Qualitative Research Methods for Public Health

Why Qualitative Public Health?

WHEN AND HOW TO DO QUALITATIVE RESEARCH IN PUBLIC HEALTH

CELIA EMMELHAINZ – ANTHROPOLOGY LIBRARIAN – UNIVERSITY OF CALIFORNIA BERKELEY – OCT 2016

‘Real science’ does not begin with numbers, quantification, and statistical analysis…

in medicine, scientists work with non-numerical data… qualitative data are by no means a weak form of data;

rather, they are a different form that requires different, complex, and systematic analysis.

““

Kuckartz and McWhertor (2014) Qualitative Text Analysis, p.2

Qualitative research is an inquiry process of understanding

based on distinct methodological traditions of inquiry that explore a social or human problem.

The researcher builds a complex, holistic picture, analyses words,

reports detailed views of informants, and conducts the study in a natural setting.

““

- Creswell (1998) Qualitative inquiry and research design.

In public health research…• Impact•Outcomes•Generalize

Quant

•How?•Why / not?•Replicate

Qual

Aisha Tucker Brown (2011) Using Qualitative Methods to Evaluate Public Health Programs, CDC program

Uses of Qual. Research in Public Health

1. To study the social, cultural, economic, and political factors that influence health and disease

2. To examine interactions between stakeholders3. To capture the “whole person” in their lifeworld4. To explore how people and communities interpret

health and disease5. To explore unanticipated meanings and connections

1-2,4 from Isaacs (2014) “An Overview of Qualitative Research Methodology for Public Health Researchers,” 318

Image: contextualresearch.files.wordpress.com/2012/07/the-ethnographic-research-cycle.png

“Key Elements” of Qual Health Research

1. Full literature review of background information2. Choose a conceptual framework3. Choose a sampling strategy4. Recruit participants ethically5. Collect data in focus groups or interviews6. Analyze data by immersion, coding, grouping, linking to theory7. Present; publish; give feedback to community

Isaacs (2014) “An Overview of Qualitative Research Methodology for Public Health Researchers,” p. 318-21

Sampling in Qualitative Health Research

Not a goal of representative or fully generalizable; instead, the goal is to interpret a particular context and apply results to that or similar contexts. 1. Deviant sampling (study the extremes)2. Maximum variation (most diverse views)3. Homogenous sampling (study characteristics in depth)4. Snowball sampling (hard to reach)

Isaacs (2014) “An Overview of Qualitative Research Methodology for Public Health Researchers,” 319-20

Interviews Focus Groups Observation

Case Studies Images Video

Audio Surveys Life HistoriesM

etho

ds: d

ata

colle

ction

Daly et al 2007 A hierarchy of evidence for assessing qualitative health research, p. 45

Tips for Ensuring Qualitative Rigor

1. Prolonged engagement (multiple visits or interviews)2. Method and analysis grounded in theory3. Extensive and diverse sample4. Multiple methods (interviews, observation, casual discussion)5. Triangulation across different sources, perspectives6. Negative case analysis; highlight what contradicts your theory7. Diverse interviewers, peer debriefing, and multiple coders8. Respondent validation (community reviews your findings and reports)9. Clear documentation and data trail of all methodological decisions

Gilson 2011, adapted in Stoto ea 2012 … Using Qualitative Methods in Public Health Systems Research

Five Methodological ApproachesPhenomenology: studies how humans make sense and meaningEthnography: develop nuanced picture of social system or cultureInstitutional Ethnography: explore relations between organizations and human experienceGrounded Theory: build up from the data to theoretical insightDiscourse Analysis: what people are doing/building with language

Journals for qualitative health research

Books in the UCB Library:

What to know about qualitative analysis with CAQDAS softwareHOW DO I ACTUALLY ANALYZE MY INTERVIEWS AND OBSERVATIONS?

CELIA EMMELHAINZ - ANTHROPOLOGY LIBRARIAN – UNIVERSITY OF CALIFORNIA BERKELEY

Data type and data analysis are not the same!

Kuckartz and McWhertor (2014) Qualitative Text Analysis, p.3; table from Bernard & Ryan 2010

Qualitative Data Analysisa. Typically starts with individual cases and builds up to a

hypothesis or argument.b. But depends on whether qualitative study is exploratory,

descriptive, hypothesis-testing, or evaluative (Diekmann 2007)c. Often begins with a close reading, and moves on to building

themes, case studies, categories, or concepts, which are shared along with descriptions and evocative quotations.

d. Most useful to provide a “rich understanding” for practitioners or to develop ideas to be tested using representative sample.

Kuckartz and McWhertor (2014) Qualitative Text Analysis, p.5, 9

Paper methods of qualitative analysis:

Whether to use qualitative analysis software:

Reasons to use

• Build complex codes • Test relationships• Handle large data• Good for teams

Reasons not to use

• Cost• Learning curve• Simple or few

interviews

Questions to ask before using software:

* How many interviews, observations, photos, news clippings, or fieldnotes have I collected?

* How in depth does my analysis need to be? * Does my advisor recommend a certain method of coding? * Have I studied a given method of coding or analysis? * Is software likely to help with this method for this project? * Do you need software skills for the job market?

Major CAQDAS software packages for students

Atlas.ti

• $99/2 yrs• Flat codes

MaxQDA

• $115/2 yrs• Hierarchy

NVIVO

• $120/1 yr• Hierarchy

Dedoose

• $11/month• Web based• Big project

slows site

Most programs can:

Takes many file types

Merge two versions (not

Dedoose)

View codes in margin

Import demographics

from Excel

Print reportsAdd

comments and memos

Run searches (X and Y, near) Auto-code

Atlas.ti in ActionA WALKTHROUGH

CELIA EMMELHAINZ - ANTHROPOLOGY LIBRARIAN – UNIVERSITY OF CALIFORNIA BERKELEY

Atlas.ti resources Manual and sample projects: http://atlasti.com/manuals-docs/

Student licenses: http://atlasti.com/students/

Survey import instructions:

atlasti.com/wp-content/uploads/2014/05/survey-import.pdf

QuestionsEmail Celia Emmelhainz:

emmelhainz@berkeley.edu