Conducting qualitative research on cervical cancer screening among diverse groups of immigrant women: research reflections: challenges and solutions.

OBJECTIVE: To explore the research lessons learned in the process of conducting qualitative research on cervical cancer screening perspectives among multiple ethnolinguistic groups of immigrant women and to provide guidance to family medicine researchers on methodologic and practical issues related to planning and conducting focus group research with multiple immigrant groups. DESIGN: Observations based on a qualitative study of 11 focus groups. SETTING: Hamilton, Ont. PARTICIPANTS: Women from 1 of 5 ethnolinguistic immigrant groups and Canadian-born women of low socioeconomic status. METHODS: We conducted 11 focus groups using interactive activities and tools to learn about women's views of cervical cancer screening, and we used our research team reflections, deliberate identification of preconceptions or potential biases, early and ongoing feedback from culturally representative field workers, postinterview debriefings, and research team debriefings as sources of information to inform the process of such qualitative research. MAIN FINDINGS: Our learnings pertain to 5 areas: forming effective research teams and community partnerships; culturally appropriate ways of accessing communities and recruiting participants; obtaining written informed consent; using sensitive or innovative data collection approaches; and managing budget and time requirements. Important elements included early involvement, recruitment, and training of ethnolinguistic field workers in focus group methodologies, and they were key to participant selection, participation, and effective groups. Research methods (eg, recruitment approaches, inclusion criteria) needed to be modified to accommodate cultural norms. Recruitment was slower than anticipated. Acquiring signed consent might also require extra time. Novel approaches within focus groups increased the likelihood of more rich discussion about sensitive topics. High costs of professional translation might challenge methodologic rigour (eg, back-translation). CONCLUSION: By employing flexible and innovative approaches and including members of the participating cultural groups in the research team, this project was successful in engaging multiple cultural groups in research. Our experiences can inform similar research by providing practical learning within the context of established qualitative methods.

"I take what I think works for me": a qualitative study to explore patient perception of diabetes treatment benefits and risks.

BACKGROUND: Diabetes is impacting more and more people each year. A key aspect of disease management is patient adherence to prescribed treatments. Treatment adherence is influenced by many factors, including the understanding of a treatment's benefits and risks. OBJECTIVE: This study sought to describe the experience of benefit and risk assessment for people with type 2 diabetes when making treatment decisions. METHODS: This study utilized qualitative research methods. Individual interviews were conducted using a semi-structured interview guide. Both purposeful and theoretical sampling was used. A grounded theory approach was employed to facilitate data collection and analysis. RESULTS: The 18 study participants were on varying treatment regimens for diabetes (diet therapy, oral medications, and insulin). Many people felt that they had not received enough information about the benefits and risks of treatment at the point of decision-making and later sought this information on their own. Participants did not seem to consciously assess treatment benefits and risks when treatments were prescribed or suggested, but rather continued to make decisions after the clinical encounter by means of experimentation or experience with treatments. In general, benefits and risks were conceptualized very broadly, and some people were not able to verbally articulate their perceptions of treatment benefits and risks. CONCLUSION: Patients' assessment of treatment benefits and risks is an ongoing, often unconscious process that requires continuous interaction with the health care system. Access to information and an opportunity to discuss treatment options with health care providers are important to people with diabetes when making treatment decisions.

Revisiting the Quantitative-Qualitative Debate: Implications for Mixed-Methods Research.

Health care research includes many studies that combine quantitative and qualitative methods. In this paper, we revisit the quantitative-qualitative debate and review the arguments for and against using mixed-methods. In addition, we discuss the implications stemming from our view, that the paradigms upon which the methods are based have a different view of reality and therefore a different view of the phenomenon under study. Because the two paradigms do not study the same phenomena, quantitative and qualitative methods cannot be combined for cross-validation or triangulation purposes. However, they can be combined for complementary purposes. Future standards for mixed-methods research should clearly reflect this recommendation.