Qualitative Research Methods

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Qualitative Research Methods
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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
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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
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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)

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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.
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Methods

• Participant Observation
• Key Informant Interviews
• Open ended Interview
• Focus Group Discussions
• Pile sort

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Participant Observation

• insiders view of a culture emic approach
• an integral part of study of a culture and its
  practices

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Key Informants Interview

• Quick insights into a phenomenon
• Selecting an ambassador who represents the best
  knowledge on a phenomenon
• Face-to-face interviews
• Pre-designed format
• Assumes a prior knowledge of phenomenon and rests
  on the knowledge of the ambassador
• Used in conjunction with other methods

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In-depth Interviews

• Open ended
• Structured
• About what people feel and think, how they see
  events and world around them
• Informal/ formal
• Prelude to quantitative assessment to delineate
  areas of further enquiry

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Focus Group Discussions

• Theme / topic discussions
• Informed discussants
• Rapid method to assess outlook on a topic in a
  cross-section of representative population
• Multiple applications
• Fast emerging as an effective technique

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Pile - Sort

• Informed participants
• Quick classification of concepts
• Precursor to instrument development and
  classification

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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

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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

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Analysis Steps
Free listing
Domain Evolution
Coding
Tabulation
Summarizing
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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 dont 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)
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GHW10 In you opinion, who are the people that
generally do not bring their
children for polio drops on NIDs ?
Identified Domains

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

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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 dont 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)
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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

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• 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

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Data Display

• This is an organized, compressed assembly of
  information that permits conclusion drawing and
  action
• Matrices, graphs, charts and networks are used

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Summary

• Qualitative 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

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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 research
• Allow the researcher to palpate the unique
  cross-cultural features

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Applying Qualitative Methods in Intervention
Research

• Glorian Sorensen, PhD, MPH
• Harvard School of Public Health
• Dana-Farber Cancer Institute
• Boston, Massachusetts, USA

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Overview

• Uses of qualitative methods
• Toolbox of qualitative methods
• Integration of qualitative and quantitative
  methods
• Focus group methods
• Examples from my research in the US and India

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Qualitative versus quantitative When to use what?
Qualitative Quantitative
Subject 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
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Study design

• Research question and guiding theoretical
  framework
• Qualitative research study design and methods
• sampling (non-random, purposive,
  theoretically-based)
• gaining access
• choosing data collection methods (interviews,
  documents, observation, etc)
• ethical considerations
• validity
• Analysis
• Reporting

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Qualitative methods toolbox

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

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On combining qualitative and quantitative

• Explore or refine constructs for surveys
• Pre-test surveys
• Pre-test intervention materials
• Plan for survey administration
• Interpret quantitative results
• Understand process of change that may be measured
  through surveys

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Illustrative example combining qualitative and
quantitative methods

• Research problem High rates of smoking among
  construction laborers
• Research aims
• conduct formative research to assess smoking
  patterns and factors associated with smoking
  among laborers
• develop and test a smoking cessation
  intervention, using an RCT design

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Laborers and smoking How can qualitative methods
enhance study?

• Survey constructs and administration
• Develop intervention strategies and messages
• Assess intervention components
• Interpret quantitative study results

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Focus groups What and why?

• Facilitated small group discussion
• Experiences and perspectives
• Exploring specific area of interest in detail
  particularly useful for sensitive topics
• Interaction among members is key
• Not for generalizing findings

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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

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Focus groups vs. other methods

• Observation
• more efficient
• easier access
• - relying on reports of behavior vs. actual
  observations of behavior
• - not a natural setting

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Ethical considerations

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

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Application of qualitative methods Example

• Research questions
• how 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?

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Qualitative methods

• Direct 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

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Sampling

• Observation convenience sample close by no
  major differences by region
• Group and individual interviews stratified by
  region include racial/ethnic, gender, and age
  mix current and former smokers
• Recruitment and gaining access through
  international union training sites (bias?)

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Topic guide development

• Based on theoretical model we developed by mixing
  existing models (behavioral theories and work
  environment policy theory)
• Working group developed topic guide
• Pilot tested and refined guide
• Revised throughout data collection (iterative)

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Data collection and analysis

• Trained staff to conduct interviews and code data
• Collected data and almost immediately began
  analysis
• group discussions
• coding (structural and thematic, multiple coders)
• creation of themes document
• revision of focus group guides
• retrieving codes for thematic analysis

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Application of results to the intervention

• Identify themes in qualitative data
• Define intervention methods
• Incorporate into intervention messages
• Reflect in visuals in materials
• Use in staff training
• Apply to quality assurance

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Examples within the laborers intervention
materials

• Value 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 youve got the strength you need to
  get the job done and take care of other
  responsibilities too.
• General Presidents introduction to the TFR

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Examples within the laborers intervention
materials

• Value of family and friends
• Tobacco use can be a problem for your family
  members and your LIUNA brothers and sisters too.
  Thats because secondhand smoke causes over
  53,000 deaths a year among people who dont even
  use tobacco spouses, co-workers, buddies.

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Examples within the laborers intervention
materials

• Health concerns
• One thing you can do is make good decisions
  about your health. Sometimes that means talking
  to your steward if youre 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.

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Examples within the laborers intervention
materials
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Planned tobacco control research in India

• Analysis of Global School Personnel Survey
• Focus groups to elucidate observed relationships
• Apply to intervention development

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Summary Applications of qualitative methods in
intervention research

• Understanding the social context of the
  population
• Survey development
• Intervention design
• Staff training
• Understanding the process of observed changes

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Focus groups Size and number

• Six to eight participants
• Over-recruit slightly and reminder about group
  day before
• Three to five groups per topic of interest
• Saturation when stop hearing new info

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Constructing a topic guide

• Avoid close-ended questions going for experience
  and perspectives
• Based on your research questions
• Topic areas, then questions within each topic,
  list probes
• Start with icebreakers and easy question

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Data management and analysis

• Transcribe recordings and check
• In-depth analysis
• Analysis across groups by theme

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Focus groups Composition

• Purposive
• Sub-groups return to your research question
• Homogenous vs. heterogeneous

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Logistics

• Eligibility screening
• Conducted in primary language of group
• Length 1-2 hours, no more
• Location convenient
• Tape record
• Take notes (note-taker)
• Incentives

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Focus group facilitation

• Two people facilitator and note-taker
• Show interest and respect
• Introduce group members and yourself
• Actively listen follow leads but stay on topic
• Encourage between-participant discussion avoid
  group interview dynamic
• Eye contact tip

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THANK YOU