There is an urgent need for innovation in the use of qualitative methods alongside randomised controlled trials (RCTs) of health interventions. RCTs are widely used in public health to evaluate complex interventions, which aim to change the context or social environment that influences individual health behaviours. However, complex interventions raise a number of challenges for RCTs: they are often multifaceted, have multiple outcomes, and are highly influenced by the surrounding social context.
Qualitative methodologies are ideally suited for considering the role of social context in interventions, for generating theory about how interventions work, and for developing broader understandings of social behaviour. However, less than 13% of RCTs use qualitative methods, and the value gained from the qualitative methods that are used alongside RCTs is limited by a narrow focus on interviews and focus group discussions as appropriate data collection methods. This fails to acknowledge the diverse toolbox of methods that have been developed by qualitative researchers in public health over the last 50 years.
This project aims to bring together studies from RCTs that draw on the rich history of qualitative health methodologies in public health. This include qualitative methods such as life history narratives and conversation analysis of patient-doctor interactions, which have been designed to capture the way in which our experiences and social interactions influence health-related behaviours. Other methods, including photo-voice, ethno-drama and participatory approaches, have helped overcome the challenges of doing research with vulnerable groups and have given individuals an active role in researching their own health needs.
The development of qualitative methods has also kept pace with rapid advances in new technologies with innovative methods such as digital storytelling, digital ethnography, and methods for analysing data produced by mobile apps, social media, blogs and online discussion forums. In addition, there have been significant enhancements in qualitative analysis with leading software providers such as NVIVO and ATLAS.ti introducing comprehensive tools for systematically analysing video, images and sound.
These qualitative methods and tools offer an enormous opportunity to move beyond interviews and focus groups to develop rigorous understandings of the context in which intervention take place. Equally, they provide an opportunity to develop structural interventions that are better able to address the social determinants of health and challenge structural inequalities such as race, class and gender.