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Qualitative Research – Methods, Analysis Types and Guide

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Qualitative Research

Qualitative research is a type of research methodology that focuses on exploring and understanding people’s beliefs, attitudes, behaviors, and experiences through the collection and analysis of non-numerical data. It seeks to answer research questions through the examination of subjective data, such as interviews, focus groups, observations, and textual analysis.

Qualitative research aims to uncover the meaning and significance of social phenomena, and it typically involves a more flexible and iterative approach to data collection and analysis compared to quantitative research. Qualitative research is often used in fields such as sociology, anthropology, psychology, and education.

Qualitative Research Methods

Qualitative Research Methods are as follows:

One-to-One Interview

This method involves conducting an interview with a single participant to gain a detailed understanding of their experiences, attitudes, and beliefs. One-to-one interviews can be conducted in-person, over the phone, or through video conferencing. The interviewer typically uses open-ended questions to encourage the participant to share their thoughts and feelings. One-to-one interviews are useful for gaining detailed insights into individual experiences.

Focus Groups

This method involves bringing together a group of people to discuss a specific topic in a structured setting. The focus group is led by a moderator who guides the discussion and encourages participants to share their thoughts and opinions. Focus groups are useful for generating ideas and insights, exploring social norms and attitudes, and understanding group dynamics.

Ethnographic Studies

This method involves immersing oneself in a culture or community to gain a deep understanding of its norms, beliefs, and practices. Ethnographic studies typically involve long-term fieldwork and observation, as well as interviews and document analysis. Ethnographic studies are useful for understanding the cultural context of social phenomena and for gaining a holistic understanding of complex social processes.

Text Analysis

This method involves analyzing written or spoken language to identify patterns and themes. Text analysis can be quantitative or qualitative. Qualitative text analysis involves close reading and interpretation of texts to identify recurring themes, concepts, and patterns. Text analysis is useful for understanding media messages, public discourse, and cultural trends.

This method involves an in-depth examination of a single person, group, or event to gain an understanding of complex phenomena. Case studies typically involve a combination of data collection methods, such as interviews, observations, and document analysis, to provide a comprehensive understanding of the case. Case studies are useful for exploring unique or rare cases, and for generating hypotheses for further research.

Process of Observation

This method involves systematically observing and recording behaviors and interactions in natural settings. The observer may take notes, use audio or video recordings, or use other methods to document what they see. Process of observation is useful for understanding social interactions, cultural practices, and the context in which behaviors occur.

Record Keeping

This method involves keeping detailed records of observations, interviews, and other data collected during the research process. Record keeping is essential for ensuring the accuracy and reliability of the data, and for providing a basis for analysis and interpretation.

This method involves collecting data from a large sample of participants through a structured questionnaire. Surveys can be conducted in person, over the phone, through mail, or online. Surveys are useful for collecting data on attitudes, beliefs, and behaviors, and for identifying patterns and trends in a population.

Qualitative data analysis is a process of turning unstructured data into meaningful insights. It involves extracting and organizing information from sources like interviews, focus groups, and surveys. The goal is to understand people’s attitudes, behaviors, and motivations

Qualitative Research Analysis Methods

Qualitative Research analysis methods involve a systematic approach to interpreting and making sense of the data collected in qualitative research. Here are some common qualitative data analysis methods:

Thematic Analysis

This method involves identifying patterns or themes in the data that are relevant to the research question. The researcher reviews the data, identifies keywords or phrases, and groups them into categories or themes. Thematic analysis is useful for identifying patterns across multiple data sources and for generating new insights into the research topic.

Content Analysis

This method involves analyzing the content of written or spoken language to identify key themes or concepts. Content analysis can be quantitative or qualitative. Qualitative content analysis involves close reading and interpretation of texts to identify recurring themes, concepts, and patterns. Content analysis is useful for identifying patterns in media messages, public discourse, and cultural trends.

Discourse Analysis

This method involves analyzing language to understand how it constructs meaning and shapes social interactions. Discourse analysis can involve a variety of methods, such as conversation analysis, critical discourse analysis, and narrative analysis. Discourse analysis is useful for understanding how language shapes social interactions, cultural norms, and power relationships.

Grounded Theory Analysis

This method involves developing a theory or explanation based on the data collected. Grounded theory analysis starts with the data and uses an iterative process of coding and analysis to identify patterns and themes in the data. The theory or explanation that emerges is grounded in the data, rather than preconceived hypotheses. Grounded theory analysis is useful for understanding complex social phenomena and for generating new theoretical insights.

Narrative Analysis

This method involves analyzing the stories or narratives that participants share to gain insights into their experiences, attitudes, and beliefs. Narrative analysis can involve a variety of methods, such as structural analysis, thematic analysis, and discourse analysis. Narrative analysis is useful for understanding how individuals construct their identities, make sense of their experiences, and communicate their values and beliefs.

Phenomenological Analysis

This method involves analyzing how individuals make sense of their experiences and the meanings they attach to them. Phenomenological analysis typically involves in-depth interviews with participants to explore their experiences in detail. Phenomenological analysis is useful for understanding subjective experiences and for developing a rich understanding of human consciousness.

Comparative Analysis

This method involves comparing and contrasting data across different cases or groups to identify similarities and differences. Comparative analysis can be used to identify patterns or themes that are common across multiple cases, as well as to identify unique or distinctive features of individual cases. Comparative analysis is useful for understanding how social phenomena vary across different contexts and groups.

Applications of Qualitative Research

Qualitative research has many applications across different fields and industries. Here are some examples of how qualitative research is used:

Market Research: Qualitative research is often used in market research to understand consumer attitudes, behaviors, and preferences. Researchers conduct focus groups and one-on-one interviews with consumers to gather insights into their experiences and perceptions of products and services.
Health Care: Qualitative research is used in health care to explore patient experiences and perspectives on health and illness. Researchers conduct in-depth interviews with patients and their families to gather information on their experiences with different health care providers and treatments.
Education: Qualitative research is used in education to understand student experiences and to develop effective teaching strategies. Researchers conduct classroom observations and interviews with students and teachers to gather insights into classroom dynamics and instructional practices.
Social Work : Qualitative research is used in social work to explore social problems and to develop interventions to address them. Researchers conduct in-depth interviews with individuals and families to understand their experiences with poverty, discrimination, and other social problems.
Anthropology : Qualitative research is used in anthropology to understand different cultures and societies. Researchers conduct ethnographic studies and observe and interview members of different cultural groups to gain insights into their beliefs, practices, and social structures.
Psychology : Qualitative research is used in psychology to understand human behavior and mental processes. Researchers conduct in-depth interviews with individuals to explore their thoughts, feelings, and experiences.
Public Policy : Qualitative research is used in public policy to explore public attitudes and to inform policy decisions. Researchers conduct focus groups and one-on-one interviews with members of the public to gather insights into their perspectives on different policy issues.

How to Conduct Qualitative Research

Here are some general steps for conducting qualitative research:

Identify your research question: Qualitative research starts with a research question or set of questions that you want to explore. This question should be focused and specific, but also broad enough to allow for exploration and discovery.
Select your research design: There are different types of qualitative research designs, including ethnography, case study, grounded theory, and phenomenology. You should select a design that aligns with your research question and that will allow you to gather the data you need to answer your research question.
Recruit participants: Once you have your research question and design, you need to recruit participants. The number of participants you need will depend on your research design and the scope of your research. You can recruit participants through advertisements, social media, or through personal networks.
Collect data: There are different methods for collecting qualitative data, including interviews, focus groups, observation, and document analysis. You should select the method or methods that align with your research design and that will allow you to gather the data you need to answer your research question.
Analyze data: Once you have collected your data, you need to analyze it. This involves reviewing your data, identifying patterns and themes, and developing codes to organize your data. You can use different software programs to help you analyze your data, or you can do it manually.
Interpret data: Once you have analyzed your data, you need to interpret it. This involves making sense of the patterns and themes you have identified, and developing insights and conclusions that answer your research question. You should be guided by your research question and use your data to support your conclusions.
Communicate results: Once you have interpreted your data, you need to communicate your results. This can be done through academic papers, presentations, or reports. You should be clear and concise in your communication, and use examples and quotes from your data to support your findings.

Examples of Qualitative Research

Here are some real-time examples of qualitative research:

Customer Feedback: A company may conduct qualitative research to understand the feedback and experiences of its customers. This may involve conducting focus groups or one-on-one interviews with customers to gather insights into their attitudes, behaviors, and preferences.
Healthcare : A healthcare provider may conduct qualitative research to explore patient experiences and perspectives on health and illness. This may involve conducting in-depth interviews with patients and their families to gather information on their experiences with different health care providers and treatments.
Education : An educational institution may conduct qualitative research to understand student experiences and to develop effective teaching strategies. This may involve conducting classroom observations and interviews with students and teachers to gather insights into classroom dynamics and instructional practices.
Social Work: A social worker may conduct qualitative research to explore social problems and to develop interventions to address them. This may involve conducting in-depth interviews with individuals and families to understand their experiences with poverty, discrimination, and other social problems.
Anthropology : An anthropologist may conduct qualitative research to understand different cultures and societies. This may involve conducting ethnographic studies and observing and interviewing members of different cultural groups to gain insights into their beliefs, practices, and social structures.
Psychology : A psychologist may conduct qualitative research to understand human behavior and mental processes. This may involve conducting in-depth interviews with individuals to explore their thoughts, feelings, and experiences.
Public Policy: A government agency or non-profit organization may conduct qualitative research to explore public attitudes and to inform policy decisions. This may involve conducting focus groups and one-on-one interviews with members of the public to gather insights into their perspectives on different policy issues.

Purpose of Qualitative Research

The purpose of qualitative research is to explore and understand the subjective experiences, behaviors, and perspectives of individuals or groups in a particular context. Unlike quantitative research, which focuses on numerical data and statistical analysis, qualitative research aims to provide in-depth, descriptive information that can help researchers develop insights and theories about complex social phenomena.

Qualitative research can serve multiple purposes, including:

Exploring new or emerging phenomena : Qualitative research can be useful for exploring new or emerging phenomena, such as new technologies or social trends. This type of research can help researchers develop a deeper understanding of these phenomena and identify potential areas for further study.
Understanding complex social phenomena : Qualitative research can be useful for exploring complex social phenomena, such as cultural beliefs, social norms, or political processes. This type of research can help researchers develop a more nuanced understanding of these phenomena and identify factors that may influence them.
Generating new theories or hypotheses: Qualitative research can be useful for generating new theories or hypotheses about social phenomena. By gathering rich, detailed data about individuals’ experiences and perspectives, researchers can develop insights that may challenge existing theories or lead to new lines of inquiry.
Providing context for quantitative data: Qualitative research can be useful for providing context for quantitative data. By gathering qualitative data alongside quantitative data, researchers can develop a more complete understanding of complex social phenomena and identify potential explanations for quantitative findings.

When to use Qualitative Research

Here are some situations where qualitative research may be appropriate:

Exploring a new area: If little is known about a particular topic, qualitative research can help to identify key issues, generate hypotheses, and develop new theories.
Understanding complex phenomena: Qualitative research can be used to investigate complex social, cultural, or organizational phenomena that are difficult to measure quantitatively.
Investigating subjective experiences: Qualitative research is particularly useful for investigating the subjective experiences of individuals or groups, such as their attitudes, beliefs, values, or emotions.
Conducting formative research: Qualitative research can be used in the early stages of a research project to develop research questions, identify potential research participants, and refine research methods.
Evaluating interventions or programs: Qualitative research can be used to evaluate the effectiveness of interventions or programs by collecting data on participants’ experiences, attitudes, and behaviors.

Characteristics of Qualitative Research

Qualitative research is characterized by several key features, including:

Focus on subjective experience: Qualitative research is concerned with understanding the subjective experiences, beliefs, and perspectives of individuals or groups in a particular context. Researchers aim to explore the meanings that people attach to their experiences and to understand the social and cultural factors that shape these meanings.
Use of open-ended questions: Qualitative research relies on open-ended questions that allow participants to provide detailed, in-depth responses. Researchers seek to elicit rich, descriptive data that can provide insights into participants’ experiences and perspectives.
Sampling-based on purpose and diversity: Qualitative research often involves purposive sampling, in which participants are selected based on specific criteria related to the research question. Researchers may also seek to include participants with diverse experiences and perspectives to capture a range of viewpoints.
Data collection through multiple methods: Qualitative research typically involves the use of multiple data collection methods, such as in-depth interviews, focus groups, and observation. This allows researchers to gather rich, detailed data from multiple sources, which can provide a more complete picture of participants’ experiences and perspectives.
Inductive data analysis: Qualitative research relies on inductive data analysis, in which researchers develop theories and insights based on the data rather than testing pre-existing hypotheses. Researchers use coding and thematic analysis to identify patterns and themes in the data and to develop theories and explanations based on these patterns.
Emphasis on researcher reflexivity: Qualitative research recognizes the importance of the researcher’s role in shaping the research process and outcomes. Researchers are encouraged to reflect on their own biases and assumptions and to be transparent about their role in the research process.

Advantages of Qualitative Research

Qualitative research offers several advantages over other research methods, including:

Depth and detail: Qualitative research allows researchers to gather rich, detailed data that provides a deeper understanding of complex social phenomena. Through in-depth interviews, focus groups, and observation, researchers can gather detailed information about participants’ experiences and perspectives that may be missed by other research methods.
Flexibility : Qualitative research is a flexible approach that allows researchers to adapt their methods to the research question and context. Researchers can adjust their research methods in real-time to gather more information or explore unexpected findings.
Contextual understanding: Qualitative research is well-suited to exploring the social and cultural context in which individuals or groups are situated. Researchers can gather information about cultural norms, social structures, and historical events that may influence participants’ experiences and perspectives.
Participant perspective : Qualitative research prioritizes the perspective of participants, allowing researchers to explore subjective experiences and understand the meanings that participants attach to their experiences.
Theory development: Qualitative research can contribute to the development of new theories and insights about complex social phenomena. By gathering rich, detailed data and using inductive data analysis, researchers can develop new theories and explanations that may challenge existing understandings.
Validity : Qualitative research can offer high validity by using multiple data collection methods, purposive and diverse sampling, and researcher reflexivity. This can help ensure that findings are credible and trustworthy.

Limitations of Qualitative Research

Qualitative research also has some limitations, including:

Subjectivity : Qualitative research relies on the subjective interpretation of researchers, which can introduce bias into the research process. The researcher’s perspective, beliefs, and experiences can influence the way data is collected, analyzed, and interpreted.
Limited generalizability: Qualitative research typically involves small, purposive samples that may not be representative of larger populations. This limits the generalizability of findings to other contexts or populations.
Time-consuming: Qualitative research can be a time-consuming process, requiring significant resources for data collection, analysis, and interpretation.
Resource-intensive: Qualitative research may require more resources than other research methods, including specialized training for researchers, specialized software for data analysis, and transcription services.
Limited reliability: Qualitative research may be less reliable than quantitative research, as it relies on the subjective interpretation of researchers. This can make it difficult to replicate findings or compare results across different studies.
Ethics and confidentiality: Qualitative research involves collecting sensitive information from participants, which raises ethical concerns about confidentiality and informed consent. Researchers must take care to protect the privacy and confidentiality of participants and obtain informed consent.

Also see Research Methods

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

Survey Research – Types, Methods, Examples

Phenomenology – Methods, Examples and Guide

One-to-One Interview – Methods and Guide

Qualitative Research Methods

Observational Research – Methods and Guide

Basic Research – Types, Methods and Examples

Chapter 1. Introduction

“Science is in danger, and for that reason it is becoming dangerous” -Pierre Bourdieu, Science of Science and Reflexivity

Why an Open Access Textbook on Qualitative Research Methods?

I have been teaching qualitative research methods to both undergraduates and graduate students for many years. Although there are some excellent textbooks out there, they are often costly, and none of them, to my mind, properly introduces qualitative research methods to the beginning student (whether undergraduate or graduate student). In contrast, this open-access textbook is designed as a (free) true introduction to the subject, with helpful, practical pointers on how to conduct research and how to access more advanced instruction.

Textbooks are typically arranged in one of two ways: (1) by technique (each chapter covers one method used in qualitative research); or (2) by process (chapters advance from research design through publication). But both of these approaches are necessary for the beginner student. This textbook will have sections dedicated to the process as well as the techniques of qualitative research. This is a true “comprehensive” book for the beginning student. In addition to covering techniques of data collection and data analysis, it provides a road map of how to get started and how to keep going and where to go for advanced instruction. It covers aspects of research design and research communication as well as methods employed. Along the way, it includes examples from many different disciplines in the social sciences.

The primary goal has been to create a useful, accessible, engaging textbook for use across many disciplines. And, let’s face it. Textbooks can be boring. I hope readers find this to be a little different. I have tried to write in a practical and forthright manner, with many lively examples and references to good and intellectually creative qualitative research. Woven throughout the text are short textual asides (in colored textboxes) by professional (academic) qualitative researchers in various disciplines. These short accounts by practitioners should help inspire students. So, let’s begin!

What is Research?

When we use the word research , what exactly do we mean by that? This is one of those words that everyone thinks they understand, but it is worth beginning this textbook with a short explanation. We use the term to refer to “empirical research,” which is actually a historically specific approach to understanding the world around us. Think about how you know things about the world. [1] You might know your mother loves you because she’s told you she does. Or because that is what “mothers” do by tradition. Or you might know because you’ve looked for evidence that she does, like taking care of you when you are sick or reading to you in bed or working two jobs so you can have the things you need to do OK in life. Maybe it seems churlish to look for evidence; you just take it “on faith” that you are loved.

Only one of the above comes close to what we mean by research. Empirical research is research (investigation) based on evidence. Conclusions can then be drawn from observable data. This observable data can also be “tested” or checked. If the data cannot be tested, that is a good indication that we are not doing research. Note that we can never “prove” conclusively, through observable data, that our mothers love us. We might have some “disconfirming evidence” (that time she didn’t show up to your graduation, for example) that could push you to question an original hypothesis , but no amount of “confirming evidence” will ever allow us to say with 100% certainty, “my mother loves me.” Faith and tradition and authority work differently. Our knowledge can be 100% certain using each of those alternative methods of knowledge, but our certainty in those cases will not be based on facts or evidence.

For many periods of history, those in power have been nervous about “science” because it uses evidence and facts as the primary source of understanding the world, and facts can be at odds with what power or authority or tradition want you to believe. That is why I say that scientific empirical research is a historically specific approach to understand the world. You are in college or university now partly to learn how to engage in this historically specific approach.

In the sixteenth and seventeenth centuries in Europe, there was a newfound respect for empirical research, some of which was seriously challenging to the established church. Using observations and testing them, scientists found that the earth was not at the center of the universe, for example, but rather that it was but one planet of many which circled the sun. [2] For the next two centuries, the science of astronomy, physics, biology, and chemistry emerged and became disciplines taught in universities. All used the scientific method of observation and testing to advance knowledge. Knowledge about people , however, and social institutions, however, was still left to faith, tradition, and authority. Historians and philosophers and poets wrote about the human condition, but none of them used research to do so. [3]

It was not until the nineteenth century that “social science” really emerged, using the scientific method (empirical observation) to understand people and social institutions. New fields of sociology, economics, political science, and anthropology emerged. The first sociologists, people like Auguste Comte and Karl Marx, sought specifically to apply the scientific method of research to understand society, Engels famously claiming that Marx had done for the social world what Darwin did for the natural world, tracings its laws of development. Today we tend to take for granted the naturalness of science here, but it is actually a pretty recent and radical development.

To return to the question, “does your mother love you?” Well, this is actually not really how a researcher would frame the question, as it is too specific to your case. It doesn’t tell us much about the world at large, even if it does tell us something about you and your relationship with your mother. A social science researcher might ask, “do mothers love their children?” Or maybe they would be more interested in how this loving relationship might change over time (e.g., “do mothers love their children more now than they did in the 18th century when so many children died before reaching adulthood?”) or perhaps they might be interested in measuring quality of love across cultures or time periods, or even establishing “what love looks like” using the mother/child relationship as a site of exploration. All of these make good research questions because we can use observable data to answer them.

What is Qualitative Research?

“All we know is how to learn. How to study, how to listen, how to talk, how to tell. If we don’t tell the world, we don’t know the world. We’re lost in it, we die.” -Ursula LeGuin, The Telling

At its simplest, qualitative research is research about the social world that does not use numbers in its analyses. All those who fear statistics can breathe a sigh of relief – there are no mathematical formulae or regression models in this book! But this definition is less about what qualitative research can be and more about what it is not. To be honest, any simple statement will fail to capture the power and depth of qualitative research. One way of contrasting qualitative research to quantitative research is to note that the focus of qualitative research is less about explaining and predicting relationships between variables and more about understanding the social world. To use our mother love example, the question about “what love looks like” is a good question for the qualitative researcher while all questions measuring love or comparing incidences of love (both of which require measurement) are good questions for quantitative researchers. Patton writes,

Qualitative data describe. They take us, as readers, into the time and place of the observation so that we know what it was like to have been there. They capture and communicate someone else’s experience of the world in his or her own words. Qualitative data tell a story. ( Patton 2002:47 )

Qualitative researchers are asking different questions about the world than their quantitative colleagues. Even when researchers are employed in “mixed methods” research ( both quantitative and qualitative), they are using different methods to address different questions of the study. I do a lot of research about first-generation and working-college college students. Where a quantitative researcher might ask, how many first-generation college students graduate from college within four years? Or does first-generation college status predict high student debt loads? A qualitative researcher might ask, how does the college experience differ for first-generation college students? What is it like to carry a lot of debt, and how does this impact the ability to complete college on time? Both sets of questions are important, but they can only be answered using specific tools tailored to those questions. For the former, you need large numbers to make adequate comparisons. For the latter, you need to talk to people, find out what they are thinking and feeling, and try to inhabit their shoes for a little while so you can make sense of their experiences and beliefs.

Examples of Qualitative Research

You have probably seen examples of qualitative research before, but you might not have paid particular attention to how they were produced or realized that the accounts you were reading were the result of hours, months, even years of research “in the field.” A good qualitative researcher will present the product of their hours of work in such a way that it seems natural, even obvious, to the reader. Because we are trying to convey what it is like answers, qualitative research is often presented as stories – stories about how people live their lives, go to work, raise their children, interact with one another. In some ways, this can seem like reading particularly insightful novels. But, unlike novels, there are very specific rules and guidelines that qualitative researchers follow to ensure that the “story” they are telling is accurate , a truthful rendition of what life is like for the people being studied. Most of this textbook will be spent conveying those rules and guidelines. Let’s take a look, first, however, at three examples of what the end product looks like. I have chosen these three examples to showcase very different approaches to qualitative research, and I will return to these five examples throughout the book. They were all published as whole books (not chapters or articles), and they are worth the long read, if you have the time. I will also provide some information on how these books came to be and the length of time it takes to get them into book version. It is important you know about this process, and the rest of this textbook will help explain why it takes so long to conduct good qualitative research!

Example 1 : The End Game (ethnography + interviews)

Corey Abramson is a sociologist who teaches at the University of Arizona. In 2015 he published The End Game: How Inequality Shapes our Final Years ( 2015 ). This book was based on the research he did for his dissertation at the University of California-Berkeley in 2012. Actually, the dissertation was completed in 2012 but the work that was produced that took several years. The dissertation was entitled, “This is How We Live, This is How We Die: Social Stratification, Aging, and Health in Urban America” ( 2012 ). You can see how the book version, which was written for a more general audience, has a more engaging sound to it, but that the dissertation version, which is what academic faculty read and evaluate, has a more descriptive title. You can read the title and know that this is a study about aging and health and that the focus is going to be inequality and that the context (place) is going to be “urban America.” It’s a study about “how” people do something – in this case, how they deal with aging and death. This is the very first sentence of the dissertation, “From our first breath in the hospital to the day we die, we live in a society characterized by unequal opportunities for maintaining health and taking care of ourselves when ill. These disparities reflect persistent racial, socio-economic, and gender-based inequalities and contribute to their persistence over time” ( 1 ). What follows is a truthful account of how that is so.

Cory Abramson spent three years conducting his research in four different urban neighborhoods. We call the type of research he conducted “comparative ethnographic” because he designed his study to compare groups of seniors as they went about their everyday business. It’s comparative because he is comparing different groups (based on race, class, gender) and ethnographic because he is studying the culture/way of life of a group. [4] He had an educated guess, rooted in what previous research had shown and what social theory would suggest, that people’s experiences of aging differ by race, class, and gender. So, he set up a research design that would allow him to observe differences. He chose two primarily middle-class (one was racially diverse and the other was predominantly White) and two primarily poor neighborhoods (one was racially diverse and the other was predominantly African American). He hung out in senior centers and other places seniors congregated, watched them as they took the bus to get prescriptions filled, sat in doctor’s offices with them, and listened to their conversations with each other. He also conducted more formal conversations, what we call in-depth interviews, with sixty seniors from each of the four neighborhoods. As with a lot of fieldwork , as he got closer to the people involved, he both expanded and deepened his reach –

By the end of the project, I expanded my pool of general observations to include various settings frequented by seniors: apartment building common rooms, doctors’ offices, emergency rooms, pharmacies, senior centers, bars, parks, corner stores, shopping centers, pool halls, hair salons, coffee shops, and discount stores. Over the course of the three years of fieldwork, I observed hundreds of elders, and developed close relationships with a number of them. ( 2012:10 )

When Abramson rewrote the dissertation for a general audience and published his book in 2015, it got a lot of attention. It is a beautifully written book and it provided insight into a common human experience that we surprisingly know very little about. It won the Outstanding Publication Award by the American Sociological Association Section on Aging and the Life Course and was featured in the New York Times . The book was about aging, and specifically how inequality shapes the aging process, but it was also about much more than that. It helped show how inequality affects people’s everyday lives. For example, by observing the difficulties the poor had in setting up appointments and getting to them using public transportation and then being made to wait to see a doctor, sometimes in standing-room-only situations, when they are unwell, and then being treated dismissively by hospital staff, Abramson allowed readers to feel the material reality of being poor in the US. Comparing these examples with seniors with adequate supplemental insurance who have the resources to hire car services or have others assist them in arranging care when they need it, jolts the reader to understand and appreciate the difference money makes in the lives and circumstances of us all, and in a way that is different than simply reading a statistic (“80% of the poor do not keep regular doctor’s appointments”) does. Qualitative research can reach into spaces and places that often go unexamined and then reports back to the rest of us what it is like in those spaces and places.

Example 2: Racing for Innocence (Interviews + Content Analysis + Fictional Stories)

Jennifer Pierce is a Professor of American Studies at the University of Minnesota. Trained as a sociologist, she has written a number of books about gender, race, and power. Her very first book, Gender Trials: Emotional Lives in Contemporary Law Firms, published in 1995, is a brilliant look at gender dynamics within two law firms. Pierce was a participant observer, working as a paralegal, and she observed how female lawyers and female paralegals struggled to obtain parity with their male colleagues.

Fifteen years later, she reexamined the context of the law firm to include an examination of racial dynamics, particularly how elite white men working in these spaces created and maintained a culture that made it difficult for both female attorneys and attorneys of color to thrive. Her book, Racing for Innocence: Whiteness, Gender, and the Backlash Against Affirmative Action , published in 2012, is an interesting and creative blending of interviews with attorneys, content analyses of popular films during this period, and fictional accounts of racial discrimination and sexual harassment. The law firm she chose to study had come under an affirmative action order and was in the process of implementing equitable policies and programs. She wanted to understand how recipients of white privilege (the elite white male attorneys) come to deny the role they play in reproducing inequality. Through interviews with attorneys who were present both before and during the affirmative action order, she creates a historical record of the “bad behavior” that necessitated new policies and procedures, but also, and more importantly , probed the participants ’ understanding of this behavior. It should come as no surprise that most (but not all) of the white male attorneys saw little need for change, and that almost everyone else had accounts that were different if not sometimes downright harrowing.

I’ve used Pierce’s book in my qualitative research methods courses as an example of an interesting blend of techniques and presentation styles. My students often have a very difficult time with the fictional accounts she includes. But they serve an important communicative purpose here. They are her attempts at presenting “both sides” to an objective reality – something happens (Pierce writes this something so it is very clear what it is), and the two participants to the thing that happened have very different understandings of what this means. By including these stories, Pierce presents one of her key findings – people remember things differently and these different memories tend to support their own ideological positions. I wonder what Pierce would have written had she studied the murder of George Floyd or the storming of the US Capitol on January 6 or any number of other historic events whose observers and participants record very different happenings.

This is not to say that qualitative researchers write fictional accounts. In fact, the use of fiction in our work remains controversial. When used, it must be clearly identified as a presentation device, as Pierce did. I include Racing for Innocence here as an example of the multiple uses of methods and techniques and the way that these work together to produce better understandings by us, the readers, of what Pierce studied. We readers come away with a better grasp of how and why advantaged people understate their own involvement in situations and structures that advantage them. This is normal human behavior , in other words. This case may have been about elite white men in law firms, but the general insights here can be transposed to other settings. Indeed, Pierce argues that more research needs to be done about the role elites play in the reproduction of inequality in the workplace in general.

Example 3: Amplified Advantage (Mixed Methods: Survey Interviews + Focus Groups + Archives)

The final example comes from my own work with college students, particularly the ways in which class background affects the experience of college and outcomes for graduates. I include it here as an example of mixed methods, and for the use of supplementary archival research. I’ve done a lot of research over the years on first-generation, low-income, and working-class college students. I am curious (and skeptical) about the possibility of social mobility today, particularly with the rising cost of college and growing inequality in general. As one of the few people in my family to go to college, I didn’t grow up with a lot of examples of what college was like or how to make the most of it. And when I entered graduate school, I realized with dismay that there were very few people like me there. I worried about becoming too different from my family and friends back home. And I wasn’t at all sure that I would ever be able to pay back the huge load of debt I was taking on. And so I wrote my dissertation and first two books about working-class college students. These books focused on experiences in college and the difficulties of navigating between family and school ( Hurst 2010a, 2012 ). But even after all that research, I kept coming back to wondering if working-class students who made it through college had an equal chance at finding good jobs and happy lives,

What happens to students after college? Do working-class students fare as well as their peers? I knew from my own experience that barriers continued through graduate school and beyond, and that my debtload was higher than that of my peers, constraining some of the choices I made when I graduated. To answer these questions, I designed a study of students attending small liberal arts colleges, the type of college that tried to equalize the experience of students by requiring all students to live on campus and offering small classes with lots of interaction with faculty. These private colleges tend to have more money and resources so they can provide financial aid to low-income students. They also attract some very wealthy students. Because they enroll students across the class spectrum, I would be able to draw comparisons. I ended up spending about four years collecting data, both a survey of more than 2000 students (which formed the basis for quantitative analyses) and qualitative data collection (interviews, focus groups, archival research, and participant observation). This is what we call a “mixed methods” approach because we use both quantitative and qualitative data. The survey gave me a large enough number of students that I could make comparisons of the how many kind, and to be able to say with some authority that there were in fact significant differences in experience and outcome by class (e.g., wealthier students earned more money and had little debt; working-class students often found jobs that were not in their chosen careers and were very affected by debt, upper-middle-class students were more likely to go to graduate school). But the survey analyses could not explain why these differences existed. For that, I needed to talk to people and ask them about their motivations and aspirations. I needed to understand their perceptions of the world, and it is very hard to do this through a survey.

By interviewing students and recent graduates, I was able to discern particular patterns and pathways through college and beyond. Specifically, I identified three versions of gameplay. Upper-middle-class students, whose parents were themselves professionals (academics, lawyers, managers of non-profits), saw college as the first stage of their education and took classes and declared majors that would prepare them for graduate school. They also spent a lot of time building their resumes, taking advantage of opportunities to help professors with their research, or study abroad. This helped them gain admission to highly-ranked graduate schools and interesting jobs in the public sector. In contrast, upper-class students, whose parents were wealthy and more likely to be engaged in business (as CEOs or other high-level directors), prioritized building social capital. They did this by joining fraternities and sororities and playing club sports. This helped them when they graduated as they called on friends and parents of friends to find them well-paying jobs. Finally, low-income, first-generation, and working-class students were often adrift. They took the classes that were recommended to them but without the knowledge of how to connect them to life beyond college. They spent time working and studying rather than partying or building their resumes. All three sets of students thought they were “doing college” the right way, the way that one was supposed to do college. But these three versions of gameplay led to distinct outcomes that advantaged some students over others. I titled my work “Amplified Advantage” to highlight this process.

These three examples, Cory Abramson’s The End Game , Jennifer Peirce’s Racing for Innocence, and my own Amplified Advantage, demonstrate the range of approaches and tools available to the qualitative researcher. They also help explain why qualitative research is so important. Numbers can tell us some things about the world, but they cannot get at the hearts and minds, motivations and beliefs of the people who make up the social worlds we inhabit. For that, we need tools that allow us to listen and make sense of what people tell us and show us. That is what good qualitative research offers us.

How Is This Book Organized?

This textbook is organized as a comprehensive introduction to the use of qualitative research methods. The first half covers general topics (e.g., approaches to qualitative research, ethics) and research design (necessary steps for building a successful qualitative research study). The second half reviews various data collection and data analysis techniques. Of course, building a successful qualitative research study requires some knowledge of data collection and data analysis so the chapters in the first half and the chapters in the second half should be read in conversation with each other. That said, each chapter can be read on its own for assistance with a particular narrow topic. In addition to the chapters, a helpful glossary can be found in the back of the book. Rummage around in the text as needed.

Chapter Descriptions

Chapter 2 provides an overview of the Research Design Process. How does one begin a study? What is an appropriate research question? How is the study to be done – with what methods ? Involving what people and sites? Although qualitative research studies can and often do change and develop over the course of data collection, it is important to have a good idea of what the aims and goals of your study are at the outset and a good plan of how to achieve those aims and goals. Chapter 2 provides a road map of the process.

Chapter 3 describes and explains various ways of knowing the (social) world. What is it possible for us to know about how other people think or why they behave the way they do? What does it mean to say something is a “fact” or that it is “well-known” and understood? Qualitative researchers are particularly interested in these questions because of the types of research questions we are interested in answering (the how questions rather than the how many questions of quantitative research). Qualitative researchers have adopted various epistemological approaches. Chapter 3 will explore these approaches, highlighting interpretivist approaches that acknowledge the subjective aspect of reality – in other words, reality and knowledge are not objective but rather influenced by (interpreted through) people.

Chapter 4 focuses on the practical matter of developing a research question and finding the right approach to data collection. In any given study (think of Cory Abramson’s study of aging, for example), there may be years of collected data, thousands of observations , hundreds of pages of notes to read and review and make sense of. If all you had was a general interest area (“aging”), it would be very difficult, nearly impossible, to make sense of all of that data. The research question provides a helpful lens to refine and clarify (and simplify) everything you find and collect. For that reason, it is important to pull out that lens (articulate the research question) before you get started. In the case of the aging study, Cory Abramson was interested in how inequalities affected understandings and responses to aging. It is for this reason he designed a study that would allow him to compare different groups of seniors (some middle-class, some poor). Inevitably, he saw much more in the three years in the field than what made it into his book (or dissertation), but he was able to narrow down the complexity of the social world to provide us with this rich account linked to the original research question. Developing a good research question is thus crucial to effective design and a successful outcome. Chapter 4 will provide pointers on how to do this. Chapter 4 also provides an overview of general approaches taken to doing qualitative research and various “traditions of inquiry.”

Chapter 5 explores sampling . After you have developed a research question and have a general idea of how you will collect data (Observations? Interviews?), how do you go about actually finding people and sites to study? Although there is no “correct number” of people to interview , the sample should follow the research question and research design. Unlike quantitative research, qualitative research involves nonprobability sampling. Chapter 5 explains why this is so and what qualities instead make a good sample for qualitative research.

Chapter 6 addresses the importance of reflexivity in qualitative research. Related to epistemological issues of how we know anything about the social world, qualitative researchers understand that we the researchers can never be truly neutral or outside the study we are conducting. As observers, we see things that make sense to us and may entirely miss what is either too obvious to note or too different to comprehend. As interviewers, as much as we would like to ask questions neutrally and remain in the background, interviews are a form of conversation, and the persons we interview are responding to us . Therefore, it is important to reflect upon our social positions and the knowledges and expectations we bring to our work and to work through any blind spots that we may have. Chapter 6 provides some examples of reflexivity in practice and exercises for thinking through one’s own biases.

Chapter 7 is a very important chapter and should not be overlooked. As a practical matter, it should also be read closely with chapters 6 and 8. Because qualitative researchers deal with people and the social world, it is imperative they develop and adhere to a strong ethical code for conducting research in a way that does not harm. There are legal requirements and guidelines for doing so (see chapter 8), but these requirements should not be considered synonymous with the ethical code required of us. Each researcher must constantly interrogate every aspect of their research, from research question to design to sample through analysis and presentation, to ensure that a minimum of harm (ideally, zero harm) is caused. Because each research project is unique, the standards of care for each study are unique. Part of being a professional researcher is carrying this code in one’s heart, being constantly attentive to what is required under particular circumstances. Chapter 7 provides various research scenarios and asks readers to weigh in on the suitability and appropriateness of the research. If done in a class setting, it will become obvious fairly quickly that there are often no absolutely correct answers, as different people find different aspects of the scenarios of greatest importance. Minimizing the harm in one area may require possible harm in another. Being attentive to all the ethical aspects of one’s research and making the best judgments one can, clearly and consciously, is an integral part of being a good researcher.

Chapter 8 , best to be read in conjunction with chapter 7, explains the role and importance of Institutional Review Boards (IRBs) . Under federal guidelines, an IRB is an appropriately constituted group that has been formally designated to review and monitor research involving human subjects . Every institution that receives funding from the federal government has an IRB. IRBs have the authority to approve, require modifications to (to secure approval), or disapprove research. This group review serves an important role in the protection of the rights and welfare of human research subjects. Chapter 8 reviews the history of IRBs and the work they do but also argues that IRBs’ review of qualitative research is often both over-inclusive and under-inclusive. Some aspects of qualitative research are not well understood by IRBs, given that they were developed to prevent abuses in biomedical research. Thus, it is important not to rely on IRBs to identify all the potential ethical issues that emerge in our research (see chapter 7).

Chapter 9 provides help for getting started on formulating a research question based on gaps in the pre-existing literature. Research is conducted as part of a community, even if particular studies are done by single individuals (or small teams). What any of us finds and reports back becomes part of a much larger body of knowledge. Thus, it is important that we look at the larger body of knowledge before we actually start our bit to see how we can best contribute. When I first began interviewing working-class college students, there was only one other similar study I could find, and it hadn’t been published (it was a dissertation of students from poor backgrounds). But there had been a lot published by professors who had grown up working class and made it through college despite the odds. These accounts by “working-class academics” became an important inspiration for my study and helped me frame the questions I asked the students I interviewed. Chapter 9 will provide some pointers on how to search for relevant literature and how to use this to refine your research question.

Chapter 10 serves as a bridge between the two parts of the textbook, by introducing techniques of data collection. Qualitative research is often characterized by the form of data collection – for example, an ethnographic study is one that employs primarily observational data collection for the purpose of documenting and presenting a particular culture or ethnos. Techniques can be effectively combined, depending on the research question and the aims and goals of the study. Chapter 10 provides a general overview of all the various techniques and how they can be combined.

The second part of the textbook moves into the doing part of qualitative research once the research question has been articulated and the study designed. Chapters 11 through 17 cover various data collection techniques and approaches. Chapters 18 and 19 provide a very simple overview of basic data analysis. Chapter 20 covers communication of the data to various audiences, and in various formats.

Chapter 11 begins our overview of data collection techniques with a focus on interviewing , the true heart of qualitative research. This technique can serve as the primary and exclusive form of data collection, or it can be used to supplement other forms (observation, archival). An interview is distinct from a survey, where questions are asked in a specific order and often with a range of predetermined responses available. Interviews can be conversational and unstructured or, more conventionally, semistructured , where a general set of interview questions “guides” the conversation. Chapter 11 covers the basics of interviews: how to create interview guides, how many people to interview, where to conduct the interview, what to watch out for (how to prepare against things going wrong), and how to get the most out of your interviews.

Chapter 12 covers an important variant of interviewing, the focus group. Focus groups are semistructured interviews with a group of people moderated by a facilitator (the researcher or researcher’s assistant). Focus groups explicitly use group interaction to assist in the data collection. They are best used to collect data on a specific topic that is non-personal and shared among the group. For example, asking a group of college students about a common experience such as taking classes by remote delivery during the pandemic year of 2020. Chapter 12 covers the basics of focus groups: when to use them, how to create interview guides for them, and how to run them effectively.

Chapter 13 moves away from interviewing to the second major form of data collection unique to qualitative researchers – observation . Qualitative research that employs observation can best be understood as falling on a continuum of “fly on the wall” observation (e.g., observing how strangers interact in a doctor’s waiting room) to “participant” observation, where the researcher is also an active participant of the activity being observed. For example, an activist in the Black Lives Matter movement might want to study the movement, using her inside position to gain access to observe key meetings and interactions. Chapter 13 covers the basics of participant observation studies: advantages and disadvantages, gaining access, ethical concerns related to insider/outsider status and entanglement, and recording techniques.

Chapter 14 takes a closer look at “deep ethnography” – immersion in the field of a particularly long duration for the purpose of gaining a deeper understanding and appreciation of a particular culture or social world. Clifford Geertz called this “deep hanging out.” Whereas participant observation is often combined with semistructured interview techniques, deep ethnography’s commitment to “living the life” or experiencing the situation as it really is demands more conversational and natural interactions with people. These interactions and conversations may take place over months or even years. As can be expected, there are some costs to this technique, as well as some very large rewards when done competently. Chapter 14 provides some examples of deep ethnographies that will inspire some beginning researchers and intimidate others.

Chapter 15 moves in the opposite direction of deep ethnography, a technique that is the least positivist of all those discussed here, to mixed methods , a set of techniques that is arguably the most positivist . A mixed methods approach combines both qualitative data collection and quantitative data collection, commonly by combining a survey that is analyzed statistically (e.g., cross-tabs or regression analyses of large number probability samples) with semi-structured interviews. Although it is somewhat unconventional to discuss mixed methods in textbooks on qualitative research, I think it is important to recognize this often-employed approach here. There are several advantages and some disadvantages to taking this route. Chapter 16 will describe those advantages and disadvantages and provide some particular guidance on how to design a mixed methods study for maximum effectiveness.

Chapter 16 covers data collection that does not involve live human subjects at all – archival and historical research (chapter 17 will also cover data that does not involve interacting with human subjects). Sometimes people are unavailable to us, either because they do not wish to be interviewed or observed (as is the case with many “elites”) or because they are too far away, in both place and time. Fortunately, humans leave many traces and we can often answer questions we have by examining those traces. Special collections and archives can be goldmines for social science research. This chapter will explain how to access these places, for what purposes, and how to begin to make sense of what you find.

Chapter 17 covers another data collection area that does not involve face-to-face interaction with humans: content analysis . Although content analysis may be understood more properly as a data analysis technique, the term is often used for the entire approach, which will be the case here. Content analysis involves interpreting meaning from a body of text. This body of text might be something found in historical records (see chapter 16) or something collected by the researcher, as in the case of comment posts on a popular blog post. I once used the stories told by student loan debtors on the website studentloanjustice.org as the content I analyzed. Content analysis is particularly useful when attempting to define and understand prevalent stories or communication about a topic of interest. In other words, when we are less interested in what particular people (our defined sample) are doing or believing and more interested in what general narratives exist about a particular topic or issue. This chapter will explore different approaches to content analysis and provide helpful tips on how to collect data, how to turn that data into codes for analysis, and how to go about presenting what is found through analysis.

Where chapter 17 has pushed us towards data analysis, chapters 18 and 19 are all about what to do with the data collected, whether that data be in the form of interview transcripts or fieldnotes from observations. Chapter 18 introduces the basics of coding , the iterative process of assigning meaning to the data in order to both simplify and identify patterns. What is a code and how does it work? What are the different ways of coding data, and when should you use them? What is a codebook, and why do you need one? What does the process of data analysis look like?

Chapter 19 goes further into detail on codes and how to use them, particularly the later stages of coding in which our codes are refined, simplified, combined, and organized. These later rounds of coding are essential to getting the most out of the data we’ve collected. As students are often overwhelmed with the amount of data (a corpus of interview transcripts typically runs into the hundreds of pages; fieldnotes can easily top that), this chapter will also address time management and provide suggestions for dealing with chaos and reminders that feeling overwhelmed at the analysis stage is part of the process. By the end of the chapter, you should understand how “findings” are actually found.

The book concludes with a chapter dedicated to the effective presentation of data results. Chapter 20 covers the many ways that researchers communicate their studies to various audiences (academic, personal, political), what elements must be included in these various publications, and the hallmarks of excellent qualitative research that various audiences will be expecting. Because qualitative researchers are motivated by understanding and conveying meaning , effective communication is not only an essential skill but a fundamental facet of the entire research project. Ethnographers must be able to convey a certain sense of verisimilitude , the appearance of true reality. Those employing interviews must faithfully depict the key meanings of the people they interviewed in a way that rings true to those people, even if the end result surprises them. And all researchers must strive for clarity in their publications so that various audiences can understand what was found and why it is important.

The book concludes with a short chapter ( chapter 21 ) discussing the value of qualitative research. At the very end of this book, you will find a glossary of terms. I recommend you make frequent use of the glossary and add to each entry as you find examples. Although the entries are meant to be simple and clear, you may also want to paraphrase the definition—make it “make sense” to you, in other words. In addition to the standard reference list (all works cited here), you will find various recommendations for further reading at the end of many chapters. Some of these recommendations will be examples of excellent qualitative research, indicated with an asterisk (*) at the end of the entry. As they say, a picture is worth a thousand words. A good example of qualitative research can teach you more about conducting research than any textbook can (this one included). I highly recommend you select one to three examples from these lists and read them along with the textbook.

A final note on the choice of examples – you will note that many of the examples used in the text come from research on college students. This is for two reasons. First, as most of my research falls in this area, I am most familiar with this literature and have contacts with those who do research here and can call upon them to share their stories with you. Second, and more importantly, my hope is that this textbook reaches a wide audience of beginning researchers who study widely and deeply across the range of what can be known about the social world (from marine resources management to public policy to nursing to political science to sexuality studies and beyond). It is sometimes difficult to find examples that speak to all those research interests, however. A focus on college students is something that all readers can understand and, hopefully, appreciate, as we are all now or have been at some point a college student.

Patton’s Ten Suggestions for Doing Qualitative Research

The following ten suggestions were made by Michael Quinn Patton in his massive textbooks Qualitative Research and Evaluations Methods . This book is highly recommended for those of you who want more than an introduction to qualitative methods. It is the book I relied on heavily when I was a graduate student, although it is much easier to “dip into” when necessary than to read through as a whole. Patton is asked for “just one bit of advice” for a graduate student considering using qualitative research methods for their dissertation. Here are his top ten responses, in short form, heavily paraphrased, and with additional comments and emphases from me:

Make sure that a qualitative approach fits the research question. The following are the kinds of questions that call out for qualitative methods or where qualitative methods are particularly appropriate: questions about people’s experiences or how they make sense of those experiences; studying a person in their natural environment; researching a phenomenon so unknown that it would be impossible to study it with standardized instruments or other forms of quantitative data collection.
Study qualitative research by going to the original sources for the design and analysis appropriate to the particular approach you want to take (e.g., read Glaser and Straus if you are using grounded theory )
Find a dissertation adviser who understands or at least who will support your use of qualitative research methods. You are asking for trouble if your entire committee is populated by quantitative researchers, even if they are all very knowledgeable about the subject or focus of your study (maybe even more so if they are!)
Really work on design. Doing qualitative research effectively takes a lot of planning. Even if things are more flexible than in quantitative research, a good design is absolutely essential when starting out.
Practice data collection techniques, particularly interviewing and observing. There is definitely a set of learned skills here! Do not expect your first interview to be perfect. You will continue to grow as a researcher the more interviews you conduct, and you will probably come to understand yourself a bit more in the process, too. This is not easy, despite what others who don’t work with qualitative methods may assume (and tell you!)
Have a plan for analysis before you begin data collection. This is often a requirement in IRB protocols , although you can get away with writing something fairly simple. And even if you are taking an approach, such as grounded theory, that pushes you to remain fairly open-minded during the data collection process, you still want to know what you will be doing with all the data collected – creating a codebook? Writing analytical memos? Comparing cases? Having a plan in hand will also help prevent you from collecting too much extraneous data.
Be prepared to confront controversies both within the qualitative research community and between qualitative research and quantitative research. Don’t be naïve about this – qualitative research, particularly some approaches, will be derided by many more “positivist” researchers and audiences. For example, is an “n” of 1 really sufficient? Yes! But not everyone will agree.
Do not make the mistake of using qualitative research methods because someone told you it was easier, or because you are intimidated by the math required of statistical analyses. Qualitative research is difficult in its own way (and many would claim much more time-consuming than quantitative research). Do it because you are convinced it is right for your goals, aims, and research questions.
Find a good support network. This could be a research mentor, or it could be a group of friends or colleagues who are also using qualitative research, or it could be just someone who will listen to you work through all of the issues you will confront out in the field and during the writing process. Even though qualitative research often involves human subjects, it can be pretty lonely. A lot of times you will feel like you are working without a net. You have to create one for yourself. Take care of yourself.
And, finally, in the words of Patton, “Prepare to be changed. Looking deeply at other people’s lives will force you to look deeply at yourself.”
We will actually spend an entire chapter ( chapter 3 ) looking at this question in much more detail! ↵
Note that this might have been news to Europeans at the time, but many other societies around the world had also come to this conclusion through observation. There is often a tendency to equate “the scientific revolution” with the European world in which it took place, but this is somewhat misleading. ↵
Historians are a special case here. Historians have scrupulously and rigorously investigated the social world, but not for the purpose of understanding general laws about how things work, which is the point of scientific empirical research. History is often referred to as an idiographic field of study, meaning that it studies things that happened or are happening in themselves and not for general observations or conclusions. ↵
Don’t worry, we’ll spend more time later in this book unpacking the meaning of ethnography and other terms that are important here. Note the available glossary ↵

An approach to research that is “multimethod in focus, involving an interpretative, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them. Qualitative research involves the studied use and collection of a variety of empirical materials – case study, personal experience, introspective, life story, interview, observational, historical, interactional, and visual texts – that describe routine and problematic moments and meanings in individuals’ lives." ( Denzin and Lincoln 2005:2 ). Contrast with quantitative research .

In contrast to methodology, methods are more simply the practices and tools used to collect and analyze data. Examples of common methods in qualitative research are interviews , observations , and documentary analysis . One’s methodology should connect to one’s choice of methods, of course, but they are distinguishable terms. See also methodology .

A proposed explanation for an observation, phenomenon, or scientific problem that can be tested by further investigation. The positing of a hypothesis is often the first step in quantitative research but not in qualitative research. Even when qualitative researchers offer possible explanations in advance of conducting research, they will tend to not use the word “hypothesis” as it conjures up the kind of positivist research they are not conducting.

The foundational question to be addressed by the research study. This will form the anchor of the research design, collection, and analysis. Note that in qualitative research, the research question may, and probably will, alter or develop during the course of the research.

An approach to research that collects and analyzes numerical data for the purpose of finding patterns and averages, making predictions, testing causal relationships, and generalizing results to wider populations. Contrast with qualitative research .

Data collection that takes place in real-world settings, referred to as “the field;” a key component of much Grounded Theory and ethnographic research. Patton ( 2002 ) calls fieldwork “the central activity of qualitative inquiry” where “‘going into the field’ means having direct and personal contact with people under study in their own environments – getting close to people and situations being studied to personally understand the realities of minutiae of daily life” (48).

The people who are the subjects of a qualitative study. In interview-based studies, they may be the respondents to the interviewer; for purposes of IRBs, they are often referred to as the human subjects of the research.

The branch of philosophy concerned with knowledge. For researchers, it is important to recognize and adopt one of the many distinguishing epistemological perspectives as part of our understanding of what questions research can address or fully answer. See, e.g., constructivism , subjectivism, and objectivism .

An approach that refutes the possibility of neutrality in social science research. All research is “guided by a set of beliefs and feelings about the world and how it should be understood and studied” (Denzin and Lincoln 2005: 13). In contrast to positivism , interpretivism recognizes the social constructedness of reality, and researchers adopting this approach focus on capturing interpretations and understandings people have about the world rather than “the world” as it is (which is a chimera).

The cluster of data-collection tools and techniques that involve observing interactions between people, the behaviors, and practices of individuals (sometimes in contrast to what they say about how they act and behave), and cultures in context. Observational methods are the key tools employed by ethnographers and Grounded Theory .

Research based on data collected and analyzed by the research (in contrast to secondary “library” research).

The process of selecting people or other units of analysis to represent a larger population. In quantitative research, this representation is taken quite literally, as statistically representative. In qualitative research, in contrast, sample selection is often made based on potential to generate insight about a particular topic or phenomenon.

A method of data collection in which the researcher asks the participant questions; the answers to these questions are often recorded and transcribed verbatim. There are many different kinds of interviews - see also semistructured interview , structured interview , and unstructured interview .

The specific group of individuals that you will collect data from. Contrast population.

The practice of being conscious of and reflective upon one’s own social location and presence when conducting research. Because qualitative research often requires interaction with live humans, failing to take into account how one’s presence and prior expectations and social location affect the data collected and how analyzed may limit the reliability of the findings. This remains true even when dealing with historical archives and other content. Who we are matters when asking questions about how people experience the world because we, too, are a part of that world.

The science and practice of right conduct; in research, it is also the delineation of moral obligations towards research participants, communities to which we belong, and communities in which we conduct our research.

An administrative body established to protect the rights and welfare of human research subjects recruited to participate in research activities conducted under the auspices of the institution with which it is affiliated. The IRB is charged with the responsibility of reviewing all research involving human participants. The IRB is concerned with protecting the welfare, rights, and privacy of human subjects. The IRB has the authority to approve, disapprove, monitor, and require modifications in all research activities that fall within its jurisdiction as specified by both the federal regulations and institutional policy.

Research, according to US federal guidelines, that involves “a living individual about whom an investigator (whether professional or student) conducting research: (1) Obtains information or biospecimens through intervention or interaction with the individual, and uses, studies, or analyzes the information or biospecimens; or (2) Obtains, uses, studies, analyzes, or generates identifiable private information or identifiable biospecimens.”

One of the primary methodological traditions of inquiry in qualitative research, ethnography is the study of a group or group culture, largely through observational fieldwork supplemented by interviews. It is a form of fieldwork that may include participant-observation data collection. See chapter 14 for a discussion of deep ethnography.

A form of interview that follows a standard guide of questions asked, although the order of the questions may change to match the particular needs of each individual interview subject, and probing “follow-up” questions are often added during the course of the interview. The semi-structured interview is the primary form of interviewing used by qualitative researchers in the social sciences. It is sometimes referred to as an “in-depth” interview. See also interview and interview guide .

A method of observational data collection taking place in a natural setting; a form of fieldwork . The term encompasses a continuum of relative participation by the researcher (from full participant to “fly-on-the-wall” observer). This is also sometimes referred to as ethnography , although the latter is characterized by a greater focus on the culture under observation.

A research design that employs both quantitative and qualitative methods, as in the case of a survey supplemented by interviews.

An epistemological perspective that posits the existence of reality through sensory experience similar to empiricism but goes further in denying any non-sensory basis of thought or consciousness. In the social sciences, the term has roots in the proto-sociologist August Comte, who believed he could discern “laws” of society similar to the laws of natural science (e.g., gravity). The term has come to mean the kinds of measurable and verifiable science conducted by quantitative researchers and is thus used pejoratively by some qualitative researchers interested in interpretation, consciousness, and human understanding. Calling someone a “positivist” is often intended as an insult. See also empiricism and objectivism.

A place or collection containing records, documents, or other materials of historical interest; most universities have an archive of material related to the university’s history, as well as other “special collections” that may be of interest to members of the community.

A method of both data collection and data analysis in which a given content (textual, visual, graphic) is examined systematically and rigorously to identify meanings, themes, patterns and assumptions. Qualitative content analysis (QCA) is concerned with gathering and interpreting an existing body of material.

A word or short phrase that symbolically assigns a summative, salient, essence-capturing, and/or evocative attribute for a portion of language-based or visual data (Saldaña 2021:5).

Usually a verbatim written record of an interview or focus group discussion.

The primary form of data for fieldwork , participant observation , and ethnography . These notes, taken by the researcher either during the course of fieldwork or at day’s end, should include as many details as possible on what was observed and what was said. They should include clear identifiers of date, time, setting, and names (or identifying characteristics) of participants.

The process of labeling and organizing qualitative data to identify different themes and the relationships between them; a way of simplifying data to allow better management and retrieval of key themes and illustrative passages. See coding frame and codebook.

A methodological tradition of inquiry and approach to analyzing qualitative data in which theories emerge from a rigorous and systematic process of induction. This approach was pioneered by the sociologists Glaser and Strauss (1967). The elements of theory generated from comparative analysis of data are, first, conceptual categories and their properties and, second, hypotheses or generalized relations among the categories and their properties – “The constant comparing of many groups draws the [researcher’s] attention to their many similarities and differences. Considering these leads [the researcher] to generate abstract categories and their properties, which, since they emerge from the data, will clearly be important to a theory explaining the kind of behavior under observation.” (36).

A detailed description of any proposed research that involves human subjects for review by IRB. The protocol serves as the recipe for the conduct of the research activity. It includes the scientific rationale to justify the conduct of the study, the information necessary to conduct the study, the plan for managing and analyzing the data, and a discussion of the research ethical issues relevant to the research. Protocols for qualitative research often include interview guides, all documents related to recruitment, informed consent forms, very clear guidelines on the safekeeping of materials collected, and plans for de-identifying transcripts or other data that include personal identifying information.

Research Methodologies

Quantitative Research Methodologies

Qualitative Research Methodologies

Systematic Reviews
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What is qualitative research.

Qualitative research methodologies seek to capture information that often can't be expressed numerically. These methodologies often include some level of interpretation from researchers as they collect information via observation, coded survey or interview responses, and so on. Researchers may use multiple qualitative methods in one study, as well as a theoretical or critical framework to help them interpret their data.

Qualitative research methods can be used to study:

How are political and social attitudes formed?
How do people make decisions?
What teaching or training methods are most effective?

Qualitative Research Approaches

Action research.

In this type of study, researchers will actively pursue some kind of intervention, resolve a problem, or affect some kind of change. They will not only analyze the results but will also examine the challenges encountered through the process.

Ethnography

Ethnographies are an in-depth, holistic type of research used to capture cultural practices, beliefs, traditions, and so on. Here, the researcher observes and interviews members of a culture — an ethnic group, a clique, members of a religion, etc. — and then analyzes their findings.

Grounded Theory

Researchers will create and test a hypothesis using qualitative data. Often, researchers use grounded theory to understand decision-making, problem-solving, and other types of behavior.

Narrative Research

Researchers use this type of framework to understand different aspects of the human experience and how their subjects assign meaning to their experiences. Researchers use interviews to collect data from a small group of subjects, then discuss those results in the form of a narrative or story.

Phenomenology

This type of research attempts to understand the lived experiences of a group and/or how members of that group find meaning in their experiences. Researchers use interviews, observation, and other qualitative methods to collect data.

Often used to share novel or unique information, case studies consist of a detailed, in-depth description of a single subject, pilot project, specific events, and so on.

Hossain, M.S., Runa, F., & Al Mosabbir, A. (2021). Impact of COVID-19 pandemic on rare diseases: A case study on thalassaemia patients in Bangladesh. Public Health in Practice, 2(100150), 1-3.
Nožina, M. (2021). The Czech Rhino connection: A case study of Vietnamese wildlife trafficking networks’ operations across central Europe. European Journal on Criminal Policy and Research, 27(2), 265-283.

Focus Groups

Researchers will recruit people to answer questions in small group settings. Focus group members may share similar demographics or be diverse, depending on the researchers' needs. Group members will then be asked a series of questions and have their responses recorded. While these responses may be coded and discussed numerically (e.g., 50% of group members responded negatively to a question), researchers will also use responses to provide context, nuance, and other details.

Dichabeng, P., Merat, N., & Markkula, G. (2021). Factors that influence the acceptance of future shared automated vehicles – A focus group study with United Kingdom drivers. Transportation Research: Part F, 82, 121–140.
Maynard, E., Barton, S., Rivett, K., Maynard, O., & Davies, W. (2021). Because ‘grown-ups don’t always get it right’: Allyship with children in research—From research question to authorship. Qualitative Research in Psychology, 18(4), 518–536.

Observational Study

Researchers will arrange to observe (usually in an unobtrusive way) a set of subjects in specific conditions. For example, researchers might visit a school cafeteria to learn about the food choices students make or set up trail cameras to collect information about animal behavior in the area.

He, J. Y., Chan, P. W., Li, Q. S., Li, L., Zhang, L., & Yang, H. L. (2022). Observations of wind and turbulence structures of Super Typhoons Hato and Mangkhut over land from a 356 m high meteorological tower. Atmospheric Research, 265(105910), 1-18.
Zerovnik Spela, Kos Mitja, & Locatelli Igor. (2022). Initiation of insulin therapy in patients with type 2 diabetes: An observational study. Acta Pharmaceutica, 72(1), 147–157.

Open-Ended Surveys

Unlike quantitative surveys, open-ended surveys require respondents to answer the questions in their own words.

Mujcic, A., Blankers, M., Yildirim, D., Boon, B., & Engels, R. (2021). Cancer survivors’ views on digital support for smoking cessation and alcohol moderation: a survey and qualitative study. BMC Public Health, 21(1), 1-13.
Smith, S. D., Hall, J. P., & Kurth, N. K. (2021). Perspectives on health policy from people with disabilities. Journal of Disability Policy Studies, 32(3), 224–232.

Structured or Semi-Structured Interviews

Researchers will recruit a small number of people who fit pre-determined criteria (e.g., people in a certain profession) and ask each the same set of questions, one-on-one. Semi-structured interviews will include opportunities for the interviewee to provide additional information they weren't asked about by the researcher.

Gibbs, D., Haven-Tang, C., & Ritchie, C. (2021). Harmless flirtations or co-creation? Exploring flirtatious encounters in hospitable experiences. Tourism & Hospitality Research, 21(4), 473–486.
Hongying Dai, Ramos, A., Tamrakar, N., Cheney, M., Samson, K., & Grimm, B. (2021). School personnel’s responses to school-based vaping prevention program: A qualitative study. Health Behavior & Policy Review, 8(2), 130–147.
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Criteria for Good Qualitative Research: A Comprehensive Review

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Open access
Published: 18 September 2021
Volume 31 , pages 679–689, ( 2022 )

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Drishti Yadav ORCID: orcid.org/0000-0002-2974-0323 1

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This review aims to synthesize a published set of evaluative criteria for good qualitative research. The aim is to shed light on existing standards for assessing the rigor of qualitative research encompassing a range of epistemological and ontological standpoints. Using a systematic search strategy, published journal articles that deliberate criteria for rigorous research were identified. Then, references of relevant articles were surveyed to find noteworthy, distinct, and well-defined pointers to good qualitative research. This review presents an investigative assessment of the pivotal features in qualitative research that can permit the readers to pass judgment on its quality and to condemn it as good research when objectively and adequately utilized. Overall, this review underlines the crux of qualitative research and accentuates the necessity to evaluate such research by the very tenets of its being. It also offers some prospects and recommendations to improve the quality of qualitative research. Based on the findings of this review, it is concluded that quality criteria are the aftereffect of socio-institutional procedures and existing paradigmatic conducts. Owing to the paradigmatic diversity of qualitative research, a single and specific set of quality criteria is neither feasible nor anticipated. Since qualitative research is not a cohesive discipline, researchers need to educate and familiarize themselves with applicable norms and decisive factors to evaluate qualitative research from within its theoretical and methodological framework of origin.

Good Qualitative Research: Opening up the Debate

Beyond qualitative/quantitative structuralism: the positivist qualitative research and the paradigmatic disclaimer.

What is Qualitative in Research

Avoid common mistakes on your manuscript.

Introduction

“… It is important to regularly dialogue about what makes for good qualitative research” (Tracy, 2010 , p. 837)

To decide what represents good qualitative research is highly debatable. There are numerous methods that are contained within qualitative research and that are established on diverse philosophical perspectives. Bryman et al., ( 2008 , p. 262) suggest that “It is widely assumed that whereas quality criteria for quantitative research are well‐known and widely agreed, this is not the case for qualitative research.” Hence, the question “how to evaluate the quality of qualitative research” has been continuously debated. There are many areas of science and technology wherein these debates on the assessment of qualitative research have taken place. Examples include various areas of psychology: general psychology (Madill et al., 2000 ); counseling psychology (Morrow, 2005 ); and clinical psychology (Barker & Pistrang, 2005 ), and other disciplines of social sciences: social policy (Bryman et al., 2008 ); health research (Sparkes, 2001 ); business and management research (Johnson et al., 2006 ); information systems (Klein & Myers, 1999 ); and environmental studies (Reid & Gough, 2000 ). In the literature, these debates are enthused by the impression that the blanket application of criteria for good qualitative research developed around the positivist paradigm is improper. Such debates are based on the wide range of philosophical backgrounds within which qualitative research is conducted (e.g., Sandberg, 2000 ; Schwandt, 1996 ). The existence of methodological diversity led to the formulation of different sets of criteria applicable to qualitative research.

Among qualitative researchers, the dilemma of governing the measures to assess the quality of research is not a new phenomenon, especially when the virtuous triad of objectivity, reliability, and validity (Spencer et al., 2004 ) are not adequate. Occasionally, the criteria of quantitative research are used to evaluate qualitative research (Cohen & Crabtree, 2008 ; Lather, 2004 ). Indeed, Howe ( 2004 ) claims that the prevailing paradigm in educational research is scientifically based experimental research. Hypotheses and conjectures about the preeminence of quantitative research can weaken the worth and usefulness of qualitative research by neglecting the prominence of harmonizing match for purpose on research paradigm, the epistemological stance of the researcher, and the choice of methodology. Researchers have been reprimanded concerning this in “paradigmatic controversies, contradictions, and emerging confluences” (Lincoln & Guba, 2000 ).

In general, qualitative research tends to come from a very different paradigmatic stance and intrinsically demands distinctive and out-of-the-ordinary criteria for evaluating good research and varieties of research contributions that can be made. This review attempts to present a series of evaluative criteria for qualitative researchers, arguing that their choice of criteria needs to be compatible with the unique nature of the research in question (its methodology, aims, and assumptions). This review aims to assist researchers in identifying some of the indispensable features or markers of high-quality qualitative research. In a nutshell, the purpose of this systematic literature review is to analyze the existing knowledge on high-quality qualitative research and to verify the existence of research studies dealing with the critical assessment of qualitative research based on the concept of diverse paradigmatic stances. Contrary to the existing reviews, this review also suggests some critical directions to follow to improve the quality of qualitative research in different epistemological and ontological perspectives. This review is also intended to provide guidelines for the acceleration of future developments and dialogues among qualitative researchers in the context of assessing the qualitative research.

The rest of this review article is structured in the following fashion: Sect. Methods describes the method followed for performing this review. Section Criteria for Evaluating Qualitative Studies provides a comprehensive description of the criteria for evaluating qualitative studies. This section is followed by a summary of the strategies to improve the quality of qualitative research in Sect. Improving Quality: Strategies . Section How to Assess the Quality of the Research Findings? provides details on how to assess the quality of the research findings. After that, some of the quality checklists (as tools to evaluate quality) are discussed in Sect. Quality Checklists: Tools for Assessing the Quality . At last, the review ends with the concluding remarks presented in Sect. Conclusions, Future Directions and Outlook . Some prospects in qualitative research for enhancing its quality and usefulness in the social and techno-scientific research community are also presented in Sect. Conclusions, Future Directions and Outlook .

For this review, a comprehensive literature search was performed from many databases using generic search terms such as Qualitative Research , Criteria , etc . The following databases were chosen for the literature search based on the high number of results: IEEE Explore, ScienceDirect, PubMed, Google Scholar, and Web of Science. The following keywords (and their combinations using Boolean connectives OR/AND) were adopted for the literature search: qualitative research, criteria, quality, assessment, and validity. The synonyms for these keywords were collected and arranged in a logical structure (see Table 1 ). All publications in journals and conference proceedings later than 1950 till 2021 were considered for the search. Other articles extracted from the references of the papers identified in the electronic search were also included. A large number of publications on qualitative research were retrieved during the initial screening. Hence, to include the searches with the main focus on criteria for good qualitative research, an inclusion criterion was utilized in the search string.

From the selected databases, the search retrieved a total of 765 publications. Then, the duplicate records were removed. After that, based on the title and abstract, the remaining 426 publications were screened for their relevance by using the following inclusion and exclusion criteria (see Table 2 ). Publications focusing on evaluation criteria for good qualitative research were included, whereas those works which delivered theoretical concepts on qualitative research were excluded. Based on the screening and eligibility, 45 research articles were identified that offered explicit criteria for evaluating the quality of qualitative research and were found to be relevant to this review.

Figure 1 illustrates the complete review process in the form of PRISMA flow diagram. PRISMA, i.e., “preferred reporting items for systematic reviews and meta-analyses” is employed in systematic reviews to refine the quality of reporting.

PRISMA flow diagram illustrating the search and inclusion process. N represents the number of records

Criteria for Evaluating Qualitative Studies

Fundamental criteria: general research quality.

Various researchers have put forward criteria for evaluating qualitative research, which have been summarized in Table 3 . Also, the criteria outlined in Table 4 effectively deliver the various approaches to evaluate and assess the quality of qualitative work. The entries in Table 4 are based on Tracy’s “Eight big‐tent criteria for excellent qualitative research” (Tracy, 2010 ). Tracy argues that high-quality qualitative work should formulate criteria focusing on the worthiness, relevance, timeliness, significance, morality, and practicality of the research topic, and the ethical stance of the research itself. Researchers have also suggested a series of questions as guiding principles to assess the quality of a qualitative study (Mays & Pope, 2020 ). Nassaji ( 2020 ) argues that good qualitative research should be robust, well informed, and thoroughly documented.

Qualitative Research: Interpretive Paradigms

All qualitative researchers follow highly abstract principles which bring together beliefs about ontology, epistemology, and methodology. These beliefs govern how the researcher perceives and acts. The net, which encompasses the researcher’s epistemological, ontological, and methodological premises, is referred to as a paradigm, or an interpretive structure, a “Basic set of beliefs that guides action” (Guba, 1990 ). Four major interpretive paradigms structure the qualitative research: positivist and postpositivist, constructivist interpretive, critical (Marxist, emancipatory), and feminist poststructural. The complexity of these four abstract paradigms increases at the level of concrete, specific interpretive communities. Table 5 presents these paradigms and their assumptions, including their criteria for evaluating research, and the typical form that an interpretive or theoretical statement assumes in each paradigm. Moreover, for evaluating qualitative research, quantitative conceptualizations of reliability and validity are proven to be incompatible (Horsburgh, 2003 ). In addition, a series of questions have been put forward in the literature to assist a reviewer (who is proficient in qualitative methods) for meticulous assessment and endorsement of qualitative research (Morse, 2003 ). Hammersley ( 2007 ) also suggests that guiding principles for qualitative research are advantageous, but methodological pluralism should not be simply acknowledged for all qualitative approaches. Seale ( 1999 ) also points out the significance of methodological cognizance in research studies.

Table 5 reflects that criteria for assessing the quality of qualitative research are the aftermath of socio-institutional practices and existing paradigmatic standpoints. Owing to the paradigmatic diversity of qualitative research, a single set of quality criteria is neither possible nor desirable. Hence, the researchers must be reflexive about the criteria they use in the various roles they play within their research community.

Improving Quality: Strategies

Another critical question is “How can the qualitative researchers ensure that the abovementioned quality criteria can be met?” Lincoln and Guba ( 1986 ) delineated several strategies to intensify each criteria of trustworthiness. Other researchers (Merriam & Tisdell, 2016 ; Shenton, 2004 ) also presented such strategies. A brief description of these strategies is shown in Table 6 .

It is worth mentioning that generalizability is also an integral part of qualitative research (Hays & McKibben, 2021 ). In general, the guiding principle pertaining to generalizability speaks about inducing and comprehending knowledge to synthesize interpretive components of an underlying context. Table 7 summarizes the main metasynthesis steps required to ascertain generalizability in qualitative research.

Figure 2 reflects the crucial components of a conceptual framework and their contribution to decisions regarding research design, implementation, and applications of results to future thinking, study, and practice (Johnson et al., 2020 ). The synergy and interrelationship of these components signifies their role to different stances of a qualitative research study.

Essential elements of a conceptual framework

In a nutshell, to assess the rationale of a study, its conceptual framework and research question(s), quality criteria must take account of the following: lucid context for the problem statement in the introduction; well-articulated research problems and questions; precise conceptual framework; distinct research purpose; and clear presentation and investigation of the paradigms. These criteria would expedite the quality of qualitative research.

How to Assess the Quality of the Research Findings?

The inclusion of quotes or similar research data enhances the confirmability in the write-up of the findings. The use of expressions (for instance, “80% of all respondents agreed that” or “only one of the interviewees mentioned that”) may also quantify qualitative findings (Stenfors et al., 2020 ). On the other hand, the persuasive reason for “why this may not help in intensifying the research” has also been provided (Monrouxe & Rees, 2020 ). Further, the Discussion and Conclusion sections of an article also prove robust markers of high-quality qualitative research, as elucidated in Table 8 .

Quality Checklists: Tools for Assessing the Quality

Numerous checklists are available to speed up the assessment of the quality of qualitative research. However, if used uncritically and recklessly concerning the research context, these checklists may be counterproductive. I recommend that such lists and guiding principles may assist in pinpointing the markers of high-quality qualitative research. However, considering enormous variations in the authors’ theoretical and philosophical contexts, I would emphasize that high dependability on such checklists may say little about whether the findings can be applied in your setting. A combination of such checklists might be appropriate for novice researchers. Some of these checklists are listed below:

The most commonly used framework is Consolidated Criteria for Reporting Qualitative Research (COREQ) (Tong et al., 2007 ). This framework is recommended by some journals to be followed by the authors during article submission.

Standards for Reporting Qualitative Research (SRQR) is another checklist that has been created particularly for medical education (O’Brien et al., 2014 ).

Also, Tracy ( 2010 ) and Critical Appraisal Skills Programme (CASP, 2021 ) offer criteria for qualitative research relevant across methods and approaches.

Further, researchers have also outlined different criteria as hallmarks of high-quality qualitative research. For instance, the “Road Trip Checklist” (Epp & Otnes, 2021 ) provides a quick reference to specific questions to address different elements of high-quality qualitative research.

Conclusions, Future Directions, and Outlook

This work presents a broad review of the criteria for good qualitative research. In addition, this article presents an exploratory analysis of the essential elements in qualitative research that can enable the readers of qualitative work to judge it as good research when objectively and adequately utilized. In this review, some of the essential markers that indicate high-quality qualitative research have been highlighted. I scope them narrowly to achieve rigor in qualitative research and note that they do not completely cover the broader considerations necessary for high-quality research. This review points out that a universal and versatile one-size-fits-all guideline for evaluating the quality of qualitative research does not exist. In other words, this review also emphasizes the non-existence of a set of common guidelines among qualitative researchers. In unison, this review reinforces that each qualitative approach should be treated uniquely on account of its own distinctive features for different epistemological and disciplinary positions. Owing to the sensitivity of the worth of qualitative research towards the specific context and the type of paradigmatic stance, researchers should themselves analyze what approaches can be and must be tailored to ensemble the distinct characteristics of the phenomenon under investigation. Although this article does not assert to put forward a magic bullet and to provide a one-stop solution for dealing with dilemmas about how, why, or whether to evaluate the “goodness” of qualitative research, it offers a platform to assist the researchers in improving their qualitative studies. This work provides an assembly of concerns to reflect on, a series of questions to ask, and multiple sets of criteria to look at, when attempting to determine the quality of qualitative research. Overall, this review underlines the crux of qualitative research and accentuates the need to evaluate such research by the very tenets of its being. Bringing together the vital arguments and delineating the requirements that good qualitative research should satisfy, this review strives to equip the researchers as well as reviewers to make well-versed judgment about the worth and significance of the qualitative research under scrutiny. In a nutshell, a comprehensive portrayal of the research process (from the context of research to the research objectives, research questions and design, speculative foundations, and from approaches of collecting data to analyzing the results, to deriving inferences) frequently proliferates the quality of a qualitative research.

Prospects : A Road Ahead for Qualitative Research

Irrefutably, qualitative research is a vivacious and evolving discipline wherein different epistemological and disciplinary positions have their own characteristics and importance. In addition, not surprisingly, owing to the sprouting and varied features of qualitative research, no consensus has been pulled off till date. Researchers have reflected various concerns and proposed several recommendations for editors and reviewers on conducting reviews of critical qualitative research (Levitt et al., 2021 ; McGinley et al., 2021 ). Following are some prospects and a few recommendations put forward towards the maturation of qualitative research and its quality evaluation:

In general, most of the manuscript and grant reviewers are not qualitative experts. Hence, it is more likely that they would prefer to adopt a broad set of criteria. However, researchers and reviewers need to keep in mind that it is inappropriate to utilize the same approaches and conducts among all qualitative research. Therefore, future work needs to focus on educating researchers and reviewers about the criteria to evaluate qualitative research from within the suitable theoretical and methodological context.

There is an urgent need to refurbish and augment critical assessment of some well-known and widely accepted tools (including checklists such as COREQ, SRQR) to interrogate their applicability on different aspects (along with their epistemological ramifications).

Efforts should be made towards creating more space for creativity, experimentation, and a dialogue between the diverse traditions of qualitative research. This would potentially help to avoid the enforcement of one's own set of quality criteria on the work carried out by others.

Moreover, journal reviewers need to be aware of various methodological practices and philosophical debates.

It is pivotal to highlight the expressions and considerations of qualitative researchers and bring them into a more open and transparent dialogue about assessing qualitative research in techno-scientific, academic, sociocultural, and political rooms.

Frequent debates on the use of evaluative criteria are required to solve some potentially resolved issues (including the applicability of a single set of criteria in multi-disciplinary aspects). Such debates would not only benefit the group of qualitative researchers themselves, but primarily assist in augmenting the well-being and vivacity of the entire discipline.

To conclude, I speculate that the criteria, and my perspective, may transfer to other methods, approaches, and contexts. I hope that they spark dialog and debate – about criteria for excellent qualitative research and the underpinnings of the discipline more broadly – and, therefore, help improve the quality of a qualitative study. Further, I anticipate that this review will assist the researchers to contemplate on the quality of their own research, to substantiate research design and help the reviewers to review qualitative research for journals. On a final note, I pinpoint the need to formulate a framework (encompassing the prerequisites of a qualitative study) by the cohesive efforts of qualitative researchers of different disciplines with different theoretic-paradigmatic origins. I believe that tailoring such a framework (of guiding principles) paves the way for qualitative researchers to consolidate the status of qualitative research in the wide-ranging open science debate. Dialogue on this issue across different approaches is crucial for the impending prospects of socio-techno-educational research.

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Yadav, D. Criteria for Good Qualitative Research: A Comprehensive Review. Asia-Pacific Edu Res 31 , 679–689 (2022). https://doi.org/10.1007/s40299-021-00619-0

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DOI : https://doi.org/10.1007/s40299-021-00619-0

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Organizing Your Social Sciences Research Paper

6. The Methodology
Purpose of Guide
Design Flaws to Avoid
Independent and Dependent Variables
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Narrowing a Topic Idea
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The methods section describes actions taken to investigate a research problem and the rationale for the application of specific procedures or techniques used to identify, select, process, and analyze information applied to understanding the problem, thereby, allowing the reader to critically evaluate a study’s overall validity and reliability. The methodology section of a research paper answers two main questions: How was the data collected or generated? And, how was it analyzed? The writing should be direct and precise and always written in the past tense.

Kallet, Richard H. "How to Write the Methods Section of a Research Paper." Respiratory Care 49 (October 2004): 1229-1232.

Importance of a Good Methodology Section

You must explain how you obtained and analyzed your results for the following reasons:

Readers need to know how the data was obtained because the method you chose affects the results and, by extension, how you interpreted their significance in the discussion section of your paper.
Methodology is crucial for any branch of scholarship because an unreliable method produces unreliable results and, as a consequence, undermines the value of your analysis of the findings.
In most cases, there are a variety of different methods you can choose to investigate a research problem. The methodology section of your paper should clearly articulate the reasons why you have chosen a particular procedure or technique.
The reader wants to know that the data was collected or generated in a way that is consistent with accepted practice in the field of study. For example, if you are using a multiple choice questionnaire, readers need to know that it offered your respondents a reasonable range of answers to choose from.
The method must be appropriate to fulfilling the overall aims of the study. For example, you need to ensure that you have a large enough sample size to be able to generalize and make recommendations based upon the findings.
The methodology should discuss the problems that were anticipated and the steps you took to prevent them from occurring. For any problems that do arise, you must describe the ways in which they were minimized or why these problems do not impact in any meaningful way your interpretation of the findings.
In the social and behavioral sciences, it is important to always provide sufficient information to allow other researchers to adopt or replicate your methodology. This information is particularly important when a new method has been developed or an innovative use of an existing method is utilized.

Bem, Daryl J. Writing the Empirical Journal Article. Psychology Writing Center. University of Washington; Denscombe, Martyn. The Good Research Guide: For Small-Scale Social Research Projects . 5th edition. Buckingham, UK: Open University Press, 2014; Lunenburg, Frederick C. Writing a Successful Thesis or Dissertation: Tips and Strategies for Students in the Social and Behavioral Sciences . Thousand Oaks, CA: Corwin Press, 2008.

Structure and Writing Style

I. Groups of Research Methods

There are two main groups of research methods in the social sciences:

The e mpirical-analytical group approaches the study of social sciences in a similar manner that researchers study the natural sciences . This type of research focuses on objective knowledge, research questions that can be answered yes or no, and operational definitions of variables to be measured. The empirical-analytical group employs deductive reasoning that uses existing theory as a foundation for formulating hypotheses that need to be tested. This approach is focused on explanation.
The i nterpretative group of methods is focused on understanding phenomenon in a comprehensive, holistic way . Interpretive methods focus on analytically disclosing the meaning-making practices of human subjects [the why, how, or by what means people do what they do], while showing how those practices arrange so that it can be used to generate observable outcomes. Interpretive methods allow you to recognize your connection to the phenomena under investigation. However, the interpretative group requires careful examination of variables because it focuses more on subjective knowledge.

II. Content

The introduction to your methodology section should begin by restating the research problem and underlying assumptions underpinning your study. This is followed by situating the methods you used to gather, analyze, and process information within the overall “tradition” of your field of study and within the particular research design you have chosen to study the problem. If the method you choose lies outside of the tradition of your field [i.e., your review of the literature demonstrates that the method is not commonly used], provide a justification for how your choice of methods specifically addresses the research problem in ways that have not been utilized in prior studies.

The remainder of your methodology section should describe the following:

Decisions made in selecting the data you have analyzed or, in the case of qualitative research, the subjects and research setting you have examined,
Tools and methods used to identify and collect information, and how you identified relevant variables,
The ways in which you processed the data and the procedures you used to analyze that data, and
The specific research tools or strategies that you utilized to study the underlying hypothesis and research questions.

In addition, an effectively written methodology section should:

Introduce the overall methodological approach for investigating your research problem . Is your study qualitative or quantitative or a combination of both (mixed method)? Are you going to take a special approach, such as action research, or a more neutral stance?
Indicate how the approach fits the overall research design . Your methods for gathering data should have a clear connection to your research problem. In other words, make sure that your methods will actually address the problem. One of the most common deficiencies found in research papers is that the proposed methodology is not suitable to achieving the stated objective of your paper.
Describe the specific methods of data collection you are going to use , such as, surveys, interviews, questionnaires, observation, archival research. If you are analyzing existing data, such as a data set or archival documents, describe how it was originally created or gathered and by whom. Also be sure to explain how older data is still relevant to investigating the current research problem.
Explain how you intend to analyze your results . Will you use statistical analysis? Will you use specific theoretical perspectives to help you analyze a text or explain observed behaviors? Describe how you plan to obtain an accurate assessment of relationships, patterns, trends, distributions, and possible contradictions found in the data.
Provide background and a rationale for methodologies that are unfamiliar for your readers . Very often in the social sciences, research problems and the methods for investigating them require more explanation/rationale than widely accepted rules governing the natural and physical sciences. Be clear and concise in your explanation.
Provide a justification for subject selection and sampling procedure . For instance, if you propose to conduct interviews, how do you intend to select the sample population? If you are analyzing texts, which texts have you chosen, and why? If you are using statistics, why is this set of data being used? If other data sources exist, explain why the data you chose is most appropriate to addressing the research problem.
Provide a justification for case study selection . A common method of analyzing research problems in the social sciences is to analyze specific cases. These can be a person, place, event, phenomenon, or other type of subject of analysis that are either examined as a singular topic of in-depth investigation or multiple topics of investigation studied for the purpose of comparing or contrasting findings. In either method, you should explain why a case or cases were chosen and how they specifically relate to the research problem.
Describe potential limitations . Are there any practical limitations that could affect your data collection? How will you attempt to control for potential confounding variables and errors? If your methodology may lead to problems you can anticipate, state this openly and show why pursuing this methodology outweighs the risk of these problems cropping up.

NOTE: Once you have written all of the elements of the methods section, subsequent revisions should focus on how to present those elements as clearly and as logically as possibly. The description of how you prepared to study the research problem, how you gathered the data, and the protocol for analyzing the data should be organized chronologically. For clarity, when a large amount of detail must be presented, information should be presented in sub-sections according to topic. If necessary, consider using appendices for raw data.

ANOTHER NOTE: If you are conducting a qualitative analysis of a research problem , the methodology section generally requires a more elaborate description of the methods used as well as an explanation of the processes applied to gathering and analyzing of data than is generally required for studies using quantitative methods. Because you are the primary instrument for generating the data [e.g., through interviews or observations], the process for collecting that data has a significantly greater impact on producing the findings. Therefore, qualitative research requires a more detailed description of the methods used.

YET ANOTHER NOTE: If your study involves interviews, observations, or other qualitative techniques involving human subjects , you may be required to obtain approval from the university's Office for the Protection of Research Subjects before beginning your research. This is not a common procedure for most undergraduate level student research assignments. However, i f your professor states you need approval, you must include a statement in your methods section that you received official endorsement and adequate informed consent from the office and that there was a clear assessment and minimization of risks to participants and to the university. This statement informs the reader that your study was conducted in an ethical and responsible manner. In some cases, the approval notice is included as an appendix to your paper.

III. Problems to Avoid

Irrelevant Detail The methodology section of your paper should be thorough but concise. Do not provide any background information that does not directly help the reader understand why a particular method was chosen, how the data was gathered or obtained, and how the data was analyzed in relation to the research problem [note: analyzed, not interpreted! Save how you interpreted the findings for the discussion section]. With this in mind, the page length of your methods section will generally be less than any other section of your paper except the conclusion.

Unnecessary Explanation of Basic Procedures Remember that you are not writing a how-to guide about a particular method. You should make the assumption that readers possess a basic understanding of how to investigate the research problem on their own and, therefore, you do not have to go into great detail about specific methodological procedures. The focus should be on how you applied a method , not on the mechanics of doing a method. An exception to this rule is if you select an unconventional methodological approach; if this is the case, be sure to explain why this approach was chosen and how it enhances the overall process of discovery.

Problem Blindness It is almost a given that you will encounter problems when collecting or generating your data, or, gaps will exist in existing data or archival materials. Do not ignore these problems or pretend they did not occur. Often, documenting how you overcame obstacles can form an interesting part of the methodology. It demonstrates to the reader that you can provide a cogent rationale for the decisions you made to minimize the impact of any problems that arose.

Literature Review Just as the literature review section of your paper provides an overview of sources you have examined while researching a particular topic, the methodology section should cite any sources that informed your choice and application of a particular method [i.e., the choice of a survey should include any citations to the works you used to help construct the survey].

It’s More than Sources of Information! A description of a research study's method should not be confused with a description of the sources of information. Such a list of sources is useful in and of itself, especially if it is accompanied by an explanation about the selection and use of the sources. The description of the project's methodology complements a list of sources in that it sets forth the organization and interpretation of information emanating from those sources.

Azevedo, L.F. et al. "How to Write a Scientific Paper: Writing the Methods Section." Revista Portuguesa de Pneumologia 17 (2011): 232-238; Blair Lorrie. “Choosing a Methodology.” In Writing a Graduate Thesis or Dissertation , Teaching Writing Series. (Rotterdam: Sense Publishers 2016), pp. 49-72; Butin, Dan W. The Education Dissertation A Guide for Practitioner Scholars . Thousand Oaks, CA: Corwin, 2010; Carter, Susan. Structuring Your Research Thesis . New York: Palgrave Macmillan, 2012; Kallet, Richard H. “How to Write the Methods Section of a Research Paper.” Respiratory Care 49 (October 2004):1229-1232; Lunenburg, Frederick C. Writing a Successful Thesis or Dissertation: Tips and Strategies for Students in the Social and Behavioral Sciences . Thousand Oaks, CA: Corwin Press, 2008. Methods Section. The Writer’s Handbook. Writing Center. University of Wisconsin, Madison; Rudestam, Kjell Erik and Rae R. Newton. “The Method Chapter: Describing Your Research Plan.” In Surviving Your Dissertation: A Comprehensive Guide to Content and Process . (Thousand Oaks, Sage Publications, 2015), pp. 87-115; What is Interpretive Research. Institute of Public and International Affairs, University of Utah; Writing the Experimental Report: Methods, Results, and Discussion. The Writing Lab and The OWL. Purdue University; Methods and Materials. The Structure, Format, Content, and Style of a Journal-Style Scientific Paper. Department of Biology. Bates College.

Writing Tip

Statistical Designs and Tests? Do Not Fear Them!

Don't avoid using a quantitative approach to analyzing your research problem just because you fear the idea of applying statistical designs and tests. A qualitative approach, such as conducting interviews or content analysis of archival texts, can yield exciting new insights about a research problem, but it should not be undertaken simply because you have a disdain for running a simple regression. A well designed quantitative research study can often be accomplished in very clear and direct ways, whereas, a similar study of a qualitative nature usually requires considerable time to analyze large volumes of data and a tremendous burden to create new paths for analysis where previously no path associated with your research problem had existed.

To locate data and statistics, GO HERE .

Another Writing Tip

Knowing the Relationship Between Theories and Methods

There can be multiple meaning associated with the term "theories" and the term "methods" in social sciences research. A helpful way to delineate between them is to understand "theories" as representing different ways of characterizing the social world when you research it and "methods" as representing different ways of generating and analyzing data about that social world. Framed in this way, all empirical social sciences research involves theories and methods, whether they are stated explicitly or not. However, while theories and methods are often related, it is important that, as a researcher, you deliberately separate them in order to avoid your theories playing a disproportionate role in shaping what outcomes your chosen methods produce.

Introspectively engage in an ongoing dialectic between the application of theories and methods to help enable you to use the outcomes from your methods to interrogate and develop new theories, or ways of framing conceptually the research problem. This is how scholarship grows and branches out into new intellectual territory.

Reynolds, R. Larry. Ways of Knowing. Alternative Microeconomics . Part 1, Chapter 3. Boise State University; The Theory-Method Relationship. S-Cool Revision. United Kingdom.

Yet Another Writing Tip

Methods and the Methodology

Do not confuse the terms "methods" and "methodology." As Schneider notes, a method refers to the technical steps taken to do research . Descriptions of methods usually include defining and stating why you have chosen specific techniques to investigate a research problem, followed by an outline of the procedures you used to systematically select, gather, and process the data [remember to always save the interpretation of data for the discussion section of your paper].

The methodology refers to a discussion of the underlying reasoning why particular methods were used . This discussion includes describing the theoretical concepts that inform the choice of methods to be applied, placing the choice of methods within the more general nature of academic work, and reviewing its relevance to examining the research problem. The methodology section also includes a thorough review of the methods other scholars have used to study the topic.

Bryman, Alan. "Of Methods and Methodology." Qualitative Research in Organizations and Management: An International Journal 3 (2008): 159-168; Schneider, Florian. “What's in a Methodology: The Difference between Method, Methodology, and Theory…and How to Get the Balance Right?” PoliticsEastAsia.com. Chinese Department, University of Leiden, Netherlands.

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1. How many high school students use smartphones for over four hours a day?

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2. What is the average GPA of students in our school?

You'll get a specific number, like 3.5, as an answer to this question.

3. How much has the average temperature increased over the last decade?

In this case, you're looking for a specific temperature change in degrees Celsius or Fahrenheit.

Considerations for Quantitative Research

Data Collection Methods : To answer quantitative research questions, you'll often use structured surveys, experiments, or observations with predefined variables. These methods help you collect precise, quantifiable data.

Data Analysis : Quantitative research involves statistical analysis, where you'll use mathematical tools to identify patterns and relationships in the data. Understanding how to write a research paper outline can help you organize these methods effectively.

Generalizability : Quantitative research often aims for generalizability, meaning you can draw conclusions that apply to a larger population.

Qualitative Research Questions

On the other hand, the qualitative research method is more about words, descriptions, and understanding the "whys" and "hows" of a phenomenon. It's like exploring the stories behind the beans in the jar. Qualitative analysis questions aim to answer questions about experiences, feelings, and behaviors.

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How do high school students feel about using smartphones for extended periods of time?

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2. What are the main challenges that students face when it comes to maintaining a high GPA?

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3. In what ways has climate change affected the daily lives of people in our community?

This question encourages people to share their stories about how they've been impacted.

Considerations for Qualitative Research

Data Collection Methods : Qualitative research methods often involve open-ended interviews, observations, or content analysis. These methods allow you to collect rich, descriptive data.

Data Analysis : Qualitative research method requires a more interpretive approach. You'll analyze text or visual data to identify themes, patterns, and any unique insight.

In-Depth Understanding : Qualitative research delves deep into the experiences and perceptions of individuals, providing a nuanced understanding of a specific topic.

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Open access
Published: 05 June 2024

Older adults’ perceptions about meat consumption: a qualitative study in Gasabo district, Kigali, Rwanda

Theogene Habumugisha 1 ,
Inger E. Måren 2 , 3 ,
Eric Matsiko 4 ,
Matthias Kaiser 5 ,
Jutta Dierkes 6 , 7 , 8 &
Ingunn M.S. Engebretsen 1

BMC Public Health volume 24 , Article number: 1515 ( 2024 ) Cite this article

Metrics details

The global population is increasingly aging, imposing a substantial burden on social and healthcare systems as aging is associated with gradual muscle wasting and functional decline. Consumption of protein-rich foods, such as livestock-based meat, providing high-quality proteins can prevent muscle wasting and related functional decline in older adults. However, there is a lack of data on the older adults’ perceptions about meat consumption, particularly in Sub-Saharan Africa.

To explore the perceptions about dietary meat consumption among older adults in Gasabo district, Kigali, Rwanda.

We conducted a descriptive qualitative study, using focus group discussions. A total of eight FGDs, lasting between 55 and 80 min, were conducted with gender-mixed groups, including 31 men and 33 women aged ≥ 55 years old. Eight older adults participated in each FGD session, and all discussions were conducted in the local language (Kinyarwanda) using a pre-designed interview guide. The discussions were audio-recorded and transcribed verbatim and translated into English. The transcript was inductively analyzed using thematic analytical process.

Three themes were identified from the data, predominantly related to motives and barriers of meat consumption. The motives of meat consumption included improved quality and taste of the diet, improving own health, and having a social function. Barriers of meat consumption were perceived to be related to health risks, sustainability concerns (depletion of resources), and religious beliefs. Lastly, it was widely perceived that meat was unavailable and economically inaccessible, thus meat consumption was perceived to be associated with improved wealth.

The findings revealed a low and declining meat consumption among older adults due to poverty. Improving financial capacity or strategic public health work to improve protein consumption in the elderly is necessary to meet nutritional needs and facilitate healthy aging.

Peer Review reports

The global population is increasingly aging, imposing a substantial burden on social and healthcare systems [ 1 ]. Globally, the number of older persons (aged over 60 years) was estimated to be around 900 million in 2015, and this number is expected to rise, reaching over 1.4 and 2 billion in 2030 and 2050 [ 2 ], respectively. Global longevity is due to the rising life expectancy (LE) and mortality decline [ 3 ], where in the past two decades, the average years of LE rose from 66 to 73 years [ 2 ]. In Africa, LE has also increased, reaching around 60 years in 2021, and it is expected to continue rising in the next decades [ 4 ]. In Rwanda, LE has similarly increased over the past years, and it was estimated to be around 70 years in 2022 [ 5 ].

Aging increases the risks of poor health and malnutrition due to physiological, physical, and psychosocial changes with advancing age [ 6 ]. Skeletal muscle wasting is one of the physiological changes that begins in midlife and gradually intensifies in later life [ 7 ]. The loss of muscle mass is partly due to inefficient synthesis of muscle protein in older people [ 8 ], resulting in a relatively higher protein requirements for the older population. The loss of muscle mass is associated with many consequences in older persons, including the loss of strength and increased functional dependency [ 9 ]. Additionally, skeletal muscles play a major role in homeostatic regulation of bodily glucose, and thus, the decline of muscle mass negatively affects glucose control [ 10 ].

Adequate protein consumption can prevent muscle wasting and related functional decline in older adults [ 11 ]. However, increasing protein intake of older persons continues to be a challenge as food intake declines with advancing age [ 12 ]. The decline in food intake is primarily related to the sub-optimal function of the digestive system and poor appetite in older persons [ 13 ]. Changes in social and eating behavior are also among the non-physiological factors that have been shown to affect food intake in later life [ 14 ]. Many older adults experience bereavement, depression, and loneliness, reducing their apathy towards food [ 15 ].

To meet the protein needs of older adults, they need to consume foods that are rich in protein, such as fish, milk, and meat [ 16 ]. These protein-rich foods provide large amounts of high-quality protein at consumption of relatively small amounts of foods [ 17 ]. Proteins from animal-sourced foods (ASFs) have also an advantage of being more bio-digestible than plant-based proteins [ 18 ]. In addition to enriching the diet, ASFs consumption has been associated with increased appetite in older adults [ 19 ]. Thus, ASFs can improve both food acceptability and protein intake in older persons.

Generally, people do not consume an isolated nutrient but rather select foods providing that particular nutrient [ 20 ]. However, food choices are complex, and food consumption motivations extend beyond physiological needs [ 9 , 21 ]. Food choice process of the older adults is, particularly, heterogenous [ 22 ], and it is it influenced by different factors, including age-related chemosensory changes, personal health, and living situation [ 22 , 23 ]. Moreover, prior experience with food, including self-sufficiency and hunger, have also an influence on how older people view and decide what to eat [ 24 ].

ASFs generally receives positive nutritional disposition and sensory ratings compared with plant-based foods [ 20 , 25 ]. On the other hands, people also associate ASFs consumption, particularly red and processed meat, with undesirable health and environmental effects, including climate change and cardiovascular diseases [ 26 ]. However, most of the available research on adults’ behavior about ASFs consumption has been limited to high-income countries (HICs) [ 27 ]. In these countries, motives to consume or not consume meat have been perceived to be related to health, environmental sustainability, animal welfare, sensory appeal (taste, texture, flavor, etc.), costs, and socialization [ 12 , 20 , 28 , 29 ]. In Sub-Saharan Africa, the studies investigating ASFs consumption among older adults have been limited to understanding the role these foods play in the diversity and quality of the diet [ 30 , 31 ]. Thus, studies assessing older adults’ perceptions about meat consumption in sub-Saharan Africa are still lacking.

Moreover, although protein-rich foods are essential for protein needs in later life, studies, mainly from HICs, have shown that older adults may lack awareness about the importance of meat and other protein-rich foods in healthy aging [ 19 , 25 , 32 ]. Additionally, perceived motives and barriers of dietary meat consumption in older adults from LMICs may differ from HICs. Therefore, the aim of this study was to explore the perceptions about meat consumption in a sample of older adults (≥ 55 years old) residing in Gasabo district, Rwanda.

An exploratory, descriptive, qualitative study design was employed to explore the perception about meat consumption among older adults, as described by Sandelowski (2000) [ 33 ]. Descriptive qualitative study design is used to explore and interpret the perceptions about a particular issue, problem, or phenomenon as experienced by the participants in a real-life context [ 34 ]. Descriptive qualitative design was also deemed appropriate for this study based on its data-driven orientation in exploring people’s perceptions and experiences [ 33 ].

Study context

This study was conducted as part of a larger research project seeking to understand protein intake, dietary sources of protein, and nutrition status of older adults in Gasabo District, Rwanda. One part of this main project was to assess protein intake of older adults and estimate the contribution of ASFs to total protein intake using a (quantitative) dietary survey. However, quantitative studies are not appropriate for exploring beliefs and perceptions, and their results do not provide an understanding of why certain foods are eaten or not. Thus, this study was conducted to gather the viewpoints of older adults on meat consumption in Gasabo district, Kiali City, Rwanda.

Rwanda is a small, landlocked, and densely populated country with a population of about 13.5 million [ 35 ]. After the 1994 genocide against the Tutsi, the country is undergoing urbanization and economic transition [ 35 ]. The urban population in Rwanda rose from 4.6% in 1978 to 16.5% in 2012, and 28% in 2015 [ 35 ]. The country also recorded one of the fastest-growing economies in Africa, with annual gross domestic product (GDP) growth averaging over 7% between 2008 and 2017 [ 36 ].

Kigali is the capital city and largest urban settlement in Rwanda, and one of Africa’s fastest-growing cities. The estimates show that the population of Kigali city grew from around 350,000 in 1996 to over 1,7 million in 2022 [ 5 , 37 ]. This rapid growth in urban settings is driven by rising life expectancy, population growth (2.9%), and rural-to-urban migration [ 38 ]. Kigali city comprises three districts, namely Kicukiro, Gasabo, and Nyarugenge district. Constituted by 15 sectors, Gasabo is the largest district in Kigali, and it hosts more than half (55.1%) of Kigali city’s residents [ 5 ].

Selection of the study participants

In qualitative studies, the main goal of sampling is to identify people experiencing or who are closely related to the condition (context) being studied [ 39 ]. The identified people are expected to provide information-rich data required to explore the topic or phenomenon of interest [ 39 ]. It is also important that the selected people share homogenous experiences on the issue or phenomenon being studied [ 40 ]. . Variation in the sample units brings different perspectives required to capture various experiences related to the subject [ 41 ], and efforts should be taken to achieve variation.

In our study, the participants were also purposively recruited from eight sectors covering urban and peri-urban areas of the Gasabo district. The participants were enrolled in the study between January and February 2022 if they fulfilled all the following criteria: (1) were aged ≥ 55 years old, (2) were meat-eaters, (3) lived in Gasabo district for at least six months before the study, (4) were involved in food purchase or preparation within the household, and (5) able to provide informed consent. The criterion for being involved in household food purchase decisions was set to ensure that the participants have, in one way or another, experience and an understanding of the food market in Rwanda.

The recruitment process was jointly completed by the research team and community health workers (CHWs). First, the research team identified potential participants during a parallel dietary cross-sectional study conducted from November 2021 through January 2022. The CHWs used population lists retrieved from administrative unit stratified on the age criterion and they were randomly sampled. For the qualitative study, the research team asked the CHWs to identify and suggest other older adults fulfilling the eligibility criteria in their villages but not taking part in the dietary survey. The CHWs were familiar with the purpose of the study, and they were also involved in the quantitative study and served as the liaison between the research team and study participants in the dietary survey. The CHWs were trained on the specific profiles of the participants eligible to partake in FGDs. The recruitment process was conducted separately in each sector, and enrolment was closed upon reaching the desired group size ( n = 8). While recruitment sought diverse representation and covered both urban and peri-urban areas, the selected villages constituted a convenience sample.

Focus group discussion

We chose focus group discussion (FGD) as our method to gather ideas and opinions on meat consumption practices [ 42 ]. Previous research has shown that focus group discussions are suitable for exploring meat consumption behaviors by allowing individuals to interact freely and share ideas, opinions, and lived experiences [ 28 ]. The FGD method is particularly useful for capturing the ‘why’ and ‘how’ required to understand a specific issue or phenomenon [ 42 ].

Initially, six FGDs were planned. However, eight FGDs were conducted. Two additional FGDs were conducted to gather assertive ideas and views on some topics that emerged as important. Each FGD session lasted between 55 and 80 min. Eight participants (men and women) were invited per FGD, and the number was decided based on the recommended group size (6–12 participants) to allow for optimal interaction [ 43 ]. Mixing men and women in the same FGDs may be problematic when discussing sensitive issues, such as domestic violence and reproductive health, which affect men and women differently [ 44 ]. Failing to address such issues may lead to limited disclosure and expression of socially desirable views. Our topic of discussion was dietary meat consumption, and it was, therefore, deemed unlikely that having men and women in the same FGD would affect self-expression and discussions.

Sessions of FGDs were conducted in the villages of the participants. In Rwanda, villages are the smallest administrative units after Cells and Sectors, in ascending order. All these administrative units have venues (halls) designed for community meetings. Our FGDs were conducted either in the villages or cells’ meeting halls, depending on the availability and accessibility of the venue.

All FGDs were conducted using an interview guide (See S1 Table 1 ), and the interview guide’s questions were adapted from previous studies investigating meat consumption behaviors [ 20 , 45 , 46 , 47 , 48 ]. The adaptation involved translating the questions from English to Kinyarwanda. The translated questions were also checked and rephrased by the research team to ensure semantic equivalence. All FGDs were conducted in Kinyarwanda (local language) and facilitated by the first author (TH) and a research assistant (PN), who were native speakers and experienced with qualitative methods. The focus group discussion guide included open-ended questions exploring the participants’ perceptions regarding personal views and lived experiences on meat consumption. The interview guide also contained items aimed to capture how older adults situate meat in the broader scope (theme) of health and sustainability as well as over- and under-consumption. A pilot FGD was conducted and analyzed in one sector, resulting in minor changes to the interview guide. However, the interview guide changed only in wording, and the data collected from the pilot FGD were used in this study. All FGDs were audio-recorded with the permission of the participants.

Demographic characteristics of the participants we recorded were age, sex, marital status, family size, education level, and wealth category. In Rwanda, a wealth index classification system exists, and it is based on a combination of the household’s income, properties, and assets [ 49 ]. The categories range from 1 to 4, corresponding to 1 = poorest, 2 = poor, 3 = rich, and 4 = richest [ 49 ]. Focus group participants received 5000 Rwandan Francs (equivalent to 5 USD) as reimbursement for travel expenses.

Operational definition of “meat”

The meaning of the term “meat” may vary depending on the context, and thus, different levels of characterization are used to differentiate between types of meat, including the sources (wild/bush vs. livestock-based), processing level (processed vs. unprocessed), mode of production (conventional vs. organic), religion (halala vs. haram), and environmental footprint (low vs. high-carbon intensive) of meat. The present study focuses on the role of meat in the diet as a source of animal proteins and its role in both health and sustainability. Thus, the term meat refers to livestock flesh, including beef, pork, goats, sheep, and poultry (chicken, turkey, duck, etc.). This contextualization of meat was informed by the dominance of livestock-based meat in the Rwandan diet compared with other ASFs [ 50 ]. As a landlocked country, consumption of fish and seafood is very limited in Rwanda, contributing to < 3% of daily (total) protein intake [ 51 ]. Moreover, similar to other LMICs, animal-based proteins are produced from dual-purpose livestock in Rwanda, where eggs and milk are the co-products of meat-producing ruminants (beef, goat, and sheep) and non-ruminant (poultry) livestock [ 52 ].

Data processing, synthesis, and interpretation

All FGDs were transcribed verbatim, and transcripts were checked and enriched with field notes. The first author and a professional translator independently translated the transcript from Kinyarwanda to English. Two translated copies were compared, and discrepancies were discussed to generate the final transcript.

Synthesis of the data was completed using a thematic analytic process [ 53 ]. Thematic is a flexible analytical process that is employed to synthesize large amounts of text-based data, answering an exploratory qualitative question [ 54 ]. This analysis process is particularly useful in exploring people’s views, opinions, knowledge, or experiences on a specific subject [ 53 ]. Thematic synthesis of the data can be done either inductively or deductively. Deductive synthesis deploys a pre-designed theoretical framework or coding scheme [ 55 ]. In contrast, inductive thematic synthesis is a flexible and data-driven analytical process where the researchers iteratively code and reflect on the data to identify meaning, patterns, and themes [ 55 ]. Our study was exploratory in nature, and therefore, the transcript was inductively analyzed using the open coding process. Thematic analysis has also been widely applied in studies analyzing focus group discussions exploring meat consumption behaviors [ 9 , 45 ].

Our thematic analysis followed the approach described by Braun & Clarke (2006) [ 56 ], where the transcript was first read thoroughly to familiarize with the data, followed by coding. The coding process started with generating keywords or phrases that best described the participants’ accounts. The draft of codes was shared and discussed between authors. After the initial coding, the transcript was re-read thoroughly to identify new (missing) keywords (phrases) or modify existing ones. Then, all the codes generated were re-shared and discussed between authors. All similar codes were then organized into categories and compared with the initial questions in the interview guide. At this stage, only the codes fitting within the overall aim of the study were selected and used to develop categories (sub-themes) and themes that were also shared and discussed between the authors.

The analytical process was completed with the aid of Nvivo software (Version 12). This software helps to manage and easily navigate through the text of the transcript, including coding, code organization, and creation of a thematic map. Specifically, the node features of this software allowed us to collect and mark references (quote, sentence, or part of the quote) directly from participants’ account while reading the transcript. The software also helped us to organize similar references under the same node. The software contains different levels of (parent and child) nodes, and this feature also allows for creation of hierarchies linking codes to categories (sub-themes) and themes.

Reflexivity

The first author (TH) is a nutritionist from Rwanda and holds a MSc in nutrition and health, with a particular interest in nutrition and aging as well as sustainable consumption. He was enrolled in PhD training disembarking on this topic and led the conceptualization and planning of the current research. The study data was conceptualized and analyzed in an interdisciplinary team (TH, IMSE, MK, IEM, EM, and JD) of authors with different professional backgrounds, including health, nutrition, biology, sustainability, and ethics. Whilst TH’s understanding of the Rwandan and study context was necessary and informed the planned and conducted data capture, his research interest may have also influenced the interpretation and discussion. The international collaboration has enriched the thematic analysis process and self-reflexive awareness.

The use of computer software (Nvivo) helped to sort and manage a large amount of text-based data efficiently. It also made it easy to access references within the nodes with a direct link to the part of the transcript (participants’ account) where they were derived from, and this facilitated the process of re-coding or decoding, which, in turn, increased the reliability of the analysis process. However, using computer software has some advantages in qualitative research. These tools reduce the time that researchers need to interact, reflect, and make sense of the data [ 57 ]. In our study, the first author (TH) was very familiar with the data since he was involved in the entire process, from conceptualization to data collection, transcription, translation, and data synthesis. Other authors also familiarized themselves with the data through study visits (IE) and by reading the transcript thoroughly.

Ethical consideration

The study was reviewed and approved by the Institutional Review Board (IRB) at the College of Medicine and Health Sciences (CMHS), University of Rwanda (Ref. No: 291/CMHS IRB/2021) and the Regional Committees for Medical and Health Research Ethics of Western Norway (Ref. No: 163,823). Permission to conduct the study was also obtained from the authorities of Gasabo district (Ref. No: 1999/070102/2021). The purpose of the study was explained to all the participants, and all provided informed consent.

Privacy and confidentiality

The privacy of the participants and confidentiality of the provided information were safeguarded throughout the study. First, after informed consent, the participants agreed to the rules for the group including respect and confidentiality. Recording of the FGDs was anonymized during data collection. This was done by giving the participants identification numbers which they used every time they responded to the questions or intervened during the discussions. This ensured that participants could not be identified during transcription, translation, and data synthesis. The audio recordings, transcripts, and demographic data were stored on the digital infrastructure offered by the University of Bergen for safe handling of personal and health data. Additionally, access to the data was only restricted to the authorized members of the research team.

A total of 64 older adults (31 men and 33 women) participated in FGDs (Table 1 ). Ages ranged from 55 to 91 years (median: 64 years). Their education level varied, with 32% ( n = 19) having no education at all, 55% ( n = 32) having primary education, and 12% ( n = 7) having secondary or higher education. The family size of the participants ranged from 1 to 15 household members (median: 5). More than half (53%, n = 32) of the participants reported being classified in the poorest- or poor wealth categories, whereas 47% ( n = 28) were classified in the rich or richest wealth category.

Emerging themes

Three main themes were identified throughout the analysis, including (1) perceived motives of meat consumption, (2) perceived barriers of meat consumption, and (3) perceived current availability and affordability of meat, Fig. 1 . Example of selected quotes and related categories and themes are presented in S1 Table 2 .

Overview of sub-themes and themes

Perceived motives of meat consumption

Three categories were identified under this theme comprising diet quality and sensory attractiveness, healthy life, and socialization.

Quality and sensory attractive diet

The older adults’ motivation to consume meat was related to higher nutritional values and better sensory properties of meat than other (plant-based) foods. Meat was perceived as superior food, and it was explained that meat had the ability to complement nutrients lacking in plant-based foods.

“… despite containing some nutrients, plant-based foods still need to be complemented by animal foods” FGD8, R5, Female.

Affinity for meat consumption was also perceived to be related to the lack of alternative sources of high-quality nutrients. While elaborating on this subject, the participants described that older adults do not like to consume small animal foods like eggs and small fish. Fish (normal size, not small fish) was another source of protein that people could eat, but it was perceived not to be affordable compared to meat.

Older people are not interested in small fish. But fish consumption is only for rich people because it [fish] is expensive. If you stop eating meat, you will likely develop deficiencies” FGD6, R8, Female.

In addition to its nutrient content, organoleptic properties of meat were perceived to be more sensory appealing than other (plant-based) foods. The participants described that adding meat to one’s diet improved the taste of foods and made it more presentable (attractive). But, most importantly, these attributes made older adults associate meat consumption with eating pleasure and a positive psychological feeling.

“When you eat meat, it also gives you the appetite to eat other foods. You feel energized and feel good … Your body feels much more relaxed. It makes you happy and think positively” FGD7, R6, Male.

Healthy life

The participants perceived that meat consumption was necessary for better health, and many of them believed that lacking meat consumption was associated with frequent episodes of illness. Nutrient deficiencies were described to be one of the points of concern for the older adults who lack access to ASFs. It was also perceived that older adults, in particular, needed to consume meat to stay healthy and physically fit. This belief in the health-promoting effects of meat would in its absence have detrimental effects including premature death.

“… not eating ASFs [meat] can lead to diseases or dying prematurely. It may result in the loss of strength for older people, and frequent sickness due to the lack of meat’s nutrients” FGD8, R1, Female.

Socialization

Meat consumption was perceived to be essential for the family relationships and social networks of the participants. It was described that people would be judged negatively by their friends and families if they decided to reduce or stop eating meat. The role of meat consumption in social and family life was also viewed (framed) in the lenses of enhanced trust, bonding, and social status.

“. If they see that I have stopped eating meat while I used to eat it [meat] with them, they will start saying that she no longer has money to buy meat. They will say that she has become poor and devastated” FGD2, R5, Female.

It was explained that people would be perceived to distance themselves from their peers or have changed their socio-economic status if they stopped sharing meat with others, and thus, meat served as an ingredient in building and keeping social relationship.

“If you do not eat meat, they will say that you are becoming greedy, or it is because you have become rich and you are no longer in their peer category” FGD7, R1, Female.

Perceived barriers of meat consumption

Just as beliefs about health and diseases influenced the positive attitudes, meat was also believed to be negatively related to health and sustainability. Religious beliefs could also result in meat avoidance.

Medical and diseases conditions

Medical and diseases conditions were perceived to inhibit people from consuming meat. Some of the participants explained that they or their peers received medical recommendations advising them to reduce or stop meat consumption. Most of the conditions preventing them from consuming meat were allergies and underlying chronic disease conditions, such as gout, hypertension, and type 2 diabetes. High or excess meat consumption was not favored, and it was perceived that it could lead to adiposity and distorted body shape.

“ I was also about to say that if we continue eating too much meat, … That’s what causes diseases like hypertension and types 2 diabetes. Normally, if you have those diseases, you are not allowed to eat meat. Therefore, I think that if we stop eating a lot of meat, or if we reduce eating them, those diseases will also decrease” FGD4, R4, Female.

Sustainability concern

High meat consumption was perceived to be unsustainable. The unsustainability of meat consumption was discussed using its implications for the future: everybody was fully aware of its negative impact on livestock, the household’s economy, and other resources. This was highlighted by the participants’ fear of being unable to feed themselves and future generation if people continue to consume meat excessively.

“ For me, I feel that eating a lot of meat would deplete livestock, that’s the first. The second point is that if everyone eats too much meat regularly, this may affect the economy since meat is expensive. So, money-wise, you feel some pressure” FGD8. R7, Male.

Religious beliefs

Religious belief was known to affect meat consumption. The Seventh Day Adventist Church members were described as the religious who reduced or avoided meat consumption.

“ … There are other people who do not eat meat due to their religious beliefs …” FGD7, R2, Male.

Perceived current availability and affordability of meat

The last theme was largely centered around low- and reduced meat consumption coupled with low affordability.

Perceived current meat availability

The reduced consumption was largely explained by reduced availability due to reduced production of ASFs, population growth, and changed social norms. Throughout the discussions, the participants described that both quantity and frequency of meat consumption had declined compared with the past. The decline or scarcity of meat consumption was perceived to be linked to the imbalance between the demand and supply of meat in the country. While elaborating on this topic, the participants explained that the population has increased, but the population growth was not proportional to meat production. They also explained that, besides the increasing number of people consuming meat, population growth had also affected meat availability and other ASFs by reducing arable land for livestock production.

“ We used to eat a lot of meat and other animal products in the past because they were available. One could drink a jug of milk alone! Nowadays, a similar jug is shared at least between four people since the number of people has increased” FGD4, R7, Female.

Moreover, from a production point of view, it was perceived, to some extent, that a change in meat production policy contributed to the decline in meat availability by reducing the number of livestock for the farmers across the country.

“Meat used to be available in the past because farmers had enough cows [herds] grazing on hills. These days, livestock are only kept on farms, and farmers can only rear a few livestock” FGD4, R3, Male.

The increase in the number of meat consumers was also perceived to be related to the vanishing of some social norms that previously inhibited some population groups from consuming meat and other animal products. The participants explained that, in the past, households’ meat consumption was primarily determined by men’s decisions, and women were expected to consume some types of meat only. Today, these social norms are not that evident, and women make their own decisions and can eat meat anywhere and at any time without requiring men’s approval.

“In the past, there were few people, and there was also respect. But nowadays, I can go out with my wife, and she can decide to buy herself a brochette [grilled meat]” FGD4, R7, Male.

Perceive affordability of meat

Meat was perceived unaffordable compared to other foods, and low purchasing power was frequently cited by the participants within and across the FGDs. However, the influence of purchasing power was described using high prices of meat and large families that people need to feed. The affordability of livestock-based meat was discussed by comparing it with plant-based foods and other non-livestock sources of proteins (fish and seafood). Across all FGDs, there was a consensus that livestock-based meat was more expensive than plant-based protein sources (beans, peas, lentils, etc.) while being cheaper than fish (normal sized fish).

“ … when you go to the market you buy according to your [financial] capacity and family size. You buy foods which will last longer … that’s why people buy beans instead of meat” FGD6, R2, Male.

The perceived role of purchasing power in meat consumption was also reinforced by the view that people increase their meat consumption as their financial capacity increases.

“ I will talk about what I see in Rwanda. When a person’s economic situation improves, a person starts eating a lot of meat …. [laughing]. Meat is always on their plate because they have that [financial] capacity” FGD6, R2, Male.

This study explored the perceptions about dietary meat consumption among the older adult population (aged > 55 years old) living in Gasabo district, Kigali, Rwanda. Meat consumption was strongly related to the perceptions about diet quality and health with strong sensory and social attachment. However, it was perceived that meat consumption of older adults had declined compared with the past decades. Sustainability concern, medical and disease conditions (such as hypertension, types 2 diabetes, etc.), and religious beliefs were perceived to be the barriers of meat consumption among older adults. The perceptions about meat consumption were shared across the geographical locations (urban and peri-urban) as well as for men and women.

Meat consumption was perceived to be required for the physiological needs of older adults. The participants appeared to be aware that nutrients from meat may contribute to maintaining ‘physical strength’ and boosting the ‘immune system’. It has also been reported in other studies that perceived healthiness, in terms of nutrient content, influences older adults’ choice of meat [ 58 ]. In a study from Senegal, a preference for bush meat based was connected to its nutritional value and low price [ 59 ]. In a study from Nairobi, it was found that low-income households reported that nutritional value was the main reason to consume beef meat and other animal products (eggs, fish, and milk) [ 60 ]. In a study from Uruguay it was seen that high nutritional value motivated consumers to choose meat over other foods [ 61 ].

Besides enriching the diet, organoleptic properties of meat were perceived as important in increasing appetite. Sensory attributes have been shown to influence consumers’ preferences for animal foods over plant-based foods [ 20 , 62 ]. Studies in Brazil and Switzerland have reported that sensory properties influenced meat preferences among older adults and elderlies [ 63 , 64 ]. A study on barriers and facilitators of animal-based protein-rich foods found that taste was an independent predictor for the consumption of animal-based proteins [ 12 ]. An intervention study to improve intake of protein-rich foods showed that older adults needed spices to increase the taste of plant-based foods to the level of meat-based meals [ 65 ]. Additionally, the role of animal foods on food-liking has been shown by the studies mixing animal foods with plant-based foods to enhance the texture and taste of plant-based foods [ 66 ].

Older adults perceived meat consumption as essential for their social life. These findings re-affirmed that, unlike other foods, meat is valued beyond nutritional needs and taste [ 67 ]. Meat holds essential social values in various societies and is eaten for pleasure and socialization [ 68 ]. In Rwanda and other African countries, meat also plays a similar role. For example, Rwandans eat grilled meat, called Nyamachoma, together with alcohol to socialize in private and social settings [ 69 ]. In the Central African Republic of Congo, forest foragers reported using meat exchange to strengthen their relationships [ 70 ]. In the Republic of Congo, consumers ate animal foods because they were luxury items and a symbol of high social status [ 71 ]. Also in other parts of the world, similar findings have been observed, for example in New Zealand, consumers reported eating meat to socialize and feel accepted by their peers [ 72 ].

In our study, it was mostly perceived that meat consumption had declined, and it was broadly interpreted to be related to the imbalance between meat demand and supply in the country. The Rwandan population has grown exponentially over the past decades [ 5 ], and this may increase the demand for meat [ 73 ]. Population growth has been reported to affect meat availability in Nairobi, where annual meat consumption increased by 2.2% between 1980 and 2000 [ 74 ], but during the same period, per capita meat consumption decreased by 11% [ 74 ].

Change in meat consumption was also perceived to be linked with the transformation of social norms vis-à-vis the food-based myth and taboos [ 75 ]. In the past, it was culturally taboo for women to eat goat meat, and it was stereotyped that women would grow beards [ 76 ]. But, all these negative norms vanished as in the country, alongside global trends, promoted gender equality was widely [ 77 ]. On the other hand, the participants also explained that eating certain types of meat, such as rabbit and sheep, was unpopular. Many Rwandans considered sheep unclean, and it was consumed by the population in the low socioeconomic category [ 78 ]. This expansion of meat consumption to unpopular sources can also be seen as an adaptation to the increasing scarcity of meat.

Our results also revealed that only a minority of the population voluntarily reduce or stop meat consumption due to their religious belief. Contrary to religion, sustainability concern, and medical constraints were perceived as involuntary barriers for older adults seeking to consume meat. In high-income countries, there are also barriers to meat consumption in older adults which include the cost of meat, diseases (medical constraints such as oral or mental health conditions), and accessibility (e.g. distance to shopping centers) [ 25 , 28 , 79 ]. However, although there were concerns that it would not be enough in the future if people over-consumed ASFs, the older adults did not elaborate on choices based on climate change and animal welfare. The older adults appeared to mainly be concerned with having enough resources to cover their current dietary needs and future generations. A similar lack of awareness of the link between the ASFs consumption and animal welfare and environmental sustainability (climate change) has been reported among emerging adults in Ghana [ 80 ]. This contrasts with a growing number of consumers in HICs who are increasingly adopting meatless diets for ethical and environmental reasons [ 29 ].

Furthermore, affordability was perceived to be a major challenge for older adults seeking to consume meat and other animal products. Unlike diseases, affordability is a factor that can be modified to improve older adults’ access to meat by either targeting prices or increasing the purchasing power [ 81 ]. ASFs are highly priced foods in LMICs and tend to cost more than other staple (plant-based) foods [ 27 ]. Wealth has also been shown to positively correlate with meat consumption [ 82 ]. The relationship between wealth and meat consumption was shown to be stronger in the population with a rising economy than in the affluent population [ 83 ]. This may also imply that targeting poverty reduction may increase access to meat consumption in the older adult population. It also highlights that there are opportunities to influence Rwandan consumers to make conscious demand for meat.

Moreover, based on the Rwanda’s economic growth recorded in the last decades, one would expect a perceived increase in the affordability of meat, and thus, an increased meat consumption. But it is possible that the income growth have not reached the threshold needed to make dietary shifts toward meat-rich diets [ 84 ]. Of note, this study was conducted on a sample of predominantly older adults in the poorest wealth categories (53%), and whose income may not increase [ 85 ]. Further, this study was conducted during the Covid-19 pandemic that affected families’ economy and income, and this may also have influenced how older adults viewed highly priced food products, including meat [ 84 ].

Strengths and limitations of the study

This study employed a focus group discussion (FGD) method, allowing the participants to interact freely. The data from FGDs enables the analysis and interpretation of the social meaning of the views and opinions expressed on the studied topic [ 42 ]. The study team iteratively reflected on data and assumptions made during study design, enhancing methodological rigor. However, the data presented in this study are solely based on public (community) perspectives as no additional data collection method or informant groups were included, such as in-depth interviews or key-informant interviews with leaders, health workers, and other relevant groups. As the participants were from the capital city of Rwanda, their views cannot be generalized to the population in rural settings. Further, the study only included older adults who are meat eaters by preference, and their views may also not entirely represent the views of the population who do not eat meat for various reasons other than religion, income, and disease conditions. Men and women were mixed in the groups which we assumed would stimulate the discussion, and we cannot rule out any power, social and gender dynamics which may have affected the responses. Using CHWs as recruiters, there is always a risk of preferential selection, although we believe that necessary training and follow-up was done to mitigate that. Moreover, this study only highlighted the factors perceived to influence meat consumption among older adults, but their relative importance remains unknown. Thus, future behavioral studies are also needed to identify the most important factors influencing meat consumption in this population.

Implications for research and policy

Despite the limitations, the findings of this study provide an important contribution with relevant implications for both research and policy. First, the findings of this study provide an empirical foundation for future investigations of dietary behavior about ASFs consumption, meat in particular, among older adults in Rwanda, but with assumed relevance to other Sub-Saharan African countries. From policy perspectives, motives and barriers to meat consumption identified in this study can inform the development of strategies to increase access to protein-rich foods and promote healthy aging in Rwanda. This is important, considering that older adults are becoming a large part of societies both in both low- and high-income settings and also given that older persons are disproportionally affected by poor health and malnutrition, including muscle wasting.

Older adults perceived that meat consumption had declined over time compared with the past decades. The study also revealed motives and barriers influencing meat consumption among older adults rising the capital city of Rwanda. Overall, our study included a high percentage of persons in the lower wealth categories and thus highlighted that improving financial capacity can be targeted by interventions seeking to increase protein consumption among the older adult population with inadequate meat consumption. However, population studies using different designs and methodologies, including older adults from rural and urban settings, are needed to fully understand current practices among older adults in Rwanda.

Data availability

The data that support the findings of this study are available from the corresponding author (TH) up a reasonable request.

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Acknowledgements

The authors wish to thank Phionah Nziza (PN) for her valuable input in revising the interview guide and assisting during data collection.

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TH, JD, IMSE, IM, and MK conceptualized the study. IMSE and EM supervised data collection. TH performed data analysis under the supervision of IMSE, MK, and IM. TH prepared the first draft of the manuscript. JD, IMSE, IM, EM, and MK contributed to the subsequent versions of the manuscript. All authors read and approved the final version of the manuscript.

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Habumugisha, T., Måren, I.E., Matsiko, E. et al. Older adults’ perceptions about meat consumption: a qualitative study in Gasabo district, Kigali, Rwanda. BMC Public Health 24 , 1515 (2024). https://doi.org/10.1186/s12889-024-19038-z

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Introduction

Qualitative research is a type of research that explores and provides deeper insights into real-world problems. [1] Instead of collecting numerical data points or intervening or introducing treatments just like in quantitative research, qualitative research helps generate hypothenar to further investigate and understand quantitative data. Qualitative research gathers participants' experiences, perceptions, and behavior. It answers the hows and whys instead of how many or how much. It could be structured as a standalone study, purely relying on qualitative data, or part of mixed-methods research that combines qualitative and quantitative data. This review introduces the readers to some basic concepts, definitions, terminology, and applications of qualitative research.

Qualitative research, at its core, asks open-ended questions whose answers are not easily put into numbers, such as "how" and "why." [2] Due to the open-ended nature of the research questions, qualitative research design is often not linear like quantitative design. [2] One of the strengths of qualitative research is its ability to explain processes and patterns of human behavior that can be difficult to quantify. [3] Phenomena such as experiences, attitudes, and behaviors can be complex to capture accurately and quantitatively. In contrast, a qualitative approach allows participants themselves to explain how, why, or what they were thinking, feeling, and experiencing at a particular time or during an event of interest. Quantifying qualitative data certainly is possible, but at its core, qualitative data is looking for themes and patterns that can be difficult to quantify, and it is essential to ensure that the context and narrative of qualitative work are not lost by trying to quantify something that is not meant to be quantified.

However, while qualitative research is sometimes placed in opposition to quantitative research, where they are necessarily opposites and therefore "compete" against each other and the philosophical paradigms associated with each other, qualitative and quantitative work are neither necessarily opposites, nor are they incompatible. [4] While qualitative and quantitative approaches are different, they are not necessarily opposites and certainly not mutually exclusive. For instance, qualitative research can help expand and deepen understanding of data or results obtained from quantitative analysis. For example, say a quantitative analysis has determined a correlation between length of stay and level of patient satisfaction, but why does this correlation exist? This dual-focus scenario shows one way in which qualitative and quantitative research could be integrated.

Qualitative Research Approaches

Ethnography

Ethnography as a research design originates in social and cultural anthropology and involves the researcher being directly immersed in the participant’s environment. [2] Through this immersion, the ethnographer can use a variety of data collection techniques to produce a comprehensive account of the social phenomena that occurred during the research period. [2] That is to say, the researcher’s aim with ethnography is to immerse themselves into the research population and come out of it with accounts of actions, behaviors, events, etc, through the eyes of someone involved in the population. Direct involvement of the researcher with the target population is one benefit of ethnographic research because it can then be possible to find data that is otherwise very difficult to extract and record.

Grounded theory

Grounded Theory is the "generation of a theoretical model through the experience of observing a study population and developing a comparative analysis of their speech and behavior." [5] Unlike quantitative research, which is deductive and tests or verifies an existing theory, grounded theory research is inductive and, therefore, lends itself to research aimed at social interactions or experiences. [3] [2] In essence, Grounded Theory’s goal is to explain how and why an event occurs or how and why people might behave a certain way. Through observing the population, a researcher using the Grounded Theory approach can then develop a theory to explain the phenomena of interest.

Phenomenology

Phenomenology is the "study of the meaning of phenomena or the study of the particular.” [5] At first glance, it might seem that Grounded Theory and Phenomenology are pretty similar, but the differences can be seen upon careful examination. At its core, phenomenology looks to investigate experiences from the individual's perspective. [2] Phenomenology is essentially looking into the "lived experiences" of the participants and aims to examine how and why participants behaved a certain way from their perspective. Herein lies one of the main differences between Grounded Theory and Phenomenology. Grounded Theory aims to develop a theory for social phenomena through an examination of various data sources. In contrast, Phenomenology focuses on describing and explaining an event or phenomenon from the perspective of those who have experienced it.

Narrative research

One of qualitative research’s strengths lies in its ability to tell a story, often from the perspective of those directly involved in it. Reporting on qualitative research involves including details and descriptions of the setting involved and quotes from participants. This detail is called a "thick" or "rich" description and is a strength of qualitative research. Narrative research is rife with the possibilities of "thick" description as this approach weaves together a sequence of events, usually from just one or two individuals, hoping to create a cohesive story or narrative. [2] While it might seem like a waste of time to focus on such a specific, individual level, understanding one or two people’s narratives for an event or phenomenon can help to inform researchers about the influences that helped shape that narrative. The tension or conflict of differing narratives can be "opportunities for innovation." [2]

Research Paradigm

Research paradigms are the assumptions, norms, and standards underpinning different research approaches. Essentially, research paradigms are the "worldviews" that inform research. [4] It is valuable for qualitative and quantitative researchers to understand what paradigm they are working within because understanding the theoretical basis of research paradigms allows researchers to understand the strengths and weaknesses of the approach being used and adjust accordingly. Different paradigms have different ontologies and epistemologies. Ontology is defined as the "assumptions about the nature of reality,” whereas epistemology is defined as the "assumptions about the nature of knowledge" that inform researchers' work. [2] It is essential to understand the ontological and epistemological foundations of the research paradigm researchers are working within to allow for a complete understanding of the approach being used and the assumptions that underpin the approach as a whole. Further, researchers must understand their own ontological and epistemological assumptions about the world in general because their assumptions about the world will necessarily impact how they interact with research. A discussion of the research paradigm is not complete without describing positivist, postpositivist, and constructivist philosophies.

Positivist versus postpositivist

To further understand qualitative research, we must discuss positivist and postpositivist frameworks. Positivism is a philosophy that the scientific method can and should be applied to social and natural sciences. [4] Essentially, positivist thinking insists that the social sciences should use natural science methods in their research. It stems from positivist ontology, that there is an objective reality that exists that is wholly independent of our perception of the world as individuals. Quantitative research is rooted in positivist philosophy, which can be seen in the value it places on concepts such as causality, generalizability, and replicability.

Conversely, postpositivists argue that social reality can never be one hundred percent explained, but could be approximated. [4] Indeed, qualitative researchers have been insisting that there are “fundamental limits to the extent to which the methods and procedures of the natural sciences could be applied to the social world,” and therefore, postpositivist philosophy is often associated with qualitative research. [4] An example of positivist versus postpositivist values in research might be that positivist philosophies value hypothesis-testing, whereas postpositivist philosophies value the ability to formulate a substantive theory.

Constructivist

Constructivism is a subcategory of postpositivism. Most researchers invested in postpositivist research are also constructivist, meaning they think there is no objective external reality that exists but instead that reality is constructed. Constructivism is a theoretical lens that emphasizes the dynamic nature of our world. "Constructivism contends that individuals' views are directly influenced by their experiences, and it is these individual experiences and views that shape their perspective of reality.” [6] constructivist thought focuses on how "reality" is not a fixed certainty and how experiences, interactions, and backgrounds give people a unique view of the world. Constructivism contends, unlike positivist views, that there is not necessarily an "objective"reality we all experience. This is the ‘relativist’ ontological view that reality and our world are dynamic and socially constructed. Therefore, qualitative scientific knowledge can be inductive as well as deductive.” [4]

So why is it important to understand the differences in assumptions that different philosophies and approaches to research have? Fundamentally, the assumptions underpinning the research tools a researcher selects provide an overall base for the assumptions the rest of the research will have. It can even change the role of the researchers. [2] For example, is the researcher an "objective" observer, such as in positivist quantitative work? Or is the researcher an active participant in the research, as in postpositivist qualitative work? Understanding the philosophical base of the study undertaken allows researchers to fully understand the implications of their work and their role within the research and reflect on their positionality and bias as it pertains to the research they are conducting.

Data Sampling

The better the sample represents the intended study population, the more likely the researcher is to encompass the varying factors. The following are examples of participant sampling and selection: [7]

Purposive sampling- selection based on the researcher’s rationale for being the most informative.
Criterion sampling selection based on pre-identified factors.
Convenience sampling- selection based on availability.
Snowball sampling- the selection is by referral from other participants or people who know potential participants.
Extreme case sampling- targeted selection of rare cases.
Typical case sampling selection based on regular or average participants.

Data Collection and Analysis

Qualitative research uses several techniques, including interviews, focus groups, and observation. [1] [2] [3] Interviews may be unstructured, with open-ended questions on a topic, and the interviewer adapts to the responses. Structured interviews have a predetermined number of questions that every participant is asked. It is usually one-on-one and appropriate for sensitive topics or topics needing an in-depth exploration. Focus groups are often held with 8-12 target participants and are used when group dynamics and collective views on a topic are desired. Researchers can be participant-observers to share the experiences of the subject or non-participants or detached observers.

While quantitative research design prescribes a controlled environment for data collection, qualitative data collection may be in a central location or the participants' environment, depending on the study goals and design. Qualitative research could amount to a large amount of data. Data is transcribed, which may then be coded manually or using computer-assisted qualitative data analysis software or CAQDAS such as ATLAS.ti or NVivo. [8] [9] [10]

After the coding process, qualitative research results could be in various formats. It could be a synthesis and interpretation presented with excerpts from the data. [11] Results could also be in the form of themes and theory or model development.

Dissemination

The healthcare team can use two reporting standards to standardize and facilitate the dissemination of qualitative research outcomes. The Consolidated Criteria for Reporting Qualitative Research or COREQ is a 32-item checklist for interviews and focus groups. [12] The Standards for Reporting Qualitative Research (SRQR) is a checklist covering a more comprehensive range of qualitative research. [13]

Applications

Many times, a research question will start with qualitative research. The qualitative research will help generate the research hypothesis, which can be tested with quantitative methods. After the data is collected and analyzed with quantitative methods, a set of qualitative methods can be used to dive deeper into the data to better understand what the numbers truly mean and their implications. The qualitative techniques can then help clarify the quantitative data and also help refine the hypothesis for future research. Furthermore, with qualitative research, researchers can explore poorly studied subjects with quantitative methods. These include opinions, individual actions, and social science research.

An excellent qualitative study design starts with a goal or objective. This should be clearly defined or stated. The target population needs to be specified. A method for obtaining information from the study population must be carefully detailed to ensure no omissions of part of the target population. A proper collection method should be selected that will help obtain the desired information without overly limiting the collected data because, often, the information sought is not well categorized or obtained. Finally, the design should ensure adequate methods for analyzing the data. An example may help better clarify some of the various aspects of qualitative research.

A researcher wants to decrease the number of teenagers who smoke in their community. The researcher could begin by asking current teen smokers why they started smoking through structured or unstructured interviews (qualitative research). The researcher can also get together a group of current teenage smokers and conduct a focus group to help brainstorm factors that may have prevented them from starting to smoke (qualitative research).

In this example, the researcher has used qualitative research methods (interviews and focus groups) to generate a list of ideas of why teens start to smoke and factors that may have prevented them from starting to smoke. Next, the researcher compiles this data. The research found that, hypothetically, peer pressure, health issues, cost, being considered "cool," and rebellious behavior all might increase or decrease the likelihood of teens starting to smoke.

The researcher creates a survey asking teen participants to rank how important each of the above factors is in either starting smoking (for current smokers) or not smoking (for current nonsmokers). This survey provides specific numbers (ranked importance of each factor) and is thus a quantitative research tool.

The researcher can use the survey results to focus efforts on the one or two highest-ranked factors. Let us say the researcher found that health was the primary factor that keeps teens from starting to smoke, and peer pressure was the primary factor that contributed to teens starting smoking. The researcher can go back to qualitative research methods to dive deeper into these for more information. The researcher wants to focus on keeping teens from starting to smoke, so they focus on the peer pressure aspect.

The researcher can conduct interviews and focus groups (qualitative research) about what types and forms of peer pressure are commonly encountered, where the peer pressure comes from, and where smoking starts. The researcher hypothetically finds that peer pressure often occurs after school at the local teen hangouts, mostly in the local park. The researcher also hypothetically finds that peer pressure comes from older, current smokers who provide the cigarettes.

The researcher could further explore this observation made at the local teen hangouts (qualitative research) and take notes regarding who is smoking, who is not, and what observable factors are at play for peer pressure to smoke. The researcher finds a local park where many local teenagers hang out and sees that the smokers tend to hang out in a shady, overgrown area of the park. The researcher notes that smoking teenagers buy their cigarettes from a local convenience store adjacent to the park, where the clerk does not check identification before selling cigarettes. These observations fall under qualitative research.

If the researcher returns to the park and counts how many individuals smoke in each region, this numerical data would be quantitative research. Based on the researcher's efforts thus far, they conclude that local teen smoking and teenagers who start to smoke may decrease if there are fewer overgrown areas of the park and the local convenience store does not sell cigarettes to underage individuals.

The researcher could try to have the parks department reassess the shady areas to make them less conducive to smokers or identify how to limit the sales of cigarettes to underage individuals by the convenience store. The researcher would then cycle back to qualitative methods of asking at-risk populations their perceptions of the changes and what factors are still at play, and quantitative research that includes teen smoking rates in the community and the incidence of new teen smokers, among others. [14] [15]

Qualitative research functions as a standalone research design or combined with quantitative research to enhance our understanding of the world. Qualitative research uses techniques including structured and unstructured interviews, focus groups, and participant observation not only to help generate hypotheses that can be more rigorously tested with quantitative research but also to help researchers delve deeper into the quantitative research numbers, understand what they mean, and understand what the implications are. Qualitative research allows researchers to understand what is going on, especially when things are not easily categorized. [16]

Issues of Concern

As discussed in the sections above, quantitative and qualitative work differ in many ways, including the evaluation criteria. There are four well-established criteria for evaluating quantitative data: internal validity, external validity, reliability, and objectivity. Credibility, transferability, dependability, and confirmability are the correlating concepts in qualitative research. [4] [11] The corresponding quantitative and qualitative concepts can be seen below, with the quantitative concept on the left and the qualitative concept on the right:

Internal validity: Credibility
External validity: Transferability
Reliability: Dependability
Objectivity: Confirmability

In conducting qualitative research, ensuring these concepts are satisfied and well thought out can mitigate potential issues from arising. For example, just as a researcher will ensure that their quantitative study is internally valid, qualitative researchers should ensure that their work has credibility.

Indicators such as triangulation and peer examination can help evaluate the credibility of qualitative work.

Triangulation: Triangulation involves using multiple data collection methods to increase the likelihood of getting a reliable and accurate result. In our above magic example, the result would be more reliable if we interviewed the magician, backstage hand, and the person who "vanished." In qualitative research, triangulation can include telephone surveys, in-person surveys, focus groups, and interviews and surveying an adequate cross-section of the target demographic.
Peer examination: A peer can review results to ensure the data is consistent with the findings.

A "thick" or "rich" description can be used to evaluate the transferability of qualitative research, whereas an indicator such as an audit trail might help evaluate the dependability and confirmability.

Thick or rich description: This is a detailed and thorough description of details, the setting, and quotes from participants in the research. [5] Thick descriptions will include a detailed explanation of how the study was conducted. Thick descriptions are detailed enough to allow readers to draw conclusions and interpret the data, which can help with transferability and replicability.
Audit trail: An audit trail provides a documented set of steps of how the participants were selected and the data was collected. The original information records should also be kept (eg, surveys, notes, recordings).

One issue of concern that qualitative researchers should consider is observation bias. Here are a few examples:

Hawthorne effect: The effect is the change in participant behavior when they know they are being observed. Suppose a researcher wanted to identify factors that contribute to employee theft and tell the employees they will watch them to see what factors affect employee theft. In that case, one would suspect employee behavior would change when they know they are being protected.
Observer-expectancy effect: Some participants change their behavior or responses to satisfy the researcher's desired effect. This happens unconsciously for the participant, so it is essential to eliminate or limit the transmission of the researcher's views.
Artificial scenario effect: Some qualitative research occurs in contrived scenarios with preset goals. In such situations, the information may not be accurate because of the artificial nature of the scenario. The preset goals may limit the qualitative information obtained.
Clinical Significance

Qualitative or quantitative research helps healthcare providers understand patients and the impact and challenges of the care they deliver. Qualitative research provides an opportunity to generate and refine hypotheses and delve deeper into the data generated by quantitative research. Qualitative research is not an island apart from quantitative research but an integral part of research methods to understand the world around us. [17]

Enhancing Healthcare Team Outcomes

Qualitative research is essential for all healthcare team members as all are affected by qualitative research. Qualitative research may help develop a theory or a model for health research that can be further explored by quantitative research. Much of the qualitative research data acquisition is completed by numerous team members, including social workers, scientists, nurses, etc. Within each area of the medical field, there is copious ongoing qualitative research, including physician-patient interactions, nursing-patient interactions, patient-environment interactions, healthcare team function, patient information delivery, etc.

Review Questions
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Disclosure: Steven Tenny declares no relevant financial relationships with ineligible companies.

Disclosure: Janelle Brannan declares no relevant financial relationships with ineligible companies.

Disclosure: Grace Brannan declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

Cite this Page Tenny S, Brannan JM, Brannan GD. Qualitative Study. [Updated 2022 Sep 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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Published: 03 June 2024

Offering extended use of the contraceptive implant via an implementation science framework: a qualitative study of clinicians’ perceived barriers and facilitators

Nicole Rigler 1 ,
Gennifer Kully 2 , 3 ,
Marisa C. Hildebrand 2 ,
Sarah Averbach 2 , 3 &
Sheila K. Mody 2

BMC Health Services Research volume 24 , Article number: 697 ( 2024 ) Cite this article

53 Accesses

Metrics details

The etonogestrel contraceptive implant is currently approved by the United States Food and Drug Administration (FDA) for the prevention of pregnancy up to 3 years. However, studies that suggest efficacy up to 5 years. There is little information on the prevalence of extended use and the factors that influence clinicians in offering extended use. We investigated clinician perspectives on the barriers and facilitators to offering extended use of the contraceptive implant.

Using the Consolidated Framework for Implementation Research (CFIR), we conducted semi-structured qualitative interviews. Participants were recruited from a nationwide survey study of reproductive health clinicians on their knowledge and perspective of extended use of the contraceptive implant. To optimize the diversity of perspectives, we purposefully sampled participants from this study. We used content analysis and consensual qualitative research methods to inform our coding and data analysis. Themes arose deductively and inductively.

We interviewed 20 clinicians including advance practice clinicians, family medicine physicians, obstetrician/gynecologist and complex family planning sub-specialists. Themes regarding barriers and facilitators to extended use of the contraceptive implant emerged. Barriers included the FDA approval for 3 years and clinician concern about liability in the context of off-label use of the contraceptive implant. Educational materials and a champion of extended use were facilitators.

Conclusions

There is opportunity to expand access to extended use of the contraceptive implant by developing educational materials for clinicians and patients, identifying a champion of extended use, and providing information on extended use prior to replacement appointments at 3 years.

Peer Review reports

The etonogestrel contraceptive implant is currently approved by the U.S. Food and Drug Administration (FDA) for 3 years of continuous use for the prevention of pregnancy [ 1 ]. However, there is evidence to support its use for up to 5 years while maintaining a low risk of pregnancy [ 2 , 3 , 4 ]. The off-label use of the contraceptive implant past its FDA-approved duration and up to 5 years is known as extended use. Importantly, the FDA supports off-label use of marketed drugs and medical devices so long as there is strong relevant published evidence [ 5 ]. Off-label use such as extended use of the contraceptive implant is common with many other reproductive devices and medications, including misoprostol for labor induction, the copper intrauterine device (IUD) for emergency contraception, and, prior to its recent FDA-approval for extended use, the 52 mg levonorgestrel (LNG) IUD for pregnancy prevention. The 52 mg LNG IUD was previously FDA-approved for 5 years, however strong published evidence demonstrated longer efficacy up to 8 years, leading clinicians to counsel on extended use and eventually contributing to updated federal guidelines [ 6 , 7 ].

Though there are clinicians who counsel patients on extended use of the contraceptive implant, many patients still undergo implant replacement after only 3 years of use [ 8 , 9 ]. Continuation rates of the contraceptive implant after 1 and 2 years of use is estimated to be at 81.7% and 68.7%, with the most common reason for early discontinuation prior to 3 years being changes to bleeding pattern [ 10 , 11 , 12 , 13 ]. Ali et al. report the most common reasons that patients decided to stop implant use in years 4 and 5: unspecified personal reasons, desired fertility, bleeding problems, and other medical reasons [ 4 ]. Additionally, a recent nationwide, web-based survey amongst a diverse group of reproductive health clinicians investigated the barriers and facilitators regarding extended use of the contraceptive implant up to 5 years [ 14 ]. The most common barriers found in the study were provider concerns about pregnancy risk and the current FDA approval for only 3 years of use. The key facilitators included strong published evidence supporting extended use and patient and clinician education on extended use. Other than these studies, the patient and clinician factors that facilitate and hinder widespread implementation of extended use of the contraceptive implant have not been explored.

Increasing implementation of extended use of the contraceptive implant across practice settings may decrease unnecessary procedures, devices, healthcare visits, and could improve access to, and satisfaction with, the contraceptive implant. Long-acting reversible contraceptive (LARC) methods such as the contraceptive implant and LNG IUD have significantly higher continuation and approval rates and are more efficacious at preventing pregnancy than non-LARC methods such as oral contraceptive pills and depot medroxyprogesterone acetate injection [ 12 , 15 , [ 16 ]. Given the continued high rates of unintended pregnancies in the United States and the consequential increase in healthcare costs and poor outcomes secondary to pregnancy complications, efficacious pregnancy prevention is an important public health objective and cost-saving measure [ 17 ].

Using a qualitative approach guided by an implementation science framework, the Consolidated Framework for Implementation Research (CFIR), [ 18 ] we sought to explore clinician perspectives on extended use of the contraceptive implant up to 5 years as well as the perceived barriers and facilitators for clinicians to offer extended use.

We conducted semi-structured interviews with 20 clinicians including obstetrics and gynecology generalists, family medicine physicians, complex family planning sub-specialists, and advanced practice clinicians. We recruited interview participants from a nationwide, web-based survey that assessed the prevalence of extended use of the contraceptive implant [ 17 ]. This study recruited respondents through email listservs for the Fellowship in Complex Family Planning, the Ryan Residency Training in Family Planning Program, women’s health nurse practitioners, and family medicine physicians, as well as private social media groups for obstetrician-gynecologists. The total reach of the survey was unknown, however, the study had a survey completion rate of 66.6% ( n = 300/450). Of the 300 completed surveys, 290 respondents indicated their interest in being interviewed (96.7%).

Among the survey respondents, we invited 24 clinicians to participate in interviews, yielding an 83.3% response rate. We selectively recruited interview participants to enrich our sample, specifically focusing on clinician type, practice setting, and region of practice within the United States (U.S.). We also selected interview participants based on whether they always, sometimes, or never counsel on extended use to investigate a broad range of perspectives. For this study, offering extended use is defined as counseling on use past the current FDA-approved duration of 3 years and up to 5 years of use. Offering extended use can occur at any clinical encounter, including insertion appointments, replacement and removal appointments at or before 3 years, and general reproductive health appointments. Clinicians who always offer extended use were defined as those who counsel on extended use to patients who are considering or currently have the contraceptive implant. Clinicians who sometimes offer extended use were defined as those who counsel on extended use, but only to particular patients based on patient-specific factors such as body mass index or insurance coverage. Clinicians who never offer extended use were defined as those who never counsel on use of the contraceptive implant past 3 years of use.

The interview guide was created utilizing an implementation science framework that identifies factors for effectively enacting interventions [ 18 ]. The Consolidated Framework for Implementation Research (CFIR) is organized into 5 major domains: characteristics of the intervention, individual characteristics, inner setting, outer setting, and the process of implementation. The first domain, intervention characteristics, relates to the inherent qualities of the intervention, such as pharmacologic properties and side effects of the contraceptive implant when used up to 5 years. Individual characteristics relates to the roles and characteristics of individual patients and clinicians interacting with the intervention, such as educational background and type of insurance coverage. The inner setting domain assesses the internal setting in which an intervention will be implemented (i.e., clinic type, culture, and policies). The broader context in which an intervention will be implemented, including national policies and social norms is evaluated within the outer setting domain. Finally, the process of implementation domain explores the activities and strategies used to implement the intervention, such as educational materials or clinician and staff trainings on extended use.

We designed the interview guide around these specific domains with questions that aimed to identify targeted strategies to support successful implementation. The complete interview guide is in Appendix A . The interview guide was designed with input from clinicians who regularly prescribe contraception, including extended use of the contraceptive implant, as well as CFIR and implementation science experts. The Human Research Protection Program at our institution approved the study.

A single research team member conducted semi-structured interviews via secure video conference between July and August 2021. Interview participants provided informed consent. All participants were asked a full set of open-ended questions based on the interview guide, with focused follow-up questions to further investigate potential themes or to clarify points. All interviews were audio recorded, then transcribed. For data analysis, we used a content analysis approach to identify concepts and patterns within the dataset [ 19 ]. Themes arose deductively and inductively, with deductive themes identified from the CFIR domains and inductive themes arising from interview insights. Consensual qualitative research methods informed both our data analysis and coding process [ 20 ]. Three authors were involved in the thematic coding of the transcripts. Initially, 5 transcripts were independently coded then checked for inter-coder reliability. Any disagreements were discussed, and a consensus was achieved. The remaining transcripts were then coded by one of the three authors. Once all interviews were coded, major themes and representative quotes were identified. The research team utilized ATLAS.ti for analysis [ 21 ].

Between July and August 2021, we interviewed 20 clinicians from a variety of clinical settings, regions, and women’s health professions, achieving the intended diversity of perspectives (Table 1 ). Among participants, 7 (35.0%) always, 8 (40.0%) sometimes, 5 (25.0%) never offer extended use of the contraceptive implant (Table 2 ).

Characteristics of the intervention

We found that changes to bleeding pattern in or after the third year of use was a barrier to clinicians offering extended use of the contraceptive implant. The participants in this study noted that perceived increases in the irregularity or frequency of a patient’s bleeding makes extended use of the implant difficult for patients to accept. One clinician noticed that some patients correlate changes in their bleeding pattern with a perceived decrease in the efficacy of their implant:

"People who do start noticing changes in bleeding pattern […] [and] associating that with, ‘Oh, my implant is wearing out or becoming expired. I need to get this changed out."

-Complex Family Planning Specialist, Southwest, Academic Setting, sometimes offers extended use

The same clinician discussed that more research on bleeding patterns in the extended use period and potential treatments for implant-associated irregularities could be a facilitator of extended use:

"For bleeding, I think it would be awesome if there is a research study, looking at use of OCPs [oral contraceptive pills] to manage bleeding near the end of the use of an implant or near that three-year mark,, […] So that we could give people… Honestly, either a natural history or a, ‘Here’s how you can manage that if you do want to keep using your implant longer.’"

- Complex Family Planning Specialist, Southwest, Academic Setting, sometimes offers extended use

Information on the bleeding pattern in years 4 and 5 of use and how clinicians can address irregular bleeding during implant use may increase acceptability of extended use.

Individual characteristics

We found that insurance impacts whether a clinician offers extended use:

"I do sometimes have patients saying, ‘I might be changing jobs or I’m going to be turning 27 or whatever.’ And so insurance is a barrier and so they’re like, ‘I want the new one while I still have this insurance.’"

- Family Medicine Physician, Midwest, Community Setting, sometimes offers extended use

Many participants agreed with this concept and stated that acceptability of extended use depends on a patient’s perception of their future insurance status. Clinicians observed that if a patient believes they will have coverage for a replacement or removal in the future, they are more likely to pursue extended use of their implant. Conversely, one clinician discussed how lack of current insurance coverage could be a facilitator of extended use:

"So, I would generally offer extended use to people that didn’t have insurance and would have to self-pay. I would like go through the data with them so they wouldn’t have to pay like $1,000 to get a new implant because it could work another year, or people that were concerned about changing side effects at that time."

- Obstetrician-Gynecologist, Southwest, Academic Setting, sometimes offers extended use

Overall, clinicians perceived that patients’ concerns about current and future insurance coverage may affect acceptance of extended use.

Inner setting

This study found that having a champion of extended use at a clinician’s home or affiliate institution was a facilitator of extended use. Most clinicians in the study stated that it is or would be helpful to have someone who worked with them clinically that was knowledgeable on the data about extended use. When asked which factor would promote extended use of the implant the most, this clinician stated:

"…having a champion who is really ready to present the evidence, because the evidence can be there, but people don’t have time to read it. If it’s not brought to them, they’re not really going to know about it."

- Obstetrician-Gynecologist, West Coast, Community Setting, does not offer extended use

Potential champions identified were physicians, nurses, medical directors, or other clinicians in leadership positions, but participants generally believed that the position should be held by someone who is passionate about contraception, highly familiar with the specific setting, and knowledgeable about the clinical studies on extended use.

A barrier noted by a few participants was the effect of discordant counseling by different clinicians, sometimes within the same clinic, on acceptability of extended use:

"I mean, I guess like getting everyone on the same page, like in your practice can be a barrier. Especially in the practice I’ve been at, which like I said was in a state that was very litigious, so people weren’t always willing to like go outside guidelines that were… So getting your whole group on the same page so patients get like a more consistent message."

- Obstetrician-Gynecologist, Southwest, Academic Setting, sometimes offers extended use.

Participants discussed that it is important for clinician teams to relay a cohesive message to patients, especially in settings where patients may see multiple clinicians for their contraceptive care.

Outer setting

Lack of FDA approval for extended use was identified as barrier by many clinicians, and some clinicians counseled patients only on the FDA-approved duration of the contraceptive implant:

"So, generally in our practice we don’t really talk about extended use. We say this is FDA approved for three years."

- Advanced Practice Clinician, Southeast, Community Setting, sometimes offers extended use.

Even clinicians who do offer extended use of the implant noted that off-label use can be confusing to patients, making it difficult to counsel on extended use:

"So I have patients all the time, who’ll say, ‘Well, what do you mean I can keep X, Y or Z in for an extra year?’ And I’ll say, ‘We have big studies that tell us that this is an okay thing to do.’ But that just feels weird. People don’t necessarily understand the role of the FDA or sort of how it works. And so it’s something like extended use just might be a really such a foreign concept. Right? It’s so far outside. But I think that there are also, there are lay outlets that cover this stuff. So it’s not that it’s impossible to access. It’s just that the patient has to be interested just like the provider has to be interested."

- Complex Family Planning Specialist, East Coast, Academic Setting, sometimes offers extended use.

Clinicians also observed that certain clinics must follow official guidelines without the flexibility to offer extended use, regardless of a clinician’s perspective or willingness to counsel on extended use. Interestingly, patient confusion as well as mistrust of the healthcare system may impact patient acceptability of extended use in the context of a three-year FDA-approved duration:

"The other thing is the FDA approval because the box says three years, but then like I tell people, you can take it out in five years. And then they don’t believe… Like who is right. Is it my doctor who’s getting in front of me right or the box, right?"

- Family Medicine Physician, West Coast, Community Setting, always offers extended use.

This clinician noted that a disconnect between a clinician’s counseling and prescription information may lead patients to be confused about the recommendation for extended use.

Another barrier mentioned by a few participants was provider concern about liability in the event of an unintended pregnancy. Participants discussed fear of both legal and interpersonal repercussions of unintended pregnancy after counseling on off-label use of a contraceptive device:

"Even though there’s a slim chance that a patient would get pregnant on Nexplanon [the contraceptive implant], I feel like if we were to say, ‘Yeah, you can use it beyond the four years,’ and they come up and they get pregnant, they’re that 1% chance that gets pregnant, I feel like there could be a little bit of blame laid on us if we were to tell them that they’re able to it beyond the three years when the label doesn’t say that yet."

- Advanced Practice Clinician, Southeast, Private Practice, does not offer extended use.

Some participants felt that they would “have no ground to stand on” in the event of a lawsuit (OBGYN Physician, Midwest, Private Practice), making them concerned about the possibility of increased liability in counseling on off-label use without FDA approval.

Interestingly, multiple clinicians also discussed abortion restrictions in the United States as influencing patients in their decision to pursue extended use or not:

"In the past four years [2017–2021] have also had a lot of patients express concern about the administration. And so wanting to kind of be as current as they can be with their devices and so potentially exchanging them sooner than they need."

- Complex Family Planning Specialist, West Coast, Academic Setting, always offers extended use.

Clinicians observed that patients are noticing and reacting to abortion restrictions when making their contraceptive decisions, which may impact the widespread implementation of extended use.

Process of implementation

Many clinicians reported that a barrier to implementing extended use was patient preference for removal when they are already in clinic for a scheduled removal or replacement procedure, regardless of being counseled on extended use at that time:

“’Oh, I’m already here. I’m approved. Let’s just go ahead and get it done.’ So there’s probably not a whole lot you can do about that either, once they’re already in the clinic, and have their mind set on it.”

- Obstetrician-Gynecologist, Southeast, Academic Setting, does not offer extended use.

Many participants in this study noted that patients have made logistical arrangements prior to their appointments including paid time off, childcare, or prior authorization. It can be difficult for clinicians to offer extended use within this context, therefore counseling is better done prior to a patient coming in for a replacement appointment.

A perceived facilitator of extended use that was mentioned often was clear, concise clinician educational services or materials that illustrates existing data on efficacy and risks. Clinicians believed that this education could be in the form of continued medical education, targeted trainings, or written summaries of relevant studies, data, and recommendations. One consistency across interviews was that education on extended use must be integrated into regular practice and be easily understood by busy clinicians:

"I think that when we get a pamphlet or a brochure or a one page, something that just has everything condensed so it’s a really quick, oh, okay, this is something that we can be offering patients. And these are the reasons why it would be a benefit to them, and these are the patients that maybe would fall out of not offering this to. I think because of how busy we are, that’s the best way for us to make change."

- Advanced Practice Clinician, Southwest, Academic Setting, does not offer extended use.

Participants reported that these resources should be widely distributed beyond the complex family planning and obstetrician-gynecology community to increase accessibility to extended use.

Another potential facilitator identified was effective patient educational materials such as flyers that state the 5-year efficacy of the contraceptive implant, though producing these might require FDA approval. Participants in this study report that patients rely on clinicians to provide information on the efficacy and duration of their contraceptive implant. However, it is difficult for patients to accept extended use when there are inconsistencies across multiple sources of information:

"I mean, if online, there was information where it said you can keep it in for three to five years and they’re able to back that up. You know, people like to do their own research. I think that would be helpful, versus it says everywhere three, three, three, three, three, and then you’re the only person telling them something different, then it’s a little more tricky."

- Obstetrician-Gynecologist, West Coast, Community Setting, does not offer extended use.

Overall, participants in this study expressed that it would be helpful to have easily understood information for clinicians and patients that explained the evidence for extended use.

Our results demonstrate that there is an opportunity to increase widespread implementation of extended use through multiple interventions. Clinicians reported that patients prefer to have their implants replaced when they are already in clinic for the procedure. Therefore, intervening prior to replacement appointments at 3 years in the form of telemedicine visits or notifications from scheduling staff may make extended use of the contraceptive implant more acceptable to patients. Further, clinician and patient education on extended use that is easily understood and widely disseminated would likely increase use of the contraceptive implant up to 5 years.

The implementation of extended use of the contraceptive implant up to 5 years likely decreases healthcare costs secondary to fewer procedures and unintended pregnancies, and expands reproductive choices for patients seeking contraception. It has been found that clinicians who offer extended use state that most of their patients accept extended use when it is offered [ 14 ]. However, the reasons why a patient may or may not accept extended use are unclear, but may include changes in bleeding and concerns about use past the FDA-approved duration. Research on bleeding patterns in the extended use period may facilitate counseling and give patients a better expectation of possible changes they may see in years 4 and 5. Additionally, research on the patient perspective and acceptability of using the contraceptive implant past its FDA-approved timeframe is needed.

This study focused on clinicians and their perspectives on extended use. However, it is important to note that patients may be fully informed about extended use and choose to replace their implant at or before 3 years of duration. All discussions regarding contraception, including extended use of the implant, should always occur within a patient-centered and shared decision-making model. Widespread offering of extended use may allow for more patients to make fully informed decisions about the duration and use of their contraceptive devices, therefore expanding reproductive choice and agency in addition to potentially sparing patients from unnecessary procedures and extra healthcare costs.

Interestingly, although there are data to reflect high implant efficacy in years 4 and 5, [ 2 , 3 , 4 ] some participants in this study believe there is increased liability in counseling on off-label use without FDA approval. Importantly, off-label use is common among reproductive clinicians and is protected by the FDA if there is strong published evidence supporting off label use [ 5 ]. Additionally, the Society of Family Planning supports extended use of the contraceptive implant up to 5 years [ 22 ]. The FDA requires implant training for clinicians before they can insert or remove the implant. This training includes the FDA product labeling indicating the maximum duration of use for pregnancy prevention as three years [ 1 ]. It is possible that clinician training and product labels that advertise a 3-year duration dissuade clinicians from offering extended use of the contraceptive implant due to concerns about legal repercussions in the event of an unintended pregnancy with extended use. Therefore, organization- or systems-level guidelines, policy changes, and trainings in support of extended use may allow clinicians to feel comfortable offering off-label use of the implant. Additionally, FDA approval of the contraceptive implant to 5 years would likely greatly facilitate implementation of extended use.

Changing the FDA label to reflect extended use can be expensive, and contraceptive companies may not be incentivized to change the label. However, increasing the FDA approval of the contraceptive implant would allow for companies to have a longer-acting contraceptive device that is more directly comparable to other LARC devices such as the 52 mg LNG IUD that can be used for up to 8 years. If FDA approval for 5 years of use were to occur, it is not known if the barriers described in this study would continue to apply. However, it is likely that the facilitators of extended use from this study would support implementation of extended use irrespective of the federally approved duration.

One strength of the study is the national sample and the diversity of clinician types and settings. There is also representation of clinicians who consistently offer extended use and those who do not offer extended use. Another strength of this study is that it was designed utilizing a framework focusing on implementation, thus yielding results that can be used to create effective interventions.

Limitations of this study include the small sample size and selection bias from recruiting from a prior study that utilized listservs and social media. Additionally, we recruited from a population that was specifically interested in family planning and identified mostly as Caucasian and female. Because of this, our results may not be generalizable to the national population of clinicians who offer contraceptive implant services. However, our direct selection of participants who only sometimes or do not offer extended use allowed us to hear diverse perspectives regardless of prior knowledge or interest in extended use. Another limitation is that we did not ask advanced practice clinicians what their specific training was (i.e., nurse practitioner or physician’s assistant). As the training for advanced practice clinicians can vary greatly, our results may not be generalizable to all advanced practice clinicians.

In conclusion, this study describes the barriers and facilitators to widespread implementation of extended use of the contraceptive implant. These results offer new perspectives and potential strategies to increase widespread implementation of extended use of the contraceptive implant up to 5 years of use. Based on our findings, there is opportunity to expand access to extended use by developing educational materials for clinicians and patients, identifying a champion of extended use, and counseling on extended use prior to removal appointments at 3 years. Of note, these results should be viewed in the context of recent policy access issues regarding reproductive health and used to support patient-centered contraceptive choices, regardless of a patient’s decision to extend use of their contraceptive implant up to 5 years. It is important that clinicians and patients utilize shared decision making when discussing extended use of the contraceptive implant.

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to being stored in a private, HIPAA-compliant database, but are available from the corresponding author on reasonable request.

Abbreviations

Consolidated Framework for Implementation Research

Food and Drug Administration

CoIntrauterine device

Long-acting reversible contraception

Levonorgestrel

Obstetrician-Gynecologist

United States

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Acknowledgements

We thank the participants in this study.

This study was funded by Organon (Study #201908). The funder had no role in the study design, analysis, or interpretation of findings.

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School of Medicine, University of California San Diego, San Diego, CA, USA

Nicole Rigler

Division of Complex Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, 9300 Campus Point Dr. MC 7433, La Jolla, San Diego, CA, USA

Gennifer Kully, Marisa C. Hildebrand, Sarah Averbach & Sheila K. Mody

Center on Gender Equity and Health, University of California, San Diego, CA, USA

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Contributions

SM is the principal investigator and lead data analysis, including qualitative coding, and dissemination of findings. She was also involved in study design and participant recruitment. NR was the primary interviewer and was involved in study design, recruitment, data management, data analysis, and dissemination of findings. GK and MH were involved with study design, recruitment, coordination of the study, IRB documentation, data analysis, and dissemination of findings. SA was involved with study design and dissemination of findings. All authors read and approved the final draft of the manuscript.

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Correspondence to Sheila K. Mody .

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This study was approved by the Institutional Review Board at University of California, San Diego (Study #201908). All participants gave written informed consent.

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Competing interests

S.M. is a consultant for Bayer and Merck. She has grant funding from Organon and receives authorship royalties from UpToDate. S.A. has served as a consultant for Bayer on immediate postpartum IUD use. The remaining authors report no conflict of interest.

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Rigler, N., Kully, G., Hildebrand, M.C. et al. Offering extended use of the contraceptive implant via an implementation science framework: a qualitative study of clinicians’ perceived barriers and facilitators. BMC Health Serv Res 24 , 697 (2024). https://doi.org/10.1186/s12913-024-10991-4

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Published : 03 June 2024

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Qualitative Research – Methods, Analysis Types and Guide

Qualitative Research

Qualitative Research Methods

One-to-One Interview

Focus Groups

Ethnographic Studies

Text Analysis

Process of Observation

Record Keeping

Qualitative Research Analysis Methods

Thematic Analysis

Content Analysis

Discourse Analysis

Grounded Theory Analysis

Narrative Analysis

Phenomenological Analysis

Comparative Analysis

Applications of Qualitative Research

How to Conduct Qualitative Research

Examples of Qualitative Research

Purpose of Qualitative Research

When to use Qualitative Research

Characteristics of Qualitative Research

Advantages of Qualitative Research

Limitations of Qualitative Research

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Muhammad Hassan

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