Hi Rebecca,
Thanks for your response, in particular for clarifying how you posed and worded your questions - very useful - especially in relation to introducing theories as a follow-up question.
I was actually referring to the same interview, although I am also doing follow-up interviews too (longitudinal I suppose). My current interview schedule (which will develop iteratively through data collection...) also has both open and more direct questions.
In relation to your final question, I am also using other methods in the study :)
Best wishes,
Andy
Doctoral researcher
Bournemouth University - Faculty of Health & Social Sciences
Bournemouth House, B112a
19 Christchurch Road
Bournemouth
BH1 3LH
@AndrewJEHarding
Office - 01202 963025
Mobile - 07808794141
________________________________________
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards <[log in to unmask]> on behalf of Rebecca Randell <[log in to unmask]>
Sent: 06 November 2015 12:23
To: [log in to unmask]
Subject: Re: Qualitative interviewing for mechanisms & 'active ingredient' terminology
Hi Andy
I understand your concerns but I think it's also about how you present your study to your participants. Yes, talking about the teacher-learner cycle, I was referring to the realist interview approach as advocated by Pawson and Tilley in Realistic Evaluation. In using this approach, we never used the word 'theory' when talking to our participants - we talked about 'ideas' (in our case, ideas that had come up in the literature and in earlier interviews), but we were also very careful to emphasise the participants' expertise and that it was only by learning from their experience that we would be able to do the research. Included in our theories were some rival theories. What is also important is the 'probe' questions that you ask - so after asking 'Something that's come up in the literature that we've been looking at is the idea that.... Does that fit with your experience?', if they say yes, asking them to expand on that with examples. So, they may initially say yes but as you probe further you may find that actually there are subtle differences between their 'theory' and yours.
When you say about 'following up with more direct questions', do you mean in the same interview or in a later, separate interview? From your response to Sonia's email, I think you mean the latter but while we used the teacher-learner cycle approach, we did also have more open-ended questions. The combination of both styles of questioning in the same interview was quite revealing - so, for example, in some cases we'd ask them if they thought robotic surgery impacted on teamwork and they'd say no but then when it came to talking about the theories they were able to identify instances from their experience that fitted with those theories.
Also, in reference to your comment about using interviews for both eliciting and testing your theories and thinking of Ray Pawson and Ana Manzano's 'A realist diagnostic workshop' (in Evaluation, 2012 and also chapter 2 in Pawson 'The Science of Evaluation'), while interviews can be powerful for eliciting theories for testing and for understanding mechanisms when testing your theories, a mixture of methods is needed for obtaining evidence about the Cs, Ms, and Os (but maybe you already have plans for that).
Thanks for the references - I wasn't aware of them and will check them out.
Best wishes
Rebecca
Dr Rebecca Randell
Lecturer
School of Healthcare
Baines Wing
University of Leeds
Leeds LS2 9UT
Email: [log in to unmask]
-----Original Message-----
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Andrew Harding
Sent: 06 November 2015 11:41
To: [log in to unmask]
Subject: Re: Qualitative interviewing for mechanisms & 'active ingredient' terminology
Thanks for that insight Sonia. Very interesting. I would draw from that that the style of questioning is dependent on the study and participant group.
In my case, the use of more direct follow up questions is where theories will be tested - accepted, rejected, refined etc. Again, this is the thrust of Smith and Elgers discussion.
Best wishes,
Andy
Doctoral researcher
Bournemouth University - Faculty of Health & Social Sciences
Bournemouth House, B112a
19 Christchurch Road
Bournemouth
BH1 3LH
@AndrewJEHarding
Office - 01202 963025
Mobile - 07808794141
________________________________
From: Sonia Dalkin <[log in to unmask]>
Sent: 06 November 2015 11:05
To: Realist and Meta-narrative Evidence Synthesis: Evolving Standards; Andrew Harding
Subject: RE: Qualitative interviewing for mechanisms & 'active ingredient' terminology
Hi Andy,
This topic actually came up at the conference, in a presentation by Mel Punton from Itad Ltd (a firm specialising in the monitoring and evaluation of international development programmes). Mel explained how in some cultures, it was rude to disagree and therefore the realist interview could be difficult and/or inappropriate to use in some research projects.
Ray Pawson responded, stating that confirmation bias is a challenge in realist methods but you should look to disprove your theory in interviews. In order to so, the framing of the questions you pose is crucial. He also stated that the interviewer should be asking the participant about rival theories etc. which may stop participants form just agreeing with your theories.
I hope that helps. I'm sure others will have comments to follow.
Best wishes,
Sonia
__________________________________________________________________________
Dr Sonia Dalkin
Lecturer in Public Health, Department of Public Health, Faculty of Health & Life Sciences
Email: [log in to unmask]<mailto:[log in to unmask]>
Twitter: @SoniaDalkin
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The UKCRC Centre for Translational Research in Public Health www.fuse.ac.uk<http://www.fuse.ac.uk/>
Room H005, Coach Lane Campus East, Northumbria University, Newcastle upon Tyne, NE7 7XA, United Kingdom
-----Original Message-----
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Andrew Harding
Sent: 06 November 2015 10:51
To: [log in to unmask]
Subject: Re: Qualitative interviewing for mechanisms & 'active ingredient' terminology
Hi all,
Would just like to reopen this interesting discussion if I may, particularly around style of interview questions.
Just as a bit of context, participants in my PhD are older people who have engaged with an information and advice service on their housing situation...
The teacher-learner cycle approach mentioned below I assume to be the realist interview approach as advocated by Pawson and Tilley in Realistic Evaluation?
The issue I have with this is that considering the dynamics in my study - older people (65+) who are often 'grateful' for being given I&A on their housing - I'm unsure as to whether participants will be receptive to being imparted with theories to engage with (and actually think it may alienate in some cases), and that direct questions will merely serve to shape and bias their responses.
I'm not solely advocating open constructivist/narrative style questioning (doesn't philosophically align...), but I think more indirect queries have a place in realist research interviews, and then following up with more direct questions - particularly considering my study dynamic. 'Critical Realism and Interviewing Subjects' by Elger and Smith - a working paper (2012) and book chapter (2014) - suggest this when discussing P&Ts realist interview approach... (will send separately if people want these).
Just wonder if anyone else has grappled with these issues?
I hope the Leeds conference was good. It certainly looked it from twitter!
Best wishes,
Andy
Doctoral researcher
Bournemouth University - Faculty of Health & Social Sciences Bournemouth House, B112a
19 Christchurch Road
Bournemouth
BH1 3LH
@AndrewJEHarding
Office - 01202 963025
Mobile - 07808794141
________________________________
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards <[log in to unmask]<mailto:[log in to unmask]>> on behalf of Caroline Stretton <[log in to unmask]<mailto:[log in to unmask]>>
Sent: 04 November 2015 22:03
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Qualitative interviewing for mechanisms & 'active ingredient' terminology
Excellent. Great advice. Thank you Rebecca -Thanks also for the reminder about that paper. I came across it a couple of years ago and dismissed it as being too hard to understand. Time to revisit it I think!
Cheers
Caroline
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Rebecca Randell
Sent: Tuesday, 3 November 2015 4:23 a.m.
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Qualitative interviewing for mechanisms & 'active ingredient' terminology
Hi Caroline
Another article that I would recommend to help with your thinking about the active ingredients question is one that I came across thanks to this list:
Clark A. What are the components of complex interventions in healthcare? Theorizing approaches to parts, powers and the whole intervention. Social Science & Medicine 93 (2013) 185-193
Regarding the interviews, we have used the teacher-learner cycle approach which I have found really helpful in drawing out people’s reasoning – similar to Avril’s comment about giving people examples from other interviews, presenting the theories we found in the literature gave the interviewees something to engage with, test their ideas against, and I think provided us with much richer data than if we’d taken a more standard semi-structured interview approach.
Best wishes
Rebecca
Dr Rebecca Randell
Lecturer
School of Healthcare
Baines Wing
University of Leeds
Leeds LS2 9UT
Email: [log in to unmask]<mailto:[log in to unmask]<mailto:[log in to unmask]:[log in to unmask]>>
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From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Avril Nicoll
Sent: 02 November 2015 09:36
To: [log in to unmask]<mailto:[log in to unmask]<mailto:[log in to unmask]:[log in to unmask]>>
Subject: Re: Qualitative interviewing for mechanisms & 'active ingredient' terminology
Hi Caroline,
Would it be worth your RA trying out a less structured approach? Being asked questions about reasoning can be quite confronting, particularly where there are power differentials, so there's a case for just getting people talking about their stroke, about their everyday activities and being ready to pick up on anything that seems to be relevant to your research questions, particularly if there are signs of heightened emotion. I also think examples from other interviews can be really helpful in allowing participants to see that other people have a range of experiences, and it's fairly natural to compare these with their own. Your longitudinal design also allows similar discussion around changes in their accounts over time. There are some interesting papers around interviewing people with learning disabilities and children with speech, language and communication needs that might give you other ideas. I'm on a train to the Realism Leeds conference, but could send you links off list when I get home on Friday if you like.
Re 'active ingredients', metaphors that resonate are worth capitalising on. Could you adapt it in terms of context by also talking about 'the kitchen'?? You may already have come across Penelope Hawe but, if not, she writes very well on context and complex interventions - see eg 'Lessons from complex interventions to improve health' Annu. Rev. Public Health 2015 36:307-23. Point 6 in her summary seems especially relevant: 'Theory and evaluation of complex interventions have moved away from viewing an intervention as a program, technology, or set of products to represent interventions as routines, relationships, resources, power structures, symbols, forms of talk, "powerful ideas," and sets of values.'
Looking forward to hearing more about your study in due course.
Avril
(PhD student, NMAHP Research Unit, University of Stirling)
Sent from my Sony Xperia™ smartphone
---- Caroline Stretton wrote ----
Hello fellow realists,
I have two questions I would welcome any thoughts on:
My project is am trying to build and refine a treatment ( programme theory) on how to promote sustained behaviour change in people with stroke.
I have developed an intervention based on my programme theory and am doing small a case study impact evaluation on the recipients of the programme.
I have a research assistant completing semi-structured qualitative interviews at mid programme, post programme and at 3 months follow up. I want to understand the causal change mechanisms that are hopefully being activated by the innovative programme.
I have just listened to some of the mid-programme interviews and the post programme interviews are due to be completed later this week. There is some interesting information coming through but I am struggling to know how to guide my RA to ask questions that can really get to the heart of the participants reasoning. One of the main reasons I think is the characteristics of my population. My participants come from a low socio economic area, many have English as a second language, the majority have delayed information processing ( cognitive problems) following their stroke, and are not used to being particularly self-reflective or dealing with abstract issues. Does anyone have any helpful suggestions for how to phrase questions that might help me get some more in-depth data at the next interview point ?
My second questions relates to the use of the phrase ‘active ingredients’ and whether it is helpful. I am hoping that my programme theory will be of practical use for clinicians. From my professional background- theory based approaches are very uncommon and viewed as largely irrelevant to practice. However the metaphor of ‘active ingredients’ taken from a pharmacological model seems to resonate clinicians. Using the concept of ‘active ingredients’ and defining it as being the rehabilitation component that can ‘activate’ the causal change mechanism on one level would make sense to clinicians. However this runs the risk of ignoring the very significant contextual issues that affect firing or perhaps the fact that it is likely it is interacting ingredients that are part of complex interventions like rehabilitation. What are your thoughts about the phrase ‘active ingredients’ from a realist perspective
Thank you in anticipation
Caroline Stretton
Caroline Stretton
Doctoral Student
School of Clinical Sciences
Auckland University of Technology
P 09 921 9999 ext 7697 E [log in to unmask]<mailto:[log in to unmask]<mailto:[log in to unmask]:[log in to unmask]>> W aut.ac.nz<https://www.aut.ac.nz>
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