Qualitative methodology in public health


Written by Dr Georgia Rowley, Research Associate, ELDAC

Qualitative methods are key to public health research, conducive to extracting lay knowledge and detailed, rich accounts of peoples’ lived experiences. (1, 2) Qualitative research is particularly well-suited to exploring the experiences of diverse populations (1, 3), and studying sensitive themes like death and dying. During my PhD, I conducted 41 in-depth interviews with older Greek migrants within an empathetic, and culturally and linguistically relevant setting, to investigate key socio-cultural phenomena from peoples’ subjective viewpoints. The topic at hand was sensitive – widowhood, grief and well-being in older age.

Culturally and linguistically diverse (CALD) individuals are often excluded from mainstream research. Barriers include access and recruitment of interviewees, limited availability of researchers with appropriate cultural and linguistic backgrounds, and/or the time and resource intensive nature of sampling non-English speakers due to interpreting and translating barriers and costs. (4, 5) I sought to capture and preserve interviewees’ unique ‘voices’ in their native tongue; to counter their exclusion from most academic research, and the fact they have been otherwise spoken ‘for’ at the expense of their own voices being privileged. (6) Interviewees were provided the opportunity to communicate within a warm and supportive discussion environment, with a member of their cultural community.

Researcher reflexivity is essential to qualitative research (7), especially in loss and grief fields. (8) Reflexive thinking commences at the beginning of projects and is re-evaluated throughout. (9) Reflexive approaches attempt to deconstruct traditional hierarchies and to form reciprocal, authentic, collaborative, meaningful, trusting and empathetic relations with interviewees. (1, 7, 9, 10, 11, 12) I employed a feminist methodological approach, stressing inclusiveness of diverse populations and sampling beyond dominant groups to capture the meaning of concepts from the perspective of those experiencing it. (13)

I critically evaluated the influence of my background (including gender, ethnicity, class, language, social positionality, and relevant lived experiences) on the entirety of the research (including project conception, recruitment, data collection, translation and analysis). I acknowledged my historical location and positionality as a young rural woman, third-generation Greek-Australian, granddaughter of older widowed Greek migrants, and daughter of ageing second-generation Greeks on the research topic and project. My cultural membership and shared rural positionality to interviewees afforded a somewhat ‘insider’ status, which enhanced their willingness to participate, established rapport, intimacy and acceptance, and fostered cultural sensitivity. This allowed for a deeper understanding of data collected in terms of participants’ cultural, historical, socio-economic, religious, political and familial context. Importantly, it created a more relevant and empowering experience for interviewees.

For this study, entry was gained by approaching community and organisational stakeholders, harvesting personal community connections, and employing a snowball sampling technique. Reputational recruitment is especially useful for cultural research, particularly in accessing ‘difficult-to-reach’ or vulnerable migrant and refugee groups, especially in rural areas. (14) Snowball sampling helps researchers gain access, build trust and develop rapport within communities, and allows interviewees to verify researcher credibility and cultural competency by process of established and trusted personal relations, positive recommendation, network referral (15), or simply ‘knowing the person’. (16, 17) Living in the Riverland region until age 17, in addition to a shared linguistic, cultural and religious background and identity with rural residents assisted recruitment efforts. Such connections are particularly essential when undertaking research with marginalised or minority groups, who may initially perceive researchers with suspicion or mistrust.

Project information and the interview schedule were constructed in English and translated to Modern Greek. Interview questions were largely open-ended, to encourage interviewees to share rich stories, understood within particular social, cultural and historical contexts. All but three interviews were conducted in Greek and were audio-recorded to preserve spoken word. By simultaneously translating and transcribing Greek data to English, I eliminated the need for external translators.

Though interviews dealt with sensitive topics, people talked freely and without prompting of spousal illness and death. Many stated that they had enjoyed our interactions, and indeed revelled in the opportunity to openly discuss the death of their spouse and associated grief with an active listener. I was humbled by the experience of conducting this cross-cultural research and am eternally grateful for interviewees’ honesty and openness in sharing a wealth of lay knowledge about death, grief, ageing and well-being. I remain hopeful that interviewees felt empowered in having their voices privileged and the opportunity to share aspects of their life stories.


1. Denzin NK, Lincoln, YS. Handbook of qualitative research. California, USA: Sage Publications, Inc.; 2000.
2. Johnson SJ, Waterfield, J. Making words count: the value of qualitative research. Physiotherapy Research International. 2004;9:121-131.
3. Creswell JW, Clark VLP. Designing and conducting mixed methods research. California USA: Sage Publications Ltd; 2007.
4. Atkin N. Getting the message across: professional interpreters in general practice. Australian Family Physical. 2008;37:174-176.
5. Temple B. Crossed wires: interpreters, translators, and bilingual workers in cross-language research. Qualitative Health Research. 2002;12:844-854.
6. Sultana F. Reflexivity, positionality, and participatory ethics: negotiating fieldwork dilemmas in international research. ACME: An International E-Journal for Critical Geographies, 2007;6:374-385.
7. Ellingson LL. Embodied knowledge: writing researchers’ bodies into qualitative health research. Qualitative Health Research. 2006;16:298-310.
8. Rowling L. Being in, being out, being with: affect and the role of the qualitative researcher in loss and grief research. Mortality. 1999;4:167-181.
9. Jones SJ. Reflexivity and feminist practice: ethical dilemmas in negotiating meaning. Feminism & Psychology. 1997;7:348-353.
10. England KVL. Getting personal: reflexivity, positionality, and feminist research. The Professional Geographer. 1994;46:80-89.
11. Moore T. “Me” as the research instrument: subject positions, feminist values and multiple “Mes”. International Journal of Pedagogies and Learning. 2008;4:31-41.
12. Oakley A. People’s ways of knowing: gender and methodology. In: Hood S, Mayall B, Oliver, S, editors. Critical Issues in Social Research Buckingham, UK. Open University Press: 1999. p.154-177.
13. Blieszner R. A socialist-feminist perspective on widowhood. Journal of Aging Studies. 1993;7:171-182.
14. Liamputtong P. Doing research in a cross-cultural context: methodological and ethical challenges. In: Liamputtong P, editor. Doing cross-cultural research. Netherlands: Springer; 2008.
15. Blaikie N. Designing social research. Cambridge UK: Polity Press; 2010.
16. Eide P, Allen CB. Recruiting transcultural qualitative research participants: A conceptual model. International Journal of Qualitative Methods. 2008;4:44-56.
17. Feldman S, Radermacher H, Browning C, Bird S, Thomas S. Challenges of recruitment and retention of older people from culturally diverse communities in research. Ageing & Society. 2008;28:473-493.

Posted in
CALD Methodology

Leave a Reply