Abstracts,Oral Presentations

Abstract

Community needs driven qualitative research: Evidence based practice from within

Liliana Alvarez

Institute for Continuing Care Education and Research (ICCER), University of Alberta

Sandra Woodhead-Lyons

Institute for Continuing Care Education and Research (ICCER)

The continuing care sector is under-researched, and research that does occur is often driven by academic interests rather than the needs of the care providers. Front-line staff are relegated to the role of data sources instead of being partners in the research and knowledge translation processes. In 2012, with funding from Alberta Innovates Health Solutions, the Institute for Continuing Care Education and Research (ICCER) piloted a Community Needs Driven Research Network (CNDRN) for the continuing care sector to address these issues. Qualitative methods were used to identify research needs at the front line. The development of the CNDRN was guided by a Reference Group of researchers, academics, providers, and policy makers. Data was collected through focus groups and interviews from individuals in the continuing care sector from central and southern Alberta (N=69). Data from four prior community networking events in northern Alberta (N=75) were also analyzed. QSR NVivo 10##x00E2;^® software was used for analysis. Critical research needs were identified across the province. Participants asked whether the consultation was a ‘one off’ process, or whether qualitative research could continue to support this form of knowledge translation. The use of qualitative methods allows the identification of research gaps from the perspective of front-line workersï¿½ï¿½ experiences and attributions of meaning. Qualitative methods can be used to make knowledge translation a continuous research component. The process can provide valuable information to academics, researchers, providers, and policy makers. However, there are difficulties in sustaining the process.

Investigator Triangulation: A Missed Opportunity in Mixed Methods Research?

Mandy Archibald

University of Alberta

In this article, the underexplored realm of investigator triangulation in mixed methods research (MMR) is examined. Investigator triangulation, it is argued, is particularly well suited for use in MMR because it may assist investigators to address complexity and expertise related challenges inherent in many mixed methods studies. This article examines 20 peer-reviewed articles retrieved from a comprehensive search of qualitative and mixed methods literature on investigator triangulation to demonstrate variability in its conceptualization and application. Findings illustrate that claims associated with investigator triangulation, such as reduction of researcher bias, may be overstated. The article concludes by offering guidelines for the conduct and reporting of investigator triangulation for use in MMR.

Keywords: investigator triangulation; mixed methods research; reporting; collaboration

Revealing Perceptions of the Role of Environment in Physical Activity through Community Lenses

Ana P. Belon

Centre for Health Promotion Studies/School of Public Health

Candace I.J. Nykiforuk

Centre for Health Promotion Studies/School of Public Health

Laura Nieuwendyk

Centre for Health Promotion Studies/School of Public Health

Helen Vallianatos

Department of Anthropology/Faculty of Arts

Growing evidence has shown the influence of built and social environments on physical activity (PA) participation. Considering environmental perceptions are a key mediator between objective environmental factors and active living, it is important to understand how people perceive opportunities in their community environment. Photovoice has emerged as a powerful participatory method that enables participants to portray and share issues affecting their community through active engagement in research. This study aimed to identify the barriers to and opportunities for PA engagement among 35 residents of four communities in Alberta, Canada. Participants used digital cameras to document perceived environmental attributes that might foster or inhibit PA in their community. Photographs were discussed in individual semi-structured interviews. The transcripts of the interviews were examined through content analysis. The Analysis Grid for Environments Linked to Obesity (ANGELO) framework was used to organize the themes that emerged. Results indicated that obstacles and facilitators to be physically active related to the physical (e.g., walking infrastructure) and sociocultural environments (e.g., trash and debris) most frequently. In contrast, discussions and images related to the economic (e.g., affordability of recreation facilities) and policy environments (e.g., rules limiting access to spaces) were less prominent. Overall, the findings reinforce the need for inter-sectoral policies and programs addressing the barriers identified by participants to help make communities more healthy and active.

One white woman's journeys alongside Indigenous languages and literacies: An autoethnographic retrospective exploration

Heather Blair

University of Alberta

This presentation will be an exploration of autoethnographic research methodologies based on a retrospection of four decades of one white woman's journeys in the field of Indigenous languages and literacies research. It will include a sketch of ethnographic methods and a discussion of issues of representation. The field of ethnography has been expanded, refined, elaborated on and comes in many shapes and forms. From the days of anthropologists doing field work and studying “others” to more reflective stances such as that of autoethnography based on the work of Schrag (1986, 1999, 2003) and focusing on communicative praxis in understanding the self and intersubjectivity. The researcher is turning her research lenses back on her past ethnographic research work to examine the embodiment of the ethnographic self, discourses, actions, and ways of being in Indigenous languages and literacies research processes.

Mixed Method Research in Capturing Systemic Change

Shovan Chakraborty

Swisscontact Katalyst

Md. Muaz Jalil

Making ‘markets work for the poor’ is an approach, used mostly by bilateral donor agencies in PSD projects, where poverty is addressed by improving the competitiveness of market systems where poor participates. DFID alone has 28 M4P projects around the world with individual budgets as high as 50 million pounds. But result measurement in M4P is a challenge because firstly, goals of scale are ambitious and impacts costly to quantify relative to available resources. Secondly, systemic changes in market don't follow narrow and conventionally defined mechanistic models of inputs to impact. However, there is growing pressure to attribute better. Unfortunately, standalone quasi experimental or experimental research designs are often unsuitable. This presentation showcases how a mixed method research design was used to capture systemic impact of an intervention in Bangladesh where better quality seed was promoted through appropriate packaging and channeling aiming the poor population. In Bangladesh 10 million farmers don't use quality seeds however this intervention resulted in a sales of 1.9 million better quality seed packets. An intervention with such large potential benefit outreach, attribution had to be solid. A tracer study across 35 sub-districts led to identification of dispersed treatment group. Subsequent survey gave breakthrough in setting criteria to select control group; use of multiple stages eliminated recall bias. The novelty of the research lies in the use of result chain to guide research design, integration of difference in difference design in M4P, use multi-layer investigation for triangulation and use of newly developed qualitative systemic change framework.

Institutional ethnography and critical discourse analysis: A mixed methods approach to analyzing texts

Laura Charles

Ontario Institute for Studies in Education

Simon Adam

Ontario Institute for Studies in Education at the University of Toronto

This approach has come about because of a shared interest in exploring different methods of textual analysis within Institutional Ethnography (IE). IE is recognized for its ability to access and explicate the institutional and organizational rulings or power systems, structures, and regimes. However, while recognizing the powerful insights that IE can unlock through its analysis of texts and its placement of texts as central to institutional coordination and their manifesting of the social relations of power, we argue that power also operates through other ways than coordinating and organizing institutional social relations. Viewing power as a correspondent of language and discourse as would a Critical Discourse Analysis (CDA), brings the study of language to the front. CDA evidentially exposes the power in language using particular tools such as deletion of agency, transitivity, deception of appearances, to name but a few. Our study combines IE and CDA. This combination promises to capture both the ideological power and the coordinating power of texts.

Examining the use of participant observation to explore senior hospital manager relations: Purpose, pitfalls, and priorities in a grounded theory study

Christina Clausen

McGill University Ingram School of Nursing

Lori Rietze, Laurentian

University School of Nursing

Fay Strohschein

McGill University Ingram School of Nursing

The Canadian healthcare system faces a number of complex challenges related to cost containment, health professional shortages and patient safety. Changing the approach to management and leadership has been identified as key in facilitating change and transforming care delivery. The development of collaborative management structures and working relations at every level within health care organizations is critical to achieving this transformation. Specifically, collaboration among senior leaders is essential.

One approach has been the institution of co-leadership and co-management models; however, little is known about the nature and dynamics of this phenomenon, what it looks like in practice or how it originates and develops in the healthcare setting. Participant observation offers a valuable method to contribute to understanding this phenomenon. In the context of a grounded theory study that explores how senior nurse and physician co-managers work together within a formalized dyad to address matters of clinical management, we will examine how participant observation complements other forms of data collection such as interviews which may be limited as terminology used by participants to describe how they interact and manage together may be ambiguous. However, this context presents particular challenges to anonymity and confidentiality. We will propose that the nature of the researcher's relationship to the participants and transparency in terms of the researcher's role in the setting is key to how data is collected and represented through the stages of a grounded theory study.

Online Bulletin Board Focus Groups (BBFG) with Medically Fragile Young Adults

Karen Cook

McMaster University

Dr. Gina Browne

McMaster University

Dr. Susan Jack

McMaster University

Dr. Lehana Thabane

McMaster University

Dr. Hal Siden

University of British Columbia

A new group of medically fragile young adults are graduating from pediatric palliative care with limited expectations to live beyond early adulthood, and no comparable adult services to support their complex needs. A case study was conducted to understand the experiences of this population simultaneously striving to achieve young adult goals and experiencing their end of life trajectory.

Accessing this population with traditional qualitative methods is difficult because of the complexity of their conditions. Most require 24-hour attendant care and their independent function may be reduced to minimal movement of their index finger on a joystick to control power wheel chairs, computers and phones. An asynchronous modification of an online focus group, a BBFG, was created to engage participants who have limited mobility to travel and commit to specific interview times, and have divergent communication abilities such as computer mediated voice recognition, typing or speech.

Two groups of four graduates of a children's hospice were recruited to participate in a BBFG. There was an average of 225 participant posts over 5 days yielding approximately 11 posts per participant per day. The greatest strength of the BBFG is that the method is an intervention. Participants reported that the topics discussed provoked new thinking and learning from others on the same journey, they would highly recommend the experience and be willing to participate again. An important limitation of this method was participant follow through on discussion threads. This BBFG provided rich data and participant experiences for a medically fragile population.

Use of Draw & Write (D&W) with children in health and wellbeing research: A review

Anna Cooper

University of Salford

Cynthia Pine

Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK

Lorna Porcellato

Liverpool John Moores University

Lindsey Dugdill

University of Salford

Although D&W methods are popular and becoming more widely used in health and wellbeing research with children, in contrast to many self-report methods, it is still a relatively underutilised technique. In D&W, children are invited to draw a picture and write about it; prompted by open-ended questions, enabling children to freely express their beliefs, understanding and current knowledge around the given topic. The objectives of the review were: to examine the use of D&W in health and wellbeing literature, with children aged 4–11 years, and to understand the context in which the technique was used and how research was translated for future use. Six key databases were searched in February 2013. Only studies in English, reporting outcomes and in peer review journals were included. 50 papers met these inclusion criteria (n=19,000 children). Papers were grouped into 5 areas of research: cancer (n=12), smoking & drugs (n=8), hospitals (n=7), health promotion and other health topics (n=18) and methodology papers (n=5). 78% (n=39) of articles used D&W as a precursor to one-to-one interviews or focus groups with the children. The methodology was predominantly used with children 7-10 years; however evidence from this review supports the opinion of the methodology being effective with children aged 4-11 years. The focus of included papers was predominantly on childrens knowledge and understanding of the health topic, rather than translation of this knowledge into interventions or services for children; highlighting a gap in future opportunities for health service redesign.

Recording the Experience: Using Digital Technology in Challenging Settings

Leslie Cove

McMaster University

Studies of volunteerism use a multitude of methodological approaches however; the vast majority of North American studies are quantitative designs. While these quantitative studies have developed into a large and growing literature on the diverse types of people who volunteer and the many ways they do, this study is concerned with real time reactions and long term impacts of exposure to extreme poverty and participation as a volunteer. This paper offers reflections on the data collection process of interview and observation data collected with Habitat for Humanity Canada in their Global Village program. Data was collected on site in a developing country using video journals both by the researchers and the research subjects along with traditional field notes. This presentation discusses a series of challenges faced in the field including power outages, security of technology, heat and how research subjects can be encouraged to use technology to talk about their experience. Overall, this paper seeks to stimulate a conversation regarding solutions for using digital recording technology in the field in both developed and developing settings and the ways to critically assess the development of this data collection method.

Qualitative methodology and spatial justice theory: What are the implications for critical, rural social research?

Lindy Croft-Piggin

Charles Stuart University

Lisa M. Given

School of Information Studies, Charles Sturt University

In Nanterre, Paris in 2008 a new conference focused on the concept of spatial justice. Speakers observed the relationship between geographic location and the social opportunities of inhabitants. The generative effects of location were explored to find inequalities in technological innovation, artistic creativity, economic development, social change, environmental degradation, social polarization and income gaps. The impact of spatial causality on everyday behaviour pointed to the importance of place and space at the micro and macro levels. This conference demonstrated that place and space were implicated in the production of justice and injustice.

Since 2008, many publications have focused on the (in)justices apparent in the urban or cityscape settings (e.g., the work of E.W. Soja), but few have examined the concept of spatial justice in rural sites. Further, few publications address the methodological implications of this theoretical approach. The work of C. Sidoti and others demonstrate that there are disparities between rural and urban locations, as rural populations suffer poorer health, education, communication and economic opportunities, but few scholars have questioned the implications for these findings on rural, qualitative research methodology. Place and space are too often invisible in the process of data gathering and analysis as the material world vanishes beneath the abstract world. Research methodologists need to revive a consciousness of the potency of space in the construction of social worlds as we strive to contribute to a world that is more just.

The Beating of Bryan Stow: Race, Cyberspace and Criminalizing Immigrants

Adrian Cruz

University of Massachusetts-Lowell

Kazuyo Kubo

Lesley University

News media websites offer opportunities for individuals to anonymously post reactions and opinions on a wide gamut of reported stories. Social network websites, though not necessarily anonymous, also create space to engage in discourse on various topics. Typically, virtual spaces provide a more comfortable setting as compared to other kinds of space for the expression and exchange of views. News stories that involve racial and ethnic minorities attract their fair share of readers comments and opinions. Social media, as a nascent social institution, provides a new forum upon which attitudes and beliefs about race and ethnicity can be recreated, conformed, and contested. In this study, we examine how Latinas/Latinos in the US are racialized in cyberspace through analysis of online postings in reaction to the vicious beating of a white baseball fan in Los Angeles. We argue that cyberspace allows both overt and covert racist practices to be in effect. This argument interrogates a major theoretical line of thinking in the sociology of race and ethnicity, which presents the historical trajectory of racism as moving in a one-way direction from overt to covert practices. In fact, online social actors do not necessarily have to be careful about expressing racial animosity; indeed they are able to openly express disdain for racial and ethnic minorities. Therefore, we offer a fresh methodological approach to the study of how racial animus is practiced and maintained.

Grounded Theory: A Teaching Strategy to Bridge the Theory-Practice Gap in Nursing

Mohamed El Hussein

Mount Royal University

Grounded theory has been used as a qualitative research method to gather and analyze data (Charmaz, 2006). In this presentation I am going to highlight another benefit to using GT. I am taking this method further to use it as a teaching method to help nursing students retain knowledge and readily apply it into practice. Grounded theory is unique among other qualitative traditions in its ability to generate concepts by utilizing the logic of constant comparison and frequent memo writing. This specific approach to theory development is derived from the continuous interplay between data collection and data analysis. Glaser (1978) argues that concepts have broadening power and are easier to remember as they encompass a myriad of descriptive details, which facilitates the retention and transferability of these concepts into unfamiliar contexts. Consequently helping nursing students to promptly utilize knowledge and apply it into practice. In my presentation I will present several concepts that I share with students. These concepts were developed over several years and so far have helped students in their practice. Concepts are presented in the form of Cartoons. Each concept has a story (Data) to support its emergence. Anecdotal evidence from students has been positive and encouraging to continue using GT to develop new concepts. Glaser (1978) ascertains that there is much value in the conceptualizing and conceptual ordering arguing that by far the most exciting use of grounded theory over the last ten years is its legitimating of concept generation.

The Dos and Don'ts in Grounded Theory

Mohamed El Hussein

Mount Royal University

Grounded theory is a qualitative research method that is used for data collection and analysis. Although Grounded theory provided a structured approach to qualitative data analysis utilizing, this method needs a mentor to avoid falling into the dilemma of methodological slurring. Methodological mistakes such as muddling qualitative methods, generational erosion, premature closure and methodological transgression are common among novice grounded theorists. The purpose of this presentation is to shed light on these mistakes and provide some insight into how to avoid them.

Grounded Theory is misconstrued to be the easiest and the simplest method when researchers decide to use qualitative method. Researchers tend to default to GT whenever they want to justify their qualitative data analysis approach. GT is the most widely claimed qualitative method among researchers. Clarification of the appropriate use of GT will help researcher in effectively using GT to generate a substantive theory that emerges from the data.

Reflecting on the opportunities and pitfalls of online focus groups for qualitative health research

Gillian Fergie and Nicola Boydell-Wright

MRC/CSO Social and Public Health Sciences Unit

Shona Hilton

MRC/CSO Social and Public Health Sciences Unit;

Lisa M. McDaid

MRC/CSO Social and Public Health Sciences Unit.

Researchers attempting to collect qualitative data in a timely and cost-effective manner have looked to online adaptations of established methods of qualitative data collection. Consequently, focus groups, alongside interviews, are increasingly being conducted online. This alternative online context brings with it new opportunities and potential pitfalls. To date within the literature on online focus groups, discussion has focused mainly on their suitability as a method for data collection, and the development of approaches to facilitation that maximise interaction. By reflecting on our experiences, as qualitative health researchers, of designing and attempting to recruit participants to online focus groups for two exploratory research projects, we aim to contribute some novel reflections around the less articulated issues of sampling and recruitment for online focus groups. In particular, we suggest some theoretical and practical issues for consideration, including: the complexities of offline recruitment for an online data collection method; the challenges of using social media for recruitment to online focus groups; and the uncertainties around offering incentives in online recruitment. To date these issues have received little attention in the emergent literature around online focus groups, nevertheless, they warrant further consideration from researchers interested in using the method. More broadly, our experiences suggest there is a need for consistent re-evaluation and innovation of established approaches to online methods of data collection. In order to maximise the opportunities and minimise the pitfalls of conducting research online, researchers should continue to explore and discuss the dynamic online environment and the changing practices of users.

Action Research Using CMM Creates a Collaborative Partnership in Learning

Lydia Forsythe

Londes Strategic Healthcare Consulting. University of Oklahoma

Creating innovative ways to engage and support student learning is an ongoing evolution. In particular in healthcare, professionals needs to be a part of what the learning experience will encompass from both a practical and experiential standpoint. Involving nursing students in the design and development of curriculums by using action research gives the student an opportunity to engage in research while also participating in social change in learning. In using the Coordinated Management of Meaning (CMM) a facilitator of learning can open the students to integrating theory into practice as the student synthesizes learning into practical applications with the use of story telling and developing a greater understanding of the importance of appreciative communication skills. By asking questions, which are reflexive in nature the students reflect upon their own awareness of how they perceive and integrate new learning as they span their own use of new ideas and contribute to the development of new curriculums. These experiences can then be translated into patient care delivery to enhance dialogue with patients and within care delivery teams. We need to have student input to create relevant curriculums, which will enhance their professional worlds. By promoting scholarly development and engagement in research through self-reflection and sharing of knowledge we develop a collaborative partnership in the learning environment.

The Experience of Adolescents who Have Lived with a Parent with a Brain Injury: The Use of Heuristic Inquiry

Aiofe Freeman

University of Calgary

Dr. Sharon E. Robertson

University of Calgary

Acquired brain injury (ABI) is an injury to the head resulting from trauma (e.g., motor vehicle accidents), illness (e.g., encephalitis), stroke, substance use or abuse, and/or a lack of oxygen to the brain. Individuals with ABIs often turn to family members for support throughout recovery. The literature suggests that parents, spouses, and siblings become the primary caregivers of individuals with ABIs, yet little is known of the impact on children of parents with ABIs. It is unclear what these children experience and how they cope with the inevitable changes within their family, but one can expect that this phenomenon could be further complicated if the child is an adolescent attempting to make the transition to adulthood. Due to the scarcity of information regarding this unique experience, the researcher chose to use heuristic inquiry as part of her Master##x00E2;€™s Thesis research to illuminate the experience of six adolescents who had lived with a parent with an ABI. Heuristic inquiry is a qualitative methodology in which the researcher is expected to use his/her personal experience with phenomenon to guide all research activities. Because heuristic inquiry has been previously described without a clear method of research or misunderstood, it may be overlooked as a qualitative methodology. Heuristic inquiry has been shown to provide rich, in-depth, and innovative findings when used appropriately, but it can be challenging. To encourage the appropriate use of this effective and enriching qualitative method, this presentation will demonstrate the use of heuristic inquiry within the context of the experience of adolescents living with a parent with an ABI.

Participatory video: A tool for engaging and empowering Aboriginal youth

Shelagh K. Genuis

University of Alberta

This community-based participatory study explored the efficacy of a health promotion program which engaged Indigenous youth in developing and sharing culturally relevant smoking prevention/cessation messages in the form of YouTube videos. Sixteen youth (ages 7-16), recruited through a community summer program, scripted, directed, filmed and edited two short videos. Youth interviewed one another about tobacco knowledge, perceptions and behavioural intentions at project onset; post-project information was gathered from individual and group

discussions. Semi-structured interviews exploring project impact and efficacy were conducted at study initiation and conclusion with five community partners. Analysis, facilitated by NVivo10TM, incorporated a constant-comparative and concept-development approach based on

emergent themes. Through video production youth engaged with smoking prevention/cessation messages. Two very different videos were produced and showcased at well-attended community movie and pizza nights. Participants developed new skills and confidence; several subsequently applied to a youth program at an international film festival. Findings highlight the importance of a non-smoking peer group and the videos positive community impact. This approach effectively engaged Aboriginal youth with antismoking messages. We tested program evaluation, validated the important contribution of filmmakers and tobacco experts, and confirmed the benefits of implementation in a more structured environment. Results provide a foundation for future

study of social media as a means of involving youth in producing and distributing health promoting messages. This research makes important methodological contributions by demonstrating the contribution of visual methods, not just as a means of capturing data, but as a tool for community involvement and transformative social impact.

Understanding socio-technical collaborative work routines in UK family practice through ethnographic enquiry

Suzanne Grant

University of Dundee

Bruce Guthrie

University of Dundee

Vikki Entwistle

University of Aberdeen

The study of technological innovation in healthcare organisations has largely focussed on experimental, quantitative, behaviourist study designs oriented towards developing interventions, testing hypotheses, and measuring the relationship between inputs, processes and outcomes. While such experimental and quasi-experimental research is important, there is also a need for in-depth qualitative research that is focussed on how new ideas and collective behaviours become routinised in everyday practice as socio-technical systems. Though mundane, these organisational routines have an important bearing on the quality and safety of care (Feldman & Pentland 2005).

This paper examines ethnography as a key methodological approach for exploring how socio-technical systems are enacted through an examination of organisational routines in UK family practice. In-depth ethnographic fieldwork was conducted in four UK family practices over an 18-month period. Ethnographic observations, interviews, practice documents and other artefacts were collected, analysed and mapped in order to compare the different understandings and enactments of three common routines (hospital results handling, repeat prescribing, and chronic disease management), spanning clinical and administrative spaces.

In a detailed qualitative analysis informed by sociological, anthropological and organisational theory, this paper aims to generate methodological insights into the potential of ethnography for examining how complex socio-technical collaborative work is achieved on an everyday basis. In particular, this paper shows the potential of ethnography to identify key quality and safety issues through insights gained on the hidden work and workarounds of frontline staff as they undertake work on new automated IT systems.

Optimizing Hospital And Community-Based Maternity Care For Immigrant And Minority Women In Alberta

Gina Higginbottom

University of Alberta

Beverley O'Brien

University of Alberta

Zubia Mumtaz

University of Alberta

Sophie Yohani

University of Alberta

Yvonne Chiu

Multicultural Health Broker's Co-operative

Philomina Okeke-Ihejirika

University of Alberta

Patricia Paton

Alberta Health Services

Jalal Safipour

University of Alberta

Maternity care which is not ethnoculturally appropriate may create negative consequences for immigrant women and their families. Our research question for this mixed-methodology study was: how can we reduce the disparity experienced by immigrant women in accessing and navigating maternity care? Secondary analysis was undertaken on Maternity Experiences Survey (MES) data for newcomer versus native-born women living in the Prairies. A qualitative focused ethnography in urban and rural sites comprised individual and focus group interviews among immigrant women (<5yrs residency) having maternity care experience (n=33), healthcare providers (n=29), and social service providers (n=22). Qualitative data was analyzed using Roper and Shapira's framework. The MES data suggested that newcomer women are more likely to be older, married and more educated but have lower incomes. All women reported high access of maternity services. Newcomers were less satisfied with the information provided to them and were more likely to have an assisted or caesarean birth. The qualitative findings suggest that communication difficulties due to language barriers and cultural dissonance were paramount. Access to services was also hindered from a shortage of physicians; a lack of transportation and information; ethnocultural norms and religious values; and isolation and lack of social support. Resistance to Western medicine arose from cultural beliefs and customs. Experiences of discrimination seemed to relate to lack of cultural competence among health care providers, lack of information, and misunderstandings due to language barriers. Healthcare providers require training in cultural competency, focusing on building relationships and empowering immigrant women in decision making.

Collaborative research project management. New ways of managing your research project and participants.

Hamish Holewa

Quadrant, CQ University

Contemporary qualitative and mixed methods researchers face increasing challenges associated with operating successful research projects. Such challenges include managing: institutional and regulatory obligations; academic integrity; ethical conduct; data management and project management. These challenges are often compounded with the complexity of managing research projects that are increasingly collaborative, multi-site, multi-institutional and that span disparate geographical areas.

Consequently, the issue of effective project and data management and collaboration tools to manage research projects, participants and data collection warrants increased inspection. Common practices for project management are often adhoc and rely on a combination of consumer software applications such as spread sheets, word documents, file sharing services (such as Dropbox, Google Drive, iCloud) USB keys and emails. This issue is particularly important for collaborative qualitative research projects which often involve the management of sensitive data across multiple stakeholders and data collection sites.

This presentation will detail some of project management and data management considerations concerning contemporary research practice. The presentation will also showcase Quadrant^*, an innovative cloud-based software tool designed to enable participant based researchers to collaborate, collect and store sensitive data in a secure and ethically sound environment. It will also be shown how the use of the software encourages research stakeholder engagement, increases research accountability and audit capabilities and actively assists data management activities such as de-identification, development of meta-information and data archiving.

^* Quadrant is supported by the National eResearch Tools and Resources Project (NeCTAR), an initiative of the Commonwealth (Australia) being conducted as part of the Super Science Initiative and financed from the Education Investment Fund, Department of Industry, Innovation, Science, Research and Tertiary Education. The University of Melbourne is the lead agent for the delivery of the NeCTAR project and the Queensland Cyber Infrastructure Foundation (QCIF) is the Sub-contractor.

Innovative research methods: Borrowed Spaces in the Workplace

Anne Kellock

Sheffield Hallam University

The oral presentation will outline an analysis and reflection of creative and innovative methods from a funded project at Sheffield Hallam University, UK Borrowed Spaces in the Workplace.

The exploration focused on multisensory experiences to develop understanding of lecturers' interactions with their borrowed spaces in the education workplace. The project arose out of respective research and professional interests in how staff engage creatively with their allocated workspace(s). The project explored a) how personal expressions of identity are enacted and embodied in particular workplace spaces; b) the ways in which workspaces are invested with material, affective, political, symbolic dimensions; and c) how workspaces are constructed though individual and collective endeavour.

The participants included the authors of the paper as well as a selection of academic colleagues from a University department. Participants were invited to select and develop their own preferred method for data collection. These methods included for example, use of audio, photomontage, narrative and journaling. As part of the project, participants were provided with the opportunity to reflect on their chosen methods and how this may have impacted upon their engagement with their workspace.

Examples of the methods chosen and subsequent data will be drawn upon; individual participants' reflections on such methods; as well as some initial analysis including how the workspace extends beyond the confines of the borrowed office space that we occupy.

Exploring Family Formation: Integrating Web-based Tools for Recruitment, Data Collection and Field Management of a Large In-Depth Interview Study

Amy Kwan

CUNY Graduate Center

Diana Romero

CUNY School of Public Health

Americans continue to be concerned about childbearing among the poor and unmarried. Poverty policies include objectives aimed at reducing fertility among the poor assuming that single childbearing causes poverty. We examined how educational, financial, and other life experiences/goals influence relationship and childbearing decisions among low- and higher-income adults, an area currently lacking qualitative data. We conducted 200 in-depth interviews with women and men (ages 18-35) in NYC and northern NJ. A variety of web-based tools (eg, Google Earth, Google Docs, SurveyMonkey, Dropbox, Skype) were utilized to enhance recruitment and sampling strategies, facilitate management of 13 field interviewers across 6 sites, and streamline data collection and its submission to the project managers. Theoretical sampling was employed to ensure adequate representation across gender, age, racial/ethnic, income, and relationship categories. Recruitment was community-based (eg, libraries, gyms, cafes), as opposed to organization-based, to reduce bias from respondents' organizational associations. Our innovative and integrated use of web-based tools to support field management, data collection, and communication was instrumental in our ability to amass such a unique dataset and manage a large-scale, qualitative study in under 4 months in NYC/NJ. Consistent with the innovative use of technology, we are utilizing an academic social network and blog environment to support a collaborative data analysis approach inclusive of a web-based analytic software (Dedoose.com). In this way, we expect to contribute to the body of knowledge pertaining to family-formation decision-making among adults, as well as advance qualitative research methodologies.

One Project, Multiple Voices: The Benefits and Difficulties of Collaborative Interdisciplinary Qualitative Analysis

Jenna LaChenaye

Louisiana State University

Brittany Buquoi

Louisiana State University

Serena Fisher

Louisiana State University

Krisanna Machtmes

Louisiana State University

Pamela Blanchard

Louisiana State University

Ed Bush

Louisiana State University

Coastal Roots is a program that functions in partnership with Louisiana State University and seeks to increase environmental conservation, awareness, and stewardship through connections with the state's elementary, middle, and high schools. School curriculum is supplemented with program materials and the maintenance of a school nursery then culminates with planting trips that allow students the ability to engage with the local environment while transplanting native species into the Louisiana wetlands. In order to explore the program and develop an understanding of the phenomenon, over 60 participating teachers were interviewed regarding their experiences in the program. Due to the wide range of influences and experiences presented in the program, an interdisciplinary team (drawn from education, science, agriculture, sociology, psychology, and social work and consisting of both local and nonlocal members) was assembled to complete the coding and analysis of collected data. Drawing from the content knowledge of collected members, the research team was able to uncover a myriad of themes from multiple lenses and strengthen the overall design and data analysis of the study. However, the use of an interdisciplinary team also led to complications in developing coding schemes and reconciling discipline-specific interpretations of conceptual elements. This presentation seeks to highlight the benefits and detriments of working with an interdisciplinary team and the implications of the process and structure in the practice of mixed methods research.

The visual image as discussion point: Increasing validity in boundary crossing research

Linda Liebenberg

Resilience Research Centre, Dalhousie University

As we continue to review relationships between the researcher and the researched, we reflect on available research tools and their appropriateness in data gathering, exploring their positioning in the research process and their ability to contribute to data validity. Numerous studies demonstrate the value of image-based interviewing processes. Most of these examples however focus only on the process of data gathering and its overt value. Reviewing the experiences of teenage mothers in a sub-economic community in Cape Town, South Africa, this presentation explores the use of participant constructed photographs used in elicitation interviews as a communication tool in instances where the researcher is crossing boundaries of age, culture, and race. Situating visual methods within a phenomenological paradigm, the argument is made that by incorporating images into research conducted with the Other, contextual accuracy and relevance of data are improved, heightening validity of the data analysed, thereby expanding the argument for visual methods. Increased opportunity for self-reflexivity in the research process to allow for the exploration of the unique meanings of events and issues that are often taken for granted by participants necessarily increase the transformational validity of actual data gathered, in that topics reviewed are those that participants themselves have identified as important and central to their lives. As informants control the detailed focus of the research (albeit not the broader research topic), from very early stages, and are able to articulate their experiences following a period of self-exploration, the accuracy of findings drawn from data gathered is enhanced.

Emerging Theory of Decision-making in Residential Care Homes for Older People, Families and Staff: Methodological Issues in a Constructivist Grounded Theory Inquiry

Lisa Low

The Chinese University of Hong Kong

A constructivist grounded theory (con-GT) inquiry emerged to involve the researcher and the participants as experts in facilitating the co-construction of meaning towards an understanding of decision-making in the context of caring for Chinese older people in residential care homes. The inquiry resulted in a substantive (mid-range) theory of decision-making which was a relevant end-product to inform residential care home practices for older people, their family members and staff. With an increasing demand to provide residential care homes in Hong Kong, an understanding of the decision-making experiences and processes had illuminated how older people settled into the new home life and how their family members and staff supported them (or not) in making decisions about matters that concerned them.

This presentation will begin with an overview of the data collection procedure that interviewed 28 older residents, 22 family members and 31 staff in three homes, giving a total of 105 interviews. This will be followed by a discussion of the methodological processes that led to the construction of a decision-making theory, which is composed of four components: (1) influence of leadership styles and patterns of decision-making; (2) decision-making processes of residents; (3) influences of family and staff on residents decision-making; and, (4) decision-making patterns in the homes. Such processes led to an examination of various perspectives that drove decision-making and their subsequent outcomes in the homes. Lastly, methodological constraints and issues that considered the robustness of the results and the rigor of this inquiry will also be discussed.

The Lived Experience of Type 2 Diabetes in Urban-based American Indian Adolescents

Lisa Martin

University of Minnesota

Introduction: The aim of this study was to understand what it meant for urban-based American Indian adolescents to live with and experience Type 2 diabetes.

Methods: This qualitative research study used a hermeneutic phenomenological method guided by Max Van Manen's approach for phenomenological research. Descriptions of adolescents experiences were explored through individual face- to- face interviews eliciting in-depth recollections and descriptions on the impact of the disease in their lives. Hermeneutic phenomenology brought forth the adolescents stories in their own words on how they were living with the disease.

Results: Participants highlighted contributions from surrounding social groups, family, and the urban community to their lived experience with Type 2 diabetes. Adolescents in this study were found to experience an existential surrender to their disease state and in their stories described their world connected with culture, relatives, the past, and the present challenges of living each day.

Essential themes of experience included accepting, being in ignorance of what was happening to them, being alone, being related to as an adult, not being able to do what they were asked to do with their disease, and dependence on health insurance for survival.

Discussion or Conclusions:The study findings validated phenomenology as a culturally appropriate research method for American Indian health research. A preliminary conceptual model for understanding adolescents experiences was presented and had implications for health education, research, and practice and supported the continuing inquiry in this area.

Towards enhanced online teacher professionalism: A mixed methods examination of pre-service teachers behaviours and attitudes

Kendra McCallum

University of Alberta

Cheryl Poth

University of Alberta

The present sequential explanatory mixed methods study sought an in-depth understanding issues related to online professionalism through investigating pre-service teachers online behaviours and attitudes. The need for this study, especially focused on the use of social networking sites, is timely given the recent concerns across professionals in regards to balancing personal and professional standards of conduct (Garner & Sullivan, 2010). Furthermore there is a dearth of research related to the role teacher education might play. Thus, the study objectives were two-fold: (1) to document current online behaviours on Facebook; and (2) to examine attitudes related to these behaviours. Data sources included a followup focus group to a quantitative-focused survey. A qualitative analysis was then conducted across three different categories of focus groups. The preliminary survey results indicated that the majority of pre-service teachers (97%) have Facebook, and that individuals with low levels of personal disclosure on Facebook were more likely to agree with professional guidelines related to digital technology than individuals with high levels of disclosure. These findings were used to group the survey respondents in three groups where the qualitative analysis was inductively conducted within groups and then across. The two data sources were then integrated using a qualitative-focused cross-over analysis. The findings have important implications for informing the integration of data sources as well as providing guidance for teacher educators about how to teach and model online professionalism.

Thinking and Doing Mama-search: Feminist Research on Mothering and Inquiries into Mixed Methods

Caroline McDonald-Harker

Athabasca University

Recent feminist theorizations in sociology have drawn attention to the differences among women, have pointed to women's identities as fragmented and even conflictual, and have explored how women's subjectivities are socially constructed. One area of women's diverse experiences which has recently received much attention is their mothering experiences. Feminist theorizations of mothering have endeavored to focus on and utilize research methods that specifically consider the varied, heterogeneous, multiple facets of mother's lives. Like most feminist research in sociology, feminist research on mothering is divided in terms of its epistemological positions and research methods. Consequently this raises many questions: Is qualitative research the best method to value mother's subjective experiences and personal meanings? To what extent is quantitative research also able to shed light on mother's culture and experience? What value does mixed methods contribute to feminist research on mothering in terms of providing information not attainable by exclusively using one research method over the other? I will discuss, first, the different feminist epistemologies in mothering; second, the different feminist research methods utilized to examine mothering; and third, the possibility of epistemological and methodological pluralism in feminist research on mothering and the implications that mix methods would have for shedding light on the unique experiences of mothers. In this regard, I will examine its potential ability to shed light on different aspects of the experiences of mothers; to produce feminist research that not only remains faithful to women's mothering experiences, but that also subjects women's mothering experiences to critical scrutiny; and to contribute a broader and deeper understanding of the experiences of mothers and mothering.

A narrative inquiry of women's lives in Mugu, Nepal

Carrie Mitchell

Queen's University Belfast

This paper reflects on how narrative inquiry has been used to examine the ways in which gender and education are constructed by women in a rural area of north-west Nepal; the meanings they attach to education and how these are unique to their own lived experiences. It attempts to foreground the voices of the women to show how their understandings of education are embedded in their complex and uniquely intersecting identities and how these challenge singular definitions of gender and education.

The presentation outlines the methods used in the study, reflecting on how local expressive traditions can be incorporated along with life-story interviews and reflexive journaling to create richly textured narratives. It discusses some of the dilemmas involved in the process of researching across multiple borders and would hope to stimulate discussion around the ethical challenges involved in doing respectful narrative research in such a context.

Spiritual Nursing Care: A Concept Analysis

Lydia Monareng

University of South Africa

Nurses in practice have difficulty integrating the concept spiritual nursing care into practice, although the concept spiritual nursing care has its roots in the history of the nursing profession. There is an on-going debate in the empirical literature about its definition, clarity and application in nursing practice. The purpose of the study was to develop an operational definition of the concept â€^~spiritual nursing care to improve its clarity, unambiguous usage and application in clinical practice.

A qualitative study, based on the Symbolic Interactionism (SI) philosophy was conducted to explore and describe how professional nurses render spiritual nursing care in practice. A concept analysis on spiritual nursing care, after a comprehensive literature review, which examined the current usage of the concept and its critical attributes in the health care context, was conducted. The theoretical and operational definitions of spiritual nursing care that emerged gave evidence that it is an essential component of holistic patient care that leads to a heightened sense of well-being. Caring presence was identified as the core variable from which all the other characteristics of spiritual nursing care emerged.

An operational definition of spiritual nursing care was that it is humane care that is demonstrated by showing caring presence, respect and concern for meeting not only the body and mind needs of persons, but also the spiritual needs that demands equal attention for optimal care as provided by both religious and none religious nurses.

An exploration on how spiritual care is applied

Lydia Monareng

University of South Africa

Spiritual nursing care is a significant concept for nurses and form part of holistic care to patients. Many nurses do not understand the term and have difficulty integrating it into practice and consequently neglect this aspect of care.

The purpose of this study was to explore and describe how professional nurses provide spiritual care.

A qualitative, explorative and descriptive study, based on the Symbolic Interactionism (SI) philosophy was conducted.

The population comprised of professional nurses from a public hospital in South Africa. Participants were recruited through purposive and snowball or network sampling. Individual, focus group interviews and observation were used to collect data. Data analysis was conducted with the assistance of the NUD^*IST computer program, using coding, constant comparison methods and Tech's guidelines on data analysis.

Findings revealed that nurses struggled to conceptualise spiritual nursing care and to differentiate it from emotional, social or psychological care. However, prayer and singing spiritual songs with or for patients was seen as as the most important and effective intervention mode.

Recommendations suggest that the scope of practice and nursing curriculum in South Africa be reviewed to ensure the inclusion of evidenced training to deliver spiritual nursing care. Spiritual nursing care is still a neglected component of patient care. The scientific worldview practices, beliefs and insufficient statutory endorsement of spiritual care hinder or compromise its realization in practice.

Identity co-construction online: Using discourse analysis, netnography, and ethnomethodology to analyze an online community

Tanya Mudry

University of Calgary

Online forums are an increasingly popular source of social support for individuals concerned about addictive behaviours, including problem gambling. Despite this popularity, little research attention has been paid to how participants interact, obtain support, and co-construct their identity in these online communities. An integrative approach blending Netnography (ethnographic approaches online), discourse analysis, and ethnomethodology was used to analyze the discursive interactions of self-identified problem gamblers on an online forum. Discourse analysis and ethnomethodology are traditionally used for analyzing face-to-face conversations that occur in real time. Utilizing data from an online forum, although innovative, presents interesting challenges. In this presentation these challenges will be discussed including recruitment, ethical issues, inactive members, and asynchronicity. Advantages and disadvantages of using this medium over traditional face-to-face interactions with these particular methods are explored.

It's all in the practice: Combining qualitative methods to analyze social practices

Tanya Mudry

University of Calgary

In this presentation I describe an integrative research method I have developed as a means to capture and analyze relational and social practices. I have developed this method to examine the relational practices important to excessive behavioural patterns (excessive engagement in gambling, internet use, and eating). This method will assist my ability to capture the key micropractices identified as important in reproducing and sustaining excessive behaviours; the relationships between practices and practice contexts; and the dominant cultural discourses that influence and inform these behavioural patterns. I describe the research method proposed to carry out this investigation; I explore and incorporate methods including microethnography (Streeck & Mehus, 2005), discourse analysis (Potter & Wetherell, 1987), ethnomethodology (Garfinkel, 1967), and social practice theory (Schatzki, 2010; Shove, Pantzar, & Watson, 2012). This presentation serves to initiate conversation with participants about the complexity of establishing new methods for examining complex social processes.

Facework Theory: A theoretical approach to understanding the nature of interpersonal interactions in pharmacist-patient encounters

Muna Murad

University of Alberta

Pharmacists' role has been evolving from dispensing to educating patients and assessing the appropriateness of their medication therapy. Effective interpersonal communication skills are essential to achieve the optimal health outcomes. However, the majority of community pharmacists practice in a traditional dispensing role with low level of patient assessment and involvement. Maintaining face or the public social image one claims in social interaction is a fundamental but poorly understood dimension of interpersonal interaction. Maintaining face refers to protecting and enhancing our own and others' sense of competence, self-esteem, autonomy, and solidarity in relationships. It is communicated and negotiated through verbal and non-verbal language as people interact. Maintaining face generally occurs at a sub-conscious level. Understanding the work involved in face offers a unique way of understanding the process, the outcomes of pharmacist-patient interactions and how pharmacist develops a patient centered communication skills. This poster/presentation will outline the tenets of face work theory and the methodological implications for its use to explore how and why interactions progress as they do in pharmacy practice.

Using a Modified Delphi Method to Develop Knowledge Translation Interventions for Service Providers and Administrators with Addiction and Recovery Lived Experience.

Gabriela Novotna

Faculty of Health Sciences, University of Lethbridge

Jelena Antonic

Faculty of Health Sciences, University of Lethbridge

Depending on a jurisdiction, considerable number of service providers (19-46%) and administrators (5-35%) working in addiction agencies across Canada have personal, lived experience of addiction and/or recovery. Outlining the directions for the development of effective knowledge translation strategies tailored to this group of service providers can however be a challenging task. Research methods that engage those individuals as research participants in a collaborative, iterative process of decision-making with the intent of informing the development of knowledge translation strategies should produce information that is more likely to be relevant to end users.

We present the methodological choices that were made to create a panel of experts consisting of research participants who had previously participated in in-depth interviews that explored how their addiction and recovery-related experiences affect their practice decisions. We invited those professionals to continue in a structured and anonymous group communication process of knowledge creation, conducted as a modified Delphi Study. The purpose of the Delphi panel was to outline the directions for future knowledge translation interventions that would be tailored to the needs of service providers and administrators with lived experience. A series of sequential questionnaires known as rounds were conducted. After the initial deas generation stage that utilized an online questionnaire with open ended questions, the following rounds included questionnaires constructed from the data gathered in the previous rounds. The methodological issues pertaining to the use of modified Delphi Study in the process of reaching a consensus regarding the future knowledge translation interventions will be presented.

Triangulation of qualitative methods in palliative care research. Methodological and ethical issues

Erik Olsman

Academic Medical Center, University of Amsterdam

In our study on the dynamics of hope in palliative care we interviewed palliative care patients, their near ones and health care professionals each half year (max three times). We will outline the advantages and challenges of triangulation by semi-structured interviews, case studies and prospective studies.

Methodological advantages were: 1) analyses and interpretations of first interviews could be checked during later interviews, 2) the topic list could be specified by the analyses of first interviews, 3) cases reinforced the understanding of hope from different perspectives.

Ethical advantages were 1) the relationship between participants and researchers was reinforced because of repeated interviews, 2) interviews could be evaluated and compared to each other during the second and third interview round.

Methodological challenges were 1) cases were incomplete because of death, 2) sampling palliative care patients via their health care professional without including only the hopeful patients, 3) interviewing palliative care patients together with their near one or not.

Ethical challenges were 1) informing patients about the study without sharing medical information about the palliative status of their disease, 2) burdens of the informed consent procedure for some patients 3) sending transcribed interviews with palliative care patients after their death to their bereaved ones or not, 4) how to deal with the role of researcher who knows different perspectives (patients', near ones' and health care professionals' perspectives).

In conclusion, we encourage other researchers to use triangulation because it reinforces the validity of their study. However, researchers should reflexively deal with challenges as well.

Why palliative care patients withhold their spiritual hope from their physicians and nurses

Erik Olsman

Academic Medical Center, University of Amsterdam

Palliative care patients sometimes withhold their spiritual hope from their physicians and nurses. If we knew why patients do so, we could better understand barriers between spirituality and medicine from the patient perspective. The aim of this presentation is to describe why palliative care patients hold back their spiritual hope from their physicians and nurses.

Semi-structured interviews were conducted. We sampled patients purposively on variation in disease, age, sex and housing. Interviews were transcribed and thematically analyzed and analyzed by researchers from different professional backgrounds. We discussed on the results of our analyses until we reached consensus.

29 Dutch palliative care patients were included (11 incurable cancers, 8 severe heart failures, 8 severe COPD; 15 male, 14 female). Especially patients who had spiritual hopes that were not related to an institute, like a church, reported that they did not discuss hope with their physicians or nurses. Their hope was related to alternative medicine, transcendental meditation, belief in spirits, et cetera. These patients either felt ashamed of the non-rational features of their hope, or supposed that their healthcare professionals had no knowledge of spirituality, or perceived that physicians and nurses task was to help with bodily issues, or patients felt no need to talk about spiritual issues.

Palliative care patients have several reasons for withholding their religious hope from their nurse or physician. It is important that healthcare professionals recognize how their own rationality may exclude other rationalities and how individual spirituality differs from institutionalized religion.