Qualitative Methods

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COREQ Guidelines

Research team and reflexivity: This includes information about the researchers who conducted the study, their backgrounds and perspectives, and how they addressed potential biases. Study design: This includes information about the research design, sampling strategy, and data collection methods. Analysis and findings: This includes information about how the data were analyzed and presented, and how the researchers arrived at their conclusions. Ethics: This includes information about how the study was approved by an ethics committee, how informed consent was obtained, and how participant confidentiality was ensured. Transferability: This includes information about the context in which the study was conducted and how the findings might be transferable to other settings or populations. Following the COREQ guidelines can help to ensure that qualitative research studies are transparent, reliable, and replicable, which is important for the advancement of the field.

Distinguish between different researcher roles in data collection.

Full Observer: Does not participate in the setting being studied. Usually used in naturalistic observations. - Pro: provides a more objective view of the setting being studied Participant Observer: a researcher who participates in the setting being studied to some degree. Observe/Engage with activities, people, etc. - Pro: allows the researcher to gain a deeper understanding of the phenomena being studied Full Participant: a researcher who fully participates in the setting being studied as if they were a regular participant. Researcher becomes a member of the community - Used in ethnographic research, where the goal is to gain an in-depth understanding of a culture or subculture. - Pro: the richest and most immersive experience, but it can be difficult to maintain objectivity and distance from the research subject. Overt vs Covert Observing Overt role: Intention is clear but difficult in communities not familiar with research & cannot control peoples' interpretation of roles; gain informed consent Covert role: Ethical challenge due to lack of informed consent

Triangulation

Triangulating the data increases credibility (internal validity) - Bring the object more sharply into focus - Filling the gap between multiple methods - Sampling continuously assessed Analysis: Compare data throughout study and between different researchers

Identify ethical considerations in relation to qualitative studies.

Informed Consent: - Informed: all aspects are disclosed by the researcher (risks & benefits) & all disclosed information is understood by the participant - Consent: the participant is able to make a judgment of participation & participation is voluntary (can withdraw at any time) Confidentiality and anonymity: Personal information is kept confidential and anonymity is maintained throughout the study. Beneficence: producing benefits, doing good for others Non-maleficence: preventing harms, often health harms, such as preventable morbidity and premature death Justice: Reach groups with low or no voice; procedural (fair process), participation, and transparency Respect of autonomy: respecting the right of self-determination

Sample Size in Qual Studies

Malterud et al. Information Power: The larger the information power of a sample, the smaller the sample size needed. - Information power is related to the specificity of experiences, knowledge, or properties among the participants included in the sample - 5 domains (IP = A + SS + Th + Q + AS): Aim of the study (Broader aim = larger sample size); Sample specificity (More specific = smaller sample size); Use of established theory (Broader theory = larger ss); Quality of dialogue (unpredictable, depends on interviewers ability); Analysis strategy (Exploratory strategy = larger ss). - This concept helps guide planning, data collection, and justification of the final sample. Saturation: Saturation means no new information will be uncovered during new sessions - regardless of participant type. All information for the research question has been found. However, there is no guidance for this concept and it's not transparent.

Describe the 6 key characteristics of qualitative research in health

"CReating New Recipes Makes Us Feel Triumphant." Cultural Relativism: a person's beliefs, values, and practices should be understood in the context of their own culture. - No universal standard of morality or behavior that can be applied across all cultures (right & wrong in one culture can be different in another) - Local populations, not the outsiders, are the experts on their own sociocultural environment - Local communities are not "empty vessels" lacking the relevant knowledge, which can be solved by external "expert" knowledge Naturalism: Preferences to study in "natural" environment (everyday life, natural setting) because context matters. - Context matters: differences in human behavior depend on setting - home vs workplace - Implication: role of the researcher is delicate and important. To be able to stay/live/move around in participants' environment to understand better but also need to control/monitor how the researcher influences participant behavior. Reflexivity: The interactions between informant and researcher & interactions between informants - Acknowledging researchers' own cultural background, values, beliefs, preconceptions, biases - The researcher is "a part" of the data collection - Important: a quality control measure b/c it allows you to manage subjectivity - 2D: Why ask this question now? Who are you as a researcher? Focus on meaning and understanding: focus on understanding the world from the participants' perspective (not researcher's). - Focus on the "how, what, why questions" - Important: PH is concerned with changing behavior. Need an empathetic approach to study these changes Flexibility in research design: although it's planned beforehand, the design is open for researchers to adapt to unexpected findings or changes in circumstances during the research process - To adjust to the answers and new topics that emerge during the data collection (emerging design) - To increase or decrease the amount of data collection activities; to include additional types of informants, questions - Important: Without flexibility, researchers may miss out on valuable insights or may end up with incomplete or inaccurate data, which can impact the validity and reliability of the research findings. Role of Theory: to provide a conceptual framework for understanding and interpreting the data collected during the research process. Helps in framing the research question. - Important: help to provide a systematic and structured approach to the research process, and to ensure that the findings are grounded in established concepts and principles.

Describe different outcomes of qualitative research

- Development of new theories or conceptual frameworks that help to explain social phenomena (ie. how social identities shape health outcomes). Or further supporting existing theories - Developing conceptual definitions (safety, resilience, stigma) - Developing typologies and classifications (coping strategies during disaster—used in questionnaires) - Exploring associations between attitudes, behaviors, and experiences (attitudes in relations to experiences of illness and how it affected behavior during crisis) - Identification of areas for intervention: highlighting gaps or challenges in current healthcare or social systems, and by providing insights into how these can be addressed. - Participant empowerment and engagement: give voice to marginalized or underrepresented groups, thereby promoting participant empowerment and engagement in healthcare and social systems.

Emerging Design

- Emerging design refers to the ability to adapt to new ideas, concepts, or findings that arise while conducting qualitative research. - Welcomes unanticipated information, often adding to the richness of the data. - An important part of grounded theory - The researcher takes cues from the data, process, or conclusions, and the whole study is a reflection of varying levels of emergent characteristics within that research process.

Identify qualitative research questions.

2 basic types of questions -Closed questions: yes/no responses; pre-determined response categories; (ie. Do you like to be physically active?) -Open-ended questions: open-ended responses; give the opportunity to describe views on X; (ie. What do you like about being physically active?) Descriptive questions - Can you tell me about...What happened... Specific questions - What did you like about the last consultation? Comparative questions - How does X compare to Y? Contrasting questions - Is X different from Y? Indirect questions - How do you think other people see that? Interpreting questions - Is it correct to say that you think that... Examples of Research Questions: "What are the experiences of LGBTQ+ individuals in accessing healthcare services?" (The What, Why, How questions) "What are the attitudes and beliefs of X towards Y?"

Describe the key characteristics of the qualitative analysis methods brought up in the course.

Analysis begins when data collection begins because it is an iterative process - Thematic Analysis: a method for identifying, analyzing, and reporting patterns (themes) within data; Flexible - Types: Content, Framework, Grounded Theory, Immersion, Template... -What counts as theme? - A theme encapsulates something important about the data in relation to the research question - Represents some level of patterned response or meaning within the dataset Immersion/crystallization style - Develops categories from scratch with the empirical data as the foundation - Greater potential for new understanding than template-analysis Template analysis - Theory-driven analysis where coding categories are pre-determined from existing categories or theories - Systematic Analysis - Application of codes coherent and systematic = same meaning within each code - Codes can be modified to better fit/capture the meaning of the data - Decisions on categories or subcategories can affect your understanding of the codes Inductive approach (most common in qual studies): start with the data and work towards developing patterns and themes that emerge from it. The analysis is driven by the data itself, rather than by preconceived ideas or theories. Process of coding without trying to fit into a pre-existing coding frame Iterative (Repetitive) Process: the analysis is an ongoing process that involves refining and revising the analysis as new insights emerge from the data.

Emic vs. Etic

Emic: Insiders perspective - Risk of "going native" = researcher as member Etic: Outsiders perspective - Risk of ethnocentrism = Viewing people and ways of life in terms of one's own cultural assumptions, customs and values

Describe the strengths and limitations of observations and focus group discussions as data collection methods.

Observations -Strengths: Natural Setting (analyze aspects of everyday life), Non-intrusive, Rich data (on nonverbal behavior, communication patterns, environmental factors) -Limitations: Observer bias (interpretations influenced by own beliefs, values, and assumptions), Limited generalizability, Time-consuming Focus Groups -Strengths: Deeper and richer data (vs interviews), Generate large amounts of data quickly (efficient), Inspiration to developing quantitative questionnaires, Diverse perspectives -Limitations: Large volume of data to decipher, Might not be appropriate for sensitive topics, Peer pressure/desirability bias, Disproportionate speaking time, Lack of anonymity, Cannot be generalized beyond the group, Depends a lot on moderator skills

Identify some of the key challenges and opportunities in mixing methods

Opportunities: - Ability to collect a comprehensive and nuanced understanding of a research question - Triangulation of data sources to increase the validity - Ability to complement the strengths and weaknesses of each method. Challenges: - Time and resource constraints: more time-consuming and resource-intensive than conducting a single-method study, particularly in terms of data collection, analysis, and synthesis. - Complexity of data: a larger and more complex dataset, which can be difficult to manage and analyze. - Potential for bias: researcher bias or participant bias, which needs to be carefully considered and controlled for. - Different epistemologies and ontologies: Qualitative and quantitative methods often have different underlying epistemological and ontological assumptions, which can create tensions when mixing methods. For example, the emphasis on numerical data in quantitative research may clash with the emphasis on subjective experiences in qualitative research.

Step by Step Thematic Analysis

Phase 1: familiarizing yourself with your data; repeated reading looking for meanings, patterns, but not coding yet Phase 2: generating initial codes (semantic or latent); Not yet developing themes Phase 3: searching for themes; relationships between codes, between themes, and between major and minor themes Phase 4: reviewing themes; refining/revising candidate themes; distinctions between themes Phase 5: Defining and naming themes; Write a detailed analysis for each individual theme Phase 6: producing the report Tell the story of your data in a way that convinces the reader or the merit and validity of your analysis Choose vivid examples/extracts

Define purposive sampling and distinguish it from random sampling

Purposive: a non-probability sampling technique used in qualitative research, where the researcher deliberately selects participants who meet specific criteria or possess certain characteristics that are relevant to the research question. - The main goal of purposive sampling is to identify participants who can provide rich and meaningful data related to the research question. Random sampling: a probability sampling technique used in quantitative research, where each member of the population has an equal chance of being selected as a participant. - Used to ensure the sample is representative of the population and that the results can be generalized to the larger population.

Motivate the choice of a qualitative method.

Qual studies help with: Exploring complex phenomena: such as social and cultural norms, power dynamics, and relationships between individuals and groups. It allows researchers to gain a deep understanding of the experiences, perspectives, attitudes, and behaviors of individuals and groups. Generating new theories and hypotheses: It is particularly useful for developing theories or hypotheses based on observations of natural phenomena or social interactions. Studying hard-to-reach populations: such as those who are marginalized, stigmatized, or otherwise difficult to access. It allows researchers to gain a deeper understanding of the experiences and perspectives of these populations. Providing rich and detailed data: provide insight into complex phenomena. It allows researchers to collect data through methods such as interviews, observations, and focus groups, which can provide a rich and detailed understanding of the phenomenon being studied.

Give examples of how qualitative and quantitative differ and describe how approaches can be combined.

Qualitative - Aim: explore complex phenomena and understand subjective experiences; Find Meaning; Develop Theories - Wide Focus & Flexible Design - Methods: interviews, observations, and focus groups. - Non-numerical: collected through open-ended questions. (Why? What? How?) - Analysis: thematic coding Quantitative - Aim: measure and analyze numerical data and test hypotheses. To test theories - Narrow Focus & Not flexible design - Methods: Surveys, experiments, and observational studies - Numerical: collected through closed-ended questions (How many? How much? How often?) - Analysis: using statistical tests & hypothesis tests How to combine? Case Studies: aims to understand how and why questions related to a health phenomenon Sequential design: This involves conducting one type of research (either qualitative or quantitative) first, followed by the other type. For example, a researcher might conduct a qualitative study to generate hypotheses, and then conduct a quantitative study to test those hypotheses. Concurrent design: This involves collecting and analyzing both qualitative and quantitative data at the same time. For example, a researcher might conduct a survey to collect numerical data, and also conduct interviews to collect qualitative data. Embedded design: This involves one type of research being nested within the other. For example, a researcher might conduct a quantitative study and then use qualitative methods to explore the meaning behind the numerical data

Describe the data collection methods discussed in class and reflect on their main advantages and challenges.

Qualitative Interview: Asking participants questions in a one-on-one setting, with a focus on the individual story/experience. - Pros: the ability to obtain rich, detailed data, and the flexibility to adapt to the participant's needs and preferences (online, phone, face-to-face) - Cons: Time-consuming (transcribing), interviewer bias, and social desirability. - Ex: Exploring the experiences of queer individuals accessing healthcare services Focus groups: The simultaneous participation of several individuals in a discussion, with a moderator guiding the conversation. Provide insights into group dynamics, collective experiences, and social norms. - Pros: time-efficient, cheaper, generate a range of perspectives/behaviors - Cons: social desirability, not appropriate for sensitive questions, moderator bias. - Ex: Exploring the experiences of queer youth in their family and social contexts Observations: Detailed recording of behavior, interactions, and settings to explore social roles & interaction. Can be controlled or in natural environment - Pro: the ability to capture behaviors and interactions as they occur in real-time and the potential for rich, contextual data. - Con: potential for observer bias and the difficulty in capturing the full range of behaviors and interactions. -Ex: Observing (PDA) among queer couples Ethnography: the immersion of the researcher in the culture or setting being studied - Pro: gain an in-depth understanding of the social and cultural contexts and to observe the participants' behavior and interactions in their natural setting - Con: potential for the researcher to become too involved and lose objectivity, and the time-consuming and resource-intensive nature of ethnography. -Ex: Study of the lived experiences of transgender individuals within a particular community

Describe the 2 complementary processes involved in conducting a qualitative interview

RAPPORT: building a sense of trust and connection that is established between the interviewer and the interviewee - Rapport is not universal: cross-cultural interviews require more awareness of differences and knowledge about local patterns of interaction - Successful rapport building: "Astronauts Explore Cosmic Planets" ---Apprehension: initial uncertainty for both; unsure how to evaluate responses, keep them talking ---Exploration: Process of listening, observing, & testing. Make repeated explanations of interest "I'm interested in your views". Restate what informant says to express interest. ---Cooperation: Expectations still unknown. Do not ask for meaning - ask for use of words, concepts, expressions ("How does x affect y?") ---Participation: Informant taking the role of teaching the researcher. Not all interviews turn into this Eliciting INFORMATION: Interview accounts provide data on what people say and how they say it. -To generate stories of an issue; To explore how people talk about an issue

Discuss the difficulties that can occur during a qualitative study process and how to mitigate the impact.

Recruitment and sampling issues: can be difficult to identify and recruit participants who are willing to participate in the study and meet the inclusion criteria. - Mitigate: researchers should be flexible in their sampling strategy, use multiple recruitment methods, and ensure that they are targeting the appropriate population. Data collection issues: participants may be reluctant to share their experiences or may provide incomplete or inaccurate information. - Mitigate: researchers should establish rapport with participants, use appropriate data collection methods, such as interviews or focus groups, and ensure that they are using open-ended and non-judgmental questions. Data analysis issues: requires a rigorous and systematic approach to identify patterns and themes in the data. - Mitigate: researchers should use an appropriate data analysis method, such as thematic analysis or grounded theory, and ensure that they are using a systematic and transparent approach. Researcher bias: researcher's personal beliefs, assumptions, or values can influence the research process and the interpretation of the data. - Mitigate: reflexivity by researchers, use a systematic and transparent research process, and use triangulation of data sources to enhance the validity of the findings. Validity and reliability issues: they ensure that the findings are accurate and trustworthy. - Mitigate: researchers should use appropriate methods to establish validity and reliability, such as member checking or inter-rater reliability, and ensure that they are using a rigorous and transparent research process.

Identify and discuss quality issues in qualitative research and provide a rationale for their importance.

Researcher bias: researcher's personal beliefs, assumptions, or values influence the research process and the interpretation of the data. - Effect: can lead to a distorted or inaccurate representation of the participants' experiences; minimizes reflexivity - Solution: researchers should reflect on their own biases and assumptions (reflexivity) and use triangulation of data sources to enhance the validity of the findings. Lack of transparency: can affect the credibility and validity of the findings. - Solution: Researchers should provide a detailed description of the research process, including the sampling strategy, data collection methods, and data analysis methods. They should also provide an AUDIT TRAIL or detailed documentation of the research process so that the findings can be verified by others. Inadequate sampling: can lead to a biased or incomplete representation of the population or phenomenon under study. - Solution: researchers should use a purposive sampling strategy that is appropriate for the research question, and ensure that the sample size is sufficient to provide a rich and varied dataset. Lack of reflexivity: the failure to critically reflect on the researcher's own role in the research process, and the potential impact of the researcher's positionality on the research findings. - Solution: researchers should reflect on their own positionality, and acknowledge any potential biases or limitations in the research process. Inadequate data analysis: superficial or incomplete understanding of the data, and can undermine the credibility of the findings. - Solution: researchers should use a rigorous and systematic data analysis method, such as thematic analysis or grounded theory, and provide a detailed description of the analysis process

Types of Interviews

Structured interview (Quant): Researcher directs questions and response categories Semi-structured interview (Qual): Researcher defines a set of topics. Informant determines the kind of information that produces; Rapport building In-depth interview: Researcher defines the initial topics. Informant develops their own accounts of the topic as important to them Narrative interview: Researcher role is to facilitate capturing the story that the informant tells Unstructured interview: Guided conversations. Potentially symmetrical between researcher and informant

Give examples of the role of theory in qualitative analysis and describe the connections between method, theory, epistemology, and ontology.

Theories arrange sets of concepts to define and explain phenomena, enabling us to move beyond basic description to in-depth description, interpretation and explanation Theory helps guide the research questions, the data collection methods, and the analysis of the data. Grounded Theory: A method for conducting rigorous systematic processual analyses and constructing theory. - In grounded theory, the researcher develops a theory based on the data that emerges from the study. However, the researcher also brings their own theoretical perspective to the analysis, which shapes how they interpret the data. Epist/Ont --(influences)--> Theoretical Assumption --(influences)--> Method choice Epistemology = the study of knowledge and how we come to know things. Ontology = the study of what exists in the world For example, a researcher who believes that knowledge is subjective and constructed by individuals might choose a qualitative method that allows for the exploration of individual perspectives such as interviews or ethnography.

Describe the main quality measures discussed in the course

Trustworthiness is the Umbrella that consists of these 4 things: "Can Dogs Taste Raspberries?" 1. Credibility (Internal Validity): an indicator to what extent one has been able to measure what one set out to measure - Increased by: optimizing the quality of data and settings (prolonged engagement) along with using triangulation; Transparency - Triangulation: use multiple sources of data and methods to acquire data and use various analysis strategies to examine this acquired data 2. Dependability (Reliability / Repeatability): can be repeated and yield similar results - Increase by: thorough documentation of the entire process, an audit trail, transcribing, and recording the data. 3. Transferability (Generalizability / External Validity): how generalizable and useful our results are to other settings and contexts - Increased by: making comparisons, creating an extensive thick description to evaluate the applicability, and acquiring an outsider's professional feedback/input 4. Reflexivity (Confirmibility): researcher bias, the researcher's influence upon their research, potentially leading to bias. Refers to the objectivity of the research findings, and the degree to which they are grounded in the data - 2 Dimensions: Why is it possible to ask this question now? Who are you as a researcher? - Increased by: audit trails; reflect upon one's own influence as a researcher and be aware of the social settings and theoretical assumptions made during the process. Awareness of subjectivity & preconceptions


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