findings vs discussion in qualitative research

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How to write the analysis and discussion chapters in qualitative (SSAH) research

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Charlesworth Author Services
11 November, 2021

While it is more common for Science, Technology, Engineering and Mathematics (STEM) researchers to write separate, distinct chapters for their data/ results and analysis/ discussion , the same sections can feel less clearly defined for a researcher in Social Sciences, Arts and Humanities (SSAH). This article will look specifically at some useful approaches to writing the analysis and discussion chapters in qualitative/SSAH research.

Note : Most of the differences in approaches to research, writing, analysis and discussion come down, ultimately, to differences in epistemology – how we approach, create and work with knowledge in our respective fields. However, this is a vast topic that deserves a separate discussion.

Look for emerging themes and patterns

The ‘results’ of qualitative research can sometimes be harder to pinpoint than in quantitative research. You’re not dealing with definitive numbers and results in the same way as, say, a scientist conducting experiments that produce measurable data. Instead, most qualitative researchers explore prominent, interesting themes and patterns emerging from their data – that could comprise interviews, textual material or participant observation, for example.

You may find that your data presents a huge number of themes, issues and topics, all of which you might find equally significant and interesting. In fact, you might find yourself overwhelmed by the many directions that your research could take, depending on which themes you choose to study in further depth. You may even discover issues and patterns that you had not expected , that may necessitate having to change or expand the research focus you initially started off with.

It is crucial at this point not to panic. Instead, try to enjoy the many possibilities that your data is offering you. It can be useful to remind yourself at each stage of exactly what you are trying to find out through this research.

What exactly do you want to know? What knowledge do you want to generate and share within your field?

Then, spend some time reflecting upon each of the themes that seem most interesting and significant, and consider whether they are immediately relevant to your main, overarching research objectives and goals.

Suggestion: Don’t worry too much about structure and flow at the early stages of writing your discussion . It would be a more valuable use of your time to fully explore the themes and issues arising from your data first, while also reading widely alongside your writing (more on this below). As you work more intimately with the data and develop your ideas, the overarching narrative and connections between those ideas will begin to emerge. Trust that you’ll be able to draw those links and craft the structure organically as you write.

Let your data guide you

A key characteristic of qualitative research is that the researchers allow their data to ‘speak’ and guide their research and their writing. Instead of insisting too strongly upon the prominence of specific themes and issues and imposing their opinions and beliefs upon the data, a good qualitative researcher ‘listens’ to what the data has to tell them.

Again, you might find yourself having to address unexpected issues or your data may reveal things that seem completely contradictory to the ideas and theories you have worked with so far. Although this might seem worrying, discovering these unexpected new elements can actually make your research much richer and more interesting.

Suggestion: Allow yourself to follow those leads and ask new questions as you work through your data. These new directions could help you to answer your research questions in more depth and with greater complexity; or they could even open up other avenues for further study, either in this or future research.

Work closely with the literature

As you analyse and discuss the prominent themes, arguments and findings arising from your data, it is very helpful to maintain a regular and consistent reading practice alongside your writing. Return to the literature that you’ve already been reading so far or begin to check out new texts, studies and theories that might be more appropriate for working with any new ideas and themes arising from your data.

Reading and incorporating relevant literature into your writing as you work through your analysis and discussion will help you to consistently contextualise your research within the larger body of knowledge. It will be easier to stay focused on what you are trying to say through your research if you can simultaneously show what has already been said on the subject and how your research and data supports, challenges or extends those debates. By drawing from existing literature , you are setting up a dialogue between your research and prior work, and highlighting what this research has to add to the conversation.

Suggestion : Although it might sometimes feel tedious to have to blend others’ writing in with yours, this is ultimately the best way to showcase the specialness of your own data, findings and research . Remember that it is more difficult to highlight the significance and relevance of your original work without first showing how that work fits into or responds to existing studies.

In conclusion

The discussion chapters form the heart of your thesis and this is where your unique contribution comes to the forefront. This is where your data takes centre-stage and where you get to showcase your original arguments, perspectives and knowledge. To do this effectively needs you to explore the original themes and issues arising from and within the data, while simultaneously contextualising these findings within the larger, existing body of knowledge of your specialising field. By striking this balance, you prove the two most important qualities of excellent qualitative research : keen awareness of your field and a firm understanding of your place in it.

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Structuring a qualitative findings section

Reporting the findings from a qualitative study in a way that is interesting, meaningful, and trustworthy can be a struggle. Those new to qualitative research often find themselves trying to quantify everything to make it seem more “rigorous,” or asking themselves, “Do I really need this much data to support my findings?” Length requirements and word limits imposed by academic journals can also make the process difficult because qualitative data takes up a lot of room! In this post, I’m going to outline a few ways to structure qualitative findings, and a few tips and tricks to develop a strong findings section.

There are A LOT of different ways to structure a qualitative findings section. I’m going to focus on the following:

Tables (but not ONLY tables)

Themes/Findings as Headings

Research Questions as Headings

Anchoring Quotations

Anchoring Excerpts from Field Notes

Before I get into each of those, however, here is a bit of general guidance. First, make sure that you are providing adequate direct evidence for your findings. Second, be sure to integrate that direct evidence into the narrative. In other words, if for example, you were using quotes from a participant to support one of your themes, you should present and explain the theme (akin to a thesis statement), introduce the supporting quote, present it, explain the quote, and connect it to your finding. Below is an example of what I mean from one of my articles on implementation challenges in personalized learning ( Bingham, Pane, Steiner, & Hamilton, 2018 ). The finding supported by this paragraph was: “Inadequate Teacher Preparation, Development, and Support”

To mitigate the difficulties of enacting personalized learning in their classrooms, teachers wanted a model from which they could extrapolate practices that might serve them well in their own classrooms. As one teacher explained, “the ideas and the implementation is what’s lacking I think. I don’t feel like I know what I’m doing. I need to see things modeled and I need to know what it is. I need to be able to touch it. Show me a model, model for me.” Unfortunately, teachers had little to draw on for effective practices. Professional development was not as helpful as teachers had hoped, outside training on using the digital content or learning platforms fell short, and few examples or best practices existed for teachers to use in their own classrooms. As a result, teachers had to work harder to address gaps in their own knowledge.

Finally, you should not leave quotations to speak for themselves and you should not have quotations as standalone paragraphs or sentences, with no introduction or explanation. Don’t make the reader do the analytic work for you.

Now, on to some specific ways to structure your findings section.

Screen Shot 2020-09-26 at 9.47.48 AM.png

Tables can be used to give an overview of what you’re about to present in your findings, including the themes, some supporting evidence, and the meaning/explanation of the theme. Tables can be a useful way to give readers a quick reference for what your findings are. However, tables should not be used as your ONLY means of presenting those findings.

If you are choosing to use a table to present qualitative findings, you must also describe the findings in context, and provide supporting evidence in a narrative format (as in the paragraph outlined in the previous section).

2). Themes/Findings as Headings

Another option is to present your themes/findings as general or specific headings in your findings section. Here are some examples of findings as general headings:

Importance of Data Utilization and Analysis in the Classroom The Role of Student Discipline and Accountability Differences in the Experiences of Teachers

As you can see these headings do not describe precisely what the finding is, but they give the general idea/subject of the finding. You can have sub-headings within these findings that are more specific if you would like.

Another way to do this would be to be a bit more specific. For example:

School Infrastructure and Available Technology Do Not yet Fully Align with Teachers’ Needs

Structural support for high levels of technology use is not fully developed

Using multiple sources of digital content led to alignment issues

Measures of School and Student Success are Misaligned

Traditional methods of measuring student progress conflict with personalized learning

Difficulties communicating new measures of student success to colleges and universities.

As you can see, here the findings are shown as headings, but are structured as specific sentences, with sub-themes included as well.

3). Research Questions as Headings

You can also present your findings using your research questions as the headings in the findings section. This is a useful strategy that ensures you’re answering your research questions and also allows the reader to quickly ascertain where the answers to your research questions are. Often, you will also need to present themes within each research question to keep yourself organized and to adequately flesh out your findings. The example below presents a research question from my study of blended learning at a charter high school (Bingham, 2016) , and an excerpt from my findings that answered that research question. I have also included the associated theme.

Research Question 1: What challenges, if any, do teachers face in implementing a blended model in a school’s first year? Theme: TROUBLESHOOTING AND TASK-MANAGING: TECHNOLOGY USE IN THE CLASSROOM In the original vision for instruction at Blended Academy, technology was to be an integral part of students’ learning, meant to allow students to find their own answers to their questions, to explore their personal interests, and to provide multiple opportunities for learning. The use of iPods in the classroom was partially intended to serve the social-emotional component of the model, allowing students to enjoy music and to “tune out” from other classroom activities when working on Digital X. Further, the iPods would allow stu- dents to listen to podcasts or teacher-created content at any time, in any location. However, prior to the school’s opening, little attention was paid to the management of these devices, and their potential for misuse. As a result, teachers spent much of their time managing students’ technology use, troubleshooting, and developing classroom procedures to ensure that technology use was relevant to learning. For example, in Ms. L’s classroom, she attempted to ensure learning was happening by instituting “Technology-Free” periods in the classroom. When students had to be working on their laptops in order to complete lessons or quizzes, the majority of her time was spent walking from student to student, watching for off-task behavior, and calling out students for how long they were “logged in” to the digital curriculum. In one typical interaction, Ms. L admonished one student, saying “It says you only logged in for one minute . . . when are you going to finish your English if you only logged in one minute today?” The difficulties around ensuring students were using technology productively resulted in teachers “hovering” over students, making it difficult to provide targeted instructional help. Teachers often responded to off-task behavior/ technology use by confiscating computers and devices or restricting their use, in order to ensure that students were working. However, because the majority of tasks were meant to be delivered online or through technological devices, this was not a productive or effective solution.

4). Vignettes

Vignettes can be a strategy to spark interest in your study, add narrative context, and provide a descriptive overview of your study/site/participants. They can also be used as a strategy to introduce themes. You can place them at the beginning of a paper, or at the start of the findings section, or in your discussion of each theme. They wouldn’t typically be the only representation of your findings that you present, but you can use them to hook the reader and provide a story that exemplifies findings, themes, contexts, participants, etc. Below is an example from one of my recent studies.

The Role of Pilot Teachers in Schoolwide Technology Integration Blended High School is a lot like many other charter schools. Students wear uniforms, and as you walk through the halls, there is almost always a teacher issuing a demerit to a student who is not wearing the right shoes, or who hasn’t tucked in their shirt. In this school, however, teachers use technology in almost every facet of their instruction, operating in a school model that blends face-to-face and online learning in the classroom in order to personalize students’ learning experiences. It has, however, been a long road to this level of technology use. BHS’s first year of operation was, arguably, disastrous. Teachers were overwhelmed and students didn’t progress as expected. In one staff meeting toward the end of the schools’ first year, teachers and administrators expressed frustration with each other and with the school model, with several teachers arguing that technology was hurting, not helping. The atmosphere was tense, with one teacher finally shrugging anxiously and saying “Maybe need to ask ourselves, ‘Is this the best model to use with some of our kids?’” Ultimately, by the end of the first year, technology was not a regular classroom practice. In BHS’s second year, the administration again pushed for full technology integration, but they wanted to start slow. In a fall semester staff meeting, the principal and the assistant principal ran what the principal referred to as a “technology therapy session,” where teachers could share their struggles with using technology to engage in PL. During the session, one of the new teachers mentions that she is having a difficult time letting go – changing her focus from lecturing to computer-based work. Another teacher worries about finding good online resources. Most of the teachers, new and veteran, are alarmed by the time it is taking for them design lessons that integrate technology. Some admit only engaging in technology use in a shallow way – uploading worksheets to Google Docs, recording Powerpoints, etc. A few months after the discussion in which teachers aired their fears and struggles, the principal leads the teachers in analyzing student data from that week and spends a bit of time highlighting the work of a few teachers whose students are doing particularly well and who have been able to use technology in everyday classroom practice. Those teachers are part of a small group of “pilot teachers,” each of whom have been experimenting with various technology-based practices, including testing new learning management systems, designing their own online modules with personalized student objectives, providing students with technology-facilitated immediate feedback, and using up-to-the-minute data to develop technology-guided small-group instruction. Over the course of the next several months, administrators encouraged teachers to continue to be transparent about their concerns and share those concerns in regular staff meetings. Administrators conferred with the pilot teachers and administrators and teachers together set incremental goals based on the pilot teachers’ recommendations. In weekly staff meetings, the pilot teachers shared their progress, including concerns and challenges. They collaborated with the other teachers to find solutions and worked with the administration to get what they needed to enact those solutions. For example, after a push from the pilot teachers, administration increased funding for technology purchases and introduced shifts in the school schedule to allow for planning in order to help teachers manage the demands of a high-tech classroom. Because the pilot teachers emphasized how much time meaningful technology integration took, and knew what worked and what didn’t, they were able to train other teachers in high-tech practices and to make the case to administration for needed changes. By BHS’s third year, teachers schoolwide were able to fully integrate technology in their classrooms. All teachers were using the same learning management system, which had been initially chosen and tested by a pilot teacher. In every classroom, teachers were also engaging online modules, technology-facilitated breakout groups, and real time technology-based data analysis – all of which were practices the pilot teachers had tested and shared in the second year. The consistent collaboration between administration and pilot teachers and pilot teachers and other teachers helped calibrate classroom changes to manage the conflict between existing practices and new high-tech practices. By focusing on student learning data, creating the room for experimentation, collaborating consistently, and distributing the leadership for technology integration, teachers and administrators felt comfortable with the increasing reliance on tech-heavy practices.

I developed this vignette as a composite from my field notes and interviews and used it to set the stage for the rest of the findings section.

4). Anchoring Quotes

Using exemplar quotes from your participants is another way to structure your findings. In the following, which also comes from Bingham et al. (2018) , the finding itself is used as the heading, and the anchoring quotes come directly after the heading, prior to the rest of the narrative discussion of the finding. These quotations help provide some initial evidence and set the stage for what’s to come.

School Infrastructure and Available Technology Do Not Yet Fully Align With Teachers’ Needs “I know that computer problems are an issue almost daily.” (Middle school personalized learning teacher) “If the data was exactly what we needed, it would be easier. I think a lot of times we’re not using it enough because the way we’re using the data is not as effective as it should be.” (High school personalized learning teacher)

You can note the source next to or after the quote. This can be done with your chosen pseudonyms, or with a general description, as I've done above.

5). Anchoring Excerpts from Field Notes

Similarly, excerpts from field notes can be used to start your discussion of a finding. Again, the finding itself is used as the heading, and the excerpt from field notes supporting that finding comes directly after the heading, prior to the rest of the narrative discussion of the finding. The example below comes from a study in which I explored how a personalized learning model evolved over the course of three years (Bingham, 2017) . I used excerpts from my field notes to open the discussion of each year.

Year 1: Navigating the disconnect between vision and practice Walking into the large classroom space shared by Ms. Z and Ms. H, it is not immediately evident that these are high-tech PL classrooms. At first, there are no laptops out in either class. Both Ms. Z’s and Ms. H’s students are completing warm-up activities that are projected on each teacher’s white board. After a few minutes, Ms. Z’s students get up and get laptops. Ms. Z walks around to students and asks them what lesson from the digital curriculum they will be working on today. As Ms. Z speaks to a table of students, other students in the room listen to their iPods, sometimes singing loudly. Some students are on YouTube, watching music videos; others are messaging friends on GChat or Facebook. As Ms. Z makes her way around, students toggle back to the screen devoted to the digital curriculum. Sometimes, Ms. Z notices that students are off-task and she redirects them. Other times, she is too busy unlocking an online quiz for a student, or confiscating a student’s iPod.

This excerpt from my field notes provided an overview of what teacher practice looked like in the first year of the school, so that I could then discuss several themes that were representative of how practice evolved over that first year.

The key takeaway here is that there are many ways to structure your findings section. You have to choose the method that best supports your study, and best represents your data and participants. No matter what you choose, the findings section itself should be constructed to answer your research questions, while also providing context and thick description, and, of course, telling a story.

Writing a discussion section

Some tips for academic writing.

How To Write The Results/Findings Chapter

For qualitative studies (dissertations & theses).

By: Jenna Crossley (PhD). Expert Reviewed By: Dr. Eunice Rautenbach | August 2021

So, you’ve collected and analysed your qualitative data, and it’s time to write up your results chapter. But where do you start? In this post, we’ll guide you through the qualitative results chapter (also called the findings chapter), step by step.

Overview: Qualitative Results Chapter

What (exactly) the qualitative results chapter is
What to include in your results chapter
How to write up your results chapter
A few tips and tricks to help you along the way
Free results chapter template

What exactly is the results chapter?

The results chapter in a dissertation or thesis (or any formal academic research piece) is where you objectively and neutrally present the findings of your qualitative analysis (or analyses if you used multiple qualitative analysis methods ). This chapter can sometimes be combined with the discussion chapter (where you interpret the data and discuss its meaning), depending on your university’s preference. We’ll treat the two chapters as separate, as that’s the most common approach.

In contrast to a quantitative results chapter that presents numbers and statistics, a qualitative results chapter presents data primarily in the form of words . But this doesn’t mean that a qualitative study can’t have quantitative elements – you could, for example, present the number of times a theme or topic pops up in your data, depending on the analysis method(s) you adopt.

Adding a quantitative element to your study can add some rigour, which strengthens your results by providing more evidence for your claims. This is particularly common when using qualitative content analysis. Keep in mind though that qualitative research aims to achieve depth, richness and identify nuances , so don’t get tunnel vision by focusing on the numbers. They’re just cream on top in a qualitative analysis.

So, to recap, the results chapter is where you objectively present the findings of your analysis, without interpreting them (you’ll save that for the discussion chapter). With that out the way, let’s take a look at what you should include in your results chapter.

Free template for results section of a dissertation or thesis

What should you include in the results chapter?

As we’ve mentioned, your qualitative results chapter should purely present and describe your results , not interpret them in relation to the existing literature or your research questions . Any speculations or discussion about the implications of your findings should be reserved for your discussion chapter.

In your results chapter, you’ll want to talk about your analysis findings and whether or not they support your hypotheses (if you have any). Naturally, the exact contents of your results chapter will depend on which qualitative analysis method (or methods) you use. For example, if you were to use thematic analysis, you’d detail the themes identified in your analysis, using extracts from the transcripts or text to support your claims.

While you do need to present your analysis findings in some detail, you should avoid dumping large amounts of raw data in this chapter. Instead, focus on presenting the key findings and using a handful of select quotes or text extracts to support each finding . The reams of data and analysis can be relegated to your appendices.

While it’s tempting to include every last detail you found in your qualitative analysis, it is important to make sure that you report only that which is relevant to your research aims, objectives and research questions . Always keep these three components, as well as your hypotheses (if you have any) front of mind when writing the chapter and use them as a filter to decide what’s relevant and what’s not.

Need a helping hand?

findings vs discussion in qualitative research

How do I write the results chapter?

Now that we’ve covered the basics, it’s time to look at how to structure your chapter. Broadly speaking, the results chapter needs to contain three core components – the introduction, the body and the concluding summary. Let’s take a look at each of these.

Section 1: Introduction

The first step is to craft a brief introduction to the chapter. This intro is vital as it provides some context for your findings. In your introduction, you should begin by reiterating your problem statement and research questions and highlight the purpose of your research . Make sure that you spell this out for the reader so that the rest of your chapter is well contextualised.

The next step is to briefly outline the structure of your results chapter. In other words, explain what’s included in the chapter and what the reader can expect. In the results chapter, you want to tell a story that is coherent, flows logically, and is easy to follow , so make sure that you plan your structure out well and convey that structure (at a high level), so that your reader is well oriented.

The introduction section shouldn’t be lengthy. Two or three short paragraphs should be more than adequate. It is merely an introduction and overview, not a summary of the chapter.

Pro Tip – To help you structure your chapter, it can be useful to set up an initial draft with (sub)section headings so that you’re able to easily (re)arrange parts of your chapter. This will also help your reader to follow your results and give your chapter some coherence. Be sure to use level-based heading styles (e.g. Heading 1, 2, 3 styles) to help the reader differentiate between levels visually. You can find these options in Word (example below).

Section 2: Body

Before we get started on what to include in the body of your chapter, it’s vital to remember that a results section should be completely objective and descriptive, not interpretive . So, be careful not to use words such as, “suggests” or “implies”, as these usually accompany some form of interpretation – that’s reserved for your discussion chapter.

The structure of your body section is very important , so make sure that you plan it out well. When planning out your qualitative results chapter, create sections and subsections so that you can maintain the flow of the story you’re trying to tell. Be sure to systematically and consistently describe each portion of results. Try to adopt a standardised structure for each portion so that you achieve a high level of consistency throughout the chapter.

For qualitative studies, results chapters tend to be structured according to themes , which makes it easier for readers to follow. However, keep in mind that not all results chapters have to be structured in this manner. For example, if you’re conducting a longitudinal study, you may want to structure your chapter chronologically. Similarly, you might structure this chapter based on your theoretical framework . The exact structure of your chapter will depend on the nature of your study , especially your research questions.

As you work through the body of your chapter, make sure that you use quotes to substantiate every one of your claims . You can present these quotes in italics to differentiate them from your own words. A general rule of thumb is to use at least two pieces of evidence per claim, and these should be linked directly to your data. Also, remember that you need to include all relevant results , not just the ones that support your assumptions or initial leanings.

In addition to including quotes, you can also link your claims to the data by using appendices , which you should reference throughout your text. When you reference, make sure that you include both the name/number of the appendix , as well as the line(s) from which you drew your data.

As referencing styles can vary greatly, be sure to look up the appendix referencing conventions of your university’s prescribed style (e.g. APA , Harvard, etc) and keep this consistent throughout your chapter.

Section 3: Concluding summary

The concluding summary is very important because it summarises your key findings and lays the foundation for the discussion chapter . Keep in mind that some readers may skip directly to this section (from the introduction section), so make sure that it can be read and understood well in isolation.

In this section, you need to remind the reader of the key findings. That is, the results that directly relate to your research questions and that you will build upon in your discussion chapter. Remember, your reader has digested a lot of information in this chapter, so you need to use this section to remind them of the most important takeaways.

Importantly, the concluding summary should not present any new information and should only describe what you’ve already presented in your chapter. Keep it concise – you’re not summarising the whole chapter, just the essentials.

Tips for writing an A-grade results chapter

Now that you’ve got a clear picture of what the qualitative results chapter is all about, here are some quick tips and reminders to help you craft a high-quality chapter:

Your results chapter should be written in the past tense . You’ve done the work already, so you want to tell the reader what you found , not what you are currently finding .
Make sure that you review your work multiple times and check that every claim is adequately backed up by evidence . Aim for at least two examples per claim, and make use of an appendix to reference these.
When writing up your results, make sure that you stick to only what is relevant . Don’t waste time on data that are not relevant to your research objectives and research questions.
Use headings and subheadings to create an intuitive, easy to follow piece of writing. Make use of Microsoft Word’s “heading styles” and be sure to use them consistently.
When referring to numerical data, tables and figures can provide a useful visual aid. When using these, make sure that they can be read and understood independent of your body text (i.e. that they can stand-alone). To this end, use clear, concise labels for each of your tables or figures and make use of colours to code indicate differences or hierarchy.
Similarly, when you’re writing up your chapter, it can be useful to highlight topics and themes in different colours . This can help you to differentiate between your data if you get a bit overwhelmed and will also help you to ensure that your results flow logically and coherently.

If you have any questions, leave a comment below and we’ll do our best to help. If you’d like 1-on-1 help with your results chapter (or any chapter of your dissertation or thesis), check out our private dissertation coaching service here or book a free initial consultation to discuss how we can help you.

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22 Comments

This was extremely helpful. Thanks a lot guys

Hi, thanks for the great research support platform created by the gradcoach team!

I wanted to ask- While “suggests” or “implies” are interpretive terms, what terms could we use for the results chapter? Could you share some examples of descriptive terms?

I think that instead of saying, ‘The data suggested, or The data implied,’ you can say, ‘The Data showed or revealed, or illustrated or outlined’…If interview data, you may say Jane Doe illuminated or elaborated, or Jane Doe described… or Jane Doe expressed or stated.

I found this article very useful. Thank you very much for the outstanding work you are doing.

What if i have 3 different interviewees answering the same interview questions? Should i then present the results in form of the table with the division on the 3 perspectives or rather give a results in form of the text and highlight who said what?

I think this tabular representation of results is a great idea. I am doing it too along with the text. Thanks

That was helpful was struggling to separate the discussion from the findings

this was very useful, Thank you.

Very helpful, I am confident to write my results chapter now.

It is so helpful! It is a good job. Thank you very much!

Very useful, well explained. Many thanks.

Hello, I appreciate the way you provided a supportive comments about qualitative results presenting tips

I loved this! It explains everything needed, and it has helped me better organize my thoughts. What words should I not use while writing my results section, other than subjective ones.

Thanks a lot, it is really helpful

Thank you so much dear, i really appropriate your nice explanations about this.

Thank you so much for this! I was wondering if anyone could help with how to prproperly integrate quotations (Excerpts) from interviews in the finding chapter in a qualitative research. Please GradCoach, address this issue and provide examples.

what if I’m not doing any interviews myself and all the information is coming from case studies that have already done the research.

Very helpful thank you.

This was very helpful as I was wondering how to structure this part of my dissertation, to include the quotes… Thanks for this explanation

This is very helpful, thanks! I am required to write up my results chapters with the discussion in each of them – any tips and tricks for this strategy?

For qualitative studies, can the findings be structured according to the Research questions? Thank you.

Do I need to include literature/references in my findings chapter?

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Library Guides

Dissertations 5: findings, analysis and discussion: home.

Results/Findings

Alternative Structures

The time has come to show and discuss the findings of your research. How to structure this part of your dissertation?

Dissertations can have different structures, as you can see in the dissertation structure guide.

Dissertations organised by sections

Many dissertations are organised by sections. In this case, we suggest three options. Note that, if within your course you have been instructed to use a specific structure, you should do that. Also note that sometimes there is considerable freedom on the structure, so you can come up with other structures too.

A) More common for scientific dissertations and quantitative methods:

- Results chapter

- Discussion chapter

Example:

Introduction
Literature review
Methodology
(Recommendations)

if you write a scientific dissertation, or anyway using quantitative methods, you will have some objective results that you will present in the Results chapter. You will then interpret the results in the Discussion chapter.

B) More common for qualitative methods

- Analysis chapter. This can have more descriptive/thematic subheadings.

- Discussion chapter. This can have more descriptive/thematic subheadings.

Case study of Company X (fashion brand) environmental strategies
Successful elements
Lessons learnt
Criticisms of Company X environmental strategies
Possible alternatives

C) More common for qualitative methods

- Analysis and discussion chapter. This can have more descriptive/thematic titles.

Case study of Company X (fashion brand) environmental strategies

If your dissertation uses qualitative methods, it is harder to identify and report objective data. Instead, it may be more productive and meaningful to present the findings in the same sections where you also analyse, and possibly discuss, them. You will probably have different sections dealing with different themes. The different themes can be subheadings of the Analysis and Discussion (together or separate) chapter(s).

Thematic dissertations

If the structure of your dissertation is thematic , you will have several chapters analysing and discussing the issues raised by your research. The chapters will have descriptive/thematic titles.

Background on the conflict in Yemen (2004-present day)
Classification of the conflict in international law
International law violations
Options for enforcement of international law
Next: Results/Findings >>
Last Updated: Aug 4, 2023 2:17 PM
URL: https://libguides.westminster.ac.uk/c.php?g=696975

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How to Write a Results Section | Tips & Examples

How to Write a Results Section | Tips & Examples

Published on August 30, 2022 by Tegan George . Revised on July 18, 2023.

A results section is where you report the main findings of the data collection and analysis you conducted for your thesis or dissertation . You should report all relevant results concisely and objectively, in a logical order. Don’t include subjective interpretations of why you found these results or what they mean—any evaluation should be saved for the discussion section .

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How to write a results section, reporting quantitative research results, reporting qualitative research results, results vs. discussion vs. conclusion, checklist: research results, other interesting articles, frequently asked questions about results sections.

When conducting research, it’s important to report the results of your study prior to discussing your interpretations of it. This gives your reader a clear idea of exactly what you found and keeps the data itself separate from your subjective analysis.

Here are a few best practices:

Your results should always be written in the past tense.
While the length of this section depends on how much data you collected and analyzed, it should be written as concisely as possible.
Only include results that are directly relevant to answering your research questions . Avoid speculative or interpretative words like “appears” or “implies.”
If you have other results you’d like to include, consider adding them to an appendix or footnotes.
Always start out with your broadest results first, and then flow into your more granular (but still relevant) ones. Think of it like a shoe store: first discuss the shoes as a whole, then the sneakers, boots, sandals, etc.

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If you conducted quantitative research , you’ll likely be working with the results of some sort of statistical analysis .

Your results section should report the results of any statistical tests you used to compare groups or assess relationships between variables . It should also state whether or not each hypothesis was supported.

The most logical way to structure quantitative results is to frame them around your research questions or hypotheses. For each question or hypothesis, share:

A reminder of the type of analysis you used (e.g., a two-sample t test or simple linear regression ). A more detailed description of your analysis should go in your methodology section.
A concise summary of each relevant result, both positive and negative. This can include any relevant descriptive statistics (e.g., means and standard deviations ) as well as inferential statistics (e.g., t scores, degrees of freedom , and p values ). Remember, these numbers are often placed in parentheses.
A brief statement of how each result relates to the question, or whether the hypothesis was supported. You can briefly mention any results that didn’t fit with your expectations and assumptions, but save any speculation on their meaning or consequences for your discussion and conclusion.

A note on tables and figures

In quantitative research, it’s often helpful to include visual elements such as graphs, charts, and tables , but only if they are directly relevant to your results. Give these elements clear, descriptive titles and labels so that your reader can easily understand what is being shown. If you want to include any other visual elements that are more tangential in nature, consider adding a figure and table list .

As a rule of thumb:

Tables are used to communicate exact values, giving a concise overview of various results
Graphs and charts are used to visualize trends and relationships, giving an at-a-glance illustration of key findings

Don’t forget to also mention any tables and figures you used within the text of your results section. Summarize or elaborate on specific aspects you think your reader should know about rather than merely restating the same numbers already shown.

A two-sample t test was used to test the hypothesis that higher social distance from environmental problems would reduce the intent to donate to environmental organizations, with donation intention (recorded as a score from 1 to 10) as the outcome variable and social distance (categorized as either a low or high level of social distance) as the predictor variable.Social distance was found to be positively correlated with donation intention, t (98) = 12.19, p < .001, with the donation intention of the high social distance group 0.28 points higher, on average, than the low social distance group (see figure 1). This contradicts the initial hypothesis that social distance would decrease donation intention, and in fact suggests a small effect in the opposite direction.

Example of using figures in the results section

Figure 1: Intention to donate to environmental organizations based on social distance from impact of environmental damage.

In qualitative research , your results might not all be directly related to specific hypotheses. In this case, you can structure your results section around key themes or topics that emerged from your analysis of the data.

For each theme, start with general observations about what the data showed. You can mention:

Recurring points of agreement or disagreement
Patterns and trends
Particularly significant snippets from individual responses

Next, clarify and support these points with direct quotations. Be sure to report any relevant demographic information about participants. Further information (such as full transcripts , if appropriate) can be included in an appendix .

When asked about video games as a form of art, the respondents tended to believe that video games themselves are not an art form, but agreed that creativity is involved in their production. The criteria used to identify artistic video games included design, story, music, and creative teams.One respondent (male, 24) noted a difference in creativity between popular video game genres:

“I think that in role-playing games, there’s more attention to character design, to world design, because the whole story is important and more attention is paid to certain game elements […] so that perhaps you do need bigger teams of creative experts than in an average shooter or something.”

Responses suggest that video game consumers consider some types of games to have more artistic potential than others.

Your results section should objectively report your findings, presenting only brief observations in relation to each question, hypothesis, or theme.

It should not speculate about the meaning of the results or attempt to answer your main research question . Detailed interpretation of your results is more suitable for your discussion section , while synthesis of your results into an overall answer to your main research question is best left for your conclusion .

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I have completed my data collection and analyzed the results.

I have included all results that are relevant to my research questions.

I have concisely and objectively reported each result, including relevant descriptive statistics and inferential statistics .

I have stated whether each hypothesis was supported or refuted.

I have used tables and figures to illustrate my results where appropriate.

All tables and figures are correctly labelled and referred to in the text.

There is no subjective interpretation or speculation on the meaning of the results.

You've finished writing up your results! Use the other checklists to further improve your thesis.

If you want to know more about AI for academic writing, AI tools, or research bias, make sure to check out some of our other articles with explanations and examples or go directly to our tools!

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The results chapter of a thesis or dissertation presents your research results concisely and objectively.

In quantitative research , for each question or hypothesis , state:

The type of analysis used
Relevant results in the form of descriptive and inferential statistics
Whether or not the alternative hypothesis was supported

In qualitative research , for each question or theme, describe:

Recurring patterns
Significant or representative individual responses
Relevant quotations from the data

Don’t interpret or speculate in the results chapter.

Results are usually written in the past tense , because they are describing the outcome of completed actions.

The results chapter or section simply and objectively reports what you found, without speculating on why you found these results. The discussion interprets the meaning of the results, puts them in context, and explains why they matter.

In qualitative research , results and discussion are sometimes combined. But in quantitative research , it’s considered important to separate the objective results from your interpretation of them.

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Degree In Sight

Discussing your findings

Your dissertation's discussion should tell a story, say experts. What do your data say?

By Beth Azar

"Many students reach this stage of their careers having been focused for several years on the 'trees,'" says Yale University cognitive psychology professor Brian Scholl, PhD. "This section of the dissertation provides an opportunity to revisit the 'forest.'"

Fellow students, your adviser and your dissertation committee members can help provide that outside perspective, adds Yale clinical psychology professor Susan Nolen-Hoeksema, PhD, who teaches a course on writing in psychology.

And while the discussion should put your research into context and tell a story, say experts, it should not overstate your conclusions. How do you find the balance? Follow these do's and don'ts.

DO: Provide context and explain why people should care. DON'T: Simply rehash your results.

Your discussion should begin with a cogent, one-paragraph summary of the study's key findings, but then go beyond that to put the findings into context, says Stephen Hinshaw, PhD, chair of the psychology department at the University of California, Berkeley.

"The point of a discussion, in my view, is to transcend 'just the facts,' and engage in productive speculation," he says.

That means going back to the literature and grappling with what your findings mean, including how they fit in with previous work. If your results differ from others' findings, you should try to explain why, says Nolen-Hoeksema. Then, launch into "bigger picture" issues. For example, a clinical study might discuss how psychologists might apply the findings in a clinical setting or a social psychology project might talk about political implications.

By exploring those kinds of implications, students address what Scholl considers the most important-and often overlooked-purpose of the discussion: to directly explain why others should care about your findings.

"You can't and shouldn't rely on others to intuitively appreciate the beauty and importance of your work," he says.

Sounds simple, right? In fact, choosing what to include can be overwhelming, warns sixth-year Yale University social psychology graduate student Aaron Sackett.

"It is easy to get caught up in the desire to be extremely comprehensive and to bring up every potential issue, flaw, future direction and tangentially related concept," says Sackett. "However, this will make your dissertation seem like it has raised more questions than it answers."

Limit your discussion to a handful of the most important points, as Sackett did on the advice of his adviser.

"No reader wants to wade through ten pages of suppositional reasoning," says Roddy Roediger, PhD, chair of psychology at Washington University.

DO: Emphasize the positive. DON'T: Exaggerate.

One of the biggest errors students make in their discussion is exaggeration, say experts. Speculation is fine as long as you acknowledge that you're speculating and you don't stray too far from your data, say experts. That includes avoiding language that implies causality when your study can only make relational conclusions.

"If your study was not a true experiment, replace verbs that imply causation with words and phrases such as 'correlated with,' 'was associated with' and 'related to,'" write John Cone, PhD, and Sharon Foster, PhD, in a forthcoming revision of "Dissertations and Theses from Start to Finish" (APA, 2006).

Steven David, PhD, who successfully defended his dissertation in clinical geropsychology at the University of Southern California last May, found this point to be particularly difficult. When he defended his master's thesis, his committee told him his conclusions went too far out on a limb. He used more restraint with his dissertation and his committee thought he wasn't positive enough.

"The moral here is to try to find a balance where you set a tone that indeed celebrates interesting findings without too many leaps, while at the same time reporting limitations without being unnecessarily negative," says David.

Indeed, every discussion should include a "humility" section that addresses the study's limitations, write Cone and Foster. But avoid beginning the discussion with a long list of study limitations, says Nolen-Hoeksema.

"This makes me think 'Then why should I care or believe anything you found,' and want to stop reading right there," she says. "Limitations should be noted, but after you've discussed your positive results."

DO: Look toward the future. DON'T: End with it.

Along with noting your work's limitations, it's helpful to also suggest follow-up studies. But don't dwell on the future at the expense of the present,says Scholl.

"I think that too many discussions make the mistake of ending with 'the future,'" he says. "Too often I am left excited not by what was in the dissertation, but by what was not in the dissertation."

Roediger agrees: "Conclude the general discussion with a strong paragraph stating the main point or points again, in somewhat different terms-if possible-than used before."

Remember, adds Scholl, you want readers to remember you and your work. The discussion section is the place to leave your mark. So instead of simply summarizing your data and suggesting a few obvious follow-up studies, think about presenting your data in a novel way, showing how the work might resolve an existing controversy in the literature or explaining how it connects to an entirely different literature.

By the time readers get to your discussion, they're tired, adds Sackett. Give them something clear, concise and interesting to read, and they're sure to appreciate it.

Beth Azar is a writer in Portland, Ore.

10 most common dissertation discussion mistakes

Starting with limitations instead of implications.

Going overboard on limitations, leading readers to wonder why they should read on.

Failing to acknowledge limitations or dismissing them out of hand.

Making strong claims about weak results.

Failing to differentiate between strong and weak results as you make conclusions about them.

Lapsing into causal language when your data were correlational.

Repeating the introduction.

Restating the results without interpretation or links to other research.

Presenting new results; such data belong in the results section.

Offering no concluding statements or ending with the limitations.

Source: Susan Nolen-Hoeksema, PhD, Yale University

Letters to the Editor

Writing up results and discussion for qualitative research

This document provides guidance on writing the results and discussion chapters for qualitative research theses. It discusses styles for presenting qualitative results and analysis in a way that makes sense based on the research aims, methods, and theoretical framework. The results should be organized selectively around themes or chronologically and include evidence from the data to support interpretations. Pseudonyms or codes should be used to refer to participants. The discussion chapter should locate findings in the broader context of existing literature and theory, and discuss implications. Both chapters should have clear introductions to guide the reader and remind them of the research questions. The findings and discussion may be organized in parallel thematic sections. Read less

Quantitative and Qualitative Research

Quantitative vs. Qualitative Research
Find quantitative or qualitative research in CINAHL
Find quantitative or qualitative research in PsycINFO
Relevant book titles

Mixed Methods Research

As its name suggests, mixed methods research involves using elements of both quantitative and qualitative research methods. Using mixed methods, a researcher can more fully explore a research question and provide greater insight.

What is Empirical Research?

Empirical research is based on observed and measured phenomena. Knowledge is extracted from real lived experience rather than from theory or belief.

IMRaD: Scholarly journals sometimes use the "IMRaD" format to communicate empirical research findings.

Introduction: explains why this research is important or necessary. Provides context ("literature review").

Methodology: explains how the research was conducted ("research design").

Results: presents what was learned through the study ("findings").

Discussion: explains or comments upon the findings including why the study is important and connecting to other research ("conclusion").

What is Quantitative Research?

Quantitative research gathers data that can be measured numerically and analyzed mathematically. Quantitative research attempts to answer research questions through the quantification of data.

Indicators of quantitative research include:

contains statistical analysis

large sample size

objective - little room to argue with the numbers

types of research: descriptive studies, exploratory studies, experimental studies, explanatory studies, predictive studies, clinical trials

What is Qualitative Research?

Qualitative research is based upon data that is gathered by observation. Qualitative research articles will attempt to answer questions that cannot be measured by numbers but rather by perceived meaning. Qualitative research will likely include interviews, case studies, ethnography, or focus groups.

Indicators of qualitative research include:

interviews or focus groups

small sample size

subjective - researchers are often interpreting meaning

methods used: phenomenology, ethnography, grounded theory, historical method, case study

Video: Empirical Studies: Qualitative vs. Quantitative

This video from usu libraries walks you through the differences between quantitative and qualitative research methods. (5:51 minutes) creative commons attribution license (reuse allowed) https://youtu.be/rzcfma1l6ce.

<< Previous: Home
Next: Find quantitative or qualitative research in CINAHL >>
Last Updated: Mar 25, 2024 12:23 PM
URL: https://libguides.hofstra.edu/quantitative-and-qualitative-research

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Dissertation findings and discussion sections

(Last updated: 2 March 2020)

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Granted that at some point in the discussion you are going to have to link back to this previous research. But you still have the opportunity to demonstrate how you have met that coveted gap in the research and generally made a useful contribution to knowledge.

There are many ways to write up both your findings and discussion. In shorter dissertations, it might make sense to have both of these comprise one section. In longer pieces of work, these chapters are usually separate.

Preparing to write

We also assume that you have used some sort of software program to help you with the organisation of your findings. If you have not completed this process, you must do so before beginning to write. If not, your findings chapter may end up a confusing and unorganised mess of random information. If you need help in this area, make sure to seek it out before beginning to put your findings down on paper.

One of the main issues that students tend to encounter when writing up their findings is the amount of data to include. By the end of the research process, you've probably collected very large amounts of data . Not all of this can possibly appear in your dissertation without completely overwhelming the reader. As a result, you need to be able to make smart decisions about what to include and what to leave out.

One of the easiest ways to approach this task is to create an outline. In approaching the outline, it is in your best interest to focus on two key points. Firstly, you need to focus on answering your research questions. Secondly, you must include any particularly interesting findings that have cropped up as you completed your research.

An outline will give you the structure you need, and should make the whole process of presenting your findings easier. We realise that it is going to be a difficult process to pick and choose pieces of data to include. But you must be diligent in the work that you cut out. A findings chapter that is long and confusing is going to put the reader off reading the rest of your work.

Introducing your findings

It can be up to 40% of the total word count within your dissertation writing . This is a huge chunk of information, so it's essential that it is clearly organised and that the reader knows what is supposed to be happening. One of the ways you can achieve this is through a logical and organised introduction.

There are four main components that your introduction should include:

Reminding the reader of what you set out to do

A brief description of how you intend approaching the write up of the results

Placing the research in context

Letting the reader know where they can find the research instruments (i.e. the Appendix)

With a findings chapter, there should be no suspense for the reader. You need to tell them what they need to know right from the beginning. This way, they'll have a clear idea about what is still to come. A good introduction will start by telling the reader where you have come from in the research process and what the outcome was (in a couple of paragraphs or less).

You need to highlight the structure of the chapter (as you generally will do with all chapters) and where the reader might find any further information (e.g. in the appendices).

Organisation of data

This is really going to depend on the type of project you have created .

For example, if you have completed a qualitative research project, you might have identified some key themes within the software program you used to organise your data. In this case, highlighting these themes in your findings chapter may be the most appropriate way to proceed. Not only are you using information that you have already documented, you are telling a story in each of your sections (which can be useful in qualitative research).

But what if you undertook a more quantitative type study? You might be better off structuring your findings chapter in relation to your research questions or your hypotheses. This assumes, of course, that you have more than one research question or hypothesis. Otherwise you would end up just having one really long section.

This brings us to our next student mistake – trying to do too much within one section.

Subheadings are ultimately going to be your friend throughout your dissertation writing . Not only do they organise your information into logical pieces, they give the reader guidelines for where your research might be going. This is also a break for the reader. Looking at pages and pages of text without any breaks can be daunting and overwhelming for a reader. You don't want to overwhelm someone who is going to mark your work and who is responsible for your success (or failure).

When writing your introduction, be clear, organised and methodical. Tell the reader what they need to know and try to organise the information in a way that makes the most sense to you and your project. If in doubt, discuss this with your supervisor before you start writing.

Presentation of qualitative data

If you have conducted things like interviews or observations, you are likely to have transcripts that encompass pages and pages of work.

Putting this all together cohesively within one chapter can be particularly challenging. This is true for two reasons. First, it is always difficult to determine what you are going to cut and/or include. Secondly, unlike quantitative data, it can often be difficult to represent qualitative data through figures and tables, so condensing the information into a visual representation is simply not possible. As a writer, it is important to address both these challenges.

When considering how to present your qualitative data, it may be helpful to begin with the initial outline you have created (and the one described above). Within each of your subsections, you are going to have themes or headings that represent impactful talking points that you want to focus on.

Once you have these headings, it might be helpful to go back to your data and highlight specific lines that can/might be used as examples in your writing. If you have used multiple different instruments to collect data (e.g. interviews and observations), you are going to want to ensure that you are using both examples within each section (if possible). This is so that you can demonstrate to more well-rounded perspective of the points you are trying to make. Once you have identified some key examples for each section, you might still have to do some further cutting/editing.

Once you have your examples firmly selected for each subsection, you want to ensure that you are including enough information. This way, the reader will understand the context and circumstances around what you are trying to ‘prove’. You must set up the examples you have chosen in a clear and coherent way.

Students often make the mistake of including quotations without any other information. It is important that you embed your quotes/examples within your own thoughts. Usually this means writing about the example both before and after. So you might say something like, “One of the main topics that my participants highlighted was the need for more teachers in elementary schools. This was a focal point for 7 of my 12 participants, and examples of their responses included: [insert example] by participant 3 and [insert example] by participant 9. The reoccurring focus by participants on the need for more teachers demonstrates [insert critical thought here]. By embedding your examples in the context, you are essentially highlighting to the reader what you want them to remember.

Aside from determining what to include, the presentation of such data is also essential. Participants, when speaking in an interview might not do so in a linear way. Instead they might jump from one thought to another and might go off topic here and there.

It is your job to present the reader with information on your theme/heading without including all the extra information. So the quotes need to be paired down to incorporate enough information for the reader to be able to understand, while removing the excess.

Finding this balance can be challenging. You have likely worked with the data for a long time and so it might make sense to you. Try to see your writing through the eyes of someone else, which should help you write more clearly.

Presentation of quantitative data

Something to consider first with numeric data is that presentation style depends what department you are submitting to. In the hard sciences, there is likely an expectation of heavy numeric input and corresponding statistics to accompany the findings. In the arts and humanities, however, such a detailed analysis might not be as common. Therefore as you write out your quantitative findings, take your audience into consideration.

Just like with the qualitative data, you must ensure that your data is appropriately organised. Again, you've likely used a software program to run your statistical analysis, and you have an outline and subheadings where you can focus your findings. There are many software programs available and it is important that you have used one that is most relevant to your field of study.

For some, Microsoft Excel may be sufficient for basic analysis. Others may rely on SPSS, Stata, R, or any of the other programs available through your institution or online. Whatever program you have used, make sure that you document what you have done and the variables that have affected your analysis.

One common mistake found in student writing is the presentation of the statistical analysis. During your analysis of the data, you are likely to have run multiple different analyses from regressions to correlations. Often, we see students presenting multiple different statistical analyses without any real understanding of what the tests mean.

Presentation of quantitative data is more than just about numbers and tables. You must explain your findings and justify why you have run/presented the tests that you have. You could also explain how they relate to the research question. However, depending on how you have organised your work, this might end up in the discussion section.

Students who are not confident with statistical analysis often have a tendency to revert back to their secondary school mathematics skills. They commonly document the mean, median, and mode for all of their results. Now, these three outcomes can be important. But having a good understanding of why you are proceeding with this strategy of analysis is going to be essential in a primarily quantitative study.

That noted, there are different expectations for an undergraduate dissertation and a PhD thesis, so knowing what these expectations are can be really helpful before you begin.

Presentation of graphs, tables, and figures

The first is the use of colour and/or variables. Depending on the presentation of your dissertation, you may be required to print out a final copy for the marker(s). In many cases, this final copy must be printed in black and white. This means that any figures or graphs that you create must be readable in a black and white (or greyscale) format.

This can be challenging because there are only so many distinct shades of grey. In a pie chart, you might show one section as purple and the other as green. Yet when printed, both the purple and the green translate to approximately the same shade of grey, making your graph suddenly unreadable.

Another common error is overwhelming the reader with graphs and tables. Let's think about your outline and subheadings. If you're including a table under each subheadings, it needs to be relevant to the information that is being discussed in that chapter. There is no correct or incorrect number of graphs that should exist within the section, but you should use your judgement about what looks appropriate.

The final mistake we see is the duplication of writing (or absence of writing) when presenting a graph. Some students will present their findings in a graph or table and then write out this information again below the graph. This defeats the entire purpose of using the graph in the first place. So avoid this at all times.

Conversely, other students sometimes include a graph or figure but nothing else. Doing this denies the reader of context or purpose of said graph or figure. At some point, a balance needs to be struck where the reader has the information they require to really understand the point being made within the section.

Analysis and synthesis in a discussion

The purpose of a discussion chapter.

The structure of your discussion chapter is really going to depend on what you are trying to do and how you have structured your findings. If you chose to structure your findings by theme, it might make sense to continue this into the analysis chapter.

Other people might structure it according to the research questions. This clearly indicates to the reader how you have addressed your study. Marking a dissertation usually requires the marker to comment on the extent to which the research questions have been addressed. So by structuring a dissertation that lays out each research question for the marker, you are making their job easier. Needless to say, this a great thing.

Like any other chapter in your thesis, an introduction is an essential component of your discussion. By this point, the reader has gone through your findings and is now looking for your interpretation. Therefore, at the end of your discussion introduction you should highlight the content that each of the subsections will cover.

A conclusion to your discussion section (or a chapter summary) is also going to be beneficial. The length of the analysis chapter is usually quite long, so a wrap up of the key points at the end can help the reader digest your work. It can also help ensure that the reader actually understands the points you are trying to highlight within your project.

Critical thinking

Without any critical thinking, you are really doing yourself a disservice. It will affect the mark that you obtain on your overall dissertation. This is why the analysis chapter is usually weighted quite heavily on the marking rubric.

We tell students about critical thinking and the importance of it on a daily basis. And yet, there does seem to be a general confusion about what critical thinking entails, i.e. what constitutes critical thinking versus what is a simple description.

Critical thinking asks you to provide your own opinion on your topic, which can be daunting at first. For much of your academic career, you've likely been asked to use research to justify a position that has already been set. Unlike critical thinking, this requires you to use other people’s ideas. But even if you're new to it, try and get to grips with what critical thinking entails and use it in your work.

Creating sub-sections

Subheadings need to be informative but not too long. It is possible to layer your subheadings, so you might have a Chapter 2, a Section 2.1 and then a 2.1.1 and 2.2.2. Usually anything after 3 numerical points does not get a number and would not appear in your table of contents.

When creating titles for your subheadings, consider how they are going to look in the table of contents. They need to fit on one line, ideally, so putting your research question as the subheading might end up being too long. Conversely, one- or two-word subheadings usually doesn't give enough information about the purpose of the section.

Finding this balance is important. But remember you can always edit your subheadings retrospectively.

Linking to previous chapters

Ideally, you will be able to concisely and effectively link your research to what has been researched previously. But this can be a challenge. You don't want to repeat what has been said in your literature review or the findings . But you need to pull examples from both of these sections in order to make the points that you need to.

So, how do you tackle this?

One way is by referring the reader back to previous chapters, sections, or subsections. This process can generally be done at the end. You can put in a place holder until you know how your sections will be numbered. For example you might write: “In Section XYZ, the theme of … was discussed. Findings from this study indicate…. (see Section XYZ for details)”. While ‘XYZ’ is obviously not going to be the same section, by using the same abbreviation, you can then search ‘XYZ’ after you have completed writing and replace each term with the appropriate number. This also makes the proofreading process easier.

If you are submitting an electronic version of this document, you may also consider hyperlinks to take the reader to the different sections. But be aware that this can be considerably more work, so you should allow for this in your timescale if it's something you wish to implement.

Let's outline the main takeaway points:

It is essential that you keep in mind the ‘describe, analyse, synthesise’ model.

The findings chapter is essentially the describe part. You need to ensure that you have clearly identified data that relates to your research questions, hypotheses, or themes of your study.

For the ‘describe’ component, you are not looking to support your work with other research, but rather to present your contribution. It is also important to consider your data in the ‘describe’ section. If you have qualitative data, ensure that you have edited the quotes and examples to a reasonable length. Pick quotes that accurately represent your theme. Try not to focus solely on one or two participants (if possible). Ensure that you are demonstrating links between multiple instruments, if you used them.

If you are using quantitative data, be careful about how many statistical tests you run. Make sure you can justify why you chose one particular test over another. When presenting graphs, use a colour scheme that's appropriate for the reader when printing in black and white. Ensure that graphs and tables are appropriately explained, but that the information provided is not duplicated.

From the ‘describe’ element, you move into the 'analysis' and 'synthesis'. These parts usually appear in the discussion and ask you to employ your critical thinking skills to demonstrate how your research fits into the bigger picture. It is often the case that your analysis holds the most weight in the marking scheme. So you should spend considerable time ensuring this section is appropriate. It needs to demonstrate how you have attempted to answer your research questions.

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Open access
Published: 28 August 2024

Pre-implementation planning for a sepsis intervention in a large learning health system: a qualitative study

Tara A. Eaton 1 ,
Marc Kowalkowski 1 , 2 ,
Ryan Burns 3 ,
Hazel Tapp 4 ,
Katherine O’Hare 5 &
Stephanie P. Taylor 6

BMC Health Services Research volume 24 , Article number: 996 ( 2024 ) Cite this article

Metrics details

Sepsis survivors experience high morbidity and mortality. Though recommended best practices have been established to address the transition and early post hospital needs and promote recovery for sepsis survivors, few patients receive recommended post-sepsis care. Our team developed the Sepsis Transition and Recovery (STAR) program, a multicomponent transition intervention that leverages virtually-connected nurses to coordinate the application of evidence-based recommendations for post-sepsis care with additional clinical support from hospitalist and primary care physicians. In this paper, we present findings from a qualitative pre-implementation study, guided by the Consolidated Framework for Implementation Research (CFIR), of factors to inform successful STAR implementation at a large learning health system prior to effectiveness testing as part of a Type I Hybrid trial.

We conducted semi-structured qualitative interviews ( n = 16) with 8 administrative leaders and 8 clinicians. Interviews were transcribed and analyzed in ATLAS.ti using a combination deductive/inductive strategy based on CFIR domains and constructs and the Constant Comparison Method.

Six facilitators and five implementation barriers were identified spanning all five CFIR domains (Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individuals and Process). Facilitators of STAR included alignment with health system goals, fostering stakeholder engagement, sharing STAR outcomes data, good communication between STAR navigators and patient care teams/PCPs, clinician promotion of STAR with patients, and good rapport and effective communication between STAR navigators and patients, caregivers, and family members. Barriers of STAR included competing demands for staff time and resources, insufficient communication and education of STAR’s value and effectiveness, underlying informational and technology gaps among patients, lack of patient access to community resources, and patient distrust of the program and/or health care.

Conclusions

CFIR proved to be a robust framework for examining facilitators and barriers for pre-implementation planning of post-sepsis care programs within diverse hospital and community settings in a large LHS. Conducting a structured pre-implementation evaluation helps researchers design with implementation in mind prior to effectiveness studies and should be considered a key component of Type I hybrid trials when feasible.

Trial registration

Clinicaltrials.gov, NCT04495946 . Registered August 3, 2020.

Peer Review reports

Contributions to literature

This qualitative pre-implementation study of a telehealth nurse navigator-led sepsis transition and recovery (STAR) program demonstrates the Consolidated Framework for Implementation Research (CFIR) is useful to explore contextual conditions of healthcare settings as part of rigorous pre-implementation planning efforts.

This analysis identified actionable facilitators and barriers spanning all five CFIR domains (e.g., inner setting, outer setting) to inform and enhance initial implementation strategies of STAR.

These findings help to close recognized gaps in the literature on post-sepsis survivorship, including how to plan implementation of evidenced-based practices to address transition and early post hospital needs of sepsis survivors and promote recovery.

Sepsis, a common and life-threatening dysregulated response to infection, remains a major cause of morbidity, mortality, and healthcare costs [ 1 , 2 , 3 ]. Although hospital survival has improved in recent years, the increasing number of sepsis survivors are vulnerable to additional health problems [ 4 , 5 , 6 ]. Fewer than one-half of sepsis survivors return to their pre-sepsis health status and many experience new or worsening physical, cognitive, and psychological impairments, along with high rates of rehospitalization and excess mortality for years after sepsis hospitalization [ 7 , 8 , 9 ]. Given increasing recognition of the substantial long-term sequelae and social determinants of health-related needs after sepsis [ 10 ], recommended best practices have been established to address the transition and early post hospital needs and promote recovery for sepsis survivors [ 11 , 12 , 13 ]. However, like the majority of other evidence-based practices (EBPs) that have yet to be successfully adopted into routine practice, few patients receive recommended post-sepsis care [ 14 , 15 ].

To address the transition and early post hospital needs for sepsis survivors, our team developed the Sepsis Transition and Recovery (STAR) program, a multicomponent transition intervention that leverages centrally-located, virtually-connected nurses to coordinate the application of evidence-based recommendations for post-sepsis care with additional clinical support from hospitalist and primary care physicians [ 16 ]. The STAR program, based on the chronic care model [ 17 ], empowers patients and clinicians, via targeted education and coordinated care approaches, and was found to improve mortality and readmission outcomes among sepsis survivors [ 18 ]. There are complex barriers to translation of research findings into real-world post-sepsis care which we sought to identify and mitigate prior to effectiveness testing as part of a Type I Hybrid trial [ 19 ].

Before initiating a large-scale, pragmatic effectiveness evaluation of the STAR program (NCT04495946), we conducted a qualitative pre-implementation study with the aim to identify actionable facilitators and barriers to inform and enhance initial implementation strategies of the program across diverse hospital and community settings in a large Learning Health System (LHS). Qualitative methods are considered an integral component of implementation research and are well-known for being rigorous and efficient in the study of the hows and whys of implementation [ 20 ]. Conducting a robust pre-implementation evaluation was an intentional design choice for the overall project given the critical role of this step in the implementation process [ 21 ]. Through our qualitative investigation, we explored variations in stakeholder perspectives of the program by interviewing both administrators and clinicians.

We guided our study with the Consolidated Framework for Implementation Research (CFIR), due to its breadth, widespread use [ 22 , 23 ], and expert-recommended mapping from CFIR-identified barriers to defined implementation strategies [ 24 ]. As a framework, the CFIR offers a systematic approach well-known for planning, evaluating, and supporting behavioral change for a diverse array of studies [ 25 ], using a consistent language of 39 constructs organized across five domains—Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individuals and Process [ 22 ]. It can be used to build implementation knowledge to describe determinants of implementation [ 23 ], as well as tailor pre-implementation strategies to promote intervention success [ 26 , 27 ].

For this pre-implementation study, we conducted a qualitative investigation to identify facilitators and barriers to implementing the STAR program in hospital transition care, and to elaborate and compare key stakeholder perspectives. Instrument development, data collection, analysis, and interpretation of study results were guided by the CFIR. A PhD-level trained qualitative health services researcher (TE) on the study team with experience conducting qualitative research for program evaluations and intervention development led the process of interview instrument design, data collection, and analysis. She was not known to participants of the research prior to undertaking the study. Our study team followed the Standards for Reporting Qualitative Research in the reporting of this work [ 28 ].

Study design

The pre-implementation study was conducted from March through July of 2020 in preparation for the planned implementation of the STAR program intervention in July 2020 at a large LHS. Headquartered in Charlotte, North Carolina, Atrium Health provides not-for-profit healthcare supporting over 14 million patient encounters annually across 40 hospitals and over 1,000 care locations in North Carolina, Georgia, and Alabama. We identified all stakeholders involved with post-sepsis care in this health system according to a framework for stakeholder mapping in health research [ 29 ]. With sepsis survivors and caregivers at the center of our focus for STAR, we identified stakeholder categories relevant to them to determine our recruitment approach for the pre-implementation interviews. By employing an iterative process of delineation between key individuals and groups involved in post-sepsis care at the LHS, we identified key stakeholders.

These stakeholders comprised two main groups: administrative leaders and clinicians. Administrative leaders were chief medical and nursing officers. We selected administrators due to their understanding of outer and inner setting factors and influence on organizational policy. Clinicians were hospitalists and ambulatory care providers representing diverse practice settings. We selected clinicians as representative intervention users with knowledge of intervention characteristics, outer setting, inner setting, characteristics of individuals, and process factors. We purposively sampled potential participants to reflect these organizational roles and responsibilities at the planned intervention sites. We aimed to recruit individuals to sufficiently capture a range of beliefs about post-sepsis care in these practice settings, while limiting redundancy in our data collection.

The final sample included 8 administrators (Chief Medical Officers, Nursing Executives, and a Departmental Chair; representing 7 study hospitals and leadership over post-hospital continuing care and primary care services) and 8 clinicians (with specialty areas in one or more of the following: Hospital Medicine, Internal Medicine, Infectious Disease, Family Medicine and Critical Care; representing individuals with care privileges at 6 study hospitals and primary care responsibilities in the communities served by these hospitals). See Table 1 : Participant Characteristics.

Data collection

We conducted semi-structured qualitative interviews with 16 stakeholders from diverse hospitals and care settings to explore organizational support, culture, workflow processes, needs, and recommendations for STAR’s implementation. Separate and original interview guides were developed for administrator and clinician groups (See Additional file 1: Administrator Interview Guide and Additional file 2: Clinician Interview Guide) in this study, however, both guides included questions about stakeholder roles and work environments, the fit of the STAR program for their facilities which was facilitated using a printed intervention workflow diagram (See Fig. 1 : Patient Trajectory through the STAR Program), and questions about the implementation of STAR. Interview guides intentionally included questions representative of all 5 of the CFIR domains (Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individuals and Process) and were initially scripted by adapting questions from the CFIR Interview Guide Tool available at the CFIR website, www.cfguide.org [ 30 ]. Some of the sample questions from the guides are included below:

Patient trajectory through the STAR program

Do you think effectiveness data about the sepsis transition program would be needed to get team buy-in in your facility? (Intervention Characteristics)

How well, would you say, are new ideas (e.g., work processes, new interventions, QI projects, research) embraced and used to make improvements in your facility? (Inner Setting)

What, if any, barriers do you think patients will face to participate in the intervention? (Outer Setting)

What is your role within the organization? (Characteristics of Individuals)

Who would you recommend are the key individuals to speak with to make sure new interventions are successful in your practice or department? (Process)

We pilot tested (field tested) the interview guides in three rounds prior to their administration and iteratively refined the guides based on participant feedback and research team members’ perceptions of the usefulness of the data collection instruments for eliciting information we intended to capture for each stakeholder group (See Fig. 2 : Diagram of Interview Guide Development at Pre-Implementation). Field testing is an established technique in qualitative research for developing interview guides as it provides researchers with the opportunity to practice asking the interview questions and identify weaknesses in the wording and order of questions when spoken aloud [ 31 ]. We then used the refined data collection instruments for the interviews reported here.

Diagram of interview guide development at pre-implementation

Prior to each interview, participants received standardized background information about the study topic and verbal informed consent was obtained. As an adaptation due to research restrictions during the COVID-19 pandemic, interviews were conducted telephonically. Interviews were on average 30 min in duration, which was expected given the number of questions asked of participants (13 questions for the administrators and 15 questions for the clinicians) and what was seen during the pilot testing of the interview guides prior to data collection. Participants were offered a $25 gift card for their participation. Ethical approval for this study was granted by the Advarra IRB Committee.

Data analysis

Interview recordings were transcribed and entered into ATLAS.ti X8 as text documents for thematic coding and analysis. One team member with extensive experience in qualitative research methods (TE) led the analysis of the data set using a combination deductive/inductive strategy based on CFIR domains and constructs and the Constant Comparison Method. The Constant Comparison Method is an inductive approach for developing code structure through the iterative comparison of newly coded text with previously coded text of the same theme until final thematic refinement is achieved [ 32 ]. We referred to the cfirguide.org website’s CFIR Codebook Template [ 33 ], containing domain and construct definitions and guidance for coding qualitative data with the framework and inclusion and exclusion criteria for most constructs, in our application of the framework to our codebook development and analysis. This process included creating a codebook (a complete list of codes and definitions for each code), coding the data set among team members, comparing identified codes, and merging codes when it was necessary based on analytical discussion. Each code was labeled using the following convention: 1) if it was an implementation facilitator or barrier code, 2) a simplified title indicating what the code was, and 3) and a tag of the CFIR domains and constructs that corresponded to the code. E.g., ImplFacilitator_Family support for PT: OUTSET-PT Needs & Res. Throughout the process of analyzing the qualitative interview data, our study team met bi-weekly to discuss the results and engaged with the larger stakeholder group monthly to discuss ideas for overcoming identified barriers.

To promote the reliability of the analysis and prevent interpretive bias, two study team members (TE and RB) completed inter-rater reliability (IRR) coding for 50% of the administrator interviews (n = 4). Three team members (TE, KO, and HT) completed IRR for 50% of the clinician interviews ( n = 4). IRR was conducted by having additional coders (RB, KO, and HT) apart from the principal analyst (TE) apply the codebook to the data set to determine whether they agreed with the original coding of selected interview transcripts. Instances of disagreement were discussed thoroughly and, at times, resulted in the application of additional codes for selected quotations. All identified conflicts in coding were fully resolved, resulting in a final agreement of 100% between coders.

Using a combination deductive/inductive coding strategy, we found 77 codes related to STAR implementation facilitators ( n = 38) and barriers ( n = 39) and labeled those codes with applicable CFIR domains and constructs as appropriate. The STAR implementation facilitators and barriers codes were then aggregated into 11 themes consisting of 6 facilitators (See Table 2 ) and 5 implementation barriers (See Table 3 ). STAR implementation facilitators and barriers, together, spanned all five CFIR domains (Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individuals and Process). Administrators and clinicians reported no other sepsis-specific transition programs in their facilities at the time of data collection and indicated the STAR program would be important to address sepsis survivor needs.

Facilitators influencing the implementation of STAR

Our analysis identified six themes pertaining to implementation facilitators. See Table 2 : CFIR-Guided Facilitators of STAR Implementation.

Alignment between STAR and health system goals

Participants reported that STAR’s alignment with other telehealth programs at the LHS, such as virtual hospital care, amidst surge of telehealth care during the COVID-19 pandemic would promote implementation of STAR as indicated in the administrator’s response below:

“I also think it [STAR] would be well received based on the information regarding virtual hospital and what we have been able to achieve with that. And, again with just looking for the bright spots in COVID, there have been a lot of transitions that have taken place in the last couple of months that I think you would have a much easier time implementing this in the new world of healthcare.” (A7)

Beyond virtual care, participants also described other existing infrastructure within the LHS that would align with the STAR program objectives, including sepsis work groups and sepsis champions from physicians, nurses, pharmacy, and case management. These inner setting facilitators combined demonstrate how STAR’s alignment with the implementation climate (compatibility) and structural characteristics of the LHS would influence its adoption.

Fostering engagement with stakeholders

Participants stated that fostering engagement to promote buy-in with stakeholders, including administrators, care teams, patients and caregivers, would facilitate the implementation of STAR. They recommended stakeholders be educated about what STAR is, its benefits, and for organizational stakeholders, how best to integrate STAR into their facility. See the clinician’s response below:

“I think just education [about STAR]. Just tons of education to everyone in the hospital that touches a patient. The nurses. The critical care physicians. The Hospitalists…But I think just educating the patient [about STAR] at the time of admission, just start that process. You know, this is our sepsis program, and let them know that this is going to happen at the time of discharge. And then also provide education to the providers.” (C1)

Participants also emphasized the importance of leaders heading communication about STAR with care teams and STAR navigators establishing a good rapport with clinicians who have patients enrolled in the program. See the clinician’s response below:

“Well, definitely share the information [about STAR] with their [health system leaders] teams. We have a normal leadership structure that provides the mechanism for things like this to be communicated in top down. And for sure, expecting the leaders to disseminate it from Level 2 to Level 3, Level 3 to Level 4 and on down. You know, that would be a minimum expectation…I think they should welcome you all [the STAR study team] at the meetings and give you time on the agenda to share your initiatives, at a minimum.” (C3)

These responses illustrate the relevance of the CFIR outer setting, process, and characteristics of individuals domains for the implementation of STAR, where prioritizing patient needs, attracting and involving appropriate individuals, and individual attitudes about the intervention would be facilitators of its adoption.

Share positive STAR outcomes data

Participants reported sharing positive results or impacts from the program would be helpful. They recommended using STAR performance metrics as motivation for continued buy-in and that leaders share effectiveness data. See the clinician responses below:

“I think readmission data [would be good to provide], like at 90 days, because if you are trying to get people to buy in for 90 days, cause that’s a long time, that’s about three months, I think you need to prove that it is worthwhile. If you’re trying to cut back on that 90-day readmission, because that’s what Medicare looks at, I think that would maybe entice some people to participate.” (C7)

“But, if you want to implement it as a standard process then we are going to have to see some sort of data on it before we say “yep, let’s do it”. Because there are many things that are competing for the resources that we have. So we have to on the basis on which our decisions on where the money goes, where those resources get diverted to is based on how efficiently they affect patient care, rates of readmission, and patient mortality. So we need the data to make an informed decision.” (C2)

Responses pertaining to this theme point to the significance of the CFIR intervention characteristics, inner setting and process domains in STAR’s implementation. Participants’ remarks regarding STAR’s evidence, strength and quality, shared receptivity to STAR within the LHS, and the recommendation to provide quantitative and qualitative feedback for reflecting and evaluating STAR’s quality would be facilitators of its implementation.

Good communication between STAR navigators and patient care teams/PCPs

Participants stated that good communication and recommendation-sharing between the STAR navigator and the patient’s care team and PCP will make STAR’s implementation successful. See the clinician’s response below:

“So, I think, effectively communicating with one another [the STAR navigator and clinician] what is beneficial and helping us ultimately provide for the patient from our end would be helpful. It will be a learning process, but you know, I think once we both communicate what we need from the other to be able to do our jobs, then I think that would be fine if that makes sense.” (C5)

These intervention characteristics and inner setting facilitators demonstrate the importance of intervention design, including how well STAR is bundled, presented and assembled to stakeholders, and navigator-led communication in its implementation.

Clinician promotion of STAR with patients

Our study participants emphasized the importance of clinician promotion of STAR with enrolled patients for implementation success. Specifically, our participants recommended that the LHS show patients their primary care providers and STAR navigators are in alignment to engender patient trust in the program. See the administrator’s response below:

“It always helps if they [patients] feel like it’s their own physicians or their own team that is a part of this. I think it would be important for it not to look like it was some external program that their clinicians were not involved in. So, I think, you know, trust always is important if you feel like people that you trust are endorsing something or believing it’s going to be useful.” (A8)

Similarly, one clinician said:

“I think trust, you know, would be a factor. A lot of times if patients view resources as being disconnected from their Primary Care, they may not be very accepting of them. So, if they view them as being part of “my team”, I think patients are much more likely to participate.” (C3)

Participant responses within this theme underscore the multi-domain influence of outer setting, inner setting and the process of implementation in the success of STAR, where the LHS’s prioritization of patient needs, LHS members’ and structures’ characteristics and behaviors, and the engagement of individuals with STAR would be facilitators of its implementation.

Good rapport and effective communication between STAR navigators and patients, caregivers, and family members

Participants reported that good rapport and effective communication between STAR navigators and enrolled patients and their caregivers/families would be important for implementing STAR. They emphasized the need for STAR navigators to foster a good connection with patients and their caregivers or family members. They also spoke to the integral role caregivers and family members play in patients’ post-sepsis recovery as additional points of contact who are familiar with the program if the patient does not recall what STAR is or if the patient is too ill to speak for themselves. See the clinicians’ responses below:

“I think patients get called a lot about a lot of things and they don’t always know who the person on the phone is. So, I think having that established and really something that the patient is okay with is important. And engaging, if possible, family or support members. I think that reduces barriers if they have support people available.” (C6)

“I think obviously reaching out to the family and support staff and things like that may be helpful. Some of our patients, in general, even at their baseline and at their best day aren’t going to be able to provide you the information that you need, or may not be able to provide an adequate history, or have an appropriate follow-up, and things like that, in place to be able to give you the information you need to help them as well as you would like.” (C5)

Responses within this facilitator theme highlight the importance of intervention characteristics, such as the perceived quality of STAR, and outer setting domains and constructs (patient needs and resources) in STAR navigator communication with patients and their caregivers and family members. Results show how effective navigator communication when presenting STAR to patients and their caregivers/family members, consideration of patient needs and barriers to participation, and the involvement of caregivers or family members would be facilitators of STAR’s implementation.

Barriers influencing the implementation of STAR

Our analysis identified five themes pertaining to implementation barriers. See Table 3 : CFIR-Guided Barriers to STAR Implementation.

Competing demands for staff time and resources

Participants reported that competing demands for staff time and resources, including the busy state of the LHS’ facilities at the time, COVID priorities, other concurrent program implementations, and a lack of time among clinicians to engage with STAR could be barriers to its implementation. See the administrator’s response below:

“So, I think barriers would be too many implementations going on at the same time. It would fail. The other is, right now in COVID time, it’s unlikely to muster enough support or enough interest to do it. I think we need to look at what else is going on, so that there is not information overload for the front-end teammates. And the other thing we look at is, most of these programs become paper intensive or computer intensive. That means, you are just putting things there, and then, if you ask people to do too much, yes, they do too much, but they don’t really do the thing…So just be mindful of that, what you expect them to spend time on.” (A3)

Similarly, one clinician commented:

“Now, from a willingness standpoint, not that people would necessarily disagree with the overall goals and the process of your program, it’s just that if you’re in my field, and in some of my partners, if we are being pulled in ten different directions at one time, you have to prioritize what you can do in a day. So, not willingness from the standpoint of people not wanting to participate, but sometimes people not being able to weight or value that as high as something else that needs to be done.” (C5)

Participants responses pertaining to this barrier theme illustrate the role that the LHS’s inner setting, specifically its implementation climate of decreased organizational capacity to absorb change and a lack of resources dedicated for STAR, would play in hindering the implementation of the program.

Insufficient communication and education of program value and effectiveness

Participants reported that insufficient communication and education of STAR’s value and effectiveness to other clinicians could be barriers to its implementation. See the administrator’s response below:

“To me, it’s always a matter of communication. If there was, if communication didn’t work, people didn’t see it had value, they didn’t want to put any effort into it, you know, those would really be obviously the big things.” (A8)

“So, if it’s not marketed like correctly or appropriately. If we really as attending or residents don’t see the benefit. You know, is this just another checky box, or is this really going to impact our patients in the long term? Will this make a difference in their survival? Or getting them back to a base line or improvements on a base line? I think that’s probably what’s going to help make it successful or not.” (C8)

Responses related to this barrier theme show that the LHS’s inner setting and characteristics of individuals (clinicians) are important implementation domains in the adoption of STAR. Participants identified poor quality communication, and a lack of clinician knowledge and positive beliefs about STAR’s value, would be barriers to the implementation of the program.

Underlying informational and technology gaps among patients

Participants reported several patient-facing factors related to information and technology gaps among patients that could be barriers to implementing STAR. This included a patient’s health literacy or understanding of STAR, a patient’s digital literacy, and a patient’s lack of access to technology when communicating with the STAR telehealth navigator. See the clinician responses below:

“Well, I think a lot of our patients don’t have secure housing. I think our patients’ baseline social determinants of health, like consistent phone numbers, housing, health literacy around that, I think that’s a barrier that a patient would experience [to participate in the intervention].” (C6)

“I think the only barrier is that they [patients] may not understand what is going on. But that’s okay [as if not a big deal], as long as they are receptive to someone talking to them. And like I said, I want to be respectful of our patients, but some of them just do not have the medical literacy or the insight to understand….So, I think a barrier might be that the patient may not understand why you are calling and why you are asking those questions.” (C1)

“Definitely patients have to be capable of doing it uh participating with the Telehealth. At least from the perspective of a lot of my patients and during the Coronavirus pandemic, it has been difficult to get some buy in with Telehealth linkages to care. We have a very rural population and there is some adherence issues with trying to initiate, you know, telephonic or video visits that we have kind of noticed over the last several months. So, patient participation I think in some settings would be challenging.” (C4)

Participant responses within this barrier theme highlight the importance of the outer setting (external to the LHS) in the challenge of implementing STAR, where literacy and technology gaps among patients could be barriers to program enrollees’ participating in the telehealth-based intervention.

Lack of access to community resources for patients

Finally, participants reported that a patient’s lack of access to community resources, including limited primary care, paramedicine, home physical therapy, speech therapy and mental health resources in certain communities (e.g., rural communities), could pose a barrier to the implementation of the STAR program. See the clinicians’ responses below:

“I think that the idea is a good idea [pauses], but it’s just where it would work best based upon the resources of the area. I think that is going to be the major challenge.” (C7)

“Just getting plugged into community resources that can assist with their psycho-social needs as well as their comorbidities” [would be a barrier to patient participation]. (A1)

Participant responses within this theme demonstrate the relevance of intervention characteristics and the outer setting when implementing EBPs for post-sepsis care for patients who lack access to community resources. The extent to which STAR cannot adapt and meet patients’ local needs, especially those of patients who live in areas where there are insufficient resources, will be a barrier to its implementation.

Patient distrust of the program and/or healthcare

Both administrators and clinicians interviewed stated that patient distrust of the program and/or healthcare could be a potential barrier to STAR’s implementation. These reasons included patients being slow to trust a new provider, discomfort when talking with a navigator, feeling skeptical of providers who seem unaffiliated with their primary care, and general distrust of the healthcare system, particularly for patients in rural communities or impoverished areas. See the administrator and clinician responses below:

“You know, people are always a little wary of people they do not know, especially in small and rural communities.” (A1)

“Yeah, I think most of the barriers that are already well known that go with socio economic status or poverty. Trust in the healthcare system. I think those are all going to be barriers.” (C4)

Responses within this theme point to the significance of outer setting factors and the extent to which a patient’s need to trust their provider is accurately known and prioritized by the STAR navigator. Data suggests patient distrust of the STAR program or other providers would be a barrier to implementing EBPs for post-sepsis care.

A foundation of implementation science is that intervention delivery should be tailored to local context to maximize uptake and impact [ 34 , 35 ]. Formative, or pre-implementation, evaluations facilitate initial assessment of the local context and the potential determinants for implementation success within that context. Multiple theoretical frameworks have been applied to pre-implementation evaluations; the Consolidated Framework for Implementation Science (CFIR) is one of the most widely used due to its ability to comprehensively identify implementation facilitators and barriers [ 36 ]. In this study, we utilized qualitative pre-implementation interviews to identify actionable facilitators and barriers to inform and enhance initial implementation strategies of the STAR program across diverse hospital and community settings in a large LHS. From this work, our study offers several contributions to the literature on post-sepsis care.

First, our study successfully leveraged the CFIR to inform and enhance initial implementation strategies of the STAR program across diverse hospital and community settings in a large LHS. This is in line with other studies that similarly applied the CFIR during pre-implementation and found implementation determinants like ours, such as stakeholder involvement being necessary to promote buy-in and the relevance of intervention fit within the organization’s inner setting [ 26 , 37 ]. While some have applied CFIR in the pre-implementation planning of a sepsis management intervention at a single site [ 38 ], to our knowledge, our team is the first to apply the CFIR at pre-implementation to inform the design and dissemination of a sepsis transition and recovery intervention for patients within a large LHS. We decided to guide our interview instrument development and subsequent analysis using the CFIR because we were interested, fundamentally, in the organizational change that will be needed to successfully implement the STAR program. By incorporating the CFIR domains and constructs into our interview instruments and intervention planning, our study was able to identify implementation partners and collect stakeholder input on the potential facilitators and barriers to the STAR program at a large LHS. One benefit of using the CFIR for pre-implementation work is the potential for direct translation to implementation strategies selection using the Expert Recommendations for Implementing Change (ERIC) mapping.

Second, study findings revealed the importance of stakeholder buy-in like other CFIR-guided pre-implementation studies [ 26 , 39 ] across diverse groups, including administrators, care teams, patients, and caregivers. Implementation facilitators related to buy-in that were identified included active engagement with stakeholders, education about STAR, the sharing of positive outcomes data from STAR with clinicians, and promotion of the program’s value throughout implementation. Participants also emphasized the criticality of demonstrating alignment between clinicians and the STAR program. This included the recommendation for clinician support and promotion of STAR with patients to engender patient trust in the program. Conversely, our study found implementation barriers pertaining to lack of stakeholder buy-in as well. These included that a lack of engagement and education about the post-sepsis care program’s value and effectiveness, possible patient distrust of STAR and/or of health care, and patients’ lack of access to community resources could be potential barriers to its implementation. Together these findings point to the necessity of stakeholder buy-in for overcoming inner and outer setting barriers to implementation. They also suggest successful championing of STAR should extend beyond navigator efforts alone and include system and care team participation as well.

Third, our study found the STAR program’s fit with the LHS’s inner setting to be informative for our planning. Participants reported STAR’s compatibility with the structural characteristics and implementation climate of the LHS to likely be important considerations for implementation. At the time of this study, virtual hospital care and other telehealth programs were highly active within the LHS, in part related to the need for such programs during the surge of the COVID-19 pandemic. Additionally, STAR’s alignment with other sepsis-focused work groups and sepsis champions across the LHS was identified as another possible facilitator for implementation success. We found implementation barriers pertaining to the implementation climate of the LHS’s inner setting as well. Despite acknowledging that the program would likely align with current health system goals, participants cautioned STAR would have to compete with demands for staff time and resources. Decreased organizational capacity for a new program was another potential implementation barrier identified. Participants recommended engaging clinicians about the value and effectiveness of the program to promote support and assuage concerns. These facilitators and barriers suggest health system priorities and routine healthcare practice in the inner setting should be identified and considered carefully when making post-sepsis care program implementation decisions. They also underscore how the inner setting is not simply a background of implementation but can rather serve as an important context in implementation success.

Finally, our study findings highlighted the importance of good communication between the STAR navigator and other stakeholders, including clinicians, patients, caregivers, and family members, for successful implementation. Participants recommended clear and reciprocal communication between STAR navigators and clinicians. Similarly, they advised that navigators attempt to establish good rapport with patients, caregivers, and family members by using effective communication. Several potential implementation barriers related to communication were also reported. Participants discussed underlying patient-facing information and technology gaps that could be potential barriers to communicating with STAR navigators related to digital literacy, health literacy, or a lack of access to technology to participate in STAR. These suggest further study may be recommended to identify other patient-facing environmental conditions, such as social determinants of health, affecting sepsis recovery, as proposed in other’s work [ 10 ]. These points underscore the necessity of both effective communication and communication technology to support telehealth-based sepsis transition and recovery intervention implementation.

Study limitations

A limitation of the present research is that it is based on interviews with a small sample of employees at one, albeit large, health system. Although we carefully sampled stakeholders based on their awareness, organizational authority, and involvement in activities related to implementation of a post-sepsis care intervention at study facilities, these perspectives may not necessarily reflect the experience of all facilities within the same LHS or outside of the LHS. A second limitation is that patients were not included as participants at pre-implementation, despite later finding several facilitators and barriers related to patient needs. Third, we deliberately used the CFIR, and included all domains, to inform our approach to data collection and analysis due to its comprehensive assessment of implementation determinants and well-described associations with implementation strategies. However, using CFIR alone may have limited collection of other relevant contextual factors not represented by CFIR or specifically incorporated in our data collection. Our analysis strategy that combined inductive and deductive methods did allow for capture of themes outside of CFIR, if new information emerged from participant responses. Finally, our analysis strategy focused specifically on identifying key individual determinants; thus, additional empirical analyses examining the causal pathways or combinations of contextual factors may be helpful to advance evidence and guide decision making regarding effective implementation strategies tailored to complex determinants.

Our findings demonstrate effective use of the CFIR as a robust framework to examine facilitators and barriers for pre-implementation planning of post-sepsis care programs within diverse hospital and community settings in a large LHS. The comprehensive structure of the framework enabled researchers to identify key implementation determinants across external-, internal-, and program-level domains, plan for organizational change associated with implementation, and engage with relevant stakeholders. Conducting a structured pre-implementation evaluation helps researchers design with implementation in mind prior to effectiveness studies and should be considered a key component of Type I hybrid trials when feasible.

Availability of data and materials

The datasets generated and analyzed during the study are not available due to participant privacy and ethics restrictions, but the codebook and data collection tools may be available from the corresponding author on reasonable request.

Abbreviations

Sepsis transition and recovery

Learning health system

Consolidated framework for implementation research

Evidence-based practices

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Acknowledgements

The authors would like to thank all of the study participants for sharing their time and insights.

Research reported in this publication was supported by the National Institute Of Nursing Research of the National Institutes of Health under Award Number R01NR018434. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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TE, ST, MK, and HT contributed to the design of the study. TE, ST, MK, RB and KO contributed to the acquisition of study data. TE, RB, KO, and HT analyzed the data. TE, ST, and MK contributed to the interpretation of the data. TE, ST, MK, RB, and HT drafted the manuscript. All authors critically revised the intellectual content of the manuscript. All authors approved the final manuscript.

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Correspondence to Tara A. Eaton .

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Eaton, T.A., Kowalkowski, M., Burns, R. et al. Pre-implementation planning for a sepsis intervention in a large learning health system: a qualitative study. BMC Health Serv Res 24 , 996 (2024). https://doi.org/10.1186/s12913-024-11344-x

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Published: 25 August 2024

Navigating sexual minority identity in sport: a qualitative exploration of sexual minority student-athletes in China

Meng Xiang 1 , 2 ,
Kim Geok Soh 2 ,
Yingying Xu 3 ,
Seyedali Ahrari 4 &
Noor Syamilah Zakaria 5

BMC Public Health volume 24 , Article number: 2304 ( 2024 ) Cite this article

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Metrics details

Sexual minority student-athletes (SMSAs) face discrimination and identity conflicts in intercollegiate sport, impacting their participation and mental health. This study explores the perceptions of Chinese SMSAs regarding their sexual minority identities, aiming to fill the current gap in research related to non-Western countries.

A qualitative methodology was adopted, utilising the Interpretive Phenomenological Analysis (IPA) approach with self-categorization theory as the theoretical framework. Participants were recruited through purposive and snowball sampling, and data were collected via semi-structured interviews, documents, and field notes. Sixteen former and current Chinese SMSAs participated in this study.

The study reveals four themes: hidden truths, prioritisation of athlete identity, self-stereotyping, and attempt. The results revealed that while SMSAs were common in intercollegiate sport, their identities were often concealed and not openly discussed. The predominant focus on athlete identity in sport overshadowed their sexual minority identities. Additionally, SMSAs developed self-stereotypes that influenced their thoughts and behaviours. The non-heterosexual team atmosphere in women’s teams led to the development of intimate relationships among teammates.

Conclusions

The findings from this study could be incorporated into existing sport policies to ensure the safe participation of SMSAs in Chinese intercollegiate sports. This research offers valuable insights for the development and implementation of inclusive policies. Future research in China could investigate the attitudes of coaches and heterosexual student-athletes toward sexual minority identities to inform targeted interventions.

Peer Review reports

Collegiate sport serves as a conduit for hope, competition, learning, success, and enhanced well-being for students [ 1 , 2 ]. Within this context, situated at the intersection of student-athlete and sexual minority identities [ 3 ], sexual minority student-athletes (SMSAs) experience more challenges than their heterosexual counterparts. Sexual minority constitutes a group of individuals whose sexual and affectual orientation, romantic attraction, or sexual characteristics differ from that of heterosexuals. Sexual minority persons are inclusive of lesbian, gay, bi+, and asexual-identified individuals [ 4 ].

In an effort to enhance the support of SMSAs in sport, Team DC, the association of sexual minorities sport club, awarded seven SMSAs the 2023 Team DC College Scholarship [ 5 ]. Besides the Team DC scholarship, there are the Rambler Scholarship, US Lacrosse SMSAs Inclusion Scholarship, NCAA Women’s Athletics Scholarship and Ryan O’Callaghan Foundation [ 6 , 7 , 8 ]. These scholarships were set up to make sport a more welcoming and safer environment for SMSAs. In particular, the Sexual Minority Scholarship echoes the International Olympic Committee’s framework of equity, inclusion, and non-discrimination, which states that everyone has the right to participate in sport without discrimination and in a manner that respects their health, safety and dignity [ 9 , 10 ].

Despite efforts by educational and sport organisations to foster inclusivity, research shows that the sport environment remains hostile to sexual minority individuals [ 11 , 12 ]. In intercollegiate sport, empirical evidence points to persistent negative attitudes [ 13 , 14 , 15 , 16 , 17 ], which are expressed through marginalisation, exclusion, use of homophobic language, discrimination, and harassment [ 17 , 18 , 19 , 20 ]. SMSAs frequently confront the difficult choice of disclosing their identity, often opting for concealment. Denison et al. found that SMSAs who disclose their identity to their teams may face increased discrimination [ 21 ]. Pariera et al. also observed deep-rooted fears among SMSAs of being marginalised by their teams upon revealing their sexual orientation [ 22 ]. Consequently, the hostile environment led to lower participation rates among sexual minority youth compared to their heterosexual counterparts [ 23 ].

In China, there is a lack of clear public policies related to the sexual minority population [ 24 ]. Despite homosexuality being removed from the Chinese Classification of Mental Disorders-3 in 2001 [ 25 ]. China’s stance towards sexual minority issues remains ambiguous. Many scholars describe this attitude as “no approval, no disapproval, and no promotion” [ 26 , 27 , 28 , 29 ]. Due to the lack of legal protection, sexual minorities frequently encounter discrimination. A Chinese national survey revealed that only 5.1% of sexual minority individuals felt comfortable being open about their gender and sexual identity in China [ 30 ]. This discrimination is particularly severe among Chinese sexual minority youth, who are at higher risk of bullying in school and college [ 31 , 32 ]. These youths face childhood victimisation [ 33 , 34 , 35 ], which heightens their risk of mental and behavioural health issues [ 36 , 37 , 38 ], including non-medical use of prescription drugs [ 39 ], depression [ 40 , 41 ], and suicide [ 42 ].

While sports participation is crucial for the well-being of sexual minority individuals, research on the sports participation of sexual minority youth in China is limited. The literature highlights a significant gap in understanding the status and circumstances of SMSAs in China. Most existing studies focus on Western populations [ 43 , 44 , 45 ], overlooking the unique sociocultural interactions affecting SMSAs in non-Western contexts, making it challenging for China to apply these findings. Furthermore, the lack of reliable research on the interactions between sexual minorities and institutions in Chinese higher education hampers a comprehensive understanding of SMSAs’ situations. This research gap impedes the development of effective interventions to foster inclusivity. Persistent discrimination and inadequate protective policies underscore the urgent need for academic, policy, and practical advancements to support sexual minorities in China [ 46 ]. Therefore, the aim of this study was to explore SMSAs’ perceptions of their sexual minority identity in Chinese sports, providing insights to guide the creation of supportive educational and organisational strategies.

Homonegativity and discrimination in sport

Homonegativity refers to any prejudicial attitude or discriminatory behaviour directed towards an individual because of their homosexual orientation [ 47 ]. Compared to the more common term “homophobia,” [ 48 ] “homonegativity” more accurately describes negative attitudes towards homosexuality [ 49 ] because the fear is not irrational but is learned from parents, peers, teachers, coaches, and the daily interaction environment [ 50 ]. Sport context is an integral part of society, and an extensive body of research has consistently demonstrated the presence of homonegativity in sport [ 12 , 21 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ].

Homonegativity can manifest in forms such as verbal harassment, physical violence, or discriminatory behaviours. The “Out on the Fields” survey, conducted in 2015, represents the first large-scale international study focusing on homophobia in sports [ 60 ]. Participants were from six countries: Canada, Australia, Ireland, the United States, New Zealand, and the United Kingdom. It revealed extensive discrimination in sport, with a high percentage of gay men and lesbians experiencing verbal slander, bullying, threats, and physical assault. The OUTSPORT project, completed in 2019 and funded by the European Union, is the first comprehensive EU-wide study on homophobia and transphobia in sport. The project collected data from over 5500 sexual minority individuals across all 28 EU member countries [ 61 ]. The results revealed that a significant portion of participants faced adverse experiences in sport contexts related to their sexual orientation and gender identity, including verbal abuse, structural discrimination, physical boundary crossing, and violence. An overwhelming majority of respondents (92.9%) view homophobia and transphobia in sport as current issues. Additionally, 20% of respondents reported avoiding participation in sport due to concerns about their sexual orientation or gender identity, while 16% of active participants experienced at least one related negative incident in the past year. Notably, male student-athletes exhibited higher levels of homophobic attitudes compared to their female counterparts and non-physical education students [ 15 , 16 , 62 ]. Conversely, female athletes reported experiencing less fear of exclusion and a more inclusive team environment [ 22 , 63 , 64 ], highlighting significant gender disparities in homonegativity in sport.

Group and individual identity

The distinct team interaction inherent in sport may enhance or support expressions of homonegativity and discrimination, as Social Identity Theory posits that negative beliefs about certain groups may develop group identity [ 65 , 66 , 67 ]. This phenomenon is particularly noticeable in intercollegiate sport, where a strong emphasis on physical attributes and abilities often results in prejudices against those who deviate from established norms [ 16 ]. Such discrimination and mistreatment of SMSAs frequently stem from their teammates and coaches. Many SMSAs choose to conceal their sexual orientation due to fear of ostracism [ 60 ], with team members often identified as the primary perpetrators of discrimination [ 61 ].

Therefore, navigating sexual identity within intercollegiate sport is challenging for SMSAs, as their minority status becomes a focal point, impacting their overall experience [ 68 , 69 ]. They encounter a unique psychological and emotional burden, striving to reconcile societal norms and expectations with their true selves. This constant negotiation and management of their identity across different contexts further complicates their experiences, frequently leading to difficulties in maintaining authenticity [ 19 ]. Therefore, SMSAs in intercollegiate sport face intricate challenges in balancing their authentic identity with societal norms, significantly impacting their experience and sense of self.

Theoretical framework

Self-categorisation theory (SCT), an extension of Social Identity Theory, provides a valuable perspective for examining the perceptions of SMSAs in China, focusing on intragroup processes and individual navigation of personal and social identities [ 70 , 71 ]. Key principles of SCT, including self-categorisation, salience, depersonalisation, and individuality [ 67 ], are instrumental in understanding how SMSAs navigate their sexual identities within the confines of sport norms. Applying SCT, this study could explore the complex interplay of intragroup relations and identity processes among SMSAs in the Chinese sport context, underscoring how contextual factors distinctly shape their identity.

Purpose of the study

The purpose of this study is to explore SMSAs’ perceptions of their sexual minority identity within the Chinese sports context and understand how this identity influences their participation in sports. By illuminating the specific challenges and issues related to sexual minority identity in Chinese intercollegiate sports, this study provides a deeper understanding of the experiences of sexual minorities in this field.

Research design

This study was conducted with the interpretivist paradigm, which emphasises understanding the subjective experiences and meanings that individuals assign to their world. It posits that reality is not objective but is constructed through individual perceptions and social interactions [ 72 ]. Given the aim of exploring the perceptions of sexual minority identity in sport from SMSAs’ perspectives, a qualitative research approach is appropriate. In line with the purpose of the study, the Interpretative Phenomenological Analysis (IPA) was adopted in this study, an approach aimed at understanding people’s lived experiences and how they make sense of these experiences in the context of their personal and social worlds [ 73 ]. IPA research encompasses phenomenology, hermeneutics, and idiography and emphasises the personal significance of self-reflection among individuals with a shared experience in a specific context [ 74 ]. Additionally, IPA is particularly suitable for research focusing on identity and self-awareness [ 75 ]. The features and focus of IPA are consistent with the purpose of this study. Therefore, IPA was considered a suitable approach to explore the SMSAs’ perceptions of their sexual minority identity within the sport context in China.

Researcher characteristics and reflexivity

During the data collection phase of this study, the first researcher was a Ph.D. candidate and had obtained her Ph.D. by the time of this manuscript’s submission. Her doctoral committee continuously supervised the research. The first researcher’s doctoral committee members are proficient in qualitative research. The first researcher and the second coder have received systematic qualitative training, are skilled in qualitative analysis software (NVivo), and have published empirical studies using the IPA approach. Although none of the research team members were SMSAs, the first researcher and the second coder maintained long-term contact with SMSAs through their involvement in sport teams. The first researcher was a former student-athlete and is currently working as a coach. Given her background, she has had extensive time to interact with and understand SMSAs within student teams.

Participants and procedures

Purposive and snowball sampling methods were employed to recruit a homogeneous sample for this study, as recommended by Smith and Nizza [ 73 ]. Following approval from Universiti Putra Malaysia’s Human Research Review Committee, the researcher initially reached out to SMSAs within her network, subsequently expanding outreach through social media to reach a broader pool of potential participants. The participants were selected based on specific inclusion criteria (Table 1 ), ensuring relevance to the study’s focus. Of the 22 individuals contacted, 16 agreed to participate, while six individuals declined participation due to concerns regarding potential exposure. The sample included a diverse representation of sexual minority subgroups: one asexual man, four bisexual women, three gay men, and eight lesbians. Given the relatively low prevalence of asexual individuals [ 76 , 77 ], we only had one participant from this subgroup. Strict confidentiality measures were enforced, with participants assigned pseudonyms and their college affiliations omitted for anonymity. The demographic details of the participants are outlined in Table 2 .

In phenomenological research, the focus is on rich individual experiences rather than data saturation [ 78 ]. Similarly, IPA research aims to explore participants’ personal and social worlds through detailed, in-depth analysis [ 79 ]. Smith and Nizza [ 73 ] also highlighted that in IPA research, sample size is less crucial because of the emphasis on detailed analysis in small, homogeneous samples. Therefore, the richness of data and the depth of insight into each participant’s experience are more important than the number of participants or reaching data saturation. This study utilised IPA’s in-depth analytical approach with sixteen participants to provide detailed data. This methodological approach allows for a comprehensive exploration of individual experiences, aligning with the study’s objectives.

Data collection

Data for this study were collected through semi-structured interviews (Appendix A), allowing participants to choose the mode, time, and location, including face-to-face or online sessions on Chinese social networks. Each interview’s length is detailed in Table 2 , with an average duration of 63 min. Before each interview, participants signed informed consent forms following a detailed briefing on the study’s purpose and procedures. Given the sensitive nature of the research, the interviews were conducted solely between the researcher and the participant to ensure a safe and comfortable environment, fostering open and honest communication.

The methods of data collection exhibited some qualitative differences. In face-to-face interviews, participants were often cautious and hesitant to share personal experiences. Conversely, online interviews proved more effective, as participants felt more relaxed, leading to quicker rapport and greater openness. This difference likely stems from the reduced perceived risk of exposure in an online setting. Due to the clear objectives of the study and the structured interview guide, there were no differences between the data from current SMSAs and former SMSAs.

Notably, one participant provided data through written essays instead of a semi-structured interview due to concerns about exposure and discomfort. After discussing the matter, the participant agreed to respond to interview questions in written form. The first researcher sent the interview questions to the participant, who then provided written responses. Follow-up questions were asked based on these initial responses, resulting in four sets of essay responses. This approach, which aligns with the conventions of phenomenological research [ 80 ], allowed the participant to express their experiences comfortably. The essay data were analysed alongside the semi-structured interview data, with common themes identified across all responses.

Documents and field notes supplemented the data collection. Documents included photographs, videos, and diaries. With participant consent, these documents were analysed for relevance to the research purpose. Field notes captured contextual information during both face-to-face and online interviews, including keywords and participants’ pauses and intonations, with immediate elaboration post-interview to avoid biases [ 81 , 82 ]. These detailed notes contextualised data analysis [ 74 ] and contributed to the research’s credibility.

Data analysis

The data analysis in this study followed a seven-step process aligned with IPA research guidelines and contemporary IPA terminology. The data analysis procedure is depicted in Fig. 1 . The IPA analysis is iterative and inductive [ 83 ], involving the organisation of data into a structured format for easy tracking through various stages – from initial exploratory notes on transcripts to the development of empirical statements, theme clustering, and final group theme structure. The theoretical framework was incorporated at the final stage of empirical theme development.

To enhance the study’s validity, the first author invited another Ph.D. candidate to participate in the data analysis process. After the interview recordings were translated into transcripts using audio software, the first researcher listened to the recordings repeatedly to correct the transcripts. The second coder reviewed the recordings to ensure the transcriptions were accurate and verbatim. The first author employed NVivo software (released in March 2020) for coding, and the second coder utilised manual coding. All data were analysed in Chinese to maintain linguistic integrity and then translated into English for theme presentation.

Data Analysis Procedure. Adapted from Smith et al. ( 74 )

The procedures of this study adhered to the COREQ Checklist [ 84 ] (Appendix B) and the IPA Quality Evaluation Guide [ 85 ] to ensure rigour. The research met the good quality requirements for IPA studies as outlined by Smith [ 85 ] (Table 3 ). Throughout the research, emphasis was placed on internal validity, external validity, and reliability to maintain the study’s rigour and quality. The methods employed to address these aspects are summarised in Table 4 .

This study explored SMSAs’ perceptions of sexual minority identity within intercollegiate sport in China. From the perspective of SCT, the results uncovered four key themes from SMSA’s team-based interactive experiences. The research themes, along with their corresponding sub-themes and occurrences, are presented in Table 5 .

Hidden truths

The hidden truths refer to facts, scenarios, or knowledge that are not commonly known or readily available. In this study, the existence of SMSAs in intercollegiate sport was undeniable, yet it remained concealed due to the prevailing lack of transparency.

SMSAs are common in sport

This research uncovered the extensive existence of SMSAs in Chinese sport. Almost all participants acknowledged the ubiquity of sexual minorities in sport, with 12 out of the 16 participants specifically highlighting the presence of SMSAs in collegiate sport:

I think everyone is generally aware of sexual minorities; all people are aware of them to a greater or lesser extent. It is generally agreed that the existence of sexual minorities is a common phenomenon in modern society, and even more so in Sport, as anyone involved in sport knows that (Adam).

Participants frequently described the presence of SMSAs in intercollegiate sport, using terms like “widespread”, “common”, “normal”, and “quite many”. Several participants also provided specific details about the number of SMSAs in their respective teams. Jackie remarked, “At that time, half of my teammates were lesbians” (Jackie). Similarly, Zoe noted the significant presence of SMSAs in her team, “I think it (the number of SMSAs) was almost half of the team at that time. But I don’t know about the senior players; almost half of our junior players were SMSAs” (Zoe).

Silent identity

Participants noted the prevalence of SMSAs in sport but also emphasised the difficulty of openly discussing sexual minority identity in this context. They described the sport environment as reserved and lacking open conversations about SMSAs and their experiences.

The reticent nature of sport teams regarding sexual minority identity was evident in their attitudes. William observed, “I feel like most of my teammates just don’t take a stand. They don’t want to make a statement about SMSAs. Nor did they say they supported it or didn’t support it” (William). Similarly, Mia considered sexual minority identity as a personal issue, inappropriate for open discussion.

No one wants to ask or discuss this openly…we live in a very conservative environment all the time, and none of this content is something that teammates should be concerned about, and people would feel offended if you don’t handle it well (Mia).

Some SMSAs viewed avoiding discussions on sexual minorities in sport as respectful to teammates, aiming for a comfortable, stress-free environment. Joy said, “We came here to play, right? I don’t think any of the other players want to feel phased by who you are” (Joy). Mia echoed this sentiment:

…in team training, the game is the game, and I rarely bring other emotions into it…. In the company of most of our teammates, we don’t interact with each other in that way. It’s probably a default rule that respect is distance, I guess (Mia).

Charlotte, involved in volleyball and basketball, recounted a teammate’s public derogation due to her sexual minority identity, an incident not openly addressed by the team. She perceived sexual identity as a “taboo” topic. The narratives revealed a cautious approach among SMSAs towards expressing their sexual minority identity in sport. They felt compelled to carefully manage their sexual orientation, minimising its disclosure. This hesitancy likely stemmed from the existing reticence and limited acceptance of SMSAs in sport, fostering a sense of invisibility and concern over potential negative consequences.

Prioritisation of athlete identity

The theme of prioritisation of athlete identity suggests that for SMSAs, their identity as an athlete may play a more prominent or influential role in shaping their self-conception compared to their sexual minority identity.

Be an athlete

Several participants believed their primary role as student-athletes was to engage in sport, and they valued this aspect of their identity significantly. Joy expressed this sentiment, “I love volleyball very much … I don’t care much about relationships; I just love volleyball, and I think we are all here to do this, and nothing else matters. You don’t need to stress about it (sexual minority identity)” (Joy).

Emma echoed a similar perspective, noting, “I think my teammates are very professional; our program requires a high technical standard, and we spend most of our time training; other than that, things don’t seem that important” (Emma). When queried about the importance of sexual minority identity, she responded, “Yes, at least not concerning sport performance, or maybe it will have a bad effect” (Emma). Additionally, some participants felt that in the context of sport, sexual minority identity might be sidelined. Adam commented:

“We don’t share it (sexual minority identity) unless someone asks. We’re a team first, and then we’re individuals, and for me, I’m important personally, but in the team, we all probably need to sacrifice some of ourselves to make the team more united and stronger” (Adam).

Participants’ views as both student-athletes and sexual minorities highlighted contrasts in the intercollegiate sport environment. Their student-athlete identity was key in shaping self-perception and fostering a sense of community, while their sexual minority identity was often marginalised in aspects of interpersonal relations, team support, and self-identity development.

Sport performance first norms

In team sport, leaders are crucial in creating inclusive spaces for SMSAs and setting behavioural and attitudinal standards, including those towards SMSAs. In this study, some participants believed that coaches’ criteria for acceptance of sexual minority individuals or intra-team romantic relationships were based on athletic performance.

Some coaches firmly believe that team relationships negatively impact team performance and, therefore, strictly prohibit romantic relationships between teammates. Joy recalled,

She couldn’t accept that… she thinks being an athlete like that is ridiculous. It would make a mess; her team would be in a mess. She said you two are dating and that playing will affect your emotions, which means she meant to say there is no way I can treat another girl as a normal teammate… (Joy).

In contrast, some coaches adopt a more tolerant attitude. Jackie’s coach believes that if the team’s overall performance is not affected, issues such as sexual orientation or team relationships can be ignored. Jackie stated, “My coach is male and old, but he should know what’s going on, especially since our captain has dated several teammates and the coach pretends not to know. He would only care if we were winning games” (Jackie).

Whether it instructs prohibition or an indifferent attitude, both narratives reflect that the team’s norms for inclusivity are based on sport performance. These norms also influence how SMSAs assess their own sexual minority identity within the team, as Adam said:

As of now, I have someone in the team that I have a crush on and haven’t dated. Maybe if he and I argued over training or a game, it would affect the performance of the team and the relationship between teammates…. I don’t think I could let that happen (Adam).

The participants’ narratives emphasise how the “Sports Performance First” norms influence the attitudes and behaviours of coaches and SMSAs within the team. These norms not only shape the team culture but also profoundly affect how SMSAs navigate their identities and relationships in the team environment.

However, the excessive focus on sport performance highlights the athletic identity of student-athletes while neglecting their other identities, especially those of sexual minorities. This singular focus leads to the neglect of the personal needs and diverse identities of athletes. Although these measures may seem to ensure the overall performance of the team, they overlook the psychological health and holistic development needs of the individuals.

Self-stereotyping

Self-stereotyping denotes the tendency of SMSAs to describe themselves using stereotypical attributes in the sport context. These descriptions frequently align with stereotypical perceptions prevalent in the external environment. SMSAs tend to be perceived as having specific physical traits or behavioural tendencies.

Specific physical traits

Sophia provided an illustrative example of self-stereotyping through her personal experience. She commented:

In the beginning, I would think that if you are an SMSA, you must fit some characteristics. For example, at that time, I saw some lesbians in my team who had short hair or wore baggy t-shirts; I was a bit frustrated by my long hair and feminine appearance…and I felt that I might not quite fit those criteria. So, then I cut my hair and even wore a wrapping bra to the training ground (Sophia). Sophia’s narrative underscores how the pressure to conform to certain physical traits led her to change her appearance to fit the stereotypical image of an SMSA within the sport context.

Behavioural tendencies

In addition to physical traits, SMSAs also feel compelled to conform to certain behavioural tendencies that are stereotypically associated with SMSAs. Zoe explained, “Because of who I am (T), I felt I should have to perform stronger, so I put up with much training…. I felt I should be there to protect the other players; if I were vulnerable, I would look down on myself” (Zoe). This indicates a sense of obligation among some female SMSAs to embody strength, aligning with the stereotypical image of female SMSAs in sport. Conversely, male SMSAs in men’s teams often faced stereotypes of being fragile, weak, or exhibiting feminine traits. Royal noted that behaviours of some male SMSAs, like engaging in non-sport-related banter, led to gossip and negative perceptions within men’s sport. To avoid these stereotypes, Royal aimed to mimic the mannerisms of heterosexual athletes, as he explained:

I try to avoid being close to the team’s prominent male SMSAs and try to stay out of related conversations; I don’t want to be a standard gay; I want to have the same college life as the rest of the team (heterosexuality) (Royal).

Stereotypes in sport often forced SMSAs into roles incongruent with their authentic identities, significantly impacting their self-expression and identity. The pressure to conform to societal norms in sport settings created internal conflicts for SMSAs, challenging their ability to maintain their true sense of self.

This theme addresses situations where student-athletes engage in intra-team intimacy or mimic being SMSAs in sport. This attempt has two key elements: prolonged contact leading to intimacy and influence from sexual minority teammates.

Prolonged contact leading to intimacy

Participants noted that extensive training and competition schedules in sport fostered close bonds among team members. Lucas shared, “When we were preparing for the tournament, we trained together every morning and evening…the game spanned for almost a month, and after that, we felt as close as family to our teammates” (Lucas). Similarly, Ruby pointed out, “Back then, we were training every afternoon until late at night; it was quite hard (the training was very strenuous) … it lasted for six months” (Ruby). These prolonged interactions sometimes led to the development of more profound attractions among student-athletes.

“I think we had many moments of trust and intimacy together on the field that built up some heartfelt feelings. These feelings made me feel emotions beyond that of a teammate…. Then I realised that gender might not be so important because it’s hard to build that kind of relationship in a typical romance” (Savannah).

Influence from sexual minority teammates

Participants also described how interactions with sexual minority teammates led them to explore their own sexual identities, as illustrated by Ava’s recounting of her initial same-gender relationship experience:

That time we went out to a tournament, and I found that four of my teammates, three of them were lesbians…we didn’t have games at night, so they had been talking to their girlfriends every night on the phone, and I just felt as if that was not too bad. Probably influenced by them, I got a girlfriend at that tournament as well…. Even though we broke up when we returned, I could accept girls (Ava).

Mia described a similar experience:

There were some lesbians in my team, and then it just seemed natural that I got close to one of them…. Well, I was thinking about whether that relationship would affect the team. But then I found out that there were other couples on the team. So, I feel like I wasn’t doing anything wrong (Mia).

The phenomenon highlights the significant role of peer influence in team settings. When individuals are around many teammates in same-gender relationships, it fosters an environment that normalises such relationships. Notably, this influence is not coercive but stems from observing and interacting with teammates who are comfortable with their sexual orientations. This environment helps individuals feel accepted and more confident in exploring their identities and relationships.

This study explored the perceptions of SMSAs regarding their sexual identity within intercollegiate sport in China. Its importance lies in its contribution to understanding the complex realities of SMSAs in China, an area that has lacked depth in the literature. By reaffirming the necessity of examining these athletes’ experiences, this study reveals the intricate conflict between adhering to team norms and expressing personal characteristics within the context of the Chinese social and cultural background.

The results show that SMSAs are a recognised reality in Chinese intercollegiate sport, consistent with findings from Western countries. While precise figures of sexual minorities in sport may vary across countries, it is acknowledged that they are present at all competitive levels, from school and college sport to the professional sphere [ 22 , 86 , 87 , 88 , 89 , 90 , 91 ]. Although no national census on sexual minorities in China or in sports environments exists, related research indicates that many college and university students self-identify as sexual minorities. For instance, an online survey conducted across 26 colleges and universities in 10 Chinese provinces found that over 8% of students identify as sexual minorities [ 36 ]. Additionally, another national survey revealed that nearly a quarter of college students identify as non-heterosexual [ 92 ]. Recognising and addressing the unique challenges faced by sexual minority youth, who make up a notable percentage of the student population, is essential for sport and educational institutions.

Despite the apparent prevalence of SMSAs, the study confirms that their identities often remain hidden in the context of Chinese intercollegiate sport. This can be attributed to two main reasons: First is the concern about discrimination if exposed. Chinese sexual minorities frequently report experiencing abuse or discrimination in families, schools, and workplaces [ 93 ]. Additionally, conversion therapies and discriminatory counselling practices persist in mental health services [ 94 ], creating an environment where discrimination is a significant concern, thereby reducing the likelihood of SMSAs coming out in the sports environment. The second reason is the constraint of traditional Chinese culture. The dominant Confucian culture in China emphasises harmony, internalised homonegativity, and conformity [ 95 , 96 ], often at the expense of individual expression and identity development. This cultural backdrop influences how sexual minorities perceive their own identities [ 97 ] and creates an ideological constraint that leads to social rejection and resistance towards sexual minorities [ 98 ], thereby reducing the visibility of sexual orientation-related topics in the Chinese sport context.

Moreover, SMSAs in China often prioritise their athlete identity over their sexual minority identity, influenced by the attitudes of team leaders. This tendency is reinforced by coaches who primarily focus on the biological sex of athletes and lack training or understanding related to sexual minority issues [ 99 ]. Consequently, the Chinese coaches’ lack of knowledge about sex and sexual orientation exacerbates the silence surrounding sexual minority identities in the Chinese collegiate sport environment and intensifies the identity conflict for SMSAs. Emphasising athletic performance is central in sport but should not overshadow the holistic development of student-athletes. McCavanagh and Cadaret [ 100 ] noted that student-athletes might face challenges in reconciling various aspects of their identity in a heteronormative sport context. The suppression of sexual minority identity can lead to isolation from potential support systems that nurture positive sexual and gender identities. Prioritising athletic success over broader student development in sport departments limits growth opportunities for all students, including SMSAs. Chavez et al. [ 101 ] emphasised that student development requires recognising and valuing diversity, suggesting that a singular focus on athletic prowess can diminish the benefits of diversity among student-athletes. Embracing diversity is not only a personal journey but also one that can enhance the collective experience within sport settings.

In addition, self-stereotyping within SCT involves aligning one’s self-concept with the characteristics of valued social categories [ 102 ]. Latrofa [ 103 ] suggests that members of low-status groups, like SMSAs in sport, may self-stereotype to align more closely with their group, reflecting recognition of lower status and self-perception through peers. This study revealed SMSAs shape their self-identity based on the attitudes prevalent in their sport environment, with influences from peers and coaches being internalised as personal attitudes [ 104 ]. Such self-stereotyping supports maintaining a favourable social identity and adhering to group norms but can reinforce negative stereotypes and prejudices within sport.

Internalising stereotypes may lead SMSAs to develop prejudices against themselves and others, perpetuating discrimination. It can also hinder individual development, impacting self-esteem and confidence. For example, aligning with negative stereotypes could cause SMSAs to doubt their worth and capabilities, affecting emotional well-being and satisfaction. Liu and Song’s [ 105 ] survey of Chinese college students illustrated the direct impact of gender self-stereotypes on life satisfaction, highlighting the significant effects of self-stereotyping on individual well-being.

Furthermore, in the context of traditional and reserved Chinese culture, intercollegiate sport offers a relatively free and open space for sexual minority women. The results of this study suggest that the visibility of sexual minority women in teams and the long time spent together allow these athletes to explore and establish intimate relationships. These results are similar to findings in Spanish studies [ 103 ], which highlighted the protective and liberating role of sports teams in the sexual exploration of female sexual minority athletes. Research by Organista and Kossakowski on Polish female footballers [ 106 ] and Xiong and Guo [ 96 ] on Chinese women’s basketball teams also revealed a climate of non-heteronormativity in women’s sport. These climates provide a sanctuary from heterosexual pressures, allowing sexual minority athletes to engage in sport free from traditional constraints. Such environments help female sexual minority athletes navigate and subvert heteronormative norms by cultivating supportive subcultural networks within their teams.

This study addresses the lack of in-depth research on the experiences of SMSAs in Chinese intercollegiate sport. It fills the gap by exploring the complex realities of SMSAs, focusing on their identity conflicts and the influence of the Chinese social and cultural background. Specifically, this study provides valuable insights that align with SCT [ 71 ]. This study addresses a notable gap in the existing literature regarding sexual minority sport participation, as rarely have these perceptions been explored. Drawing from the lens of SCT, the results of this study revealed several valuable insights into how their sexual minority identity impacts their participation in sport. These findings not only enhance our understanding of how SCT applies to the sport experiences of sexual minority individuals but also contribute to the advancement of SCT in research on sexual minority sport participation. The themes uncovered in this study closely align with central SCT concepts such as identity salience, self-stereotyping, and depersonalisation, illuminating the ways SMSAs comprehend and express their sexual minority identity within the intercollegiate sport context. SCT, with its focus on both intragroup and intergroup relations within the multifaceted construct of the self, offers valuable insights into the complexities of SMSAs’ self-perceptions and the intricacies involved in developing and manifesting their identities in the realm of sport.

Based on the results, more effort needs to be put into understanding sexual minority identities in intercollegiate sport. By examining the perspectives and experiences of SMSAs, we can gain insights into the interactions and influences of sexual minority individuals in the sport context. The interplay between an individual’s self-perception and situational dynamics results in a self-identity that mirrors the collective. In addition, the prevalent pressures and normative prejudices inherent in the sport system significantly influence their self-identity. Therefore, valuing SMSAs’ understanding of their self-identity shows respect for each person’s differences and rights. We hope the findings will be incorporated into existing sport policies to promote inclusivity and ensure safe participation for sexual minority students. To encourage and support the full development of SMSAs, college athletics and related institutions should prioritise understanding and respecting their perceptions of their sexual minority identity. By doing so, institutions can create a more inclusive and supportive environment that acknowledges and addresses the unique challenges faced by SMSAs.

Nevertheless, caution should be exercised when generalizing the findings, especially for subgroups with low representation, such as asexual individuals. While the study provides valuable insights into SMSAs’ perceptions of their sexual minority identity within the Chinese sport context, the limited number of asexual participants means their unique perspectives may not be fully captured. Therefore, these findings may not fully represent all sexual minority subgroups.

Future research could focus on exploring the perceptions and experiences among various sexual minority subgroups within sport participation in China. Additionally, considering the cultural diversity across China’s vast geographic regions, it would be valuable to examine how SMSAs perceive their minority identity in different cultural contexts. Given the scarcity of related studies in China, it is also important to survey other stakeholders in the sport environment, such as coaches and heterosexual student-athletes, to gain a broader understanding of perceptions of sexual minority identities. These insights can inform the development of targeted interventions aimed at ensuring the safe and inclusive participation of SMSAs in intercollegiate sport.

Data availability

The datasets generated and/or analysed during the current study are not publicly available due to ethical considerations but are available from the corresponding author on reasonable request.

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Open access
Published: 27 August 2024

Promoting HPV vaccination: effectiveness of mobile short videos for shaping attitudes and influencing behaviors

Jinhui Li ORCID: orcid.org/0000-0002-9823-8038 1 , 2

Humanities and Social Sciences Communications volume 11 , Article number: 1092 ( 2024 ) Cite this article

Metrics details

Cultural and media studies
Science, technology and society

The explosive growth and attractive features of mobile short videos (MSVs) have made it become an effective tool for disseminating health-related information. This study aims to examine the potential informational and technical factors of MSVs, which contribute to the persuasive effects on people’s decision-making process toward HPV vaccination. An experiment with a 2 (information quality: high vs. low) × 2 (source credibility: high vs. low) × 2 (media richness: high vs. low) between-subject factorial design was conducted among 248 Chinese female students. Findings revealed significant persuasive impacts of three factors, i.e., information quality, source credibility, and media richness, on participants’ HPV vaccination intent, via the mediation effect of attitude toward HPV vaccine information. Significant two-way interaction effects indicated that the persuasive effects of media richness varied across different levels of information quality and source credibility. This research not only applied the theoretical lens of the elaboration likelihood model and media richness theory to understand the influencing mechanism within short-form videos but also offered valuable guidelines regarding how professionals best adopt emerging media to maximize health outcomes.

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Human papillomavirus (HPV) is the most common viral infection, responsible for approximately 630,000 new cancer cases worldwide each year, including cervical and other types of cancer (de Martel et al., 2017 ). Recognizing its high prevalence and severity, many national immunization programs have been implemented to promote HPV vaccination, which helps protect against HPV transmission and cancer development (Bruni et al., 2016 ). Despite the efforts, the HPV vaccination rate remains low globally, particularly in less developed regions (Bruni et al., 2021 ). Recent studies have identified social media as a promising tool for strengthening HPV vaccine confidence and increasing vaccination rates (Chen et al., 2021 ; Ortiz et al., 2019 ). As a significant source of health information, social media now plays an instrumental role in educating the public about HPV, shaping attitudes, and influencing behaviors toward HPV vaccination. Research on the impact of social media on HPV vaccination has emerged across various platforms, including Facebook (Loft et al., 2020 ), Twitter (Allen et al., 2020 ), and YouTube (Briones et al., 2012 ).

Mobile short video (MSV) applications are an emerging form of social media that has skyrocketed in popularity over the past few years (Zhang et al., 2019 ). These platforms enable users to create and share entertaining videos that last for a few minutes, or even a few seconds, with simplified editing functions. TikTok, one of the most popular MSV applications, boasts approximately 1.1 billion active users worldwide who record short videos about singing, cooking, and other daily activities, and upload them with hashtags to join various topics and trends (Geyser, 2021 ). TikTok is also notable for its uniquely addictive algorithm, which has driven extensive use among teenagers and young adults (Zhang et al., 2019 ). The explosive growth and attractive features of MSVs have made them effective tools for disseminating health-related information (Basch et al., 2020 ; Song et al., 2021b ). Compared to other social media platforms, the originality and interactivity of MSVs elicit a stronger sense of social presence and immersion (Zhang et al., 2019 ), which may further motivate changes in individuals’ health attitudes and behaviors, especially among the young generation. Previous studies of MSVs have mostly focused on identifying the factors that influence user experience and intention to use (Song et al., 2021c ; Wang, 2020 ; Zhang et al., 2019 ), but have yet to examine how to enhance their persuasive impacts on health communication. Investigating MSVs and health communication is important, as it will contribute to more effective strategies for health message design and media intervention implementation.

In HPV-related health research, although relevant findings have provided an overview of how health interventions impact HPV vaccination knowledge and attitudes, most have focused on traditional formats such as texts or images (Mavundza et al., 2021 ). Little research has devoted attention to the short video format emerging on social media, and exploration of its specific impact on persuading people to adopt HPV vaccination remains lacking. Considering the scarcity of relevant literature in this new research area, this study employs an experimental approach to examine the potential factors of MSVs that may influence people’s attitudes and intentions toward HPV vaccination, through the theoretical lens of the elaboration likelihood model (ELM) and media richness theory. The findings can extend the literature by assessing the informational and technical stimuli that contribute to the persuasive effect.

Theoretical background

Persuasion and health messages.

Persuasion is an important concept in mass communication, referring to the intentional effort to change audiences’ attitudes and behaviors by disseminating relevant information (Perloff, 2008 ). The existing literature offers a sound understanding of persuasive messages that lead to health-related behavior changes, including quitting smoking (So, 2022 ), undergoing mammography screening (Kemp et al., 2024 ), adopting a healthy diet (Friedman et al., 2022 ), and promoting home-based physical activity (Carfora and Catellani, 2021 ). Substantial research has also examined the health messages effective in changing attitudes and intentions toward HPV vaccination. For example, findings often suggest that framing strategies and narrative types of health messages are important factors in predicting individuals’ perception of and intention toward HPV vaccination (Gainforth et al., 2012 ; Nan et al., 2015 ), while graphics also play a role in promoting HPV vaccination among young adults (Teoh et al., 2019 ). Persuasive strategies used in video-based media such as YouTube to promote HPV vaccines were further examined (Kim et al., 2021 ), but their actual effects on attitudinal and behavioral changes warrant further investigation.

Elaboration likelihood model

First introduced by Petty and Cacioppo ( 1986 ), the elaboration likelihood model (ELM) is the most popular persuasion theory in social psychology and behavioral science. It seeks to understand the underlying processes of persuasion and describes two basic routes that explain how humans process stimuli and the subsequent changes in attitude and behavior (Petty and Cacioppo, 1986 ). The “central route” requires a high level of message elaboration and, consequently, a high level of audience motivation. In this scenario, attitude change occurs through a cognitive (or rational) process based on the detailed information presented in the message, such as the quality of the central argument, personal relevance, and other constructs related to the technological medium (Liang and Lin, 2018 ; Petty and Cacioppo, 1986 ; Tang et al., 2012 ). The persuasive effect of the central route is often enduring and consistent. Conversely, under the “peripheral route,” a person lacks motivation or ability and thus makes simple inferences backed by superficial cues or heuristics, such as the credibility or attractiveness of the source, or the production quality of the message (Petty et al., 2009 ; Teng and Khong, 2015 ). The results of attitude change through the peripheral route are often short-term and unpredictable.

ELM is a highly adaptable and inclusive model that considers all elements of a message and different ways of processing information. It aids in constructing and delivering persuasive messages to target audiences by considering their motivations and abilities (SanJosé-Cabezudo et al., 2009 ). ELM has been applied to investigate the multiple roles of variables in influencing health communication efficacy (e.g., Guo et al., 2020 ; Yada and Head, 2019 ) and to test various media message strategies used in health promotion (e.g., Flynn et al., 2011 ; Thompson et al., 2007 ). More importantly, unlike other classical theories, ELM accommodates the integration of new and different variables associated with novel technologies (Shahab et al., 2021 ). Consequently, ELM is well-suited to understanding the new technology of MSVs and exploring their persuasive impact on HPV vaccination in the current study.

Media richness theory

Apart from the content and source of information, it is also essential to consider the medium that transmits information. Media richness theory, introduced by Daft and Lengel ( 1986 ), describes and evaluates the ability of a communication medium to reproduce the information sent over it. The degree of this ability is known as “richness,” indicating the number of multiple cues in audio, visual, or textual formats. The use of richer media allows for more information to be conveyed and reduces ambiguity during the transmission process (Dennis and Kinney, 1998 ). With the emergence of new media, researchers have identified the varying richness among different forms of social media (Kaplan and Haenlein, 2010 ). For instance, the richness of textual media like blogs is considered low, while that of video sites such as YouTube is high due to the inclusion of visual and auditory cues. Based on these classifications, visual- or audio-based forms of social media are assumed to be more effective in communication than text-based forms.

Furthermore, findings from existing studies indicated that the use of pictures and videos in social media is more effective in triggering users’ emotions, capturing attention, and promoting behavior changes (Bhattacharya et al., 2017 ; Guidry et al., 2020 ). Nevertheless, some studies have reported controversial results, showing non-significant impacts of rich media (Chen et al., 2020 ; Kim and Yang, 2017 ). This may be because visual and audio cues can distract the audience, particularly when the primary objective is to convey a straightforward message. Robert and Dennis ( 2005 ) further argued that the use of rich media could increase motivation but decrease the ability to process information. In health promotion, an important target is to examine the impacts of media interventions on people’s attitudes and behavior toward a health issue. However, research on the association between media richness and health perception (and behavior) is largely limited. Therefore, the current study applies media richness theory to further explore the effects of medium type on attitude and behavioral intention in the context of MSV interventions.

Research hypotheses

Drawing on the theoretical frameworks of both ELM and media richness theory, the current study aims to explore the persuasive impacts of information quality, source credibility, and media richness of MSV on promoting HPV vaccination intent, via the mediation effect of attitude toward HPV vaccine information.

Attitude toward health information

Despite the long-standing recognition of the important role of attitude on behavioral intention in the psychology literature (Danes, 1981 ; Kim and Nan, 2012 ), the relationship between attitude toward health information and the intention to adopt protective health behaviors is not well articulated. For information to influence behavioral intention, individuals must believe and process the information, and then develop an intent to adopt the message’s recommendation (Somera et al., 2016 ). The attitude toward health information significantly affects people’s responses to health messages. Some scholars have examined the predictive effects of attitude toward health information (e.g., information trust) on the intention to seek and use health information (Deng et al., 2015 ). Additionally, recent evidence shows a positive relationship between health information-seeking and health-promoting behaviors (Lee et al., 2015 ; Liu et al., 2024 ). The extent and nature of gathered health information can change people’s beliefs and attitudes regarding specific health behaviors, thus promoting the decision-making process for these anticipated health behaviors (Lalazaryan and Zare-Farashbandi, 2014 ). Taking all this together, we posit the following hypothesis in the context of HPV vaccination:

H1: Attitude toward HPV vaccine information has a positive impact on HPV vaccination intention .

Information quality

Under the central route of ELM, people tend to engage in high elaboration when evaluating the content of persuasive information they receive. Consequently, the strength of information arguments determines recipients’ attitude formation and change (Teng and Khong, 2015 ). If the received information is regarded as high quality, strong, and convincing, individuals are likely to develop a positive attitude towards it and adopt corresponding decisions (O’Keefe, 1990 ). Information quality is primarily related to the accuracy, relevancy, and sufficiency of a communication topic (Zhou, 2012 ). In ELM studies, information quality serves as an important central cue in a person’s decision-making process (Zha et al., 2018 ; Zhou, 2012 ). Research from e-commerce has indicated that information quality positively affects users’ attitudes toward the information, including perceived information usefulness (Cho et al., 2019 ) and the tendency to adopt information (Jiang et al., 2021 ). Lin and colleagues ( 2017 ) further reported that the information quality of health messages had a positive impact on recipients’ attitudes toward the messages. In the field of information management, the influence of information quality on users’ behavioral intentions was also supported by prior studies (Jeong and Lambert, 2001 ; Muslichah, 2018 ), with this relationship being partially mediated by attitude toward the information (Lu et al., 2010 ). Therefore, it is reasonable to assume similar influencing paths in the context of MSVs and HPV vaccination information. The following hypotheses are posited:

H2a: Information quality of MSVs has a positive impact on attitude toward HPV vaccine information .

H2b: Information quality of MSVs has a positive impact on HPV vaccination intent .

H2c: The effect of information quality of MSVs on HPV vaccination intent is mediated by attitude toward HPV vaccine information .

Source credibility

When individuals are not highly motivated or lack the ability to engage deeply with the content, they are more likely to process information through the peripheral route, relying on source credibility to form their attitudes. Source credibility is understood as the degree to which a person or agency generating information is perceived to be trustworthy, knowledgeable, and believable (Zha et al., 2018 ). Generally, messages obtained from professional and credible sources (e.g., experts) are often more persuasive and have a significant impact on receivers’ attitudes (López and Sicilia, 2014 ). In the context of social media, source credibility is the most salient cue in the peripheral route of ELM, as other online peripheral cues are difficult to obtain (Teng and Khong, 2015 ). An extensive body of previous research in information studies has supported the impacts of source credibility on users’ perceptions and attitudes (Lee et al., 2022 ; Weber et al., 2023 ). The impact of source credibility has also been extended to behavioral intentions for recommended actions (Warkentin and Johnston, 2010 ). Evidence from Farhadpoor & Dezfuli (Farhadpoor and Dezfuli, 2021 ) confirmed the significant indirect effect of source credibility on shopping behavior through the attitude towards the source.

In the health promotion process, experimental studies (Hu and Sundar, 2009 ; Niu et al., 2020 ) have demonstrated that source credibility of online health information influences users’ attitudes toward the information and encourages corresponding behavioral intentions. Barnes et al. ( 2018 ) further identified the credibility of HPV vaccine information sources as a major theme that shaped parents’ attitudes toward the HPV vaccine. In a study of online health communities, findings from Xu et al. ( 2021 ) indicated that perceived message credibility indirectly affected HPV vaccination intention via information selection. However, the mediation role of attitude remains unexplored in this particular health context. Therefore, three hypotheses are therefore proposed related to MSVs and HPV:

H3a: Source credibility of MSVs has a positive impact on attitude toward HPV vaccine information .

H3b: Source credibility of MSVs has a positive impact on HPV vaccination intent .

H3c: The effect of source credibility of MSVs on HPV vaccination intent is mediated by attitude toward HPV vaccine information .

Media richness

When interacting with rich media that include visual and audio cues, users often demonstrate high engagement with the message and are therefore more likely to process the information (Robert and Dennis, 2005 ). As the level of engagement increases, the effort and intention devoted to the communication process also increase. In other words, the high richness of media leads to a high level of attention and motivation among users. Additionally, richer media are more capable of facilitating users’ understanding of ambiguous or equivocal messages (Daft and Lengel, 1986 ), enhancing their ability to process the message. As mentioned above, ELM proposes that the motivation and ability to process information determine the extent of elaboration, which in turn affects attitude and behavior (Petty and Cacioppo, 1986 ). Therefore, as some scholars argue (e.g., Yen, 2018 ), media richness might act as an important cue in the central route of ELM, influencing perceptual and behavioral changes. Nevertheless, other studies consider visual and audio factors to play a peripheral role in message processing (Lazard and Atkinson, 2014 ; Shin et al., 2020 ; Song et al., 2021a ). Whether via the central or peripheral route, it is reasonable to assume that the integration of visuals and audio in MSVs influences attitudes and decisions regarding behaviors.

In terms of delivering health messages, recent research suggested that websites with multimedia elements, such as videos, were more persuasive in changing attitudes (2009) and promoting risk-protective behaviors (Perrault and Silk, 2014 ). Besides the significant main effect, media richness has been found to have an indirect effect on health behavioral intentions through the mediation of attitude (Lu et al., 2014 ). To explore the relationships on the emerging MSV platform and determine the persuasive impact on HPV vaccination intent at different levels of media richness, the following hypotheses are posited:

H4a: Media richness of MSVs has a positive impact on attitude toward HPV vaccine information .

H4b: Media richness of MSVs has a positive impact on HPV vaccination intent .

H4c: The effect of media richness of MSVs on HPV vaccination intent is mediated by attitude toward HPV vaccine information .

A conceptual model is proposed based on the above hypotheses, which is shown in Fig. 1 .

Proposed conceptual model in this study.

Furthermore, it is essential to explore the potential interactions among the three factors in terms of persuasive outcomes. Studying the moderating effects of media richness within the cognitive process of information is of theoretical interest (Gosain et al., 2019 ). Although ELM and media richness theory are derived from different theoretical perspectives, they both help explain individuals’ motivation and ability to process information. Therefore, it is possible that media, based on their levels of richness, will produce different influences—either supporting or hindering—the persuasive effects of central or peripheral cues. For example, Gosain et al. ( 2019 ) examined whether media richness could strengthen the relationship between information quality and customer engagement behaviors, but no significant moderation impact was detected. Another experimental study (Hu and Sundar, 2009 ) indicated that the persuasive effects of different sources (i.e., expert or layperson) on information attitude and behavior intentions varied on specific forms of social media. Their findings further confirmed that messages with different health contents produced different interactions between source and media type, as the health issues contained in them caused differential levels of heuristic processing. Moreover, the interplay of message quality and source credibility was examined in the context of information validation, with untrustworthy sources found to disrupt the processing of plausible texts (Wertgen and Richter, 2022 ). Given the scarcity of relevant evidence in the context of MSVs and HPV vaccination, an exploratory research question is thus posed in the current study:

RQ: Are there any interaction effects among information quality, source credibility, and media richness of MSVs on HPV vaccination intent?

This study has employed an experiment with a 2 (information quality: high vs. low) × 2 (source credibility: high vs. low) × 2 (media richness: high vs. low) between-subject factorial design to investigate the impact of MSV on HPV vaccination intent. The study has gained ethical approval from the university’s institutional review board.

Participants

Considering the high incidence and mortality rates of cervical cancer in China, the Chinese government has established a national target to improve HPV vaccine coverage among young adolescent females (National Health Commission of the People’s Republic of China, 2023 ). Given the specific socio-political context, this study excluded male participants but only recruited female adolescents and young adults (aged below 25 years). They are recruited from local high schools and universities in a southern province of China, between March and April 2021. Participants would be excluded from the experiment if they: (a) were majored in a medical background (to reduce the effect of existing knowledge); (b) got the HPV vaccine before; or (c) planned to get the HPV vaccine within the coming months. An a priori power analysis was conducted using G*Power (Faul et al., 2007 ) to determine the minimum sample size required to test the study hypotheses. To achieve 80% power for detecting a small-to-medium effect ( d = 0.3) at a significance criterion of 0.05, the required sample size was 90 for main effects and 175 for interaction effects, respectively. The study initially recruited 266 participants, but 18 of them were then excluded because of conflicting schedules or previous history of HPV vaccination. Thus, the final sample size who completed the whole experiment is 248, which is adequate to test all the hypotheses.

The participants were randomly assigned to one of the eight experimental conditions, in which they received customized short videos about the HPV vaccine once per day, for a total of two days. Rather than a laboratory experiment, this study employed the field experiment design which occurred in the natural environment (i.e., everyday life) of the participants. There were no restrictions on when and where they watched these short videos—participants only needed to follow their own habits for smartphone usage. The natural setting is able to increase the external validity of the experiment, and the results can be generalized to other contexts. A post-study survey was issued to all the participants after the two-day intervention, to collect their information attitudes, and behavioral intentions toward the HPV vaccine. The actual exposure to the videos was further asked in the survey, in which all participants self-reported that they had completed watching all the videos in the two days. Figure 2 illustrates the flowchart of the experiment.

Study flowchart and details of interventions.

Intervention

A total of 16 customized short videos (2 videos per condition) were used in this experiment. They were designed based on the characteristics of the TikTok platform, and the length of the videos was about one minute. The short videos in different conditions varied from each other in terms of information quality, source credibility, and media richness. Details of the short videos in eight conditions were also shown in Fig. 2 . Detailed descriptions and screenshots of all the experimental conditions were demonstrated in Appendix 1 . The manipulation of the three factors was further described below:

Information quality. The central route of ELM is logic-driven and often uses data and facts to convince the audience. In the design of information quality in MSVs, we adopted the theoretical framework of the health belief model (HBM; Rosenstock, 1974 ) to frame the persuasion of HPV vaccination, which includes perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. Specifically, short videos with high information quality include detailed figures and scientific explanations when discussing susceptibility and severity of cervical cancer, benefits, and cues to action toward the HPV vaccine. In contrast, those with low information quality cover these topics only with ambiguous wording and emotional arguments.

Source credibility. Given the context of MSV, the presence of source credibility is mainly manipulated by the account details and appearance of the “vlogger” (i.e., persuader) in the short videos. More specifically, short videos with high source credibility link to an authorized account with a medical-related account name (e.g., “Doctor Niu in Gynecology”). The account details were shown right below the videos, and the audience could easily notice them while watching the videos. Meanwhile, the vlogger in these videos acted as a health professional, with a professional dress code such as wearing a white coat and a facial mask. For the short videos with low source credibility, they link to an unauthorized account with a random account name. The person talking in these videos appeared to be a layperson, wearing casual and normal clothes just like ordinary people.

Media richness. Following the practice from previous studies (Dennis and Kinney, 1998 ; Kaplan and Haenlein, 2010 ), media richness was mainly manipulated by the number of ways in which HPV vaccine information can be communicated, i.e., visual and audio cues in the MSV such as animation, subtitle, and music. For example, short videos with high media richness have vivid animation and/or visual effects when educating the audience on HPV illness and vaccines. Clear subtitles and relevant background music were also added to aid the persuasion process. However, all these elements were absent in those short videos with low media richness, leaving only the oral presentation of the persuader.

Manipulation check

Before the actual experiment, a manipulation check was first performed to ensure that three factors (i.e., information quality, source credibility, and attractiveness) had been effectively manipulated across the experimental conditions. An extra group of 92 participants with similar backgrounds (but didn’t participate in the final experiment) were invited to watch all 16 short videos. They were then asked to finish a survey that evaluated each video in terms of information quality, source credibility, and attractiveness. The measurement of information quality was a seven-item scale (e.g., “The information presented in the video is scientific”) adapted from Pee ( 2012 ). Source credibility was assessed by a five-item scale (e.g., “This account has a good reputation”) adapted from Ohanian ( 1990 ). A three-item scale (e.g., “This video has various ways for expression”) from Yang and Chen ( 2020 ) was used to measure media richness. The sum of the item scores was used to perform the statistical test in each of the three variables. Results from independent t -test supported the effective manipulation of experiment conditions, by indicating a significant difference between videos with high and low information quality ( t = −2.528, p = 0.013), source credibility ( t = −2.766, p = 0.007), and media richness ( t = −2.766, p < 0.001). Table 1 indicates the details results of the manipulation check.

Measurement

The main outcomes measured in this experiment were attitude toward HPV vaccine information and HPV vaccination intent. Four items of attitude toward HPV vaccine information were originally from Bhattacherjee and Sanford ( 2006 ) but modified to fit the current context. It assessed whether participants perceived the HPV vaccine information as objective, safe, comfortable, and reliable for decision-making. Six items of HPV vaccination intent were developed based on scales from Gerend and Shepherd ( 2007 ) and Fu ( 2015 ), to measure the likelihood that participants would try to get more information about and/or consider getting the HPV vaccine once it is available. A seven-Likert scale ranging from strongly disagree (1) to strongly agree (7) was used to measure all the question items. Both attitudes toward HPV vaccine information and HPV vaccination intent resulted in good reliability in the current study, with a Cronbach’s α of 0.833 and 0.892, respectively. Good convergent validity and discriminant validity were further reported among these two outcome measurements (see Appendix 2 ).

Table 2 demonstrates the descriptive statistics of outcome measures in all eight experiment conditions. Path analysis was applied to examine the proposed model and test the persuasive effects of the three factors, i.e., information quality, source credibility, and media richness. Path analysis is a form of multiple regression statistical analysis that is commonly used to evaluate causal models. Different from those in cross-sectional studies, the model in the current study involved experimentally manipulated independent variables. Thus, we followed the guidelines from Bollen ( 1989 ) and MacCallum and Austin ( 2000 ), to model the relationships of the categorical exogenous (predictor) variables to mediators and outcomes. The path analysis was conducted in Mplus version 6.0.

Hypotheses testing

Before the model examination, goodness-of-fit was first assessed to determine how the proposed model fits the actual data. Similar to previous studies (Li et al., 2020 ; Xu et al., 2016 ), multiple fit statistics were used including the Chi-square test, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR). The recommended values of good fit in these indices were adopted from prior literature (Bentler, 1990 ; Hu and Bentler, 1990 ; Steiger and Lind, 1980 ), and demonstrated in Table 3 . Based on the recommended criteria, the proposed model has resulted in a good fit for data (refer to Table 3 ). Figure 3 shows the estimations of the path coefficient and hypotheses testing results. Particularly, regarding the central route, significant positive effects of information quality in MSV were observed on attitude toward HPV vaccine information ( β = 0.242, p = 0.004), and HPV vaccination intent ( β = 0.191, p = 0.007), thereby supporting H2a and H2b. Regarding the peripheral route, the positive effects of source credibility and media richness of MSV on attitude toward HPV vaccine information were also significant, with β = 0.188, p = 0.008, and β = 0.193, p = 0.021, respectively. Similar persuasive effects of source credibility and media richness were also found on HPV vaccination intent, with β = 0.219, p = 0.002, and β = 0.181, p = 0.040, respectively. Thus H3a, H3b, H4a, and H4b were supported. Lastly, H1 was strongly supported by a significant path from the attitude toward HPV vaccine information to HPV vaccination intent ( β = 0.464, p < 0.001).

Note. Path coefficients are standardized. The solid line indicates a significant path with * p < 0.05, ** p < 0.01, *** p < 0.001.

The mediation role of attitude toward HPV vaccine information was further examined on Mplus with Andrew Hayes’ PROCESS analysis, followed by the guideline from Stride et al. ( 2015 ). Findings from the mediation tests indicated a strong indirect effect of information quality on HPV vaccination intent via medication of attitude toward HPV vaccine information ( β = 0.452, p < 0.001). Similar results were also found on the mediation effects of source credibility ( β = 0.458, p < 0.001) and media richness ( β = 0.427, p < 0.001). Consequently, H2c, H3c, and H4c were supported.

A significantly large R 2 of 0.435 in HPV vaccination intent was reported in the model. It demonstrated that 43.5% of the unique variance of HPV vaccination intent was explained by the independent and mediating variables mentioned above. Generally, the findings have revealed significant persuasive impacts of three factors on people’s decision-making process toward HPV vaccine, indicating that MSV with high information quality, source credibility, and media richness would lead to a more positive attitude toward HPV vaccine information among the audience, and further increase their likelihood to go for HPV vaccination.

Interaction effects

A series of multiple-way analyses of variance (ANOVA) was conducted in IBM SPSS, to examine the RQ of interaction effects among the three factors. Findings from the three-way ANOVA did not indicate a significant three-way interaction effect among three factors on HPV vaccination intent ( p = 0.067). Nevertheless, a significant two-way interaction effect was observed between information quality and media richness ( F (1239) = 68.793, p < 0.001, η 2 = 0.224) on HPV vaccination intent. These results suggested that the persuasive effect of media richness varied across different levels of information quality, such that MSV with richer visual and audio cues tended to be even more persuasive in promoting HPV vaccination if they communicated high information quality when compared to those with limited cues. The two-way interaction between source credibility and media richness is approaching significant ( F (1239) = 3.779, p = 0.053, η 2 = 0.016), releasing a similar conclusion on HPV vaccination intent. However, this significant two-way interaction effect was not found between information quality and source credibility ( p = 0.065). The results of ANOVAs are further shown in Table 4 .

This study seeks to investigate if and how HPV vaccine information delivered via mobile short videos (MSVs) can persuade individuals to decide to get the HPV vaccine. By varying the form of information quality, source credibility, and media richness, it provides valuable insights into how health professionals can best adopt emerging social media to maximize their persuasive effects in health education and promotion. Additionally, this research applies the theoretical lenses of the elaboration likelihood model (ELM) and media richness theory to understand the persuasive mechanisms of short-form videos in this health context. Primary results indicate that the quality of health content communicated in MSVs has a direct impact on individuals’ protective behavioral intentions and an indirect impact through changing their attitudes toward health information. This aligns with the central route of the ELM (Petty and Cacioppo, 1986 ) and confirms the role of information quality as a major determinant of health behavioral intentions on the new medium of MSVs. Health messages with strong arguments and clear evidence have been reported to be more persuasive in previous research (Goh and Chi, 2017 ; Lin et al., 2017 ). Our study further demonstrates that health messages with high argument quality of HBM constructs are more persuasive than those with low argument quality. The findings can inspire health professionals to develop better educational materials on social media to encourage HPV vaccination or other similar protective health behaviors.

Consistent with prior findings (Lin et al., 2017 ; Niu et al., 2020 ), short videos featuring health professionals were more persuasive than those featuring laypersons in affecting attitudes toward HPV vaccine information and HPV vaccination intent. In the case of health messages related to a major cancer risk, the presence of a credible and authorized communicator might be considered evidence of argument quality (Petty and Cacioppo, 1984 ), leading to increasingly positive attitudes toward the messages and the subsequent health behaviors they advocate. Additionally, source credibility was reported to be the most critical predictor of HPV vaccination intent. This finding represents an important step forward in revealing the role of source credibility in the new form of video-based media. Unlike traditional online videos, the success of MSVs relies on the core concept of “fast entertainment.” With limited video length and bitrate, users are not expected to spend much time and cognitive effort processing the content. Instead, they may rely more on peripheral cues, such as source credibility, to judge an argument within a limited time period without deep cognitive elaboration. This reliance on peripheral cues highlights the significant impact of source credibility in influencing viewers’ attitudes and behavioral intentions.

The findings also shed light on how media use influences individuals’ perceptions and decisions regarding health behaviors. Consistent with previous studies (Mohamad, 2020 ; Perrault and Silk, 2014 ; Yen, 2018 ), MSVs with high media richness resulted in more positive attitudes toward HPV vaccine information and increased intent for HPV vaccination. The heightened attention and motivation elicited by multiple visual and audio cues may explain the persuasive impact on attitudes and behavioral intentions. However, this explanation warrants further validation in future studies through proper measurement of attention and motivation. Furthermore, in predicting the persuasive impact, it is crucial to point out a (approaching) significant interaction between source credibility and media richness on HPV vaccination intent. These findings have integrated media richness into the extended ELM framework: For MSVs with multiple cues, connecting to a credible source has proven more effective in enhancing health persuasion for HPV vaccination. One possible explanation is that peripheral cues are more effectively conveyed through media with high cue multiplicity (Gold-Nöteberg, 2004 ). High media richness facilitates the evocation of peripheral cue processes, thereby enhancing message persuasiveness. Robert and Dennis ( 2005 ) argued that individuals presented with complex messages in high-richness environments tend to rely on peripheral cues and avoid cognitive evaluation. While much remains to be explored in this emerging field, this study has illuminated an important mechanism linking media richness and peripheral cues.

Additionally, this study identified a significant interaction between central cues and media richness, indicating that media richness enhances the persuasive effect of promoting HPV vaccination when the presented vaccine information is of high quality. Previous research has primarily focused on distinguishing the influences of information quality and media richness on psychological outcomes (Chen and Chang, 2018 ; Zhang et al., 2021 ), with few exploring their interaction effects within an integrated framework. This study addresses this gap by demonstrating how these two distinct characteristics collaborate to shape decision-making processes. In the context of MSVs, while high media richness enhances communication efficiency, it also presents the challenge of managing a large volume of HPV vaccine information within a short period. The abundance of novel and complex information conveyed through high-richness media increases the likelihood of information overload among recipients (Schneider, 1987 ). However, information overload can be mitigated through the delivery of accurate and clear information (Kugbey et al., 2019 ). Thus, high information quality may amplify the persuasive impact of media richness by reducing information overload. This finding holds significant implications for public health campaigns aiming to effectively communicate high-quality health messages using rich media with multiple cues.

Limitations and implications

Several limitations were identified in this study. The primary limitation is the relatively short intervention duration, which was primarily due to constraints in time and manpower. Future research could enhance validity by allowing for longer intervention periods to determine the optimal frequency of MSVs for health persuasion. Additionally, although the study interventions aimed to simulate real-world contexts, they lacked an important element of MSV—interactivity. Incorporating features such as commenting, liking, or retweeting in experiments could provide insights into the effects of MSVs in a more natural environment. Furthermore, the persuasive effects of MSVs can be significantly influenced by technological features (e.g., screen size, resolution, mobility) of the mobile medium through which they are presented, which were not controlled in this experiment. Future research could improve by systematically testing the effects of these technological variables. Lastly, the study’s use of a sample consisting solely of female students may limit the generalizability of its findings. Future studies should aim to include a broader population encompassing diverse socio-economic backgrounds.

Overall, these findings underscore the importance of information quality, source credibility, and media richness when communicating HPV vaccine information via MSVs. They offer both theoretical insights and practical implications for health persuasion in the evolving digital landscape. From a theoretical perspective, this study establishes a framework integrating ELM and media richness theory to explore their application in promoting HPV vaccination. However, in light of contemporary digital communication advancements, concerns have been raised regarding the adequacy of ELM alone (Kitchen et al., 2014 ). The study’s identification of two-way interaction effects contributes to the existing literature by confirming media richness’s moderating role in both central and peripheral routes to health persuasion. Moreover, the proposed framework extends beyond psychological outcomes to include behavioral intentions. Given the high correlation between intention and actual behavior, it serves as a more reliable indicator of the persuasive impact of health messages. The results also support the mediating role of information attitude in the persuasion process, highlighting how individuals’ beliefs about health information from various sources influence their adoption of healthy behaviors.

Regarding practical implications, the results highlight that MSV is a viable medium for promoting health messages, particularly those related to HPV vaccination. However, different methods of message delivery within short videos significantly influence their behavioral effects. Health professionals and practitioners should therefore prioritize information quality and media richness when developing strategies to disseminate health knowledge through MSVs. Given the brief duration of short videos, effectively presenting comprehensive content with a clear layout becomes crucial for audience persuasion. Theoretical frameworks such as HBM can provide guidance for designing messages. Additionally, Chinese health professionals can leverage emerging short video platforms to create HPV educational materials that utilize visual and audio cues, such as animations or scenario-based presentations, to achieve optimal persuasive effects. Furthermore, while credible and authorized sources are perceived as more persuasive than lay sources, it would be beneficial to post videos using official accounts or indicating affiliation with reputable organizations. Although not fully explored in this study, a combination of these strategies holds promise for maximizing the persuasive impact of MSVs in health promotion.

In conclusion, this study has delved into the effectiveness of using MSV to promote HPV vaccination, focusing on the interaction of information quality, source credibility, and media richness. By applying the ELM and media richness theory, we have uncovered significant insights into the persuasive mechanisms at play in this emerging digital health communication context. Our findings underscored that the quality of health information conveyed through short videos directly influences individuals’ protective behavioral intentions towards HPV vaccination. Moreover, the presence of credible sources, particularly health professionals, enhanced positive attitudes and intentions toward vaccination. Furthermore, the role of media richness emerged prominently, with higher levels of visual and auditory cues in MSVs correlating positively with increased attitude change and behavioral intent. The integration of peripheral cues, facilitated by media richness, was found to augment the persuasive impact of health messages, particularly when paired with high-quality health information. Overall, this research contributes to both theoretical advancements in digital health communication and practical guidance for leveraging emerging media formats to promote public health initiatives effectively.

Data availability

All analyzed data during this study are included in this published article and its supplementary information files. Other raw data are available from the corresponding author upon reasonable request.

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Research on K-12 maker education in the early 2020s – a systematic literature review

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Published: 27 August 2024

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Sini Davies ORCID: orcid.org/0000-0003-3689-7967 1 &
Pirita Seitamaa-Hakkarainen ORCID: orcid.org/0000-0001-7493-7435 1

This systematic literature review focuses on the research published on K-12 maker education in the early 2020s, providing a current picture of the field. Maker education is a hands-on approach to learning that encourages students to engage in collaborative and innovative activities, using a combination of traditional design and fabrication tools and digital technologies to explore real-life phenomena and create tangible artifacts. The review examines the included studies from three perspectives: characteristics, research interests and findings, previous research gaps filled, and further research gaps identified. The review concludes by discussing the overall picture of the research on maker education in the early 2020s and suggesting directions for further studies. Overall, this review provides a valuable resource for researchers, educators, and policymakers to understand the current state of K-12 maker education research.

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Introduction

Maker culture developed through the pioneering efforts of Papert ( 1980 ) and his followers, such as Blikstein ( 2013 ), Kafai and Peppler ( 2011 ), and Resnick ( 2017 ). It has gained popularity worldwide as an educational approach to encourage student engagement in learning science, technology, engineering, arts, and mathematics (STEAM) (Martin, 2015 ; Papavlasopoulou et al., 2017 ; Vossoughi & Bevan, 2014 ). Maker education involves engaging students to collaborate and innovate together by turning their ideas into tangible creations through the use of conceptual ideas (whether spoken or written), visual representations such as drawings and sketches, and material objects like prototypes and models (Kangas et al., 2013 ; Koh et al., 2015 ). Another core aspect of maker education is combining traditional design and fabrication tools and methods with digital technologies, such as 3D CAD and 3D printing, electronics, robotics, and programming, which enables students to create multifaceted artifacts and hybrid solutions to their design problems that include both digital and virtual features (e.g., Blikstein, 2013 ; Davies et al., 2023 ; Riikonen, Seitamaa-Hakkarainen, et al., 2020 ). The educational value of such multi-dimensional, concrete making has become widely recognized (e.g., Blikstein, 2013 ; Kafai, 1996 ; Kafai et al., 2014 ; Martin, 2015 ).

Maker education has been studied intensively, as indicated by several previous literature reviews (Iivari et al., 2016 ; Lin et al., 2020 ; Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ; Schad & Jones, 2020 ; Vossoughi & Bevan, 2014 ; Yulis San Juan & Murai, 2022 ). These reviews have revealed how the field has been evolving and provided a valuable overall picture of the research on maker education before the 2020s, including only a few studies published in 2020 or 2021. However, the early years of the 2020s have been an extraordinary period in time in many ways. The world was hit by the COVID-19 pandemic, followed by the global economic crises, increasing geopolitical tensions, and wars that have had a major impact on societies, education, our everyday lives, and inevitably on academic research as well. Furthermore, 2023 was a landmark year in the development of artificial intelligence (AI). In late 2022, OpenAI announced the release of ChatGPT 3.5, a major update to their large language model that is able to generate human-like text. Since then, sophisticated AI systems have rushed into our lives at an accelerating speed and are now becoming integrated with other technologies and applications, shaping how we live, work, our cultures, and our environments irreversibly (see, e.g., World Economic Forum, 2023 ). Thus, it can be argued that towards the end of 2023, the world had transitioned into the era of AI. It is essential that researchers, educators, and policymakers have a fresh overall understanding and a current picture of research on K-12 maker education to develop new, research-based approaches to technology and design education in the present rapidly evolving technological landscape of AI. This is especially important in order to avoid falling back towards shallow epistemic and educational practices of repetition and reproduction. The present systematic review was conducted to provide a ‘big picture’ of the research on K-12 maker education published in the extraordinary times of the early 2020s and to act as a landmark between the research on the field before and after the transition to the AI era. The review was driven by one main research question: How has the research on maker education developed in the early 2020s? To answer this question, three specific research questions were set:

What were the characteristics of the studies in terms of geographical regions, quantity of publications, research settings, and research methods?.

What were the research interests and findings of the reviewed studies?.

How did the reviewed studies fulfill the research gaps identified in previous literature reviews, and what further research gaps they identified?.

The following will outline the theoretical background of the systematic literature review by examining previous literature reviews on maker culture and maker education. This will be followed by an explanation of the methodologies used and findings. Finally, the review will conclude by discussing the overall picture of the research on maker education in the early 2020s and suggesting directions for further studies.

Previous literature reviews on maker culture and maker education

Several literature reviews have been conducted on maker education over the past ten years. The first one by Vossoughi and Bevan ( 2014 ) concentrated on the impact of tinkering and making on children’s learning, design principles and pedagogical approaches in maker programs, and specific tensions and possibilities within the maker movement for equity-oriented teaching and learning. They approached the maker movement in the context of out-of-school time STEM from three perspectives: (1) entrepreneurship and community creativity, (2) STEM pipeline and workforce development, and (3) inquiry-based education. At the time of their review, the research on maker education was just emerging, and therefore, their review included only a few studies. The review findings highlighted how STEM practices were developed through tinkering and striving for equity and intellectual safety (Vossoughi & Bevan, 2014 ). Furthermore, they also revealed how making activities support new ways of learning and collaboration in STEM. Their findings also pointed out some tensions and gaps in the literature, especially regarding a focus that is too narrow on STEM, tools, and techniques, as well as a lack of maker projects conducted within early childhood education or families.

In subsequent literature reviews (Iivari et al., 2016 ; Lin et al., 2020 ; Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ; Schad & Jones, 2020 ; Yulis San Juan & Murai, 2022 ), the interests of the reviews were expanded. Iivari and colleagues ( 2016 ) reviewed the potential of digital fabrication and making for empowering children and helping them see themselves as future digital innovators. They analyzed the studies based on five conditions: conditions for convergence, entry, social support, competence, and reflection, which were initially developed to help with project planning (Chawla & Heft, 2002 ). Their findings revealed that most of the studies included in their review emphasized the conditions for convergence, entry, and competence. However, only a few studies addressed the conditions for social support and reflection (Iivari et al., 2016 ). The reviewed studies emphasized children’s own interests and their voluntary participation in the projects. Furthermore, the studies highlighted projects leading to both material and learning-related outcomes and the development of children’s competencies in decision-making, design, engineering, technology, and innovation through projects.

Papavlasopoulou and colleagues ( 2017 ) took a broader scope on their systematic literature review, characterizing the overall development and stage of research on maker education through analyzing research settings, interests, and methods, synthesizing findings, and identifying research gaps. They were specifically interested in the technology used, subject areas that implement making activities, and evaluation methods of making instruction across all levels of education and in both formal and informal settings. Their data comprised 43 peer-reviewed empirical studies on maker-centered teaching and learning with children in their sample, providing participants with any making experience. In Papavlasopoulou and colleagues’ ( 2017 ) review, the included studies were published between 2011 and November 2015 as journal articles, conference papers, or book chapters. Most of the studies were conducted with fewer than 50 participants ( n = 34), the most prominent age group being children from the beginning of primary school up to 14 years old ( n = 22). The analyzed studies usually utilized more than one data collection method, mainly focusing on qualitative ( n = 22) or mixed method ( n = 11) approaches. Most included studies focused on programming skills and computational thinking ( n = 32) or STEM subjects ( n = 6). The studies reported a wide range of positive effects of maker education on learning, the development of participants’ self-efficacy, perceptions, and engagement (Papavlasopoulou et al., 2017 ). There were hardly any studies reporting adverse effects.

Schad and Jones ( 2020 ) focused their literature review on empirical studies of the maker movement’s impacts on formal K12 educational environments, published between 2000 and 2018. Their Boolean search (maker movement AND education) to three major academic research databases resulted in 599 studies, of which 20 were included in the review. Fourteen of these studies focused on K12 students, and six on K12 teachers. All but three of the studies were published between 2014 and 2018. Similarly to the studies reported in the previous literature reviews (Iivari et al., 2016 ; Papavlasopoulou et al., 2017 ; Vossoughi & Bevan, 2014 ), the vast majority of the studies were qualitative studies that reported positive opportunities for maker-centered approaches in STEM learning and promotion of excitement and motivation. On the other hand, the studies on K12 in- and preservice teacher education mainly focused on the importance of offering opportunities for teachers to engage in making activities. Both, studies focused on students or teachers, promoting equity and offering equally motivating learning experiences regardless of participants’ gender or background was emphasized.

Lin and colleagues’ ( 2020 ) review focused on the assessment of maker-centered learning activities. After applying inclusion and exclusion criteria, their review consisted of 60 peer-reviewed empirical studies on making activities that included making tangible artifacts and assessments to measure learning outcomes. The studies were published between 2006 and 2019. Lin and colleagues ( 2020 ) also focused on all age groups and activities in both formal and informal settings. Most studies included applied STEM as their main subject domain and utilized a technology-based platform, such as LilyPad Arduino microcontroller, Scratch, or laser cutting. The results of the review revealed that in most studies, learning outcomes were usually measured through the assessment of artifacts, tests, surveys, interviews, and observations. The learning outcomes measured were most often cognitive skills on STEM-related content knowledge or students’ feelings and attitudes towards STEM or computing.

The two latest systematic reviews, published in 2022, also focused on specific research interests in maker education (Rouse & Rouse, 2022 ; Yulis San Juan & Murai, 2022 ). Rouse and Rouse ( 2022 ) reviewed studies that specifically investigated learning in preK-12 maker education in formal school-based settings. Their analysis included 22 papers from seven countries, all but two published between 2017 and 2019. Only two of the studies focused on early childhood education, and three involved participants from the elementary level. Like previous reviews, most studies were conducted with qualitative methods ( n = 17). On the other hand, in contrast to the earlier reviews (Lin et al., 2020 ; Papavlasopoulou et al., 2017 ; Schad & Jones, 2020 ), the studies included in the review did not concentrate on content-related outcomes on STEM or computing. Instead, a wide range of learning outcomes was investigated, such as 21st-century skills, agency, and materialized knowledge. On the other hand, they found that equity and inclusivity were not ubiquitously considered when researchers design makerspace interventions. Yulis San Juan and Murai’s ( 2022 ) literature review focused on frustration in maker-centered learning activities. Their analysis consisted of 28 studies published between 2013 and 2021. Their findings of the studies identified six factors that are most often recognized as the causes of frustration in makerspace activities: ‘unfamiliar pedagogical approach, time constraints, collaboration, outcome expectations, lack of skills and knowledge, and tool affordances and availability’ (Yulis San Juan & Murai, 2022 , p. 4).

From these previous literature reviews, five significant research gaps emerged that required further investigation and attention:

Teacher training, pedagogies, and orchestration of learning activities in maker education (Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ; Schad & Jones, 2020 ; Vossoughi & Bevan, 2014 ).

Wide variety of learning outcomes that potentially emerge from making activities, as well as the development of assessment methods and especially systematic ways to measure student learning (Lin et al., 2020 ; Rouse & Rouse, 2022 ; Schad & Jones, 2020 ).

Equity and inclusivity in maker education (Rouse & Rouse, 2022 ; Vossoughi & Bevan, 2014 ).

Practices, tools, and technologies used in makerspaces and digital fabrication (Iivari et al., 2016 ; Papavlasopoulou et al., 2017 ).

Implementation and effects of maker education in formal, school-based settings and specific age groups, especially early childhood education (Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ).

Methodology

This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, adapting it to educational settings where studies are conducted with qualitative, quantitative, and mixed methods (Page et al., 2021 ; Tong et al., 2012 ). Review protocols were defined for data collection, inclusion, exclusion, and quality criteria and the data analysis. In the following, the method used for each stage of the review process will be defined in detail.

Data collection

To gather high-quality and comprehensive data, a search for peer-reviewed articles was conducted in three international online bibliographic databases: Scopus, Education Resources Information Center (ERIC), and Academic Search Complete (EBSCO). Scopus and EBSCO are extensive multi-disciplinary databases for research literature, covering research published in over 200 disciplines, including education, from over 6000 publishers. ERIC concentrates exclusively on educational-related literature, covering publications from over 1900 full-text journals. These three databases were considered to offer a broad scope to capture comprehensive new literature on K-12 maker education. The search aimed to capture peer-reviewed literature on maker education and related processes conducted in both formal and informal K-12 educational settings. The search was limited to articles published in English between 2020 and 2023. Major search terms and their variations were identified to conduct the search, and a Boolean search string was formed from them. The search was implemented in October 2023 with the following search string that was used to search on titles, abstracts, and keywords:

(“maker education” OR “maker pedagogy” OR “maker-centered learning” OR “maker centered learning” OR “maker-centred learning” OR “maker centred learning” OR “maker learning” OR “maker space*” OR makerspace* OR “maker culture” OR “design learning” OR “maker practices” OR “collaborative invention*” OR co-invention*) AND (“knowledge-creation” OR “knowledge creation” OR “knowledgecreation” OR maker* OR epistemic OR “technology education” OR “design-based learning” OR “design based learning” OR “designbased learning” OR “design learning” OR “design thinking” OR “codesign” OR “co-design” OR “co design” OR craft* OR tinker* OR “collaborative learning” OR inquiry* OR “STEAM” OR “project-based learning” OR “project based learning” OR “projectbased learning” OR “learning project*” OR “knowledge building” OR “making” OR creati* OR innovat* OR process*) AND (school* OR pedago* OR “secondary education” OR “pre-primary education” OR “primary education” OR “special education” OR “early childhood education” OR “elementary education” OR primary-age* OR elementary-age* OR “k-12” OR “youth” OR teen* OR adolescen* OR child* OR “tween”) .

Inclusion and exclusion criteria

The search provided 700 articles in total, 335 from Scopus, 345 from EBSCO, and 20 from ERIC that were aggregated to Rayyan (Ouzzani et al., 2016 ), a web and mobile app for systematic reviews, for further processing and analysis. After eliminating duplicates, 513 studies remained. At the next stage, the titles and abstracts of these studies were screened independently by two researchers to identify papers within the scope of this review. Any conference papers, posters, work-in-progress studies, non-peer-reviewed papers, review articles, and papers focusing on teacher education or teachers’ professional development were excluded from the review. To be included, the study had to meet all the following four inclusion criteria. It had to:

show empirical evidence.

describe any making experience or testing process conducted by the participants.

include participants from the K-12 age group in their sample.

have an educational purpose.

For example, studies that relied purely on statistical data collected outside a maker educational setting or studies that described a maker space design process but did not include any research data from an actual making experience conducted by participants from the K-12 age group were excluded. Studies conducted both in formal and informal settings were included in the review. Also, papers were included regardless of whether they were conducted using qualitative, quantitative, or mixed methods. After the independent screening process, the results were combined, and any conflicting assessments were discussed and settled. Finally, 149 studies were included to be retrieved for further evaluation of eligibility, of which five studies were not available for retrieval. Thus, the screening resulted in 144 included studies with full text retrieved to apply quality criteria and further analysis.

Quality criteria

The quality of each of the remaining 144 studies was assessed against the Critical Appraisal Skills Programme’s ( 2023 ) qualitative study checklist, which was slightly adjusted for the context of this review. The checklist consisted of ten questions that each address one quality criterion:

Was there a clear statement of the aims of the research?.

Are the methodologies used appropriate?.

Was the research design appropriate to address the research aims?.

Was the recruitment strategy appropriate to the aims of the research?.

Was the data collected in a way that addressed the research issue?.

Has the relationship between the researcher and participants been adequately considered?.

Have ethical issues been taken into consideration?.

Was the data analysis sufficiently rigorous?.

Is there a clear statement of findings?.

How valuable is the research?.

The first author assessed the quality by reading each study’s full text. To be included in the final analysis, the study had to meet both the inclusion-exclusion and the quality criteria. In this phase, the final assessment for eligibility, 50 studies were excluded due to not meeting the initial inclusion and exclusion criteria, and 32 studies for not filling the criteria for quality. A total of 62 studies were included in the final analysis of this literature review. The PRISMA flow chart (Haddaway et al., 2022 ; see also Page et al., 2021 ) of the study selection process is presented in Fig. 1 .

PRISMA study selection flow chart (Haddaway et al., 2022 )

Qualitative content analysis of the reviewed studies

The analysis of the studies included in the review was conducted through careful reading of the full texts of the articles by the first author. To answer the first research question: What were the characteristics of the studies in terms of geographical regions, quantity of publications, research settings, and methods; a deductive coding framework was applied that consisted of characterizing factors of the study, its research setting as well as data collection and analysis methods applied. The predetermined categories of the study characteristics and the codes associated with each category are presented in Table 1 . The educational level of the participants was determined by following The International Standard Classification of Education (ISCED) (UNESCO Institute for Statistics, 2012 ). Educational level was chosen instead of an age group as a coding category because, during the first abstract and title screening of the articles, it became evident that the studies describe their participants more often by their educational level than age. The educational levels were converted from national educational systems following the ISCED diagrams (UNESCO Institute for Statistics, 2021 ).

In addition to the deductive coding, the following analysis categories were gathered from the articles through inductive analysis: journal, duration of the project, number of participants, types of research data collected, and specific data analysis methods. Furthermore, the following characteristics of the studies were marked in the data when applicable: if the research was conducted as a case study, usage of control groups, specific focus on minority groups, gifted students, special needs students, or inclusion. Inductive coding and thematic analysis were applied to answer the second research question: what were the research interests and findings of the reviewed studies? The categorization of research interests was then combined with some aspects of the first part of the analysis to reveal further interesting characteristics about the latest developments in the research in maker education.

In the following, the findings of this systematic literature review will be presented for each research question separately.

Characteristics of research in K-12 maker education in the 2020s

Of the studies included in the review, presented in Table 2 and 20 studies were published in 2020, 17 in 2021, 12 in 2022, and 13 in 2023. The slight decline in publications does not necessarily indicate a decline in interest towards maker education but is more likely due to the COVID-19 pandemic that heavily limited hands-on activities and in situ data collection. Compared to the latest wide-scope review on maker education (Papavlasopoulou et al., 2017 ), the number of high-quality studies published yearly appears to be at similar levels to those in the previous reviews. The studies included in the present review were published in 34 different peer-reviewed academic journals, of which 13 published two or more articles.

Regarding the geographic distribution of studies conducted on maker education, the field seems to be becoming more internationally spread. In 2020, the studies mainly published research conducted in either the USA ( n = 6) or Finland ( n = 12), whereas in the subsequent years, the studies were distributed more evenly around the world. However, North America and Scandinavia remained the epicenters of research on maker education, conducting over half of the studies published each year.

Most of the reviewed studies used qualitative methods ( n = 42). Mixed methods were utilized in 13 studies, and quantitative methods in seven. Forty-four studies were described as case studies by their authors, and, on the other hand, a control group was used in four quantitative and two mixed methods studies. The analysis indicated an interesting research shift towards making activities part of formal educational settings instead of informal, extracurricular activities. Of the studies included in this review, 82% ( n = 51) were conducted exclusively in formal educational settings. This contrasts significantly with the previous literature review by Papavlasopoulou and colleagues ( 2017 ), where most studies were conducted in informal settings. Furthermore, Schad and Jones ( 2020 ) identified only 20 studies between 2000 and 2018 conducted in formal educational settings in K12-education, and Rouse and Rouse ( 2022 ) identified 22 studies in similar settings from 2014 to early 2020. In these reviews, nearly all studies done in formal educational settings were published in the last years of the 2010 decade. Thus, this finding suggests that the change in learning settings started to emerge in the latter half of the 2010s, and in the 2020s, maker education in formal settings has become the prominent focus of research. The need for further research in formal settings was one of the main research gaps identified in previous literature reviews (Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ).

In addition to the shift from informal to formal educational settings, the projects studied in the reviewed articles were conducted nearly as often in school and classroom environments ( n = 26) as in designated makerspaces ( n = 28). Only seven of the studied projects took place in other locations, such as youth clubs, libraries, or summer camps. One project was conducted entirely in an online learning environment. Most of the studied projects involved children exclusively from primary ( n = 27) or lower secondary ( n = 26) education levels. Only three studies were done with students in upper secondary education. Like the previous literature reviews, only a few studies concentrated on children in early childhood education (Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ). Three articles reported projects conducted exclusively on early childhood education age groups, and three studies had participants from early childhood education together with children from primary ( n = 2) or lower secondary education ( n = 1).

The number of child participants in the studies varied between 1 and 576, and 14 studies also included teachers or other adults in their sample. The number of participating children in relation to the methods used is presented in Fig. 2 . Most of the qualitative studies had less than 100 children in their sample. However, there were three qualitative studies with 100 to 199 child participants (Friend & Mills, 2021 ; Leskinen et al., 2021 ; Riikonen, Kangas, et al., 2020 ) and one study with 576 participating children (Forbes et al., 2021 ). Studies utilizing mixed methods were either conducted with a very large number of child participants or with less than 100 participants, ranging from 4 to 99. Studies using quantitative methods, on the other hand, in most cases had 50–199 participants ( n = 6). One quantitative study was conducted with 35 child participants (Yin et al., 2020 ). Many studies included participants from non-dominant backgrounds or with special educational needs. However, only two studies focused specifically on youth from non-dominant backgrounds (Brownell, 2020 ; Hsu et al., 2022 ), and three studies focused exclusively on inclusion and students with special needs (Giusti & Bombieri, 2020 ; Martin et al., 2020 ; Sormunen et al., 2020 ). In addition, one study specifically chose gifted students in their sample (Andersen et al., 2022 ).

Child participants in the reviewed studies in relation to the methods used

Slightly over half of the studied projects had only collaborative tasks ( n = 36), 11 projects involved both collaborative and individual tasks, and in 11 projects, the participants worked on their own individual tasks. Four studies did not specify whether the project was built around collaborative or individual tasks. In most cases, the projects involved both traditional tangible tools and materials as well as digital devices and fabrication technologies ( n = 54). In five projects, the students worked entirely with digital design and making methods, and in 3 cases, only with traditional tangible materials. Similarly, the outcomes of the project tasks were mainly focused on designing and building artifacts that included both digital and material elements ( n = 31), or the project included multiple activities and building of several artifacts that were either digital, material, or had both elements ( n = 17). Eleven projects included digital exploration without an aim to build a design artifact as a preparatory activity, whereas one project was based solely on digital exploration as the making activity. Material artifacts without digital elements were made in seven of the studied projects, and six concentrated solely on digital artifact making.

The duration of the projects varied between two hours (Tisza & Markopoulos, 2021 ) and five years (Keune et al., 2022 ). The number of studies in each categorized project duration range, in relation to the methods used, is presented in Fig. 3 . Over half of the projects lasted between 1 month and one year ( n = 35), nine were longer, lasting between 1 and 5 years, and 14 were short projects lasting less than one month. Three qualitative studies and one quantitative study did not give any indication of the duration of the project. Most of the projects of qualitative studies took at least one month ( n = 32), whereas projects in mixed method studies usually were shorter than three months ( n = 10). On the other hand, quantitative studies usually investigated projects that were either shorter than three months ( n = 4) or longer than one year ( n = 2).

Duration of the studied projects in relation to the methods used

A multitude of different types of data was used in the reviewed studies. The data collection methods utilized by at least three reviewed studies are presented in Table 3 . Qualitative studies usually utilized several (2 to 6) different data gathering methods ( n = 31), and all mixed method studies used more than one type of data (2 to 6). The most common data collection methods in qualitative studies were video data, interviews, and ethnographic observations combined with other data, such as design artifacts, photographs, and student portfolios. In addition to the data types specified in Table 3 , some studies used more unusual data collection methods such as lesson plans (Herro et al., 2021b ), the think-aloud protocol (Friend & Mills, 2021 ; Impedovo & Cederqvist, 2023 ), and social networks (Tenhovirta et al., 2022 ). Eleven qualitative studies used only one type of data, mainly video recordings ( n = 9). Mixed method studies, on the other hand, relied often on interviews, pre-post measurements, surveys, and video data. In addition to the data types in Table 3 , mixed-method studies utilized biometric measurements (Hsu et al., 2022 ; Lee, 2021 ), lesson plans (Falloon et al., 2022 ), and teacher assessments (Doss & Bloom, 2023 ). In contrast to the qualitative and mixed method studies, all quantitative studies, apart from one (Yin et al., 2020 ), used only one form of research data, either pre-post measurements or surveys.

The findings of the data collection methods are similar to the previous literature review of Papavlasopoulou and colleagues ( 2017 ) regarding the wide variety of data types used in qualitative and mixed-method studies. However, when compared to their findings on specific types of research data used, video recordings have become the most popular way of collecting data in recent years, replacing interviews and ethnographic observations.

Research interests and findings of the reviewed studies

Seven categories of research interests emerged from the inductive coding of the reviewed studies. The categories are presented in Table 4 in relation to the research methods and educational levels of the participating children. Five qualitative studies, four mixed methods studies, and two quantitative studies had research interests from more than one category. Processes, activity, and practices, as well as sociomateriality in maker education, were studied exclusively with qualitative methods, and, on the other hand, nearly all studies on student motivation, interests, attitudes, engagement, and mindset were conducted with mixed or quantitative methods. In the two biggest categories, most of the studies utilized qualitative methods. Studies conducted with mixed or quantitative methods mainly concentrated on two categories: student learning and learning opportunities and student motivation, interests, attitudes, engagement, and mindset. In the following section, the research interests and findings for each category will be presented in detail.

Nearly half of the reviewed studies ( n = 30) had a research interest in either student learning through making activities in general or learning opportunities provided by such activities. Five qualitative case studies (Giusti & Bombieri, 2020 ; Hachey et al., 2022 ; Hagerman et al., 2022 ; Hartikainen et al., 2023 ; Morado et al., 2021 ) and two mixed method studies (Martin et al., 2020 ; Vuopala et al., 2020 ) investigated the overall educational value of maker education. One of these studies was conducted in early childhood education (Hachey et al., 2022 ), and two in the context of inclusion in primary and lower secondary education (Giusti & Bombieri, 2020 ; Martin et al., 2020 ). They all reported positive findings on the development of children’s identity formation and skills beyond subject-specific competencies, such as creativity, innovation, cultural literacy, and learning skills. The studies conducted in the context of inclusion especially emphasized the potential of maker education in pushing students with special needs to achieve goals exceeding their supposed cognitive abilities (Giusti & Bombieri, 2020 ; Martin et al., 2020 ). Three studies (Forbes et al., 2021 ; Kumpulainen et al., 2020 ; Xiang et al., 2023 ) investigated student learning through the Maker Literacies Framework (Marsh et al., 2018 ). They also reported positive findings on student learning and skill development in early childhood and primary education, especially on the operational dimension of the framework, as well as on the cultural and critical dimensions. These positive results were further confirmed by the reviewed studies that investigated more specific learning opportunities provided by maker education on developing young people’s creativity, innovation skills, design thinking and entrepreneurship (Liu & Li, 2023 ; Timotheou & Ioannou, 2021 ; Weng et al., 2022a , b ), as well as their 21st-century skills (Iwata et al., 2020 ; Tan et al., 2021 ), and critical data literacies and critical thinking (Stornaiuolo, 2020 ; Weng et al., 2022a ).

Studies that investigated subject-specific learning most often focused on STEM subjects or programming and computational thinking. Based on the findings of these studies, maker-centered learning activities are effective but underused (Mørch et al., 2023 ). Furthermore, in early childhood education, such activities may support children taking on the role of a STEM practitioner (Hachey et al., 2022 ) and, on the other hand, provide them access to learning about STEM subjects beyond their grade level, even in upper secondary education (Tofel-Grehl et al., 2021 ; Winters et al., 2022 ). However, two studies (Falloon et al., 2022 ; Forbes et al., 2021 ) highlighted that it cannot be assumed that students naturally learn science and mathematics conceptual knowledge through making. To achieve learning in STEM subjects, especially science and mathematics, teachers need to specifically identify, design, and focus the making tasks on these areas. One study also looked at the effects of the COVID-19 pandemic on STEM disciplines and found the restrictions on the use of common makerspaces and the changes in the technologies used to have been detrimental to student’s learning in these areas (Dúo-Terrón et al., 2022 ).

Only positive findings emerged from the reviewed studies on how digital making activities promote the development of programming and computational thinking skills and practices (Iwata et al., 2020 ; Liu & Li, 2023 ; Yin et al., 2020 ) and understanding of programming methods used in AI and machine learning (Ng et al., 2023 ). Experiences of fun provided by the making activities were also found to enhance further student learning about programming (Tisza & Markopoulos, 2021 ). One study also reported positive results on student learning of academic writing skills (Stewart et al., 2023 ). There were also three studies (Brownell, 2020 ; Greenberg et al., 2020 ; Wargo, 2021 ) that investigated the potential of maker education to promote equity and learning about social justice and injustice, as well as one study that examined learning opportunities on sustainability (Impedovo & Cederqvist, 2023 ). All these studies found making activities and makerspaces to be fertile ground for learning as well as identity and community building around these topics.

The studies with research interests in the second largest category, facilitation and teaching practices ( n = 13), investigated a multitude of different aspects of this area. The studies on assessment methods highlighted the educational value of process-based portfolios (Fields et al., 2021 ; Riikonen, Kangas et al., 2020 ) and connected portfolios that are digital portfolios aligned with a connected learning framework (Keune et al., 2022 ). On the other hand, Walan and Brink ( 2023 ) concentrated on developing and analyzing the outcomes of a self-assessment tool for maker-centered learning activities designed to promote 21st-century skills. Several research interests emerged from the review related to scaffolding and implementation of maker education in schools. Riikonen, Kangas, and colleagues ( 2020 ) investigated the pedagogical infrastructures of knowledge-creating, maker-centered learning. It emphasized longstanding iterative, socio-material projects, where real-time support and embedded scaffolding are provided to the participants by a multi-disciplinary teacher team and ideally also by peer tutors. Multi-disciplinary collaboration was also emphasized by Pitkänen and colleagues ( 2020 ) in their study on the role of facilitators as educators in Fab Labs. Cross-age peer tutoring was investigated by five studies and found to be highly effective in promoting learning in maker education (Kumpulainen et al., 2020 ; Riikonen, Kangas, et al., 2020 ; Tenhovirta et al., 2022 ; Weng et al., 2022a ; Winters et al., 2022 ). Kajamaa and colleagues ( 2020 ) further highlighted the importance of team teaching and emphasized moving from authoritative interaction with students to collaboration. Sormunen and colleagues’ ( 2020 ) findings on teacher support in an inclusive setting demonstrated how teacher-directed scaffolding and facilitation of student cooperation and reflective discussions are essential in promoting inclusion-related participation, collaboration skills, and student competence building. One study (Andersen et al., 2022 ) took a different approach and investigated the possibilities of automatic scaffolding of making activities through AI. They concluded that automated scaffolding has excellent potential in maker education and went as far as to suggest that a transition should be made to it. One study also recognized the potential of combining making activities with drama education (Walan, 2021 ).

Versatile aspects of different processes, activities, and practices in maker-centered learning projects were studied by 11 qualitative studies included in this review. Two interlinked studies (Davies et al., 2023 ; Riikonen, Seitamaa-Hakkarainen et al., 2020 ) investigated practices and processes related to collaborative invention, making, and knowledge-creation in lower secondary education. Their findings highlighted the multifaceted and iterative nature of such processes as well as the potential of maker education to offer students authentic opportunities for knowledge creation. Sinervo and colleagues ( 2021 ) also investigated the nature of the co-invention processes from the point of view of how children themselves describe and reflect their own processes. Their findings showed how children could recognize different external constraints involved in their design and the importance of iterative ideation processes and testing the ideas through prototyping. Innovation and invention practices were also studied by two other studies in both formal and informal settings with children from the primary level of education (Leskinen et al., 2023 ; Skåland et al., 2020 ). Skåland and colleagues’ ( 2020 ) findings suggest that narrative framing, that is, storytelling with the children, is an especially fruitful approach in a library setting and helps children understand their process of inventing. Similar findings were made in the study on the role of play in early childhood maker education (Fleer, 2022 ), where play enhanced design cognition and related processes and helped young children make sense of design. On the other hand, Leskinen and colleagues ( 2023 ) showed how innovations are jointly practiced in the interaction between students and teachers. They also emphasized the importance of using manifold information sources and material elements in creative innovation processes.

One study (Kajamaa & Kumpulainen, 2020 ) investigated collaborative knowledge practices and how those are mediated in school makerspaces. They identified four types of knowledge practices involved in maker-centered learning activities: orienting, interpreting, concretizing, and expanding knowledge, and how discourse, materials, embodied actions, and the physical space mediate these practices. Their findings also showed that due to the complexity of these practices, students might find maker-centered learning activities difficult. The sophisticated epistemic practices involved in collaborative invention processes were also demonstrated by the findings of Mehto, Riikonen, Hakkarainen, and colleagues ( 2020a ). Other investigators examined how art-based (Lindberg et al., 2020 ), touch-related (Friend & Mills, 2021 ), and information (Li, 2021 ) practices affect and can be incorporated into making. All three studies reported positive findings on the effects of these practices on student learning and, on the other hand, on the further development of the practices themselves.

Research interests related to student motivation, interests, attitudes, engagement, and mindset were studied by eight reviewed articles, all conducted with either mixed (n = 6) or quantitative methods (n = 2). The studies that investigated student motivation and engagement in making activities (Lee, 2021 ; Martin et al., 2020 ; Ng et al., 2023 ; Nikou, 2023 ) highlighted the importance of social interactions and collaboration as highly influential factors in these areas. On the other hand, positive attitudes towards collaboration also developed through these activities (Nguyen et al., 2023 ). Making activities conducted in the context of equity-oriented pedagogy were found to have great potential in sustaining non-dominant youths’, especially girls’, positive attitudes toward science (Hsu et al., 2022 ). On the other hand, a similar potential was not found in the development of interest in STEM subjects with autistic students (Martin et al., 2020 ). Two studies investigated student mindsets in maker-centered learning activities (Doss & Bloom, 2023 ; Vongkulluksn et al., 2021 ). Doss and Bloom ( 2023 ) identified seven different student mindset profiles present in making activities. Over half (56.67%) of the students in their study were found to share the same mindset profile, characterized as: ‘Flexible, Goal-Oriented, Persistent, Optimistic, Humorous, Realistic about Final Product’ (Doss & Bloom, 2023 , p. 4). In turn, Vongkulluksn and colleagues ( 2021 ) investigated the growth mindset trends for students who participated in a makerspace program for two years in an elementary school. Their findings revealed positive results of how makerspace environments can potentially improve students’ growth mindset.

Six studies included in this review analyzed collaboration within making activities. Students were found to be supportive and respectful towards each other as well as recognize and draw on each other’s expertise (Giusti & Bombieri, 2020 ; Herro et al., 2021a , b ). The making activities and outcomes were found to act as mediators in promoting mutual recognition between students with varying cognitive capabilities and special needs in inclusive settings (Herro et al., 2021a ). Furthermore, a community of interest that emerges through collaborative making activities was also found to be effective in supporting interest development and sustainability (Tan et al., 2021 ). Students were observed to divide work and share roles during their team projects, usually based on students’ interests, expertise, and skills (Herro et al., 2021a , b ). The findings of Stewart et al.‘s ( 2023 ) study suggested that when roles are preassigned to the team members by teachers, it decreases student stress in maker activities. However, if dominating leadership roles emerged in a team, that was found to lead to less advanced forms of collaboration than shared leadership within the team (Leskinen et al., 2021 ).

Sociomaterial aspects of making activities were in the interest of three reviewed studies (Kumpulainen & Kajamaa, 2020 ; Mehto et al., 2020a ; Mehto et al., 2020b ). Materials were shown to have an active role in knowledge-creation and ideation in open-ended maker-centered learning (Mehto et al., 2020a ), which allows for thinking together with the materials (Mehto et al., 2020b ). The task-related physical materials act as a focal point for team collaboration and invite participation (Mehto et al., 2020b ). Furthermore, a study by Kumpulainen and Kajamaa ( 2020 ) emphasized the sociomaterial dynamics of agency, where agency flows in any combination between students, teachers, and materials. However, the singularity or multiplicity of the materials potentially affects the opportunities for access and control of the process (Mehto et al., 2020b ).

In addition to empirical research interests, five studies focused on developing research methods for measuring and analyzing different aspects of maker education. Biometric measurements were investigated as a potential data source to detect engagement in making activities (Lee, 2021 ). Yin and colleagues ( 2020 ) focused on developing instruments for the quantitative measurement of computational thinking skills. On the other hand, Timotheou and Ioannou ( 2021 ) designed and tested an analytic framework and coding scheme to analyze learning and innovation skills from qualitative interviews and video data. Artificial intelligence as a potential, partially automated tool for analyzing CSCL artifacts was also investigated by one study (Andersen et al., 2022 ). Finally, Riikonen, Seitamaa-Hakkarainen, and colleagues ( 2020 ) developed visual video data analysis methods for investigating collaborative design and making activities.

Slightly over half of the reviewed studies ( n = 33) made clear suggestions for future research. Expectedly, these studies suggested further investigation of their own research interests. However, across the studies, five themes of recommendations for future research interests and designs emerged from the data:

1. Studies conducted with diverse range of participants , pedagogical designs , and contexts (Hartikainen et al., 2023 ; Kumpulainen & Kajamaa, 2020 ; Leskinen et al., 2023 ; Lindberg et al., 2020 ; Liu & Li, 2023 Martin et al., 2020 ; Mehto et al., 2020b ; Nguyen et al., 2023 ; Sormunen et al., 2020 ; Tan et al., 2021 ; Weng et al., 2022a , b ; Yin et al., 2020 ).

2. Longitudinal studies to confirm the existing research findings, further develop pedagogical approaches to making, and to better understand the effects of maker education on students later in their lives (Davies et al., 2023 ; Fields et al., 2021 ; Kumpulainen et al., 2020 ; Kumpulainen & Kajamaa, 2020 ; Stornaiuolo, 2020 ; Tisza & Markopoulos, 2021 ; Walan & Brink, 2023 ; Weng et al., 2022a ).

3. Development of new methods and applying existing methods in different conditions (Doss & Bloom, 2023 ; Kumpulainen et al., 2020 ; Leskinen et al., 2021 ; Mehto et al., 2020b ; Mørch et al., 2023 ; Tan et al., 2021 ; Timotheou & Ioannou, 2021 ; Tisza & Markopoulos, 2021 ).

4. Identifying optimal conditions and practices for learning, skill, and identity development through making (Davies et al., 2023 ; Fields et al., 2021 ; Hartikainen et al., 2023 ; Tofel-Grehl et al., 2021 ).

5. Collaboration from the perspectives of how it affects processes and outcomes of making activities and, on the other hand, how such activities affect collaboration (Pitkänen et al., 2020 ; Tisza & Markopoulos, 2021 ; Weng et al., 2022a ).

Discussion and conclusions

This systematic literature review was conducted to describe the development of research on maker education in the early 2020s. Sixty-two studies from the initial 700 studies identified from the three major educational research databases were included in the review. The qualitative analysis of the reviewed studies revealed some interesting developments in the field. Overall, the research on maker education appears to be active. Maker education seems to be attracting interest from researchers around the globe. However, two epicenters of research, North America and Scandinavia, namely Finland, appear to have an active role in maker research.

Most studies relied on rich qualitative data, often collected using several methods. Video recordings have become a popular way to collect data in maker education research. Although qualitative methods remained the dominant methodological approach in the field (Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ; Schad & Jones, 2020 ), mixed and quantitative methods were used in nearly a third of the reviewed studies. These studies mainly measured learning outcomes or participants’ motivation, interests, attitudes, engagement, and mindsets. There was a great variety in the duration of the maker projects and the number of participants. The projects lasted from less than a day up to five years, and the number of participants varied similarly from one to nearly six hundred. Methodological development was also within the research interests of several studies in this review. Developments were made both in qualitative and quantitative methodologies. Such methodological development was one of the research gaps identified in the previous literature reviews (e.g., Schad & Jones, 2020 ).

The analysis of the reviewed studies revealed an interesting shift in research on maker education from informal settings to formal education. Our review revealed that most studies were conducted exclusively in formal education and often as part of the curricular activity. The need for this development was called for in the previous literature reviews (Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ). However, only a handful of studies were conducted in early childhood education. Winters and colleagues’ ( 2022 ) study adopted a very interesting setting where children from early childhood education worked together and were mentored by students from lower secondary education. This type of research setting could have great potential for future research in maker education.

Another research gap identified in the previous literature reviews was the need to study and measure a wide variety of potential learning opportunities and outcomes of maker education (Lin et al., 2020 ; Rouse & Rouse, 2022 ; Schad & Jones, 2020 ). The analysis revealed that new research in the field is actively filling this gap. Skills that go beyond subject-specific content and the development of participants’ identities through making activities were especially actively studied from various perspectives. The findings of these studies were distinctively positive, corresponding with the conclusions of the previous literature reviews (e.g., Papavlasopoulou et al., 2017 ; Schad & Jones, 2020 ; Vossoughi & Bevan, 2014 ). This potential of maker education should be recognized by educators and policymakers, especially when the advancements in AI technologies will forefront the need for the humane skills of working creatively with knowledge and different ways of knowing, empathic engagement, and collaboration (e.g., Liu et al., 2024 ; Markauskaite et al., 2022 ; Qadir, 2023 ; World Economic Forum, 2023 ). Some of these studies also addressed the issue of promoting equity through maker education, which was called for in the previous literature review (Rouse & Rouse, 2022 ; Vossoughi & Bevan, 2014 ). However, considering the small number of these studies, more research will still be needed.

The two other popular research interest categories that emerged from the analysis were facilitation and teaching practices as well as processes, activities, and practices involved in making – both identified as research gaps in the previous literature reviews (Iivari et al., 2016 ; Papavlasopoulou et al., 2017 ; Rouse & Rouse, 2022 ; Schad & Jones, 2020 ; Vossoughi & Bevan, 2014 ). The teaching practices and scaffolding of making activities were investigated from different aspects, such as assessment methods, implementation of maker education in schools, and cross-age peer tutoring. The results of these studies highlighted the positive effects of multi-disciplinary collaboration and peer tutoring. Such pedagogical approaches should be more widely promoted as integral parts of the pedagogical infrastructure in schools. However, this calls for measures from policymakers and school authorities to enable such collaborative ways of teaching that extend beyond the traditional structures of school organizations. Furthermore, although research on this area has been active and multi-faceted, the facilitation of maker education in inclusive settings especially calls for further investigation. In terms of processes, practices, and activities involved in making, the reviewed studies investigated a variety of aspects that revealed the sophisticated epistemic practices involved and the importance of concrete making, prototyping, and iterative ideation in maker-centered learning activities. These studies further highlighted the potential of maker education to offer students authentic opportunities for knowledge creation. Studies also examined collaboration and sociomateriality involved in maker education. Especially sociomateriality is a relatively new, emerging area of research in maker education.

The reviewed studies identified five research gaps that require further investigation: (1) conducting studies with a diverse range of participants, pedagogical designs, and contexts; (2) carrying out longitudinal studies; (3) developing new methods and applying existing methods in different settings; (4) identifying the most effective conditions and practices for learning, skill development and identity formation in maker education, and (5) understanding how collaboration affects the processes and outcomes of making activities and vice versa. In addition to the research gaps identified by reviewed studies, the analysis revealed additional gaps. Studies conducted in early childhood education and inclusive settings remain especially under-represented, although maker pedagogies have been found to have great potential in these areas. Similarly, many researchers have recognized the potential of maker education to promote equality between children from different backgrounds and genders. Still, only a handful of studies investigated these issues. Thus, more research is needed, especially on best practices and pedagogical approaches in this area. Furthermore, the processes involved in and affecting maker-centered learning call for further investigations.

The field has matured based on the analysis of the reviewed studies. It is moving from striving to understand what can be achieved to investigating the underlying conditions behind learning through making, how desired outcomes can be best achieved, as well as how the processes involved in making unfold, what the effects are in the long run, and how to understand best and measure different phenomena related to making. Furthermore, researchers are looking into more and more opportunities to expand the learning opportunities of maker education by combining them with other creative pedagogies and applying them to projects that seek to introduce subject-specific content beyond STEM to students.

This systematic literature review has several limitations. The typical limitations of most review studies, the potential loss of search results due to limited search terms and databases used, apply to this review. For example, more culturally diverse search results might have been reached with the addition of other databases and further search terms. However, the search string was carefully designed and tested to include as many common terms used in maker education research as possible, including possible variations. Furthermore, the three databases used in the search, Scopus, ERIC, and EBSCO, are regarded as the most comprehensive databases of educational research available. Thus, although some studies might not have been identified because of these limitations, it can be assumed that this review gives a comprehensive enough snapshot of research on maker education in the early years of the 2020s.

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Davies, S., Seitamaa-Hakkarainen, P. Research on K-12 maker education in the early 2020s – a systematic literature review. Int J Technol Des Educ (2024). https://doi.org/10.1007/s10798-024-09921-6

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Introducing your findings. The findings chapter is likely to comprise the majority of your paper. It can be up to 40% of the total word count within your dissertation writing. This is a huge chunk of information, so it's essential that it is clearly organised and that the reader knows what is supposed to be happening.
Advocating the Use of Informal Conversations as a Qualitative Method at
Whilst originally identified as a minor part of ethnographic study, scholarly literature in the 2020s has aimed to promote a greater use of the informal conversation method in qualitative research. In agreement with Swain and King (2022), informal conversations create a greater ease of communication and often produce more naturalistic data than ...
Pre-implementation planning for a sepsis intervention in a large
A PhD-level trained qualitative health services researcher (TE) on the study team with experience conducting qualitative research for program evaluations and intervention development led the process of interview instrument design, data collection, and analysis. She was not known to participants of the research prior to undertaking the study.
Critiquing Quantitative vs ( Qualitative Research Articles
One article will be a qualitative research example and the other will be a quantitative research example. (2) Write a critique on one of the articles. Use the template below for your submission. Five sections have been identified. These include the introduction, review of the literature, methodology, findings, and conclusions.
Understanding digital sweatshops: A qualitative investigation of
The small sample size of 17 people might have limited the variety of viewpoints, affecting how broadly the findings can be applied. Future research can be done on a larger sample size to better generalize the findings of the study, and researchers can also use the conceptual model derived from the study and use quantitative tools to establish ...
Navigating sexual minority identity in sport: a qualitative exploration
Sexual minority student-athletes (SMSAs) face discrimination and identity conflicts in intercollegiate sport, impacting their participation and mental health. This study explores the perceptions of Chinese SMSAs regarding their sexual minority identities, aiming to fill the current gap in research related to non-Western countries. A qualitative methodology was adopted, utilising the ...
Towards Defining STEM Professional Identity: A Qualitative Survey Study
This study employed an open-ended qualitative survey research design. Compared to close-ended, selected-response question surveys, this design provided an opportunity for respondents to have maximum flexibility in expressing their beliefs, perceptions, and values about STEM professional identity, which is suitable for exploring the dimensions of STEM identity.
Promoting HPV vaccination: effectiveness of mobile short ...
This study has employed an experiment with a 2 (information quality: high vs. low) × 2 (source credibility: high vs. low) × 2 (media richness: high vs. low) between-subject factorial design to ...
Research on K-12 maker education in the early 2020s
This systematic literature review focuses on the research published on K-12 maker education in the early 2020s, providing a current picture of the field. Maker education is a hands-on approach to learning that encourages students to engage in collaborative and innovative activities, using a combination of traditional design and fabrication tools and digital technologies to explore real-life ...

How to write the analysis and discussion chapters in qualitative (SSAH) research

Look for emerging themes and patterns

Let your data guide you

Work closely with the literature

In conclusion

Share with your colleagues

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Structuring a qualitative findings section

Writing a discussion section

How To Write The Results/Findings Chapter

Overview: Qualitative Results Chapter

What exactly is the results chapter?

What should you include in the results chapter?

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Section 1: Introduction

Section 2: Body

Section 3: Concluding summary

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Pre-implementation planning for a sepsis intervention in a large learning health system: a qualitative study

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Study design

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