1. Qualitative Research Methods

2. “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

3. Qualitative Vs Quantitative Research - the dichotomy
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

4. 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)

5. “When in doubt, observe and ask questions
“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.”

6. Methods Participant Observation Key Informant Interviews
Open ended Interview
Focus Group Discussions
Pile sort

7. Participant Observation
“insider’s view” of a culture: “emic” approach
an integral part of study of a culture and its practices

8. 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

9. 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

10. 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

11. Pile - Sort Informed participants Quick classification of concepts
Precursor to instrument development and classification

12. 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’

13. 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

14. Analysis Steps Free listing Domain Evolution Coding Tabulation
Summarizing

15. GHW10 In you opinion, who are the people that generally do not
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)

16. GHW10 In you opinion, who are the people that generally do not
GHW10 In you opinion, who are the people that generally do not bring their children for polio drops on NIDs ?
Identified Domains
Do not know
None (everybody received OPV)
Laborers / daily wagers / beggars (affordability)
No one at home / Adult sickness
Migrants / tribal (accessibility / out of station / traveling)
People with remote residence / adverse weather / transport difficulties (accessibility)
Bad past experience (due to / fear of side effects) / fear of polio even after polio drops acceptability
Non believers (no faith / believers of other systems / superstitions / rumors / socio-cultural / religious / death / caste)
Misinformed groups (rich / educated / do not like to go to IP / go to practitioner / wrong impression)
Lack of Awareness / Illiterate
Children with illness / new born (acceptability)
Negative influences of the other family members / decision / decision of family members
Pampered groups (mop-up)
Low motivation / Domestic chores / Low priority (festivals / functions etc.) / many children / female children

17. GHW10 In you opinion, who are the people that generally do not
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)

18. 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

19. “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

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

21. 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

22. 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

23. Applying Qualitative Methods in Intervention Research
Glorian Sorensen, PhD, MPH
Harvard School of Public Health
Dana-Farber Cancer Institute
Boston, Massachusetts, USA

24. 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

25. Qualitative versus quantitative: When to use what?
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
Suppose we want to examine voting behavior.
In a survey, we might ask, “Did you vote in the last election?” Yes or No.
What does a “no” really tell us?
Tells us what, but not why.
What is doesn’t tell us?
What is the social context for this choice?
What does voting mean to this individual?
What does voting mean collectively to this society?
How does the electorate feel about the voting process

26. 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

27. Qualitative methods toolbox
Individual interviews (structured, semi-structured)
Group interviews (focus groups and non-focus groups)
Observation (participant, unstructured, structured)
Document and archive reviews

28. 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

29. 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
What might the formative research entail?
Survey and qual methods, such as in-depth interviews, participant observation, focus groups.
How might we integrate qual methods in RCT?

30. 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
What do we need to know to design an intervention for this group?
Example survey constructs:
Smoking – easy to measure
Demographics (age, race/ethnicity, sex, education level, income)
Social support for smoking or quitting
Social norms wrt tobacco
What is the functional meaning of smoking among truck drivers
What work organization factors might relate to smoking or make it tough to quit
Stress related to job and to work-family spillover
Experiences with quitting
Social network smoking

31. 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

32. 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

33. Focus groups vs. other methods
Observation
+ more efficient
+ easier access
- relying on reports of behavior vs. actual observations of behavior
- not a natural setting

34. Ethical considerations
Informed consent
Provide project description at start of group
Clarify confidentiality and anonymity (within group as well)

35. 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?

36. 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

37. 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?)

38. 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)

39. 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

40. 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

41. 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 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]

42. 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. That’s because secondhand smoke causes over 53,000 deaths a year among people who don’t even use tobacco — spouses, co-workers, buddies.”

43. Examples within the laborers’ intervention materials
Health 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.”

44. Examples within the laborers’ intervention materials

45. Planned tobacco control research in India
Analysis of Global School Personnel Survey
Focus groups to elucidate observed relationships
Apply to intervention development

46. 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

47. 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

48. 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

49. Data management and analysis
Transcribe recordings and check
In-depth analysis
Analysis across groups by theme

50. Focus groups: Composition
Purposive
Sub-groups — return to your research question
Homogenous vs. heterogeneous

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

52. 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

53. THANK YOU