Qualitative Research Methods

“As a general rule, practitioners of quantitative investigations, particularly natural scientists, have looked upon qualitative inquiry as less rigorous or objective, less generalizable, and hence less meritorious”

Holman, 1993

Qualitative Vs Quantitative Research - the dichotomy

Qualitative Quantitative

Social theory Action Structure

Methods Observation, Interview

Experiment, Survey

Question What is X ?

(classification)

How many Xs?

(enumeration)

Reasoning Inductive Deductive

Sampling method Theoretical Statistical

Strength Validity Reliability

Qualitative Research

“ a particular tradition in social science that fundamentally depends on watching people in their own territory and interacting with them in their own language, on their own terms” (Kirk and Miller)

“When in doubt, observe and ask questions. When certain, observe at length and ask many more questions.”

“Qualitative inquiry cultivates the most useful of all human capacities- the capacity to learn from others.”

Methods

Participant ObservationKey Informant InterviewsOpen ended InterviewFocus Group Discussions Pile sort

Participant Observation

“insider’s view” of a culture: “emic” approach

an integral part of study of a culture and its practices

Key Informants Interview

Quick insights into a phenomenon“Selecting an ambassador” who represents the best knowledge on a phenomenonFace-to-face interviewsPre-designed format

Assumes a prior knowledge of phenomenon and rests on the knowledge of the “ambassador” Used in conjunction with other methods

In-depth Interviews

Open endedStructuredAbout what people feel and think, how they see events and world around themInformal/ formalPrelude to quantitative assessment to delineate areas of further enquiry

Focus Group Discussions

Theme / topic discussions Informed discussantsRapid method to assess outlook on a topic in a cross-section of representative populationMultiple applicationsFast emerging as an effective technique

Pile - Sort

Informed participants

Quick classification of concepts

Precursor to instrument development and classification

Data Processing

Raw field notes should be corrected

edited and typed

Tape recordings need to be transcribed

and corrected

Texts by field worker should not be changed to

make it ‘write-able’ or ‘readable’

Data Reduction

Process of selecting, focussing, simplifying, abstracting and transforming data from field notes and transcripts

By this researcher retains some data chunks, pulls out some and gets an idea of story to tell

Analysis Steps

Free listing

Domain Evolution

Coding

Tabulation

Summarizing

GHW10 In you opinion, who are the people that generally do not bring their children for polio drops on NIDs ?

Sometimes, it happens that parents are unaware of it (PPI) or neglect it or there are some parents who do not give importance to it or they go outstation. Till now, they have not understood the importance of the polio drops. Some parents feel we have given three doses (routine doses) to our children and if these are not given it is alright. These are the people who don’t bring. Usually they are from slum areas. Others are educated, they know about it, constantly hear on TV/radio, so they bring. The area which I had got was a Mohammedan area. So the women do not go out of the house. They did not even know that it had to be given. There was an announcement through the mosque but people might not have heard or something else, so many children did not turn up. (1316)

GHW10 In you opinion, who are the people that generally do not bring their children for polio drops on NIDs ?

1. Do not know

2. None (everybody received OPV)

3. Laborers / daily wagers / beggars (affordability)

4. No one at home / Adult sickness

5. Migrants / tribal (accessibility / out of station / traveling)

6. People with remote residence / adverse weather / transport difficulties (accessibility)

7. Bad past experience (due to / fear of side effects) / fear of polio even after polio drops acceptability

8. Non believers (no faith / believers of other systems / superstitions / rumors / socio-cultural / religious / death / caste)

9. Misinformed groups (rich / educated / do not like to go to IP / go to practitioner / wrong impression)

10. Lack of Awareness / Illiterate

11. Children with illness / new born (acceptability)

12. Negative influences of the other family members / decision / decision of family members

13. Pampered groups (mop-up)

14. Low motivation / Domestic chores / Low priority (festivals / functions etc.) / many children / female children

Identified Domains

GHW10 In you opinion, who are the people that generally do not bring their children for polio drops on NIDs ?

Sometimes, it happens that (9) parents are unaware of it (PPI) or (13) neglect it or there are some parents who do not give importance to it or (4) they go outstation. (9) Till now, they have not understood the importance of the polio drops. (8) Some parents feel we have given three doses (routine doses) to our children and if these are not given it is alright. These are the people who don’t bring. (2) Usually they are from slum areas. Others are educated, they know about it, constantly hear on TV/radio, so they bring. (7) The area which I had got was a Mohammedan area. So the women do not go out of the house. They did not even know that it had to be given. There was an announcement through the mosque but people might not have heard or something else, so many children did not turn up. (1316)

Quotable Quotes

Give a vivid, meaningful flavor which is far more convincing

than pages of summarized numbers

- These should not be distracters- Should not take the reader away from the real issues in hand

“This is an unprecedented event where all people irrespective of caste, creed and religion take part in PPI program on the same day (NID) throughout the country”

Health worker (150): Burdwan

“He (my husband) told me that everybody is going for polio drops. Then why should we be left out ? After all, everybody is not a fool”

Utilizer (1422): Delhi

“We have not at all immunized our son. My husband was very stubborn. He said ‘those who are immunized are also getting this disease (polio) and whatever happens let it happen’. He has not allowed me to get the child immunized”

Non utilizer (630): Hyderabad

Data Display

This is an organized, compressed assembly of information that

permits conclusion drawing and action

Matrices, graphs, charts and networks are used

SummaryQualitative methods aim to make sense of, or interpret, phenomena in terms of the meanings people bring to them

Qualitative research may define preliminary questions

which can then be addressed in quantitative studies

A good qualitative study will address a clinical

problem through a clearly formulated question and

using more than one research method (triangulation)

Analysis of qualitative data can and should be done

using explicit, systematic, and reproducible methods

Closing remarks

It is not Qualitative vs Quantitative but Qualitative and Quantitative Qualitative methods are rapid, exploratory and hypothesis generating Can be used as Impact evaluation researchAllow the researcher to palpate the unique cross-cultural features

Applying Qualitative Methods in Intervention

Research

Glorian Sorensen, PhD, MPHHarvard School of Public

HealthDana-Farber Cancer InstituteBoston, Massachusetts, USA

OverviewUses of qualitative methodsToolbox of qualitative methodsIntegration of qualitative and quantitative methodsFocus group methodsExamples from my research in the US and India

Qualitative versus quantitative: When to use

what?Qualitative QuantitativeSubject matter is unfamiliar

Subject matter clearly defined

Exploratory research, when relevant concepts are unknown or their definitions unclear

When measurement problems are minor and have been resolved

When meaning rather than frequencies are sought

When detailed numerical description of a representative sample is required

When flexibility of approach is needed to allow for discovery of unexpected; in-depth investigation

When repeatability of measurements is important

For studying selected issues, cases or events in detail

When generalizability of results and comparison across populations is needed

Study design

Research question and guiding theoretical frameworkQualitative research study design and methods

sampling (non-random, purposive, theoretically-based)gaining access choosing data collection methods (interviews, documents, observation, etc)ethical considerationsvalidity

AnalysisReporting

Qualitative methods toolbox

Individual interviews (structured, semi-structured)Group interviews (focus groups and non-focus groups)Observation (participant, unstructured, structured)Document and archive reviews

On combining qualitative and quantitative

Explore or refine constructs for surveysPre-test surveysPre-test intervention materialsPlan for survey administrationInterpret quantitative resultsUnderstand process of change that may be measured through surveys

Illustrative example combining qualitative and

quantitative methods

Research problem: High rates of smoking among construction laborersResearch aims:

conduct formative research to assess smoking patterns and factors associated with smoking among laborersdevelop and test a smoking cessation intervention, using an RCT design

Laborers and smoking: How can qualitative

methods enhance study?

Survey constructs and administrationDevelop intervention strategies and messagesAssess intervention componentsInterpret quantitative study results

Focus groups: What and why?

Facilitated small group discussionExperiences and perspectivesExploring specific area of interest in detail; particularly useful for sensitive topicsInteraction among members is keyNot for generalizing findings

Focus groups vs. other methods

Individual interviews+ multiple perspectives + observe interactions+ participants help each other clarify

ideas- difficult to manage- reluctant to reveal in group setting- social norms influence responses

Focus groups vs. other methods

Observation+ more efficient+ easier access- relying on reports of behavior vs.

actual observations of behavior- not a natural setting

Ethical considerationsInformed consent Provide project description at start of group Clarify confidentiality and anonymity (within group as well)

Application of qualitative methods: Example

Research questionshow do construction laborers view health risks associated with occupational exposures, poor nutrition, and tobacco use?what kinds of health promotion strategies will effective in decreasing in tobacco use and increase in consumption of fruits and vegetables?

Qualitative methodsDirect observation of worksites (for project staff to learn about range of work tasks, and understand where/when/with whom workers smoke, what they eat at break/meals, sources of food)Group and individual interviews (two waves of interviews) Formed a qualitative research working group for project

SamplingObservation: convenience sample; close by; no major differences by regionGroup and individual interviews: stratified by region; include racial/ethnic, gender, and age mix; current and former smokersRecruitment and gaining access: through international union; training sites (bias?)

Topic guide developmentBased on theoretical model we developed by mixing existing models (behavioral theories and work environment policy theory)Working group developed topic guidePilot tested and refined guideRevised throughout data collection (iterative)

Data collection and analysis

Trained staff to conduct interviews and code dataCollected data and almost immediately began analysis:

group discussionscoding (structural and thematic, multiple coders)creation of themes documentrevision of focus group guides retrieving codes for thematic analysis

Application of results to the intervention

Identify themes in qualitative dataDefine intervention methodsIncorporate into intervention messagesReflect in visuals in materialsUse in staff training Apply to quality assurance

Examples within the laborers’ intervention

materialsValue of being fit for work

“Being a Laborer is a demanding job. You face hazards every day, and being healthy and fit enough to meet challenges is important… Being healthy means you’ve got the strength you need to get the job done — and take care of other responsibilities too.” [General President’s introduction to the TFR]

Examples within the laborers’ intervention

materialsValue of family and friends

“Tobacco use can be a problem for your family members and your LIUNA brothers and sisters too. That’s because secondhand smoke causes over 53,000 deaths a year among people who don’t even use tobacco — spouses, co-workers, buddies.”

Examples within the laborers’ intervention

materialsHealth concerns

“…[O]ne thing you can do is make good decisions about your health. Sometimes that means talking to your steward if you’re worried about on-the-job exposures or hazards. Other times, it means taking control of your personal health, and doing what you can to make your body stronger and healthier. This is where [the program counselor] can help.”

Examples within the laborers’ intervention

materials

Planned tobacco control research in India

Analysis of Global School Personnel SurveyFocus groups to elucidate observed relationshipsApply to intervention development

Summary: Applications of qualitative methods in intervention research

Understanding the social context of the populationSurvey developmentIntervention designStaff trainingUnderstanding the process of observed changes

Focus groups: Size and number

Six to eight participantsOver-recruit slightly and reminder about group day beforeThree to five groups per topic of interest Saturation: when stop hearing new info

Constructing a topic guideAvoid close-ended questions: going for experience and perspectivesBased on your research questionsTopic areas, then questions within each topic, list probesStart with icebreakers and “easy” question

Data management and analysis

Transcribe recordings and checkIn-depth analysisAnalysis across groups by theme

Focus groups: CompositionPurposive Sub-groups — return to your research question Homogenous vs. heterogeneous

LogisticsEligibility screeningConducted in primary language of groupLength: 1-2 hours, no moreLocation: convenientTape recordTake notes (note-taker)Incentives

Focus group facilitationTwo people: facilitator and note-takerShow interest and respectIntroduce group members and yourselfActively listen; follow leads but stay “on topic”Encourage between-participant discussion; avoid group interview dynamicEye contact tip

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