QUALITATIVE RESEARCH

1. QUALITATIVE RESEARCH

2. What is qualitative research? • Describes and analysis culture & behavior from the point of view of those being studied (emic perspective) • Emphasis is on providing a “holistic” understanding of the social setting in which research is conducted • Relies on a research strategy which is flexible and iterative

3. What is qualitative research • Systematic exploration of illness requires in-depth interviewing & probing • Rapport building essential for eliciting sensitive information • Useful method of discovering local language usage by which people communicate

4. What are its uses? • QR especially useful for: • Exploring a health problem • Identifying local perceptions • Identifying relevant interventions • Investigating feasibility, acceptability & appropriateness of health programs

5. What are its uses? • Developing suitable information, education & communication • Identifying problems in on going interventions & suggesting solutions • Complementing quantitative data by helping to interpret it • Designing more valid survey instruments

6. Qualitative Research Techniques • Wide range available: • Individual in-depth interviews • Semi-structured interviews • Focus group discussions • Participant Observation • Systematic Interviewing Techniques

7. In-Depth Interview • Most widely used method of data collection in cultural anthropology • Researcher has some idea of topics to be covered • May use some sort of a topic list or guide • But, minimal control over order in which topics are covered & over respondents responses • Neither specific questions nor range and type of possible answers pre-defined

8. In-depth Interviewing • It is informal and conversational • Aim is to get informants to “open up” • Express themselves in their own terms • Key to a successful interview is effective probing • Stimulate respondent to produce more information without introducing own words, ideas

9. Key Elements of Process • Introduction Introduce project • Interview Express cultural ignorance Express interest Use local expressions • Closing Thank Informant

10. Qualitative Guides • Purpose: To identify and provide preliminary exploration of relevant topics with selected informants • Introduction: Purpose of study, consent • Questions: Open-ended; exploratory, identify local terms • Using the Guide: As a starting point; a set of cues • Not to be followed precisely like a structured survey • Yet, we do want to cover topics outlined

11. Guidelines for Formulating Questions • Avoid yes/no questions eg. “Are you currently ill?” • Avoid leading questions eg. “Do you think allopathic medicines are the best means of treatment for illnesses? • Use “describe… “tell me about…” • Learn how to rephrase questions

12. Main Techniques • Be very familiar with the field guide • Develop rapport---informal, conversational style, listen, watch and read non-verbal expressions, react as appropriate • Probe, probe, probe…..

13. Probing Techniques Silence “uh-huh” (nodding) O.K. “What else?” Repetition “Tell me more about”

14. Tape recording The Interviews • Asking permission • Benefits • Risks • Minimizing risks • Always take written notes as well • Monitor the recording as you go along

15. Follow-Up Interview Goal: • To probe deeper, more sensitive, personal topics • Read first interview and develop, adjust questions accordingly • “Last time we spoke, you mentioned…” • “Tell me more about….”

16. Ethical Issues • Respect the participant All information is voluntary All information is anonymous Everyone informed of study risks and benefits before they give permission • Protecting participants from harm Providing information/referrals

17. Interview Boundaries • Interview versus Education/Counseling • Your role as interviewer: listen, provide information or referral at end of interview, or stop interview if needed

18. In-Depth Interviews Key Informant Interviews • A KI is one from whom we receive extensive information • KIs include, experts & those in positions of authority & also “ordinary people” • “Expertness” is based on knowledge of local cultural beliefs & practices

19. Characteristics of A KI KI should be a person: • With whom we have developed a special relationship & have more than one contact • Who provides us with “expert information” • Who are “good observers”, who like to talk • Who are able to “synthesize”, “analyze”, give “thoughtful” explanations

20. Types of KIs • Administrators, leaders, other authorities eg, government officers, NGO personnel • Community based out-reach workers: eg ANMs, Community health workers • Members of the study population: eg marries & pregnant women, adolescent girls, men etc.

21. Semi-Structured Interviews • Effective means of collecting data suitable for systematic comparisons & testing hypotheses • Ensures that a range of selected items are covered systematically • Structure of interview should create a context that enables rather than impedes respondents

22. Semi-Structured Interviews • Can also include open-ended questions • These may be followed by more specific probes • Interview may include skip outs • Must recognize field conditions – importance of privacy

23. Type of information • Provides both quantifiable numeric, coded, as well as qualitative prose data “What kind of healers have you used for skin problems”? “have you consulted a health worker for a skin problem”? • Provision for comments of interviewer about interview, useful

24. Strengths of Semi-Structured Interviews • Enables coverage of wider range of topics systematically • May also facilitate comparisons of qualitative data that are keyed directly to coded variables • Provides opportunities to explain meaning of quantitative findings

25. Limitations of Semi-Structured Interviews • Demands fund of knowledge about community & research questions to be studied • Relies on substantial experience specially in research settings where cultural differences exist

26. When to Use Semi-Structured Interviews • When single subject responses are required-unit of analysis is the individual • When measurement is required on certain topics • When measurement of variation in views among study population is required

27. Case Studies • Also in-depth interviews, but focused on individual’s own actions & explanations • Individual “illness episode” very useful type of case study, wherein ask: 1. Subject to tell about entire illness episode 2. Use a checklist of items to fill in entire sequence of treatment seeking

28. 3. Get subject to tell about actual encounter with health provider, use probes 4. Ask for explanations on cause of illness, reasons for worsening/improvements 5. Re-visit subject for more details

29. Focus group Discussion A carefully planned discussion designed to obtain perceptions on a defined area of interest in a non-threatening environment

30. Focus group Discussion (Contd…) • Conducted with 7-8 people by a skilled interviewer who helps guide the discussion • Group should be homogenous with members being unfamiliar to each other • Group members influence each other by responding to ideas & comments • Ideally discussions should be recorded after obtaining the permission of the group

31. Focus Group Discussions • Conducted by a moderator, assisted by a note-taker & an organizer • Give ample time for identifying & recruiting group members • Over-include to guard against potential drop-outs • Group proceedings can be recorded after obtaining consent • Notes on body language, socio-gram on group dynamic important

32. Uses of A Focus Group Discussion • Generate information on a questionnaire • Needs assessment • Develop/Test new programs/interventions • To gain an understanding of local beliefs, cultural practices, perceptions, attitudes

33. Participant Observation • An approach where investigator becomes active functioning member of culture under study • Participates in activities, observes what others do, attempts to see through eyes of member of the culture • Is a general approach to data collection involving unstructured interviews and observations • Seeks a holistic view of people and behaviors being observed

34. Strengths of Participant Observation • Methods help to reduce reactivity • Helps to formulate appropriate & relevant questions in native language • Provides an intuitive understanding of what’s happening in a culture • Helps in understanding meaning of data collected • Maximizes ability to make valid statements

35. Useful when context is new or not well known • Particularly useful at the beginning of research when problems is not well understood • Useful when situation of interest is obscured or hidden • Especially appropriate for understanding processes, events, norms, values, context of a social situation

36. Weaknesses of Participant Observation • Can be time consuming • Researcher must speak the local language • Be skilled at observing details • Have good memory • Be skilled at writing detailed notes about what was observed • Sometimes increased familiarity with culture under study makes it difficult to notice things

37. Structured Interviewing Techniques • Involves exposing every informant in a sample to the same stimuli • These data collection methods produce data that is quantifiable • Aims to describe & analyze culture & behavior of respondents from their own point of view • Help to isolate & define cultural domains eg: ways to cure a headache; kinds of cars

38. Free Listing • Free lists help to isolate & define relevant domains • Simply asks respondents to list as many items as they can think of in a particular domain Example: “Please tell me all the illnesses that children here get?” “What are all the different kinds of drugs that people in your school use?’

39. Strengths & Weaknesses • Useful first step in research involving definition of new domains • Best way to ensure that concepts & domains are culturally relevant • Informants can usually do the task easily • Need to be familiar with culture & language of informants to identify appropriate domain names to start listing

40. Pile Sorting Aims to study relations among items within a domain Useful for discovering perceptions on similarities & differences among items Helps to look at intra-cultural variations in how informants define domains Informants asked to sort cards with names of items written into piles or groups according to their own criteria

41. Pile Sort Informants asked to make as many or as few piles as they wish Once pile sort completed, informant asked to explain the different piles Example: “What do all the items in this pile have in common?” Technique of successive pile sort used to construct taxonomies which illustrates relations among items

42. Taxonomy Based On A Pile Sort Kinds of pets Goldfish Turtle Rabbit Mouse Parrot Horse Cat Dog Goldfish Turtle Parrot Mouse Rabbit Dog Cat Horse Goldfish Turtle Parrot

43. Strengths & Weaknesses of Pile Sort • Can be done using large number of items • Is easy to administer • Cannot be used with non-literate samples unless items are pictures or actual stimuli • Simple hand analysis possible • Computerized analysis faster but requires knowledge of appropriate software

44. Sampling Techniques Selection of respondents based on information they can provide Types of sampling strategies: • Purposive • Snowball • Convenience • Quota • Extreme Cases Sample size: Sample to informational redundancy or sample to saturation

45. Qualitative Data Analysis • Taped interviews transcribed verbatim • Translated into English • Codes assigned to segments to segments of text • Coding framework developed • Look for patterns & emerging themes

46. Triangulation • Main research tool used are the researchers themselves • Subjective nature of data can open it to criticism • A method to enhance quality of data is through triangulation: Data, Researcher, Combining qualitative & quantitative methods

47. Sampling in Qualitative Studies • Techniques used vastly different from quantitative research • Logic behind the approach uniquely different from those of quantitative research • Non-probability sampling techniques used

48. Non-Probability Sampling Reasons for using non-probability sampling: Pilot studies to test questions & scales may not require representative study Subjects chosen because of special attributes There may be difficulties in identifying a sampling frame Aim is not to generalize or extrapolate findings

49. Characteristics of Non-Probability Sampling • Not specified or drawn in advance • Sample selected in serial fashion and is purposive in nature • Criteria for sampling may change as study progresses • Sampling terminated when information becomes repetitive (informational redundancy)

50. Non-Probability Sampling Techniques (1) • Extreme or deviant case sampling: Learn from highly unusual manifestations of the phenomenon of interest • Maximum variation sampling: Selecting a wide range of variation on dimensions of interest to identify common patterns • Homogenous Sampling: Selecting similar types to describe a particular group in-depth