Qualitative Research Approaches/Designs HCO 628/728 Nataliya V. Ivankova, PhD UAB School of Health Professions and School of Nursing Email: nivankov@uab.edu Qualitative Research and Methods Qualitative research is a means for exploring and understanding the meaning individuals or groups ascribe to a social or human problem. The process of research involves emerging questions and procedures; collecting data in the participants’ setting; analyzing the data inductively, building from particulars to general themes; and making interpretations of the meaning of the data. The final written report has a flexible writing structure. Qualitative methods – techniques associated with the gathering, analysis, interpretation, and presentation of narrative information. Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches. Thousand Oaks, CA: Sage Publications. Key Characteristics Focus on understanding the central phenomenon vs. relationships among the variables Data collection is in the field – natural setting Data collection and analysis is simultaneous: zigzag process Emerging research design Inductive Constant comparative analytical method Researcher is the primary instrument of data collection and analysis Research literature plays a minor role in guiding the study Interest is in both the process and outcomes Explaining or predicting variables versus exploring or understanding a central phenomenon Quantitative Explaining or predicting variables X Qualitative Understanding or exploring a central phenomenon Y Y The independent variable (X) influences a dependent variable (Y) In-depth understanding of Y; external forces shape and are shaped by Y When Designing a Qualitative Study Focus on process as well as outcomes Let the design emerge Study the phenomenon in the natural settings Look for shared patterns of experience behavior culture Use inductive reasoning Develop a complex and in-depth understanding of the central phenomenon study many ideas with few participants and sites Discuss the context of the phenomenon Follow the “scientific method” Major Qualitative Approaches/Designs Major Qualitative Research Approaches/Designs Narrative research Phenomenology Ethnography Grounded theory Case study Major Qualitative Research Approaches/Designs Narrative research Key questions: “What are the experiences in the individual’s life? How do they shape this individual’s life?” Phenomenology Key questions: “What does this experience mean to individuals? What meaning do individuals assign to this experience?” Ethnography Key questions: “What is the culture like for this group? How does it shape peoples’ beliefs, behavior, and experiences?” Major Qualitative Research Approaches/Designs Grounded theory Key questions: “How does the process work? What theory can explain the process of individuals’ experiencing the phenomenon?” Case study Key questions: “ What has happened? How do individuals describe the phenomenon and their experiences with the phenomenon?” Differences Among Major Approaches/Designs Discipline origin (single vs. multiple) Types of research problems addressed Study focus Sampling strategies Data collection strategies Data analysis procedures Nature of findings Narrative/reporting approaches Methodological Dimension Narrative Phenomenology Grounded Theory Ethnography Case Study Focus Exploring the life of an individual Understanding the essence of experiences about a phenomenon Developing a theory grounded from data in the field Describing and interpreting a cultural or social group Developing an in-depth analysis of a single case or multiple cases Data Collection Primary interviews and documents Long interviews with up to 10 people Interviews with 20-30 individuals to “saturate” categories and detail a theory Primarily observations and interviews with additional artifacts during extended time in the field (e.g. 6 months to a year) Multiple sources including documents, archival records, interviews, observations, Physical artifacts Description Analysis Interpretation Description of the cultural behavior of a group or an individual Data Analysis Stories Epiphanies Historical Context Narrative Form Detailed picture of an individual’s life Statements Meanings Meaning themes General description of the experience Description of the “essence” of the experience Open coding Axial Coding Selective Coding Conditional Matrix Theory or theoretical model Description Themes Assertions In-depth study of a “case” or “cases” Criteria for Choosing a Qualitative Approach/Design Intent or focus Study purpose and research question Researcher’s philosophical assumptions or worldviews Researcher’s training Discipline orientation Audience Study feasibility and resources Phenomenology The purpose is to describe the meaning of lived experiences for several individuals; what the participants have in common as they experience a phenomenon common, everyday human experiences (e.g., love, grief, stigma, sickness) experiences with typical sociological and psychological phenomena (e.g., having AIDS, experiencing caregiver elder abuse) experiences with common transitions or processes (e.g., caring for terminally ill relatives, coping with cancer) Design Characteristics Focus is on understanding the essence or structure of a phenomenon as described by participants Grounded in philosophy of existentialism stresses the individual's unique position as a selfdetermining agent responsible for the authenticity of his or her choices Developing a composite description of the essence of the experience that consists of “what” is experienced (textural description) and “how” it is experienced (structural description) Design Characteristics Criterion sampling – having experience with the phenomenon Heterogeneous group of participants (5-15 persons) Multiple interviews, observations, artifacts (e.g., art, poetry, music) Asking two broad general questions: What have you experienced in terms of the phenomenon? What contexts or situations have typically influenced or affected your experiences about the phenomenon? Bracketing personal experiences (epoche) researcher puts aside, or “brackets” his or her own ideas, feelings, perceptions, prior experiences Phenomenology Example Amy Morgan (2007) – PhD Dissertation “MIRROR, MIRROR: A PHENOMENOLOGICAL STUDY OF THE ROLE OF REFLECTION IN TEACHING IN ELEMENTARY SCHOOL” Purpose: “The purpose of this phenomenological study was to explore the reflective experiences of 12 currently practicing elementary school teachers working in a southeastern, suburban school district in order to illuminate, from the perspective of teachers, the meaning of reflection in teaching.” Research Questions Central question: What is the meaning of reflection in teaching? Sub-questions: In what ways do teachers experience reflection in the context of the classroom? In what ways do teachers experience reflection in contexts outside the classroom? What role does a teacher’s reflection play in the experience of teaching? What role does experience play in a teacher’s reflection? What role does the school environment play in teachers’ reflective practices? The Essence of Reflection “Reflection is part of the rhythm of teaching. It is so much a part of being a teacher that, often, teachers cannot verbalize their experience with it. Much of the reflecting that teachers do is a type of thinking on one’s feet, allowing the response from students to inform their instruction, and make adjustments on the spot. Along with reflecting upon student learning, teachers also use reflective practices to monitor their own teaching. Effective teachers will reflect on their practice in any setting, but a caring, nurturing, trusting environment is the most conducive to the effective reflection that helps teachers solve problems, adjust to changes, and become lifelong learners.” Grounded Theory The purpose is to develop a theory for an action, a process, or interaction that is “grounded” in the views of the participants Substantive theories about everyday experiences Systematic grounded theory originated in 1967 with Glaser and Strauss as a contrast to the a priori theoretical orientations in sociology Design Characteristics Theoretical sampling to help form the theory 25-30 Questions focus on the steps in the process Saturation in data collection 3-step data analysis coding, and development of logic paradigm or visual picture of the theory open, participants axial, selective Constant comparative method Theory is presented at the end of the study in a narrative statement, visual model, or a series of hypotheses or propositions. Grounded Theory Coding Process Open Coding: “What is this about? “What patterns exist?” Axial Coding: “What is the Relationship that explains How the process works? Selective Coding: What implications does it have? Constant Comparative Grounded Theory Example Elizabeth Barstow (2012) – PhD Dissertation How Older Adults with Age-Related Macular Degeneration Living in a Southeastern Metropolitan Area Develop Physical Activity Self-Efficacy: A Grounded Theory Study Research Question: How do older adults with AMD living in a southeastern metropolitan area develop Physical Activity Self-Efficacy? Focus on: knowledge and beliefs about PA, determinants of PA participation, strategies to develop PASE, understanding of the process of PASE development. Contextual Conditions Themes from Open Coding Physical Activity (Characteristics & SelfEfficacy) Self-Management of Health Physical Activity Determinants (Environmental, Intrapersonal & Interpersonal) Strategies to Enhance Participation (Vision & NonVision related) Interpersonal Physical Activity Determinants- Care giving roles, Authority driven, Reliance on others, Social support, Social opportunities Causal Conditions Intrapersonal Physical Activity Determinants- Knowledge, Experience, Emotion, Physical Self-Management BehaviorsDiet, Medication adherence, Medical appointment adherence, Abstains from substance use Self-Perceived Benefits Core Category Self-Perceived Benefits Intrinsic – improved mental and physical health, increased independence, activity enjoyment, feeling Extrinsic – exposure to environment, exposure to others Intervening Conditions Environmental Physical Activity Determinants- Terrain, Safety of Space, Facilities, Weather, Transportation Axial Coding Paradigm of PA Self-Efficacy Development in Older Adults with AMD Strategies Vision Related Strategies to Enhance Participation Prepared activities, Familiar with setting, Buddy system Non-Vision Related Strategies to Enhance Participation Combine with other activities, Commitment, Routines Consequences Physical Activity SelfEfficacy Engagement and Characteristics of Physical Activity Facilitatory Intrapersonal PA Determinants Knowledge, Experience, Emotion, Physical Interpersonal PA Determinants Caregiver Role, Authority Driven, Reliance on Others, Social Support, Social Opportunities Environmental PA Determinants Terrain, Safety of Space, Facilities, Weather, Transportation Inhibitory Self-Perceived Benefits Intrinsic-Improved Mental and Physical Health, Increased Independence, Activity Enjoyment, Feeling Extrinsic-Exposure to Environment and Others E. Barstow Conceptual Model of PA Self-Efficacy Development in Older Adults with AMD Physical Activity Self-Efficacy Physical Activity Participation & Characteristics Strategies to Enhance participation Vision & Nonvision Related Self-management behaviors ????? Diet, Medication & Appointment Adherence, Abstains from Chemicals Case Study The purpose is to study an issue through one or more cases in a setting or context (a bounded system) explores event, process or one or more individuals in depth is bounded by time and activity a case is studied within a real-life, contemporary context or setting Single vs. multiple case study Case Study “The case could be a child. It could be a classroom of children or a particular mobilization of professionals to study a childhood condition. The case is one among others…. An innovative program may be a case. All the schools in Sweden can be a case. But a relationship among schools, the reasons for innovative teaching, or the policies of school reform are less commonly considered a case. These topics are generalities rather than specifics. The case is a specific, complex, functioning thing” (p. 2). Stake, R. (1995). The art of case study research. Thousand Oaks, CA: Sage Publications. Design Characteristics Focus is on in-depth understanding of the case to present its substantive description Purposeful sampling Questions focus on understanding the context of the case and the issue Multiple sources of information interviews, observations, document analysis, artifacts, audio-visual materials Within-case and across-case analysis Case description and case themes Report consists of a rich description of the case or cases Case Study Example Rucks, A., Mulvihill, B., Wingate, M., Ivankova, N., Jeong, S.J., Xie, P. “Collaboration Among Tribal and State Maternal and Child Health (MCH) Organizations: CATSO Project” Funded by grant from the Robert Wood Johnson Foundation Public Health Service Systems (ID: 67623) Webinar: http://media.soph.uab.edu/mchwebinar20120827/collaborationamongtribalandstatematernal.swf Study Design Mixed methods, two phase sequential 34 states with federally recognized tribes in 2010 Participants State HRSA Title V Maternal and Child Health(MCH) and Children with Special Health Care Needs (CSHCN) directors in the study area Personnel working in American Indian/Alaska Native (AI/AN) organizations serving the MCH population in the study area Phase II - Multiple Case Study 5 states with respondents from both Title V and AI/AN organization/agency (“pairs”) working on MCH issues in the same geographic area To understand different points of view Interviews Document analysis Integrating QUAN and QUAL Results The quantitative survey findings suggest collaborative relationship were limited to the discussion and exchange of ideas and information among Title V and AI/AN MDH entities and were low in density and average in intensity. Case study revealed that collaborative relationships existed in a variety of forms ranging from formal to informal, depended on multiple institutional, contextual, and personal factors, and were aimed at overcoming barriers and achieving common goals. Narrative The purpose is to study an individual and his/her experiences as told to the researcher or found in documents and archival materials. Providing first-person account of experiences that are in a story format having a beginning, middle, and end. chronology of the experiences (life course stages) Forms of narrative research: biography, autobiography, life histories, personal experience story Design Characteristics Focus is on the experiences of individuals that are expressed in lived and told stories Purposeful sampling - one or a few individuals are selected Questions focus on the processes in the individual’s life Data collection – participants’ stories or narratives and information about the context of the stories Narratives are analyzed for key elements (time, place, plot, and scene) Stories are “re-storied” into a general framework Epiphanies - turning points in which the story line changes direction dramatically Ethnography The purpose is to describe and interpret the culture of a group shared and learned patterns of values, behaviors, beliefs and language of a culture-sharing group Selecting cultural themes to study about the group (e.g., enculturation, socialization, learning, domination) Realist ethnography – traditional approach used by cultural anthropologists Critical ethnography – advocating for the emancipation of groups marginalized in society Design Characteristics Focus is on developing a complex, complete description of the culture of a group Purposeful sampling – identifying an intact culturesharing group Looking for patterns in culture-sharing group Data collection – extensive fieldwork extended participant observations of the group; interviews, artifacts Gatekeepers; key informants Data is analyzed and interpreted from a cultural perspective – cultural themes Final product is a holistic cultural portrait of the group Key Readings in Five Qualitative Research Designs Clandinin, D. J., & Connelly, F. M. (2000). Narrative inquiry: Experience and story in qualitative research. San Francisco, CA: Jossey-Bass. Thousand Oaks, CA: SAGE. Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches (3rd ed.). Thousand Oaks, CA: Sage. Fetterman, D. (1998). Ethnography: Step by step. Thousand Oaks, CA: SAGE. Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks, CA: SAGE. Stake, R. (1995). The art of case study research. Thousand Oaks, CA: SAGE. Strauss, A. & Corbin, J. (2007). Basics of qualitative research: Techniques and procedures for developing grounded theory (3d ed.) Questions?