Directions in Qualitative Health Research

I am attending a session on qualitative health research, which is often a challenge in the US (as well as elsewhere, it seems). There are a lot of qualitative health researchers here in this conference, especially from the social work and nursing fields. Wondering why so few of these discussions have made their way to New York area institutions.

Some of the challenges that were identified by the first speaker, Jennifer Beale (U of Toronto).

  • integrating qualitative researcher into health sciences agenda
  • getting into the field and thus finding a site to conduct it
  • getting research published in health sciences

While she was discussing these issues and explaining some of her positive ethnographic experiences, I wondered about the other challenges to having external qualitative researchers within healthcare:

  • what’s in it for me? (WIIFM?) – Why should the organization allow access? What will the organization get for somebody looking over internal data or strategic processes? How will it promote improving patient outcomes or otherwise improve internal performance?
  • who within the organizations will review the findings from a legal or marketing perspective if the research findings are not possible
  • to what extent does the researcher know how to navigate the healthcare organization’s institutional review board (IRB)
  • establishing mutual partnerships and research possibilities first seems to be the best first step (IMHO)

Murilo Moscheta (University of Sao Paulo, Brazil) spoke next, who spoke about his paper Responsivity in Health Qualitative Research: Resources for inquiry and the development of non-discriminatory healthcare assistance. The team concern in his paper was how to serve a GLBT (gay, lesbian, bisexual, and transgender) population, as just showing up with resources did not work. His work was to work with the team to try to understand what was happening with them.

I am partly attending this session as a result of a conversation I had with Murilo during the opening reception on the first night of the conference. The ideal situation for dialogue that he established in a project imploded when a participant in the session stood up, said she could not deal with the situation at hand, and left the room. He then wondered, from the researcher’s perspective, what should the researcher’s response be? This led him to a study of dialogue, about how can we explain what happened so we can understand the situation and then respond.

Theories of dialogue were then reviewed, with one framework that dialogue is always done in response to something that was said before. Communication is a chain, and in this way, if everything that I say is a response, who is the author? Responsivity is recognizing the co-authorship of the act of communication?

Using the prescriptive model, dialogue is that conversation that occurs between the I and the Thou, when the otherness of the other is acknowledged and engaged in. This is interesting with an appreciative stance to enable creativity.

Once again, inviting people to discuss this work means more than just showing up. People often do not respond to the content, they react to the process. When he later debriefed this with the nurse, the result was a creative response. The discussant does not create meaning — that happens within the context of those involved in the interaction.

Yes, I clearly need to learn more about these communication theories. So many things to learn!

Stephanie Baller then spoke about her paper, The Influence of Materialistic Values and Activity Level on Physical Activity Location and Type. Her research was on the physical environment, including how values effect how people choose to locate themselves in time and place. She used a survey to get enough basic information to then inform a focus group. Her work thus comprised mixed methods reserach. Her research involved materialism and activity, thus for a four-quadrant perspective.

Interesting discussion about the idea of distance, and how much of this is based around perception. With this, and given that her findings showed that the people who generally use the rec center are more materialistic (want to be seen, use the same things with a sense of ownership and competition) and the result was that rather than asking everybody, “What do you all want?” the question should then be asked to those who do not use the space, “What do you need that is different?” with the understanding that this  is the population that needs to be reached.

Great discussion about how issues of race, gender, and class influence who uses or does not use gyms, which parts of the gyms, etc. Thinking about my own experiences of this, it reminds me of when I used to go to an over-priced facility where I felt that I needed to get in shape before I even entered the facility . . .