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EH/GTZ/Novembe r 2003 Qualitative Research Methods Training Course Kampot Province, Cambodia 10-16 November 2003

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Qualitative Research Methods Training Course. Kampot Province, Cambodia 10-16 November 2003. Research Question:. Who are the health providers in the village and what care do they provide?. Training objectives. - PowerPoint PPT Presentation

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EH/GTZ/November 2003

Qualitative Research Methods Training Course

Kampot Province, Cambodia10-16 November 2003

EH/GTZ/November 2003

Research Question:

Who are the health providers in the village and what care do they provide?

EH/GTZ/November 2003

Training objectives

 1. To familiarize the participants with the principles and practice of qualitative research methods in public health

2. To discuss a mix of qualitative methods and their application in public health research and programming

3. To practice using qualitative research methods in an applied context

EH/GTZ/November 2003

Qualitative Research Methods

Social mappingIn-depth interviewsObservationFree-lists and ratings

EH/GTZ/November 2003

Meaning of Methods

1. Epistemology or the study of how we do things

2. At a general level, it is about strategic choices, for example, whether we do participant observation fieldwork, document analysis or an experiment

3. At the specific level, it is about what sample you select, whether you do face to face interviews or use a telephone or use an interpreter or learn the language and do the interviews yourself

EH/GTZ/November 2003

Rationalism is the idea that human beings achieve knowledge because of their power of reason. That is, there are a priori of truths, and if we prepare our minds adequately those truths will be evident to us.

Versus Empiricism, who consider that the only knowledge that human beings acquire is from sensory experience. They consider that we are born with brains like empty boxes and that boxes are filled with the experiences throughout our life. We come to understand what is true from what we are exposed to.

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Scientific method

Science is “an objective, logical, and systematic method of analysis of phenomena, devised to permit the accumulation of reliable knowledge” (Lastrucci, 1963:6).

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Objective – “the idea of truly objective inquiry has long been understood to be a delusion. Scientists do hold, however, that striving for objectivity is useful. In practice this means constantly trying to improve measurement (to make it more precise and accurate) and submitting our findings to peer review” (Bernard 1995).

EH/GTZ/November 2003

Method – Each scientific discipline has developed a set of techniques for gathering and handling data, but there is, in general, a single scientific method.

The METHOD is based on 3 assumptions:(a) reality is “out there” to be discovered; (b) direct observation is the way to observe it; (c) material explanations for observable phenomenon are always sufficient, and that metaphysical explanations are never needed.

EH/GTZ/November 2003

Reliable – something that is true in Phnom Penh, for example, is equally true in Kampot Province

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Social Science Asks questions and seeks to explore the answers

Social science uses various methods to answer the question/sMost anthropological work is qualitative. In applied anthropology there is a growing interest in mixing qualitative and quantitative research to answer the research question/sImportant not to mix quantification and science. Keep them separate.Quantification is important in anthropology, as it is in any science. But all sciences are not quantified and all quantification is not science

     

EH/GTZ/November 2003

Some social scientists do not use quantitative methods, for example, sociologists.

Ethnography does not mean qualitative. As a noun it means a description of a culture. As a verb it is ‘doing ethnography’, and it means collection of data that describes a culture.

EH/GTZ/November 2003

The rest of the training program will be about methods that will let you build an ethnographic record. Some of these methods involve fieldwork. Some methods involved in building an ethnographic record include, watching, listening. Some methods result in words and OTHERS result in numbers.

EH/GTZ/November 2003

Characteristics of Qualitative and Quantitative Research

Qualitative researchInductiveHolisticSubjective/insider centeredProcess orientatedActor’s world viewRelative lack of controlGoal to understand actor’s viewDiscovery orientatedExplanatory

Quantitative researchDeductiveParticularisticObjective / Outsider centeredOutcome orientatedNatural scienceAttempt to control variablesGoal to find facts & causesVerification orientatedConfirmatory

EH/GTZ/November 2003

Quantitative Research Use numbers and statistics, examples, experiments, correlation studies using surveys & standardized observational protocols, simulations, supportive materials from case studies (example, test scores).

General sequence of research:1. Observe events / present questionnaire / ask questions

with fixed answers2. Tabulate3. Summarize data4. Analyze5. Draw conclusions

EH/GTZ/November 2003

Culture is the shared traditions, beliefs and life-ways of a group

of people

EH/GTZ/November 2003

Qualitative Research

Use descriptions and categories (words). Examples: open-ended interviews, naturalistic observation (common in anthropology) document analysis, case-studies, life histories, mapping, pile sorts and ratings, descriptive and self-reflective supplements to experiments and correlation studies.

EH/GTZ/November 2003

General sequence of qualitative research:

1. Observe events / ask questions with open ended answers2. Record/log what is said (or not said) and done (or not done)3. Interpret (personal reactions, write emergent speculations or hypotheses, monitor methods)4.  Return to observe, or ask more questions of people5.  [recurring cycles of 2-4 – iteration]6.  Formal theorizing [emerges out of speculations and hypotheses]7. Draw conclusions

EH/GTZ/November 2003

Three key methods

1.Detailed open-ended interviews (not highly structured or limited responses)

2.Direct observation

3. Written documents (work with words and visual data, not numbers)

EH/GTZ/November 2003

Strengths of qualitative research

 Depth and detail (versus standardized questionnaire)

Openness – can generate new theories and recognize phenomena ignored by most or all previous researchers and literature

Helps people see the world view of those studied- their categories, rather than imposing categories; simulates their experience of the world

Attempts to avoid pre-judgment (this is questionable in reality).Present people on their terms, without being judgmental, try to respect them from their perspective so the reader can see their views (always difficult)

EH/GTZ/November 2003

Weaknesses of qualitative research Fewer people studied (usually)

Less easily generalized because of few people / locations in studies

Difficult to aggregate data and make systematic comparisons

Dependent on researchers personal attributes and skills

Participation in the research can always change the social situation (although, not participating can also change the social situation as well)

EH/GTZ/November 2003

Ten themes of qualitative research

Naturalistic – not manipulating the situation, watch naturally occurring events, not controlling them.

Inductive – categories emerge from observing, creation and exploration centered, theories emerge from data. Often induce hypothesis, test it, then look for other possible explanation or additional hypothesis.

Holistic – look at total, what unifies phenomenon, it is a complex system, see overall perspective. Often research and academics study smaller and smaller parts and overlook the big picture. Need to try and get a larger picture, including the specific and unique context. But can look at specific variables too.

EH/GTZ/November 2003

Characteristics of Qualitative Research

Personal contact – share the experience, not trying to be the objective outsider. Must know people to understand them, and gain insight by reflecting and being empathetic with them. If try to be objective probably won’t understand their views (but might understand things about them).

Dynamic constant shifting with the changing phenomenon and context: what method fits now and also, use trial and error. Don’t stick with the one method when you know that it is not working. Stop. Realize that things may unfold differently than you expected, go with the flow. Respond creatively.

Unique case selection – not as concerned about generalizability (actually generalization is a cooperative venture of researcher and reader = researcher describes context fully and reader decides if new context is similar in crucial respects)

EH/GTZ/November 2003

Characteristics of Qualitative Research con’t

Thick description – lots of detail, lots of quotations

Context sensitivity - emphasize many aspects of social, historical and physical context.

Empathetic – trying to take a view of the other person and be non-judgmental. Not subjective in terms of my biases, not objective in terms of no bias, but taking on their perspective to the degree possible. How does reality appear to those being studied. Yet, also reporting own feelings and experiences as part of the data. Try to omit judgments, but freely admit own feelings. Do not try and hide them. Admitting them adds to the validity of the data.

EH/GTZ/November 2003

Characteristics of Qualitative Research con’t

Flexible design - You don’t always specify it completely before research; variables and hypotheses and sampling and methods are at least partly emergent – need to unfold. Need to be able to tolerate contradictions. Trial and error with categories too – need to reformulate categories many times. Go from parts to whole and then back again. Cycle back and forth. Then reconstruct, pull data apart again, make better reconstructions, etc. Use multiple methods or as many as feasible, as long as you get a better picture of what is happening and how it is understood – even use quantitative methods.

EH/GTZ/November 2003

Researcher Roles

The ‘traditional’ role for a qualitative researcher is to be nonexistent. This is ideal but not always possible and practical. The ideal is that participant act exactly as they would if you were not present.

Problem – tends to ignore differences made in the environment by the researcher.

Qualitative research states that the researcher should document these differences.

It is difficult to obtain the participants views without interacting

EH/GTZ/November 2003

Researcher Roles con’tThe presence of the researcher could cause other reactions, eg suspicion, affected behavior, demonstrations for the researcher’s behalf. But time and familiarity tend to blur these responses. In time the researcher becomes part of the environment. But not initially.

Researcher is an instrument in qualitative research. To gather data. People reading the research need to know about the instrument. So, you need to describe relevant aspects of the yourself, your biases and assumptions, expectations, relevant history. Keep track in your field notes personal reactions, insights into the self and past. In a separate journal – write your personal notes.

EH/GTZ/November 2003

Emic = an insider, become full participant in activity, helps minimize distinction/difference between researcher and participants

Etic = an outside view, A fly on the wall. Lots of variation in between, can vary role within a study – starts as outside and move to membership. Or change to outsider role at end to verify hypothesis generated as participant.

EH/GTZ/November 2003

Gatekeepers

Initial entry into the field of studyControl accessProblems with / for gatekeepersPosition of gatekeeper in the researchGatekeepers’ perception of the researchers, eg. SpyExpectations of gatekeepers on researchers, eg, outcomes such as reports, relationships, money CompromisesGatekeepers and problems for the research and researcherDO NO HARM

EH/GTZ/November 2003

Access to research subjectsAccess to subjects is often challenging for the researcherTrust and respect is very importantDifficulties when participants are not very verbalRole of key informant in research processPositives and Negatives of involving key informant, eg, not always representative view of ‘others’, vested interest in research subject, access to resources, political position, looking for a friend, have problems with others in the community, most educated person, others?

EH/GTZ/November 2003

Access to research subjects con’t

Stay around the study site early in the research process. This is sometimes called the “mapping phase”, ie, map the area, social context of environment, kinship relations, services or networks. Physical mapping is an excellent way to “meet and greet” and learn about the physical environment. Doing a video often helps.

If physical environment is very familiar, try to look for the ‘other’ aspects of the environment, eg, other health providers

EH/GTZ/November 2003

Sample and Selection

Study a subsection of a populationLook at selection in a probabilistic manner – try to get a representative sample of the group under study. Not generalizable for the whole population, but generalizable for the population under study. Choosing a population to study is dynamic and ongoing. The choice of who to study next are products of what is being found, not the initial plan.

EH/GTZ/November 2003

Suggestions for accessing subjects

1. Maximum variation of participants, example, women who attend health services and women who do not, different age groups, social and economic backgrounds, and so on.

2. Snowball approach and networking – each person studied is chosen by the previous participant - this will show linkages between participants. This is sometimes the only way to find and obtain a sample of certain population groups, eg, women who have been trafficked for prostitution.

3. Extreme cases – studying one or more people at some extreme. This needs to be included in the sample with the ‘average’ and the ‘opposite’. This may or may not be possible, but you have to seek these people out. There may only be one or two people, but you have to include them.

EH/GTZ/November 2003

4. Typical case - decide what characterizes ‘typical’ and go and look for them.

5. Unique case – very rare combination of things – usually found by accident.

6. Ideal case – perfect situation. “if it won’t work here, it won’t work anywhere.

EH/GTZ/November 2003

It is very important to be able to say how and why you sampled in a given manner. So, keep detailed field notes on the decisions you made about sampling and why you made them. Go into detail in the field notes, give examples and the reasons for the choices you made.

EH/GTZ/November 2003

Informed consent

Definition of informed consent consists of the elements- information, comprehension, and choice. Country specific laws provide conditions for informed consent. Local standards and protocols when conducting research with human subjects Oral or written consentAnonymousDifficulties obtaining informed consent in special populations, for example, children and refugees. Costs and benefits of obtaining informed consent

EH/GTZ/November 2003

Ethical behavior in research

Courtesy

Respect

Empathy

Honesty

EH/GTZ/November 2003

TriangulationTRIANGULATION involves using a combination of methods, researchers, data sources and theories in a research project.

Outcomes:Different results will be obtained by using different researchers and different data sources

Methods are not neutral tools that will produce the same results regardless of the method. Triangulation addresses this problem.

EH/GTZ/November 2003

Recording field work data

Two types of note-taking

1. Field-notes

2. Interview transcriptions

EH/GTZ/November 2003

Field-notesIdeal situation is to write field-notes by hand, and at the study site

Field-notes can be written in point form at the study site and expanded later

Field-notes can be typed into the computer later.

Many people do not put field-notes into the computer, they work from their journal.

EH/GTZ/November 2003

Recording Observations in the field

Write about actual eventsAvoid inferences and generalizations Write down detailDescribe the obviousTake photographs if you canDescribe actions without evaluatingPush yourself to get detailsWrite your opinion in separate sectionWhen NOTHING is happening record physical environment in detail

EH/GTZ/November 2003

Practical field-note taking

Use large margins on the page. This gives space for comments, additional information, evolving questions or theories Feel free to draw pictures, diagrams and symbolsWrite clearlyFeel comfortable where you write field-notes

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REMEMBER

You need reliable data [FACTS] to be able to generalize

Qualitative research relies upon carefully documented data so that conclusions can be formed

EH/GTZ/November 2003

Interview transcriptions

Include open-ended questions in the transcription (most formed before the interview)Include a large margin on the page for comments, quotes, etc.Write clearlyWord for word transcription is best Talk and write slowly, if possibleIf information is not clear, ask the person to repeat the information before writing it downDo not summarize informationRecord your opinion and thoughts (separately)

EH/GTZ/November 2003

ObservationsData about the environment, people, events, activities that are under studyTraditions and life-ways of people‘Special’ locations or eventsConfirm what has been said or not saidFind more key informantsCheck accuracy of information gained in interviews and social mapping Provide information previously unknownDevelop relationship with participants Provide additional data

EH/GTZ/November 2003

Key points when making observations

Begin with informal conversationThen introduce the project Obtain consent to take notes Explain the purpose of note taking and getting more detailed data Identify key informant or additional key informantsTake in-depth field notes of observations

EH/GTZ/November 2003

Free-list and rating

Simple, yet powerful research methodGenerally used to study a cultural domainEveryone knows the same free-list, example, diseases, plants, occupations, health workersEasy to develop & analyseEnjoyableCompliments other research methods, especially social mapping and interviews

EH/GTZ/November 2003

Key points when making free-list

Ask informants to list all the people who provide care when they are sick (plus, those that come into the village and those outside)Ideal to have (15) or more free-lists from the same study site (good sample for analysis)Analyse free-lists by:

Order and frequency of recallGenderAgeOccupation / practitionerLocation

EH/GTZ/November 2003

Using free-lists

Opening technique to obtain information to use in interviewsProbe local terminologyExplore ‘special’ terminology Explore cultural and social domainsInform programs

EH/GTZ/November 2003

Rating free-lists

Produce ordinal dataEasy to administerCombined with interviews they are powerful data generatorsUsed in a variety of research settingsUseful when exploring many subjects, eg, foods, diseases, health seeking practices, and so on

EH/GTZ/November 2003

Key points when making a free-lists and rating the list

Ask participants to make a list of the subject under study,eg, childhood illnessesThe order is ‘up to the participant’DO NOT probeLet the the informant make their own list and the ‘natural’ order will occur Obtain at least 15 free-lists, good for analysisAnalyse the free-lists by rating them, for example, in order of priority 1,2,3,4,5….

EH/GTZ/November 2003

Group PresentationsGuidelines

Introduction (includes literature review)Background to the researchResearch QuestionResearch Objectives

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Methods

      Methods used and why     Study site      Study population      Research process       Consent      Confidentiality       Ethical issues      Constraints / problems      Researcher role/s      Unexpected outcomes      Method of analyzing data

EH/GTZ/November 2003

Findings      Who

      Why

      When

      Where

      How

      What

      What for

“Seven Steps of Planning”

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Group Presentations

(2) Persons / group

15 minutes each presentation

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Data Analysis:Phases

Code Various Units

Develop Categories (Subcategories, & Superordinate categories)

Give Examples of Categories

Linkages Between Categories

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Coding Data

Can have multiple codes for a unit of dataWork towards developing many and varying codesTheory – preexisting or emergent theories influences codingMay need to code the same data several timesComputers help, but not essential

EH/GTZ/November 2003

Develop Categories (main & sub categories)

Requires tat you develop definitions for each category

Categories and definitions need to be revised several times during analysis

Keep track of revision of categories and reasons why you revise categories and definitions in notes. For example, data indicates that previous definitions were not sufficient.

EH/GTZ/November 2003

Making Linkages between Categories

Need to be specified manually or on computerDocument the kinds of linkages developedConsider these kinds of linkages:

TimeSpaceCausationSocial/InterpersonalMany others are possible

EH/GTZ/November 2003

Coding:Continual & dynamic

Look at the document, such as interviewsRead document (data) many times Look for indicators of categories in events and behavior-name them and code them on the documentCompare codes (often many times) to find consistencies and differencesConsistencies between codes (similar or pointing to a basic idea) reveals categories.

EH/GTZ/November 2003

Coding:Continual & Dynamic con’t

Manually, you can cut apart copies of field notes/interviews. Now people use computers.Write ‘memo’ on the comparisons of emerging categoriesEventually you reach category saturation when no new codes related to the research project are formedEventually certain categories become more of a central focus – axial and core categoriesThen– you write about (report) the data in each category