qualitative analysis boot camp final presentation slides
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Qualitative Analysis Boot Camp
Session F48Friday, 2/1/13 - 4:30 - 5:30 pm PST Yerba Buena 3-4/Lower B2
38th ACEHP Annual Conference
Presenters:Wendy Turell, DrPH, CCMEPContextive Research LLC
Alexandra Howson, MA(Hons) PhD, CCMEPThistle Editorial LLC
Today!
Qualitative Research Introduction Data Collection Coding and Analysis Reporting Resources Coding Practice! Questions/Discussion
Qualitative Research“Not everything that can be counted counts, and not everything that counts can be counted.” - William Bruce Cameron
Exploration
Unearth a complete and detailed description of the how and why behind physician, allied healthcare provider, and patient behavior.
Produce deep answers to research questions that give voice and layered explanation to the answers you seek.
Qualitative vs. Quantitative
Qualitative Research
Quantitative Research
Type of Questions
Probing; allowing immediate interactive follow up & adjustment
Limited probing; pre-determined questions
Sample Size Small Any size including large
Information per respondent Much Varies; Limited to
answer choices
Administration Requires skilled researcher
Fewer specialist skills required
Type of Analysis
Follows structured steps; subjective and interpretative
Statistical; objective
Type of Research Exploratory, descriptive Descriptive or Causal
Why Qualitative?
Patient care is complex Semi-structured, open ended approach
to inquiry Less limiting - explores beyond pre-
selected answer choices Interaction - researchers probe and react
to study subject comments Mixed methods
Applications in CEHP
Research Phases Needs Assessment Intervention Development Formative Evaluation Post Intervention
Assessment (“Outcomes”)
Methodological Focus Pure Qualitative Mixed Methods
Research Subjects Physicians Allied Healthcare
Providers Healthcare Staff Patients/Caregivers
Instrument Development Help inform
development of quantitative tools
Data Collection
Sample Methodologies/Tools
• Interviews (in person, virtual/online, telephonic)
• Focus Groups (in person, virtual/online facilities)
• Message Boards/Social Media Analysis• Observation• Document Analysis• Mixed-Methods (Qualitative and Quantitative combination)
Online Methodologies
Research methodologies = evolving with communication styles
Widely-used, often preferred options for researchers and respondents
Benefits Cost Savings Ease for wide geographical representation Ease for scheduling (no need for travel, sessions tailored to their availability)
Anonymity = less inhibition / more honesty
Webcam-enabled images.
Text based chat &
audio capable
One-on-One In-Depth Interviews
One-on-One In-Depth Interviews
Whiteboard may also be filled with text, video, images, or interactive ranking, posting, or writing activities. The interviewee can move objects onscreen, as in this card-sorting exercise.
Online Research Community
Coding and Analysis
Coding
Breaking down data into units which are then grouped according to characteristics
Proceeds linking diverse observations Helps with understanding It’s practical! Organization = quick access when you need it for analysis/description.
Coding
1st phase: review data: What’s happening? What’s important? What patterns are emerging?
2nd stage: repeat, refine, expand/reject categories
Text can be tagged with >1 code
Grounded Theory
Glaser & Straus (1967) – emphasis on developing theory/explanation from data versus gathering data to test a theory/hypothesis.
The theory is grounded in reality as represented in the data
Benefits: Theory is derived from what speakers do, vs. what
is believed they should do Ensures the researchers maintain an open mind
towards inquiry vs. imposing existing beliefs on data
• Rigor• Validity• Saturatio
n
Methodology
How can Software Assist?
GATHERORGANIZ
EANALYZE VISUALIZE RESULTS
How can Software Assist?
Source: Nvivo (QSR)
Coding Memoing
Visuals Queries
-Review-Merge-Refine
-Models-Matrices-Charts
-Key Ideas-Reflect-Link
-Text Search-Word Frequency-Matrix-Coding Comparison
Visualizing Data
Visualizing Data
Word Clouds
Visualizing Data
“Many who had once supported lobotomy began to disavow it. "It is inconceivable," reported the American Medical Association, "that any procedure that effectively destroys the brain could possibly restore the patient to a normal state." Lobotomy, one former supporter declared, was really no more subtle than a gunshot to the head. Especially vehement were Freudian psychoanalysts, who condemned lobotomy as a brutal assault on the brain. But Walter Freeman had little patience for his critics.”
Analysis: Coding with Software
Reporting
Reporting
Reports = based on trends and relationships found within the data
Includes:Trend Description Respondent QuotesVisualizations (themes, their
relationships, demographic elements)Interpretation
Reporting: Descriptive
Patient Concern about high blood pressure:
The overwhelming response to the question "Should a person be concerned about having high blood pressure?" was "yes." Most people believed that being unconcerned could result in serious health problems, specifically heart disease or even death. "A person can die if they have high blood pressure because it can cause a stroke or it can
cause heart problems."
Reporting: Trends
Patients’ opinions on how well providers explain a medication varies from “satisfied” to “very well” For some patients, the nurse practitioner provides more detail, as does the pharmacist and the information that accompanies the medication.Between the nurse practitioner and the physician, respondents tend to trust the physician more. In many cases, it appears that patients with a strong, long, and trusting relationship with their providers perceive them as explaining the medication better than those withoutan established relationship or who distrust their providers.
Reporting: Giving Voice
Provider: “After their bypass surgery, when they have seen God and all that, they listen, but after they are out of the hospital and they are going through rehab and they are fine, that period of after the bypass, they are invincible.”
Patient: “I took [the prescription] to the pharmacy and ……they were only going to give me four pills because it is so expensive, and I am saying to myself, ‘why did they give me this, I am going to die because I will not be able to afford it?’In my head, I said ‘Oh Lord; please make this work without any side effects so I can take it.’”
Reporting: Quote IntegrationHaving a normal blood pressure level:
Living a calm life, feeling relaxed, and avoiding or solving problems were seen as very effective ways to keep blood pressure normal. "Be calm in everything. Do not get angry over something small."
"I try not to have problems with anyone at home, in the street, or anywhere else. If I were to have a problem with anyone here, my blood pressure would go up immediately. A person can burst."
Resources
Software Resources: Coding & Organization
Free (QDA Miner Lite) http://provalisresearch.com/products/qualitat
ive-data-analysis-software/freeware/
Low Cost: dedoose ($10 per month) http://www.dedoose.com/
Bells and Whistles software: Nvivo or Atlas Ti http://
www.qsrinternational.com/products_nvivo.aspx
http://www.atlasti.com/index.html
Resources Cont.
Hopkins Open Coursework: http://ocw.jhsph.edu/
Qualitative course materials: http://ocw.jhsph.edu/index.cfm/go/
viewCourse/course/qualitativedataanalysis/coursePage/index/
Online Qual. Textbook: http://onlineqda.hud.ac.uk/Introduction/index.php
Resources Cont.
Cater JK. SKYPE: a cost-effective method for qualitative research. Rehab, Counselors + Educators Journal. 20011;4:
Cohen DJ, Crabtree BF. Evaluative criteria for qualitative research in health care: controversies and recommendations. Ann Fam Med. 2008;6:331-339.
Curry L, Nembhard IM, Bradley EH. Qualitative and
mixed methods provide unique contributions to outcomes research. Circulation. 2009. 119:1442-1452.
Coding Exercise
What’s happening? What’s important? What patterns are emerging?
For Additional Information or Questions: