2012.09.27 Lessons Learned from Doing Qualitative Research
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The document discusses qualitative research methods and emphasizes the importance of understanding the emotional and contextual factors that influence behavior in decision-making. It highlights various research techniques, such as projective questions, storytelling, and non-direct questions, to effectively elicit participants' feelings and insights. Additionally, it references a specific study where storytelling was found to significantly improve blood pressure in patients with uncontrolled hypertension.
![05/10/2012
9
http://annals.org/article.aspx?articleID=746718
Original Research | 18 January 2011
Thomas K. Houston, MD, MPH; et al
Ann Intern Med. 18 January 2011;154(2):77-84
Abstract
Background: Storytelling is emerging as a powerful tool for health promotion in vulnerable populations.
However, these interventions remain largely untested in rigorous studies.
Objective: To test an interactive storytelling intervention involving DVDs.
Design: Randomized, controlled trial in which comparison patients received an attention control DVD.
Separate random assignments were performed for patients with controlled or uncontrolled
hypertension.
Setting: An inner-city safety-net clinic in the southern United States.
Patients: 230 African Americans with hypertension.
Intervention: 3 DVDs that contained patient stories. Storytellers were drawn from the patient population.
Measurements: The outcomes were differential change in blood pressure for patients in the intervention
versus the comparison group at baseline, 3 months, and 6 to 9 months.
Results: 299 African American patients were randomly assigned between December 2007 and May
2008 and 76.9% were retained throughout the study. Most patients (71.4%) were women, and the
mean age was 53.7 years. Baseline mean systolic and diastolic pressures were similar in both
groups. Among patients with baseline uncontrolled hypertension, reduction favored the intervention
group at 3 months for both systolic (11.21 mm Hg [95% CI, 2.51 to 19.9 mm Hg]; P = 0.012) and
diastolic (6.43 mm Hg [CI, 1.49 to 11.45 mm Hg]; P = 0.012) blood pressures. Patients with baseline
controlled hypertension did not significantly differ over time between study groups. Blood pressure
subsequently increased for both groups, but between-group differences remained relatively constant.
Conclusion: The storytelling intervention produced substantial and significant improvements in blood
pressure for patients with baseline uncontrolled hypertension.
INTERESTING READING
Switch
by Chip and Dan Heath
Predictably Irrational
By Dan Ariely](https://image.slidesharecdn.com/2012-140916102611-phpapp01/85/2012-09-27-Lessons-Learned-from-Doing-Qualitative-Research-9-320.jpg)
2012.09.27 Lessons Learned from Doing Qualitative Research
- 1. 05/10/2012 1 LESSONS LEARNED: QUALITATIVE RESEARCH Richard A. Krueger, PhD Mary Anne Casey, PhD University of Minnesota TIPS • When writing recruiting scripts, introductions or questions, have Ginny in mind • Recruiting is tough – Use someone participants know and respect • Treat subjects like friends coming to dinner • Plan studies in phases – Conduct two or three fg, analyze, stop, rethink, revise questions to a new level, continue • Study good writing—NYT Science Section
- 2. 05/10/2012 2 CHALLENGE: GETTING AT HOW EMOTIONS AND CONTEXT INFLUENCE BEHAVIOR • Behavioral research tells us that we don’t make decisions based on the facts, or on logic. We make decisions based on emotions and context. Yet, researchers often ask direct questions that beg for rational explanations. – What do you think of this program? – What were you thinking when you made that decision? – Would you use this product? – What would you look for in home health nurse visit? – If you got this in the mail, would you return this survey? • These kinds of questions can lead to intellectualizing. • And many of us want to appear rational, so we tell others how we’d like to be, not how we are. PROJECTIVE QUESTIONS • If NUI were an animal, what would it be? • If NUI were an object in the kitchen, what would it be? • If NUI Galway, Trinity College, and University College Cork were people at a party, what would they be like? What car would they drive up in? How would they be dressed? How would they behave?
- 3. 05/10/2012 3 PHOTOS • Choose a picture that best illustrates how you feel about being a graduate student. • Or, Here are photos of mothers. Some of them breastfeed and some don’t. Sort them into two piles. DRAWING • When your boss asks, “What’s it like to be a mom who works outside the home?”… • What do you say? • What do you think? • What does your heart tell you?
- 4. 05/10/2012 4 DRAWING • Draw a typical Volkswagen Bug driver. What are they wearing? What are they holding in their hand? What are they saying? List demographics & adjectives. Name________ Age________ Marital status ________ Five adjectives to describe him/her: _______ _______ _______ _______ _______ DRAWING • Draw you. What are you wearing? What are you holding in your hand? What are you saying? List demographics & adjectives. • Describe both. • Compare. Name________ Age________ Marital status ________ Five adjectives to describe him/her: _______ _______ _______ _______ _______
- 5. 05/10/2012 5 STARBURST • Think of as many things as you can say about the University bookstore and write them on the lines shown. Book store MORE NON-DIRECT QUESTIONS • Ask respondents to develop a “chain of events” or a “causal map” that describes their action, decisions and choices. • Draw a mind-map showing associations and linkages of how they think. • Keep a daily journal of actions, behavior and thoughts on this topic. Participants use journal to answer questions. • Prepare a photo album. • Make a collage that would convince you to X. • Here is $100 (or points). Allocate $ to those features that are most important. • Listen/watch for emotional clues. Ask participants to describe what they are feeling.
- 6. 05/10/2012 6 PILOT -TEST QUESTIONS • Offer several concrete examples and ask them which they prefer • Examples could be displayed in writing, in visuals, by video or by other means • These questions allow respondents to place themselves in an actual situation EMOTIONAL CLUES • Watch for indicators of emotional response • Changes in tone, intensity, speed or statements that they feel strongly, etc. • Attempt to get them to say more about their feelings
- 7. 05/10/2012 7 STORYTELLING TYPES Types of Research Stories 1. Stories illustrate research data 2. Story collections reveal patterns and trends 3. Stories used with surveys 4. Stories produce insight on rare experiences 5. Stories that motivate RESEARCH ELEMENTS 1. Systematic procedures are used 2. Stories can be verified 3. Story process is transparent 4. Representativeness is addressed 5. Confidentiality is respected 6. Truthfulness is considered 7. Intensity and emotional impact are considered
- 8. 05/10/2012 8 STORYTELLING ELEMENTS • The story is about a person • The person has a problem, concern, obstacle or struggle • There is a setting for the story – time, place • People talk • People have feelings and emotions • The story has a sequence • Suspense, surprise or humor help the story • Language is descriptive -- use memorable words • The person is successful, achieves goal, problem is resolved or the person continues the struggle • Key message is revealed and emphasized STORIES TO MOTIVATE Culturally Appropriate Storytelling to Improve Blood Pressure: A Randomized Trial • http://annals.org/article.aspx?articleID=746718 • Thomas K. Houston, MD, MPH; et al • Annals of Internal Medicine. 18 January 2011;154(2):77-84 Storytelling: A Novel Intervention for Hypertension • Kimberly R. Myers, PhD, MA; and Michael J. Green, MD, MS • Annals of Internal Medicine. 18 January 2011;154(2):129-130 • Houston and colleagues report that listening to stories of other patients with hypertension reduced blood pressure among African Americans with poorly controlled hypertension. The editorialists discuss the findings and explore whether clinicians might use patients' stories in other settings and with other populations as a routine part of treatment.
- 9. 05/10/2012 9 http://annals.org/article.aspx?articleID=746718 Original Research | 18 January 2011 Thomas K. Houston, MD, MPH; et al Ann Intern Med. 18 January 2011;154(2):77-84 Abstract Background: Storytelling is emerging as a powerful tool for health promotion in vulnerable populations. However, these interventions remain largely untested in rigorous studies. Objective: To test an interactive storytelling intervention involving DVDs. Design: Randomized, controlled trial in which comparison patients received an attention control DVD. Separate random assignments were performed for patients with controlled or uncontrolled hypertension. Setting: An inner-city safety-net clinic in the southern United States. Patients: 230 African Americans with hypertension. Intervention: 3 DVDs that contained patient stories. Storytellers were drawn from the patient population. Measurements: The outcomes were differential change in blood pressure for patients in the intervention versus the comparison group at baseline, 3 months, and 6 to 9 months. Results: 299 African American patients were randomly assigned between December 2007 and May 2008 and 76.9% were retained throughout the study. Most patients (71.4%) were women, and the mean age was 53.7 years. Baseline mean systolic and diastolic pressures were similar in both groups. Among patients with baseline uncontrolled hypertension, reduction favored the intervention group at 3 months for both systolic (11.21 mm Hg [95% CI, 2.51 to 19.9 mm Hg]; P = 0.012) and diastolic (6.43 mm Hg [CI, 1.49 to 11.45 mm Hg]; P = 0.012) blood pressures. Patients with baseline controlled hypertension did not significantly differ over time between study groups. Blood pressure subsequently increased for both groups, but between-group differences remained relatively constant. Conclusion: The storytelling intervention produced substantial and significant improvements in blood pressure for patients with baseline uncontrolled hypertension. INTERESTING READING Switch by Chip and Dan Heath Predictably Irrational By Dan Ariely
- 10. 05/10/2012 10 Influence By Robert Cialdini Change or Die By Alan Deutschman How We Decide By Jonah Lehrer