Qualitative Research in health education pdf.pdf

This module demonstrate students basic knowledge about characteristics, types and nature research in health education and promotion

1. RESEARCH IN HE
Takele G. (BSc., MPH, Asst. Prof.)
[email protected]
Sept. 2021
Addis Ababa, Ethiopia

2. Outline
Concept of research
Types of research
Research in health education
Qualitative Vs quantitative research methods
How to develop Knowledge and Attitude –questions
for research in (KAP) Studies
Takele G. (MPH, Asst. Prof.) 24 September 2021

3. Objectivesof the session
Attheendofthischapterstudentswill
beableto:
Defineresearch&explaintheroleofresearchinhealtheducation
DescribethecharacteristicsofQualitativeResearch
Compareandcontrastqualitative&quantitativeresearch
Explaintheprocessesofqualitativeresearchmethod
Datacollectionmethodsusedinqualitativeresearches
ExplainthetechniquesofdevelopingKAPquestionnaire
4 September 2021 3Takele G. (MPH, Asst. Prof.)

4. Brainstorming
•Whatisresearch?
•What research methods is used in HE/HP?
•Whatisthedifferencebetweenqualitativeandquantitative
researches?
•Whatarethecriteriaforresearchqualityassuranceor
trustworthiness?
•Explaintheresearchprocesses
•Mentionqualitativeresearchdesignanddatacollection
methods
Takele G. (MPH, Asst. Prof.) 44 September 2021

5. “To invest in research is to
invest for a better future!”
4 September 2021 Takele G. (MPH, Asst. Prof.) 5

6. What is research?
Researchisasystematiccollectionandprocessingofdata
requiredtoanswerparticularquestionsinscientific
manner.
Isasystematiccollection,analysisandinterpretationofdatato
solvehealthproblem
Asoneofthevarioushealthprograms,healtheducation
programs(PIEinHEP)shouldbeguidedanddirectedby
scientificevidencesdrawnfromsystematicallyconducted
researches.
poorunderstanding ofthehealthproblemandthe
factorsresponsiblefortheproblemwillresultedin
failureoftheHEP
Takele G. (MPH, Asst. Prof.)4 September 2021

7. Purpose of health research
Togenerateknowledgeandtoeffectivelypromotethehealthof
thepopulation
Withoutthisknowledge,effectiveactionisimpossiblebecause
ithasnologicalorempiricalbasis
Tofindoutingreatdetailaboutwhatexistsandhowandwhyit
existsoroccurs
Progressinhealth(medicine)canonlybeachievedifgood
qualityinformationaregeneratedthroughresearchtoguide
interventionsandtoinformthegeneralpublic.
Takele G. (MPH, Asst. Prof.) 74 September 2021

8. 4 September 2021
Types of Research
Researchhasbeenclassifieddifferentlyonthebasisof
thefollowingtraits.
1)Basedonoutcomeoftheresearch
Basic/FundamentalResearch
Appliedresearch
2)Basedonpurpose(Thereasonwhyaresearchis
conducted
Exploratoryresearch
DescriptiveResearch
Analyticresearch
Actionresearch
Comparativeresearch
Takele G. (MPH, Asst. Prof.) 8

9. 4 September 2021
3)Basedtheenvironmentinwhichtheresearchis
carriedout;
Fieldresearch
Laboratoryresearch
4)Basedonthetimerequiredtocompletethe
research;
One-timeresearch;
Longitudinalresearch
Takele G. (MPH, Asst. Prof.)
Types of Research …
9

10. 4 September 2021
Types of Research…
Thebasicandappliedresearchescanbequantitative
orqualitativeorevenboth;
A)Qualitativemethod
B)Quantitativemethod
C)Mixed
Thesearethetwomajorcategoriesofresearch
methodsinhealtheducation
InHE,mostlyweusequalitativetechnique.
Takele G. (MPH, Asst. Prof.) 10

11. 4 September 2021 Takele G. (MPH, Asst. Prof.)
What is Qualitative Research?
11

12. Qualitative Research
Definition:-QRinvolvesfindingoutwhatpeoplethink,
andhowtheyfeel-oratanyrate,whattheysaythey
thinkandhowtheysaytheyfeel.
Thiskindofinformationissubjective.
Itinvolvesfeelingsandimpressions,ratherthan
numbers.
Qualitativeresearchisatypeofformativeresearch
thatoffersspecializedtechniquesforobtainingin-
depthresponsesaboutwhatpeoplethink&howthey
feel.
Takele G. (MPH, Asst. Prof.) 12

13. Qualitative….
Itemphasizesonprocessesandindepthunderstandingof
perceivedmeanings,interpretations,andbehaviors
QRisamethodofstudyingthingsintheirnatural
settings,attemptingtomakesenseof,orinterpret
phenomenaintermsofthemeaningspeoplebringto
them
Itisanykindofresearchthatproducesfindingsnot
arrivedatbymeansofstatisticalproceduresorother
meansofquantification
Takele G. (MPH, Asst. Prof.) 13

14. 4 September 2021
What Qualitative….
Ithelpustounderstandsocialphenomenainnatural
settingsgivingemphasistothemeanings,experiences
andviewsoftheparticipants.
Itisconcernedwithdevelopingexplanationsofsocial
phenomena.
Itdealswiththeemotional&contextualaspectsofhuman
responseratherthanwithobjective,measurablebehaviour
&attitude.
Takele G. (MPH, Asst. Prof.) 14

15. 4 September 2021
What Qualitative….
Itseekstoanswerquestionsabout:
Whypeoplebehavethewaytheydo?
Howopinionsandattitudesareformed?
Howpeopleareaffectedbytheeventsthatgoon
aroundthem?
Howandwhycultureshavedevelopedinthewaythey?
QualitativemethodsfillagapinthePHtoolbox;
theyhelpusunderstandbehaviors,attitudes,perceptions,
andcultureinawaythatquantitativemethodsalonecannot.
Takele G. (MPH, Asst. Prof.) 15

16. 4 September 2021
Why qualitative research?
TherearemanyreasonsforusingQLresearchmethods.
Itprovidesgreaterdepthofresponseandunderstanding
Cost-effective(moreeconomical)
Timing-saving(canbeexecutedandanalyzedquickly)
Directlinkwithtargetpublic.
Givetheopportunitytoactuallyview&experiencethetarget
groupsdirectly.
Canbeconductedwherethereisnotechnicalfacilities
Takele G. (MPH, Asst. Prof.) 16

17. 4 September 2021
How QR is Used (Applications)
1)Anideagenerationtool
2)Apreliminarysteptoaidinthedevelopmentofa
quantitativestudy(fortooldevelopmentordesigninga
questionnaire)
3)Asfollow-uptoaidintheunderstandingoftheresultsofa
quantitativestudy
4)Asaprimarydatacollectionmethod(purelyqualitative)
Takele G. (MPH, Asst. Prof.) 17

18. Model4:Quant.&qualit.methodsareusedequallyand
parallel
Model3:QMareusedtoembellishaprimarilyqualitativestudy
Model2:QMareusedtohelpexplainquantitativefindings
Result
Qualitative Quantitative
Quantitative
Qualitative
Quantitative
Qualitative
Result
Result
Qualitative QuantitativeResult
Model1:QMareusedtohelpdevelopquantitative
measuresandinstruments.
18
4 September 2021 Takele G. (MPH, Asst. Prof.)

19. 4 September 2021
Characteristics of QR
TheNaturalSetting
TheResearcherasInstrument
EmergentApproach
InterpretiveApproach
ReflexivityandSubjectivity
AHolisticView
UseofDeductiveandInductiveReasoning
StrategiesofInquiry;Usemultiplestrategies
Saturationorredundancy
Takele G. (MPH, Asst. Prof.) 19

20. 4 September 2021
The Quan vs Qual Debate
QRisoftenpresentedastheantithesisofquantitative
researchandmanyresearchersbecomeentrenchedon
oneorotherside.
Theyshouldbeseenascomplementaryratherthan
exclusive.
Itisbettertoviewnotasdichotomousbutasvarious
tools.
Bothmethodshaveuniqueandvaluablecontributions.
Takele G. (MPH, Asst. Prof.) 20

21. 4 September 2021
BasicDifference
Quantitativeandqualitativeresearchmethods
differprimarilyin:
Theiranalyticalobjectives
Differencesinanalyticalapproach
Thetypesofquestionstheypose
ThetypesofdatacollectionMethods&instruments
theyuse
Theformsofdatatheyproduce
Thedegreeofflexibilitybuiltintostudydesign
Differencesinhierarchyofstudyphases
Takele G. (MPH, Asst. Prof.)
Qualitative Vs Quantitative Research
Method
21

22. Qualitative Vs Quantitative Research
4 September 2021 Takele G. (MPH, Asst. Prof.)
Statistical
22

23. Qualitative vs. Quantitative
•Non-numeric
•Inductive
•Non-generalizable
•Small sample
•Generate
hypothesis
Numeric
Deductive
Generalizable
Large sample
Test hypothesis
4 September 2021 23Takele G. (MPH, Asst. Prof.)

24. 4 September 2021
Hierarchy of Study Phases
Quantitative Qualitative
Linear path Circle
Identify problem collect data (2)
State hypothesis Identify problem (1) Analyze data (3)
Collect data
Analyze data Spiral to next cycle
Test hypothesis Generate working
“hypothesis” (4)
Report Report(5)
Takele G. (MPH, Asst. Prof.) 24

25. 4 September 2021
Keys to Successful QR
Three Keys to Successful Qualitative Research:
First,theresearchmustdeveloptheartofasking"why?”
Second,theresearchermustdeveloptheartoflistening.
Third,theresearchermustapproachtheresearchasa
creativeprocessofinvestigation.
Ahighlevelofcreativethinkingmustbeappliedtoeach
newsituationiftheQRprocessistobetrulysuccessful.
Takele G. (MPH, Asst. Prof.) 25

26. 4 September 2021
The Process of QR
1)Defininganareaofinquiry
2)Statingtheresearchproblem
3)Developingaconceptualframework(optional)
4)Formulatingresearchquestions(objectives)
5)Qualitativeresearchmethods(Design)
6)Ensuringtrustworthiness
7)Samplingtechnique
8)Datacollection
9)QualitativedataAnalysis
10)InterpretationofthefindingsandPresentation
Takele G. (MPH, Asst. Prof.) 26

27. 4 September 2021
5. QR Methods/Designs
QRdesignscannotbecompletelyspecifiedpriortofield
work
Maychangeduringthecourseofthestudyasaresultofnewor
unforeseenevents.
Someofthedesignsare:
1)GroundedTheory
2)Phenomenology
3)Ethnography
4)Casestudies
5)Narrative
Takele G. (MPH, Asst. Prof.)
6)ProgrammaticQR
7)Historiography
8)Oralstories
9)Contentanalysis
27

28. How they can help us
Guidelinesforconductingresearch
Keywordsforliteraturesearches
Understandhowtointerprettheliteratureandinteract
withotherqualitativeresearchers
4 September 2021 Takele G. (MPH, Asst. Prof.) 28

29. 4 September 2021
6. Sampling in QR
Inquantitativeresearch,whyrandomsample?
Representativeness
Generalizability
Whatisourobjectiveinqualitativeresearch?
Understanding
Contextualrichness
Samplingshouldberelatedtothegoalandtheobjectivesof
thestudy
Takele G. (MPH, Asst. Prof.) 29

30. 4 September 2021
6. Sampling in QR
Generallypurposivesampling(techniques):
Donotseekrepresentativeness–seektheindividualswiththe
mostinformationaboutthetopic
Researcherdeliberatelysamplesgroupsorsetting
Guidedbyadesiretoselectsubjects/circumstanceswithrich
information
Sampledesignisflexible,andwillusuallyevolveasthestudy
progresses
Takele G. (MPH, Asst. Prof.) 30

31. Sampling techniques
•Purposive sampling can be achieved through different
techniques.
I. Snowball or chain sampling
The first subject is used as a resource for identifying the
next informant.
Valuable when the researcher does not know the field.
Important when individuals to provide rich data are difficult
to reach.
4 September 2021 31Takele G. (MPH, Asst. Prof.)

32. II. Extreme or deviant cases
•Selectsextremecasestohighlightandunderstandconditions
ofmoretypicalsituations.
Learnfromhighlyunusualmanifestations
-Example:Twoclinicswithdifferentlevelsofclient
satisfactions
4 September 2021 32Takele G. (MPH, Asst. Prof.)

33. III. Homogeneous sampling
Peoplewithbasicallysimilarcharacteristics
Donewithincertainstrata,i.e.,Amongsub-groupstobe
includedindifferentFGDs.
Focusgroupstypicallyusethisapproach.
Thepurposeistofocusonsimilartypesofrespondents,
simplifiesanalysis,facilitatesgroupinterviewing.
4 September 2021 33Takele G. (MPH, Asst. Prof.)

34. IV. Maximum variation sampling
Usedwhenallsubjectschosenaretobeasdifferentfrom
eachotheraspossible.
Usefulforstudyingissuesthatcutacrossindividualor
programvariation.
Thepurposeistoidentifycommonpatternsthatexistamong
differentgroups.
E.g.urban/semi-urban/ruralwithregardtoFGM
4 September 2021 34Takele G. (MPH, Asst. Prof.)

35. V. Convenience sampling
Selectingthosemostreadilyavailable
Helpstosavetime,moneyandefforts.
Theweakestsamplingschemeduetolowcredibility.
VI.Samplingpoliticallyimportant
subjects
•Selectionofpeoplewhoarepoliticallyimportanttogivemuch
emphasistothestudy
4 September 2021 35Takele G. (MPH, Asst. Prof.)

36. 4 September 2021
Sampling Techniques in QR …
Takele G. (MPH, Asst. Prof.) 36

37. 4 September 2021 Takele G. (MPH, Asst. Prof.)
Sampling Techniques in QR …
37

38. 4 September 2021 Takele G. (MPH, Asst. Prof.)
Purpose of the study dictates the sampling
approach!
Sampling Techniques in QR …
38

39. 4 September 2021
Sample size
No hard and fast rule!(Always guidelines, never strict rules).
Selectioncontinuestothepointofredundancy(saturation)
Dependonavailabletimeandresources
Toosmall
Doesnotachieveinformationalredundancyortheoretical
saturation
Toobig
Cannotmanageandfacilitatethedeepcase-orientedanalysis
thatisthehallmark/strengthofqualitativeresearchJustright!
Takele G. (MPH, Asst. Prof.) 39

40. 4 September 2021
Sample size
Getthemost(information)fromtheleast(numberof
people)
Relatedtothepurpose,approach,methods,analysisstrategy
oftheparticularstudy
Inverserelationshipbetweenamountofdatacollectedper
participantandtotalnumberofparticipants
Takele G. (MPH, Asst. Prof.) 40

41. 4 September 2021
Practical Considerations
Generallywanttoover-estimatesamplesize
Researchfundsandethicalapprovalaregenerallyokayifyou
over-estimate,notifyouunderestimate,
Iterativenatureofqualitativeresearchdesignmustbe
balancedwithpracticalnatureofplanning,review,funding.
Takele G. (MPH, Asst. Prof.) 41

42. 4 September 2021
7. Ensuring the Trustworthiness
of QR
Ensuringthequalityofdatabasedoncertainestablishedcriteria;
Thisisimportant,particularlyforQR,wherethechallengeof
understandingandmakingmeaningisputupontheresearcher.
ThefourcommoncriteriaforassessingthetrustworthinessofQR
findingsare:truthvalue,applicability,consistencyand
neutrality.
Takele G. (MPH, Asst. Prof.) 42

43. 4 September 2021
Comparison of Trustworthiness and
Validity Criteria
Qualitative Issue Non-Qualitative
Credibility
•Subjective realties
Truthvalue Internalvalidity
•Lack of bias
Transferability
•Lessons can be applied to
other contexts
ApplicabilityExternalvalidity
•Generalizabilitytooutsidethe
sourcepopulation
Dependability
•Samemethoddoesnotproduce
sameresult
ConsistencyReliability
•Repeatedmeasurementsarrive
atthesameresult
Conformability
•Neutralitytodata,Honestto
findings
Neutrality Objectivity
•Researcherisdistantand
detachedobserver
Takele G. (MPH, Asst. Prof.)
(Lincoln, 1985)
43

44. Activities to achieve credibility
Qualitative techniques to increase trustworthiness
1)Prolongedengagement
2)Tickdescription
3)Persistentobservation
4)Triangulation(combining)
5)Peerdebriefing
6)Negativecaseanalysis
7)Referentialadequacy—testingarchiveddataagainstrawdata,
8)Memberchecks
9)Audittrial/Auditorchecks:(Theprocessofresearch,Record
keeping&Decisiononemergentdesign).
10)Ethicalconsiderations
44

45. 4 September 2021
1)Data:-datatriangulation(public/private,overtime,different
perspectives)
2)Methods:-methodologicaltriangulation(interviews,
observations,documentanalysis)
3)Investigators:-investigatortriangulation
4)Analysis:-multipleanalysts,independentanalysisand
comparefindings
Takele G. (MPH, Asst. Prof.)
Triangulation: Combining
45

46. Ethical considerations
The safety of researcher and respondent.
Anonymity and confidentiality
Informed consent
Participant observation and ethics.
Research ethics and the law.
The uses of your research.
Researching sensitive topics.
Vulnerability and power
Basic Ethical Principles-Generally, three basic principles,
are particularly relevant to the ethics of research involving human subjects:
1)Respect of persons
2)Beneficence and
3)Justice
Takele G. (MPH, Asst. Prof.) 46

47. 8. Data Collection methods
Document Analysis
Photographs/Picture and Videos
Observation (participant Vs Non-participant,
direct Vs Indirect, Mysterious)
Interviewing (KII & IDI)
FGD
4 September 2021 47Takele G. (MPH, Asst. Prof.)

48. 1. Document Analysis
Negotiateaccesstoimportantdocumentsatthebeginningof
thestudyCanhelptheresearchertoidentifywhatneedstobe
pursuedfurtherindirectobservationandinterviews
Usechecklisttoguidedocumentreview
Examinationofrecords
newsletters,newsreleases
records(student)
minutesfrommeetings
philosophystatements
diaries,letters
Takele G. (MPH, Asst. Prof.) 48

49. 2. Photographs and Videos
Usetogaininsightintohowpeopleviewandinterprettheir
world
It'sbenefitsareasanaidtorecall,multipleinterpretation,
andreachingawideraudience.
E.g.filmonhomelesstomobilizecommunityactionor
publicfunding.
Takele G. (MPH, Asst. Prof.) 49

50. Takele G. (MPH, Asst. Prof.) 50

51. 3.Observation
•Systematicwatchingandrecordingofwhatpeopledoandsay
innaturallyoccurringsettingsandcarefulrecordingofwhat
occurs.
•becomeinvolvedinthesocialsettingtheyarestudying
•Nonparticipantobservers:moreremovedfromthesocial
process
Theobserver(heorshe)doesnotnormallyquestionor
communicatewiththepeoplebeingobserved.
Bothkindsofobserverscollectfieldnotes
4 September 2021 51Takele G. (MPH, Asst. Prof.)

52. •Participant-observers-Theresearcherbecomes,orispart
ofthegroupthatisbeinginvestigated.
becomeinvolvedinthesocialsettingtheyarestudying
Hasitsrootsinethnographicstudieswhereresearchers
wouldliveintribalvillagesattemptingtounderstandthe
customsandpracticesofthatculture.
4 September 2021 52Takele G. (MPH, Asst. Prof.)

53. 3.Observationcont...
Advantages
•Collectingdatainnaturalenvironmentincreasesvalidity
•Allowsinvestigatortogainsenseofunderlyingbeliefs,values,
explanationsandmeaningsofaneventforpeople.
•Non-verbalandverbalbehaviorrecorded
•Behaviorobservedasitoccurs,thusdecreasingbiasoffaulty
memory
•Investigatornotalwaysdependentonsubjecttoexplainevent
•Usefulaspilotexercisetogeneratedataorstimulateideasfor
investigation
4 September 2021 53Takele G. (MPH, Asst. Prof.)

54. Disadvantages
Time consuming and requires acute observational skills
Small sample
Between observer variability i.e. decreased reliability and
observer bias
Difficulties-gaining entry –ethics
Lacks numbers to persuade -for those who prefer numbers
4 September 2021 54Takele G. (MPH, Asst. Prof.)

55. 4.In-depthInterviews
•Facetofaceconversationtoexploreissuesinmoredetail
•Lastfor20-90minutes
•Minimumsamplesize20-30individuals
•Useofopenendedquestions-WHAT,WHY,WHERE,HOW,
WHOWHEN-thepowerofprobing
4 September 2021 55Takele G. (MPH, Asst. Prof.)
1)Informalconversationalinterview
2)Generalinterviewguideapproach
3)Standardizedopen-endedinterview
4)Closedfixed-responseinterview
5)Combinationofapproaches

56. When to use individual depth interview?
•Whenthesubjectmatterishighlysensitive.E.g.opinionof
abortioncasesaboutFP
•Geographicallydispersedrespondents.
4 September 2021 56Takele G. (MPH, Asst. Prof.)

57. StepsinConductingtheInterviews
Step 1. Formulate study questions.
Step 2. Prepare a short interview guide.
Step 3. Select informants.
Step 4. Conduct interviews.
Step 5. Take adequate notes.
Step 6. Analyse interview data.
4 September 2021 57Takele G. (MPH, Asst. Prof.)

58. In-depthInterviewscont…
Advantages
moreinformalapproach
Isflexibleandresponsivetothediscussiontakingplace
exploresensitiveissues
Enablesintroductionofotherdiagrammaticmodelsforgaining
furtherin-depthanddetailedinformatione.g.mapping,
ranking,seasonalcalendarsetc.
greaterparticipationoftheinformant
4 September 2021 58Takele G. (MPH, Asst. Prof.)

59. Disadvantages
–Timeconsuming
–needscompetentinterviewer
–Applicationsisonlyfeasibleinsmallpopulations
–Betweeninterviewervariationi.e.lowerreliability
–Analysisiscomplex
4 September 2021 59Takele G. (MPH, Asst. Prof.)

60. 5.FocusGroupDiscussion
Individualsassembledbyaresearcher
Discussionfromexperiences
Groupinteractionbetweentheparticipants
Noright/wronganswer
Aminimumof4groups??
Themostwidelyusedtechnique
4 September 2021 60Takele G. (MPH, Asst. Prof.)

61. Takele G. (MPH, Asst. Prof.) 61

62. PurposeofFGD
Assessrespondents’attitudes,feelings,beliefs,culturalnorms,
experiencesandreactions
Recordbothwordsandnon-verbalbehaviors
Usedeitheratthebeginning(exploratory)orattheend
(explanatory)ofalargequantitativestudy
Usedeitherasamethodintheirownorasacomplementto
othermethods
providessomethingmorethanthesumofitsparts
providesmoreandricherinformationandevokesinformation
thatrelatestoemotionalprocesses,innerreasonsandless
overtdeterminantsofbehaviour
Itexploresdominantandminorityviews
4 September 2021 62Takele G. (MPH, Asst. Prof.)

63. Group Composition of FGD
•Itisagroupdiscussionof6-12
personsguidedbyafacilitator,
duringwhichgroupmemberstalk
freely&spontaneouslyabouta
certaintopic.
•Homogeneous-diversityinhibits
freediscussion
•Groupcompositioninfluence
groupinteraction
•Moderator/recorder
•Time:lastsfor1-1:30hrs/group
4 September 2021 63Takele G. (MPH, Asst. Prof.)

64. FGDInterviewGuide
•FGDguides:unstructuredorsemi-structured
•Questions:Generalopen-ended
•Discussionneedsguidingandfocusing
•Theinterviewguideismodifiable(notfixed)
•Theflowisfromgeneraltospecific
4 September 2021 64Takele G. (MPH, Asst. Prof.)

65. TheRoleoftheFGDModerator
•Should be experienced
•Ensures the discussion runs smoothly
•Ensures the discussion remains focused
•Maintains group dynamics
•Good verbal and interpersonal skill
•Non-judgmental (neither agree nor disagree)
4 September 2021 65Takele G. (MPH, Asst. Prof.)

66. TheRoleoftheRecorder
•Note-taking
•Mayusetaperecorder(ensuresthatthewholeinterviewis
captured,andprovidescompletedata)
•Prepares detailed summaries at the end of each discussion
4 September 2021 66Takele G. (MPH, Asst. Prof.)

67. WhentouseFocusgroups?
•Group interaction. If Interaction stimulate richer
responses.
•Cost and timing. can be done more quickly and generally
less expensively
•When subject matter is not so sensitive.
4 September 2021 67Takele G. (MPH, Asst. Prof.)

68. Steps in Carrying out FGDs
(1)Arrangements
Processofconsent,
Where,when-convenienttime?
Travelcosts,
Equipment?,
Seatingarrangements
2)Introduction
Introduceself(moderator),observer,recorder
Objectionstorecording,effortstoensureconfidentiality
Whyyouhavebeenbroughttogether(purpose)
Therearenorightorwronganswers
Anypointsofclarification?Threatening?
4 September 2021 68Takele G. (MPH, Asst. Prof.)

69. Steps in Carrying out FGDs cont.…
(3)Discussion–
fromthegeneraltothespecifictoobtainanunderstanding
oftheissuesrelatedtothetopic
(4)Closure–summarisingandaskingforfurtherpointsand
thankingparticipants
(5)Feedback-possibilityofshortquestionnaireoropportunity
tospeaktoparticipantsindividually
4 September 2021 69Takele G. (MPH, Asst. Prof.)

70. Advantages of FGDSynergism. Likely to produce a richer insight, wider
range of information, and innovative.

Snowballing. One person’s comment often triggers a
chain reaction from the other participants and
generates more views.

Stimulation. General level of excitement over the topic
increases, and a large number of respondents want to
express their ideas and expose their feelings.

Takele G. (MPH, Asst. Prof.) 70

71. Advantages of FGD Cont.…
Security. Enables participants to feel comfortable and
uninhibited to express their ideas/feelings.

Spontaneity. Responses can be spontaneous and unconventional
reflecting an accurate idea of their views

Inexpensive. Considering the richness of output, it is a relatively
inexpensive method of data collection.




Takele G. (MPH, Asst. Prof.) 71

72. DisadvantagesofFGD
Lack of representativeness. Not representative of the
general population.
Misjudgment. Susceptible to client and researcher
biases.
Misuse. Can be misused and abused by considering the
results as conclusive rather than exploratory.

Moderation. Skills of the moderator is a major determinant

Difficult to analyze. The unstructured nature of the
responses in focus group discussions makes coding, analysis,
and interpretation difficult.



Takele G. (MPH, Asst. Prof.) 72

73. KEEP IN MIND
whatworksinsomegroupsmaynotworkinothers
Amoderatorisnotateacherorajudge
Amoderatordoesnotagreeordisagreewithwhatissaid.
Therearenorightorwronganswers.
Theremayalsobeanobserver+/orrecorder
Usefultoensureeyecontactbetweenmoderatorand
observer/recorder-drawpicture
Takele G. (MPH, Asst. Prof.) 73

74. Donottrytocovertoomanyissues.
Trytooutlinekeyissuesandspecialprobingquestionsfor
eachissue,tobeusedifinformationdoesnotcome
spontaneously
Beflexible,itisnotamusttogofromonequestiontothenext
Usesimplelanguage
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75. Takele G. (MPH, Asst. Prof.) 75

76. 9. Qualitative Data Analysis
•Beginwiththefirstfieldactivitiesandmayleadto
revisionsorrefinementsinresearchquestions
•Data could be:
–Field notes
–Transcripts
–Other written materials
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77. Transcribing qualitative data
•Producingawrittenversionoftheinterview
•Transcript analysis/tape analysis
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78. Qualitative Data Analyzing
•Summarizing the mass of data collected and presenting
the results
•Quantitative data
–Labeling or coding every item is key
–Frequency (how often)
–Differences, means, proportions, statistical tests,
significance test
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79. •Qualitative data
–Coding requires different techniques
–Transcribing
–No pre-coding
–Reading and rereading
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80. Content analysis
•Are the data complete and as expected
•Coding and classifying data
•Allitemsofdatainoneinterviewshouldbecompared
withdatacollectedfromotherinterviewees
•Two levels:
–Descriptive = describing what was actually said
–Interpretive = concerned with what was meant,
inferred or implied
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81. Strengths & weaknesses of qual. research
Strengths
Less expensive
flexible
validity:-individuals are interviewed in sufficient detail for
the results to be taken as true, correct, complete, and
believable reports their views and experiences
However, validity in QR largely hinge on the skill &
competence of the researcher conducting the investigation
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82. Weaknesses
Noismadetodrawfirmconclusionsorto
generalizeresultstothepopulationatlarge
(Lacksgeneralizability)
Lessreliability(personalandidiosyncratic)
Ethicalissues
Greatdemandforqualitativeresearchskills(observational,
interviewing,interpretive,writing,&presentationskills)
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83. Quantitative Research Method (1)
Collects specific information and facts that can be expressed as
numbers which can be analyzed mathematically to produce a
summarized finding that can represent the magnitude of
health conditionin the community.
Usually, data are collected using structured questionnaires
with close-ended questions.
The most commonly used quantitative research in behavior
related studies are KAP surveys.
In KAP survey, data are collected using questionnaires which
include questions that address Knowledge, Attitude and
Practice.
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84. Quantitative Research Method (2)
Knowledge, attitude and practice are thought to be important
determinants of health, in addition to biological and health
service factors.
Many health educators believe that the best way to teach or change
practices is to teach correct knowledge and favorable attitudes, and that
good practices will follow.
Generally, it is assumed that Correct knowledge + Positive
Attitudes = Health Practices.
Because of the importance attributed to knowledge, attitudes and
practices in health, researchers want to find out what people know, feel,
and practice.
For these purposes they develop and use KAP questionnaires.
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85. Quantitative Research Method (3)
Practiceis assessed by asking what the person currently does and
giving an exhaustive list of options, to each of which the person
responds yes or no.
Attitudeis assessed in terms of what the person prefers to do, what
they would do if they had the choice, or how favorable-unfavorable or
positive-negative they are to the object.
Knowledgeis assessed in terms of what the person knows about the
item and whether this knowledge is true or false.
Correct and incorrect statements must be included and the respondent is
asked to indicate whether a statement is true or false, or whether the
question should be answered Yes or No.
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86. Quantitative Research Method (4)
How to Develop a KAP Questionnaire:
1)DefineconceptuallywhatismeantbyKnowledge,Attitudeand
Practice.Keeptothesedefinitionswhenyoumakeuptheitems.
2)Developitemssystematicallytoincludealltherelevantones.Thismay
firstrequireaprobingpilottestwithpersonalorgroupinterviewstoelicit
therespondents'KAPspontaneously.Thecontentmustbecompleteand
includeallimportantpractices,attitudesandknowledge.
3)Phraseitemsinlaytermsnotinprofessionalterms.
4)Toimprovereliability,includeatleast10itemsforeachK,A,andP.
5)Orderitemsasfollows-PAK-tominimizecontaminatingPanswerswith
Kitems.
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87. 4 September 2021
References
1)http://www.trentrdsu.org.uk/triage.htmlTrentResearchand
DevelopmentUnit(TRIAGE)
2)http://www.nova.edu/ssss/QR/TheQualitativeReport
3)http://kerlins.net/bobbi/research/qualresearch.QualitativeResearch
WebRingCentreforQualitativeResearch
4)http://www.qsr.com.auTheForumforQualitativeResearch
5)http://wasis.ou.edu/docs/qualitative_methods.pdf
6)WHO1969.ResearchinHealtheducationReportofaWHO
scientificgroup.TRS432.WHOGeneva
7)http://www.apmf.org.sg/264,7,Observation:Advantagesand
Limitations
8)http://gild.cs.uvic.ca/docs/ltheory/276,9,ResearchMethods
9)http://sped.ed.utah.edu/courses/SPED%206610/Powerpoints/261,6,C
haracteristicsofQualitativeResearch
10)Leiyushi,healthserviceresearchmethods;universityofCarolina,
1997
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88. 894 September 2021 Takele G. (MPH, Asst. Prof.)