thematic synthesis - repository.uel.ac.uk
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Thematic synthesis
Sub-brand to go here
ESRC Research Methods Festival, St Catherine’s College Oxford, 30th June to 3rd July
Session 55: Interpretive synthesis
Angela Harden and James Thomas Methods for Research Synthesis Node, ESRC National Centre for Research Methods
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Thematic Synthesis*
• Line by line coding
• Comparing & grouping codes
• Descriptive themes
• Analytical themes
*See: Thomas J, Harden A (in press) Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research
Methodology
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An example of thematic analysis for synthesis
Children and healthy eating: a systematic review of barriers and facilitators*
*Thomas J, Sutcliffe K, Harden A, Oakley A, Oliver S, Rees R, Brunton G, Kavanagh J (2003a) Children and Healthy Eating: A systematic review of barriers and facilitators. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London (The full report of this
review is available at the EPPI-Centre website http://eppi.ioe.ac.uk/EPPIWeb/home.aspx)
:.
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Review questions
What is known about the barriers to, and facilitators of, healthy eating amongst children?
Do interventions promote healthy eating amongst children?
What are children’s perspectives on healthy eating?
What are the implications of the above for intervention development?
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REVIEW PROCESS
Searching, screening and mapping
Synthesis 1: Trials (n=33)1. Quality assessment
2. Data extraction3. Statistical meta-analysis
Synthesis 2: ‘Views’ studies (n=8)1. Quality assessment
2. Data extraction3. Thematic synthesis
Synthesis 3: Trials and ‘views’
Focus narrowed to ‘fruit &veg’
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Thematic synthesis
Stage 1 and 2: Coding text and developing descriptive themes
Stage 3: Generating analytical themes
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Data were author descriptions of study findings
Line-by-line coding applied to data • 36 initial descriptive codes (e.g. bad foods = nice; good
foods = awful)
Looked for similarities and differences among descriptive codes in order to group them• 13 descriptive themes (e.g. ‘Perceptions of health
benefits’)
Stage 1 and stage 2
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Line-by-line coding in EPPI-Reviewer
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NVivo - exampleDescriptive codes in NVivo
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Axial coding
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Structuring the descriptive codes into descriptive themes
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Final list of descriptive themes
Food in the school
Chosen foods
Provided foods
Food in the home
Influences on foods eaten
Food preferences
Non-influencing factors
Health benefits
Knowledge behaviour gap
Roles and responsibilities
Healthy eating concepts (understanding)
‘Good’ and ‘bad’ foods
Health consequences
Limited choices
Eating to socialize
Contradictions
Breaking rules
Food rules
Understandings of healthy eating
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Stage 3: generating analytical themes
The descriptive themes stayed very ‘close’ to the content of the primary studies, but…Our synthesis of descriptive themes, did not answer our review question directlyBarriers and facilitators framework:• What do children think stops them from eating healthily?• What do children think helps them to eat healthily?• What ideas do children have for what could or should be done to
promote their healthy eating?‘Recommendations for interventions’Analytical themes emerged through a cyclical process which involved interrogating the descriptive themes to answer these questions
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Example: generating analytical themes (1)
Five of the 12 descriptive themes concerned the influences on children’s choice of foods• (food preferences, perceptions of health benefits,
knowledge behaviour gap, roles and responsibilities, non-influencing factors)
Children identified that:• taste was the major concern for them when selecting
food;• health was either a secondary factor or, in some cases,
a reason for rejecting food;• buying healthy food was not a legitimate use of their
pocket money which they would use to buy sweets that could be enjoyed with friends
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Example: generating analytical themes (2)
These perspectives indicated to us that:• branding fruit and vegetables as a ‘tasty’ rather
than ‘healthy’ might be more effective in increasing consumption
• 'All adverts for healthy stuff go on about healthy things. The adverts for unhealthy things tell you how nice they taste.’
We captured this line of argument in the analytical theme entitled ‘Children do not see it as their role to be interested in health’.
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1) Children don’t see it as their role to be interested in health.
2) Children do not see future health consequences as personally relevant or credible.
3) Fruit, vegetables and confectionary have very different meanings for children.
4) Children actively seek ways to exercise their own choices with regard to foods.
5) Children value eating as a social occasion.
6) Children recognise contradiction between what is promoted and what is provided.
Children consider taste, not health, to be a key influence on their food choice
Food labelled as healthy may lead children to reject them (‘I don’t like it so it must be healthy’)
Buying healthy foods not seen as a legitimate use of their pocket money
Stage 3: Analytical themes
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Brand fruit and vegetables as ‘tasty’ rather than ‘healthy’.
Reduce health emphasis of messages
Do not promote fruit and vegetables in the same way within the same intervention.
Create situations for children to have ownership over their food choices.
Ensure messages promoting fruit and vegetables are supported by appropriate access to fruit and vegetables
1) Children don’t see it as their role to be interested in health.
2) Children do not see future health consequences as personally relevant or credible.
3) Fruit, vegetables and confectionary have very different meanings for children.
4) Children actively seek ways to exercise their own choices with regard to foods.
5) Children value eating as a social occasion.
6) Children recognise contradiction between what is promoted and what is provided.
Implications for interventions
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Thank [email protected]
Social Science Research UnitInstitute of EducationUniversity of London18 Woburn SquareLondon WC1H 0NR
Tel +44 (0)20 7612 6246Fax +44 (0)20 7612 6400Email [email protected] www.ioe.ac.uk/ssru