Transcript Qualitative Research in Health & Leisure

Qualitative Research in
Health & Leisure
Focus Groups and Interviews
Eimear Foley, BSc., MSc.
19th January 2006
Overview
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What is qualitative research?
Why use qualitative research?
Interviewing
Focus Groups
Analysis
Reporting
Examples
What is Qualitative Research?
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Qualitative research designs are those that
are associated with interpretative
approaches, from the participants point of
view, rather than measuring discrete,
observable behaviour.
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Qualitative methodologies are strong in
those areas that have been identified as
potential weaknesses within the quantitative
approach
Qualitative research …
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Allows the researcher to explore the cognitive
and affective aspects of the research question in
greater detail
Encourages participants to introduce concepts of
importance to the issues rather than adhering to
pre-determined subject area
Approaches ‘which seek to uncover the
thoughts, perceptions and feelings experienced
by informants’ (Minichiello et al., 1995:10)
Interviewing
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Structured – usually with a structured
questionnaire
Semi-structured Interviews- Guided
Conversations
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Allow for focused, conversational, two-way
conversation
Depth of information, time consuming
Provide reasons for answers
Less intrusive – sensitive issues
In Depth – 1/2 issues covered in great detail,
questions are based on what the interviewee
says
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Qualitative interviewers should try to be
interactive and sensitive to the language and
concepts used by the interviewee and also try
to keep the agenda flexible
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Good questions in qualitative interviews
should be open ended, neutral, sensitive, and
clear to the interviewee (Patton, 1987)
Types of questions for qualitative
interview (Patton, 1987)
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Behaviour or experience
Opinion or belief
Feelings
Knowledge
Sensory
Background or demographic
Tips for interviewing…
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Use questions carefully, but informally
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Ask questions exactly as written
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Follow the order given
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Ask every question
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Don't finish sentences
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Obtaining Adequate Responses - The Probe
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Silent probe
Pause and wait
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Overt encouragement
“Uh-huh”, “OK”
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Elaboration
“Is there anything else you would like to add?”
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Ask for clarification
"A minute ago you were talking about the experience you had in
primary school. Could you tell me more about that?"
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Repetition
"What I'm hearing you say is that you found that experience
very enjoyable." Followed by a pause
Focus Groups
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“a group of individuals selected and assembled
by researchers to discuss and comment on,
from personal experience, the topic that is the
subject of the researcher” (Powell et. al., 1996: 499)
Focus groups rely on interaction within the
group based on topics that are supplied by the
researcher
Why use focus groups?
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Draw upon participants attitudes, feelings,
beliefs, experiences and reactions – not
feasible using other methods e.g. observation,
one-to-one interviews, surveys
Attitudes etc. more likely to be revealed in
social group setting
Large amount of info – short amount of time
Useful when interested in everyday use of
language and culture of particular groups
Also to explore degree of consensus
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Benefits
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Interaction
Information about why issue is salient
Involvement in decision making process –
Empowerment
Forum for change
Limitations
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Researcher has less control over data produced
Social Desirability
Difficult to assemble
Not fully confidential or anonymous
Organisation of Focus Group
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No. of participants = 6 - 10 people
Duration = 1 – 2 hours
Location = Neutral
Same group meeting several times
One meeting, several groups
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Participants:
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Heterogeneous vs. Homogeneous
People need to feel comfortable
Possess similar characteristics or levels of
understanding about topic
Locating participants
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Time consuming
Specific interests – word of mouth through key
participants e.g. swimmers, parents
Advertising or poster campaign
Existing social networks e.g. ARG, ICA, Musical
Society
Role of moderator
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Clear explanation of purpose
Help people feel at ease
Promote debate by asking open ended questions
Tease out diverse range of meanings
Probe for detail/Steer conversation back on
course
Facilitate interaction
Avoid showing approval or giving personal
opinion
One moderator facilitates and other takes notes,
checks equipment and give feedback
Designing Questions
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Open-ended questions: allows respondents to
give answers in their own way
Useful to get unanticipated answers
Responses are open ended i.e. not yes or no
answers
Example: What can you tell me about diet?
What are your thoughts on yoga?
Interpretational Analysis
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There is no one correct way of analysing
qualitative data
Essential to describe the planned method and
decision criteria
Transcript – written version of the interview
Make notes when transcribing tape – provoke
memories and thoughts
First transcript will be messy and unedited
Research question must be clearly defined in
advance
Data Organisation:
Step 1 – Creating Tags
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Creating Tags – aims to produce a set of
concepts which adequately represent the
information included in interview transcript
Separates relevant meaningful portions of
data from their context
Each unit is tagged with a provisional name
describing the topic
E.g. Barriers to physical activity
Data Organisation
Step 2 – Creating categories
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List and compare the tags already derived in
step 1
Group similar tags and give a label that
captures the essence of the topic (Miles &
Huberman, 1984)
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Set of categories serves as preliminary
organising system
Segments must remain flexible
Higher order categories
Codes
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You may decide to use a set of already existing codes
with your data. These are called a priori codes.
A priori codes are codes that are developed before
examining the current data.
Many qualitative researchers like to develop the
codes as they code the data. These codes are called
inductive code.
Inductive codes are codes that are developed by the
researcher by directly examining the data.
Writing the report
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In-depth analysis of higher order categories
Intensity & Frequency of responses
Identify group consensus (agreement)
Organise report by issue (instead of by group)
Discuss similarities and differences by groups
and by individuals
Restate and answer the research question(s)
Quotes and comments should be used to
support findings
Analysing Focus Groups
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Distinct feature of working with focus group data is
the need to indicate the impact of the group dynamic
and analyse the interaction between research
participants
When coding, use special categories such as
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Jokes and anecdotes
Questions
Deferring to the opinion of others
Changes of mind
A focus group research report that is true to its data
should also usually include at least some illustrations
of the talk between participants, rather than simply
presenting isolated quotations taken out of context.
(Kitzinger, 1995)
Example: Dying from cancer in developed and developing
countries: lessons from two qualitative interview studies of
patients and their carers (Murray et al., 2003)
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Objective: To describe the experiences of illness and needs and
use of services in two groups of patients with incurable cancer, one
in a developed country and the other in a developing country.
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A qualitative approach was used so that accounts could be obtained
sensitively without upsetting participants with advanced illnesses
Participants: Scotland: 20 patients with inoperable lung cancer
and their carers. Kenya: 24 patients with common advanced
cancers and their main informal carers.
Methodology:
 Scotland - conducted and tape recorded in-depth interviews at
three monthly intervals for up to a year with patients and their
main informal carer in the patient's home.
 Kenya - guided by staff at the hospital and affiliated nurse
training school, a semi-structured interview schedule was
developed. A local nurse conducted single interviews with
patients and carers in the local language.
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Data Analysis
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Results were analysed throughout the fieldwork to
allow emergent themes to be fed back into the data
collection.
These themes and the research questions formed
the basis of the coding strategies.
QSR NVivo
At both sites transcripts and field notes were
checked and coded by two experienced researchers
Living with cancer in Scotland
Patients and their carers in Scotland were
predominantly concerned about the prospect of
death. "The doctor told me that you're actually
on borrowed time with cancer . . . They're
hoping to shrink this cancer in the right lung,
but you're more or less a time bomb" (patient
1). "You're wondering if you're going to see
tomorrow. When I first was told, that was the
first thing that went through my head, How
long? When?" . . . it's been like going to hell
and back" (patient 2).
Example: Fruits, vegetables, and football: Findings from
focus groups with alternative high school students regarding
eating and physical activity
(Kubik et al., 2005)
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Purpose: To increase our understanding of factors that may influence the
dietary and physical activity practices of adolescents attending an
alternative high school (AHS)
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Methodology: 7 schools (4 urban, 3 suburban); 76 students (36 f, 34 m);
45-60 min focus groups; incentive – healthy snack & $20 gift voucher
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Trained moderator & co-moderator, audiotaped
Questions developed by investigators & piloted with convenience sample
Introductory Q’s – last time you exercised, everything you had to eat or
drink yesterday
Key Q’s – factors that influence food choice; circumstances that make it
easier or harder to be active; ideas for a school health promotion programme
Semi-structured questioning to ensure consistency but allow flexibility
Data Analysis
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Audiotapes were transcribed verbatim to ensure systematic analysis
of focus-group discussions.
Data then were analyzed using a 3-step process (Miles & Huberman,
1994) with the student as the unit of analysis.
Interviewers reviewed and edited transcripts and abstracted
meaningful data.
Data were organized into categories representing emerging themes
such as eating options at school and factors that influence being
active.
Reviewers created a matrix that allowed for the tabulation of themes
by school and a comparison of themes across schools. Results then
were compared, contrasted, and rank ordered to create a textual
summary of findings.
To control for possible bias, all transcripts were reviewed
independently by 2 other investigators. The selection of categories
and themes also was verified by independent review.
There was a high level of concordance between reviewers
Students reported an interest in “fun” activities. Team
sports, particularly football, were considered fun by both
girls and boys. Social support and role modeling behavior of
friends and adults also were identified as factors that helped
one be active. Others liked the way it made them feel “good
about yourself” and “lighter and stronger.” Having a goal,
“something to work for,” was a motivator for both girls and
boys. Boys liked the “adrenaline rush.”
“Now I feel like I have a lot more energy and a lot
happier when I’m more active and just better able to deal
with the world” (male student at an urban school).
Points to note
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Be aware of any biases you may have towards the
topic
First, make a list of your characteristics e.g. age,
gender, religion, interests.
It is likely that these characteristics will be the root
of the bias
List ways in which your characteristics might bias
you in your efforts at research interviewing.
Then write how you might counteract these biases.
And then write how these efforts to counteract your
biases might themselves lead to other biases!
Ethical Issues
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Same for all methods of social research
Full information must be given to participants
about the purpose and uses of the contributions
Need to clarify that participants contributions
will be shared by group and moderator
Do not pressurise people to respond
Encourage participants to keep confidential
what they hear
Anonymise data e.g. (Male, aged 46)
References
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Cote, J., Salmela, J., Baria, A., (1993) Organizing and Interpreting Unstructured
Qualitative Data. The Sport Psychologist, 7, 127-137
Flick, U. (2002) An Introduction to Qualitative Research (2nd ed.) Sage
publications; London
Grbich, C. (1999) Qualitative Research in Health: An Introduction, New South
Wales: Sage
Kubik, M., Lytle, L., Fulkerson, J. Fruits, vegetables, and football: Findings
from focus groups with alternative high school students regarding eating and
physical activity Journal of Adolescent Health 2005 (36) 494-500
Miles MB, Huberman AM. Qualitative Data Analysis, 2nd ed. London:Sage,
1994.
Minichiello, V., Aroni, R., Timewell, E. and Alexander, L. (1995) In-depth
Interviewing: Principles, Techniques, Analysis, 2nd edition. Melbourne:
Longman
Murray, SA., Grant, E., Grant, A., Kendall, M. (2003) Dying from cancer in
developed and developing countries: lessons from two qualitative interview
studies of patients and their carers. BMJ, Feb 2003;326:368
Patton MQ. (1987) How to use qualitative methods in evaluation, 108-43
London: Sage
Powell R.A. and Single H.M. (1996) ‘Focus groups’, International Journal of
Quality in Health Care 8 (5): 499-504.