) project is to teach people to assess treatment claims and make informed health choices. For this purpose, the IHC learning resources were developed for primary school children. The aim of this study is to explore students’ and teachers’ experience when using the IHC resources in primary schools in Barcelona (Spain).

          Methods

          We conducted a mixed methods study for piloting the IHC resources in a convenience sample of primary schools in Barcelona. The intervention included a workshop with teachers, and nine lessons with students. We collected data using multiple approaches. We performed quantitative and qualitative analyses, and integrated the findings in a joint display. Finally, we formulated recommendations for using the IHC resources in this setting.

          Results

          Two schools, with a total of 143 students in 4th and 5th grade and six teachers, participated in the study. One school followed the suggested IHC teaching plan and competed all the lessons; the other school modified the plan substantially and did not complete all the lessons. Overall, students and teachers from both schools understood, were interested in, and were able to apply the content of the lessons. During the lessons, the textbook was useful for students; nevertheless, for the teachers, the usefulness of the IHC resources was variable. Teachers adapted the IHC resources to increase student participation and used Information and Communications Technologies tools. We observed more facilitators than barriers to teach the lessons. The teachers suggested some ideas to improve the lessons based on activities they developed and implemented. The integration analysis showed great convergence of the quantitative and qualitative findings. We propose seven recommendations for using the IHC resources in this setting.

          Conclusions

          Students and teachers from primary schools in Barcelona showed a positive experience when using IHC resources; however, these resources should be adapted to promote classroom participation.

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          Most cited references28

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          Using the framework method for the analysis of qualitative data in multi-disciplinary health research

          Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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            Achieving integration in mixed methods designs-principles and practices.

            Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs-exploratory sequential, explanatory sequential, and convergent-and through four advanced frameworks-multistage, intervention, case study, and participatory. Integration at the methods level occurs through four approaches. In connecting, one database links to the other through sampling. With building, one database informs the data collection approach of the other. When merging, the two databases are brought together for analysis. With embedding, data collection and analysis link at multiple points. Integration at the interpretation and reporting level occurs through narrative, data transformation, and joint display. The fit of integration describes the extent the qualitative and quantitative findings cohere. Understanding these principles and practices of integration can help health services researchers leverage the strengths of mixed methods. © Health Research and Educational Trust.
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              Toward a Conceptual Framework for Mixed-Method Evaluation Designs

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                7 July 2023
                2023
                : 18
                : 7
                : e0288082
                Affiliations
                [1 ] Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
                [2 ] Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
                [3 ] CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
                [4 ] Escola Virolai, Barcelona, Spain
                [5 ] Andalusian Health Service, Malaga, Spain
                [6 ] Cancer Prevention and Control Programme, Catalan Institute of Oncology - IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
                [7 ] Paediatric Hospital of Sinaloa, Culiacan, Mexico
                [8 ] Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
                [9 ] Vall d’Hebron University Hospital, Barcelona, Spain
                [10 ] Clinical Epidemiology, Biodonostia Health Research Institute, San Sebastián, Spain
                [11 ] Clinical Epidemiology Unit, Donostialdea Integrated Health Organisation, Osakidetza Basque Health Service, Donostia University Hospital, San Sebastián, Spain
                Tallinn University: Tallinna Ulikool, ESTONIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-5975-702X
                https://orcid.org/0000-0001-8334-7664
                https://orcid.org/0000-0003-4845-4899
                https://orcid.org/0000-0003-0126-8706
                Article
                PONE-D-23-05069
                10.1371/journal.pone.0288082
                10328314
                506a338d-971d-4a22-bfbe-8ee6f87fd290
                © 2023 Jofra et al

                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.

                History
                : 21 February 2023
                : 19 June 2023
                Page count
                Figures: 3, Tables: 3, Pages: 23
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100004587, Instituto de Salud Carlos III;
                Award ID: CP18/00007
                Award Recipient :
                This study has been funded by Instituto de Salud Carlos III [CP18/00007] (Cofunded by European Regional Development Fund/European Social Fund, 'Investing in your future'). LMG has a Miguel Servet research contract from the Institute of Health Carlos III [CP18/00007] (Cofunded by European Regional Development Fund/European Social Fund, 'Investing in your future'). Dr. Antoni Esteve Foundation has funded the Spanish translation and production of the IHC resources. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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