Abstract
Traditional qualitative analysis, while valuable in providing rich understandings of people’s lived experience, can be resource and time-intensive, which is challenging for time-sensitive and action-oriented research such as that required in community-engaged and human-centered design (HCD) projects. Rapid qualitative analysis (RQA) has emerged as a valuable approach to balance timeliness with rigor, enabling real-time intervention development. However, limited literature discusses how RQA has been applied to community-based and HCD approaches in public health interventions. This paper presents a methodological case study illustrating how RQA was integrated into an HCD co-design process as part of a larger community-based participatory research project addressing cervical cancer among people experiencing homelessness (PEH) in Indiana. The study aimed to co-design novel cervical cancer screening strategies with and for PEH. A RQA of qualitative interviews with PEH guided iterative intervention development by streamlining data analysis without sacrificing methodological rigor. The RQA process involved (1) establishing key domains of interest based on study aims and the interview guide, (2) creating and testing a summary template for extracting data, and (3) summarizing interview audio recordings using the template and reaching consensus among team members to ensure consistency. This process resulted in a matrix of summarized interview data (30 participants across 15 template domains) synthesized into major themes and compiled into reports that were shared in real time with community partners to inform ongoing intervention refinements. The use of RQA allowed the research team to deliver timely, actionable findings that supported iterative intervention development, and deepened community engagement. Our experience, presented here as a replicable model, demonstrates that RQA is a valuable methodological tool for community-engaged, time-sensitive public health research and should be considered in future HCD projects.
Keywords
Introduction
Qualitative research is known for its ability to provide rich understandings of people’s lived experiences. Traditional qualitative approaches aim to deliver a “theoretically rich, in-depth understanding of a concept or phenomenon” (Lewinski et al., 2021). However, conducting a traditional qualitative study—from data collection and analysis to dissemination—requires a significant amount of time, cost, and effort (Nevedal et al., 2021).
Rapid Qualitative Analysis (RQA) has emerged as a practical, non-traditional qualitative approach to address these challenges, and has been shown to be a useful method for the design of community-engaged interventions, due to its iterative, time-sensitive, and action-oriented nature. RQA enables rapid insights and therefore timely adjustments to interventions, ensuring they are relevant and actionable for community partners. This is especially valuable in addressing urgent health challenges, solving problems as they emerge, and strengthening community relationships (Gale et al., 2019; Rosenberger et al., 2024; St. George et al., 2023).
RQA has demonstrated success in reducing the time required for data collection and analysis, while yielding similar results (Nevedal et al., 2021) and maintaining scientific rigor, a core principle of traditional qualitative methods (Vindrola-Padros & Johnson, 2020). Various strategies have been introduced to ensure rigor, including structured frameworks, systematic approaches to data organization, and strategies for maintaining consistency across analyses (Hamilton, 2013; Higham et al., 2022; Vindrola-Padros & Johnson, 2020; Watkins, 2017). One recommended strategy is to use structured frameworks, research questions, or interview aims to guide rapid analysis (Hamilton, 2013). For example, one study applied the Consolidated Framework for Implementation Research (CFIR) to inform a summary template that would be completed by summarizing verbatim transcripts into “domains” that aligned with key CFIR constructs and questions specific to project goals (Gale et al., 2019). Systematic data organization is another method for maintaining rigor. Studies have used Microsoft Word or Excel to format transcripts and reduce data into high-level summaries. Using a standardized transcript format or the same template for all interview summaries has also been identified as essential for enhancing rigor in RQA by facilitating consistency across teams conducting the analysis (Hamilton, 2013; Watkins, 2017).
Human-centered design (HCD) is an increasingly valued approach in public health interventions and its principles closely align with those of community-engaged research. Community-engaged research values collaboration through embracing the voices and lived experiences of community members to ensure research is relevant, impactful, and ethical to the population it is meant to serve. Similarly, HCD projects require active participation from individuals early in the intervention design process to first accurately identify the problem, and later appropriately co-design a solution, ensuring the response directly addresses user needs while being technically and economically practical (Brown, 2008). In addition to the users, various stakeholders (e.g., community members, research partners), are involved in the process and typically expect to receive results quickly (Taylor et al., 2018) to inform decision-making.
Along with their shared emphasis on collaboration and responsiveness, HCD and community-engaged research often rely on engaging with communities through similar methods, such as interviews and focus groups (IDEO, 2015; Israel et al., 2012); however, they employ different analytical approaches. Community-engaged research commonly uses traditional qualitative methods, such as thematic analysis or grounded theory, to analyze results – a methodologically rigorous approach that yields rich insights, but is time-intensive (Israel et al., 2012). HCD approaches synthesis through “sensemaking,” using more informal, collaborative, and visual approaches to quickly translate qualitative insights into design solutions (IDEO, 2015; Kolko, 2010).
By providing efficient, actionable insights along with analytical transparency, RQA is a useful methodology for analyzing qualitative data in both community-engaged and HCD interventions, but has not yet been widely integrated in these approaches. This may be partly because RQA is an emerging methodological approach that was initially popularized through Hamilton’s (2013) cyberseminar on rapid qualitative methods and has more recently been applied in implementation research (Hamilton, 2013; Lewinski et al., 2021).
While best practices and strategies for maintaining rigor have been discussed in the literature, few published case studies demonstrate how RQA has been applied to combined community-based and HCD approaches in public health interventions. As part of a larger study addressing cervical cancer among people experiencing homelessness (PEH), an HCD approach was used to co-develop a cervical cancer screening intervention using novel screening strategies with and for homeless communities in Indiana. The objective of this paper is to present a methodological case study illustrating how RQA can be integrated into an HCD co-design process, offering a replicable model for work at the intersection of HCD and community-engaged public health research. Specifically, we describe the step-by-step RQA process our team used, the outputs it produced, and how those outputs informed iterative refinement of a cervical cancer screening intervention for PEH.
Methods
Semi-structured in-depth qualitative interviews with 30 PEH at two major homeless shelters in Indiana were conducted as part of the inspiration phase of human-centered design, which focuses on gathering insights into the needs, challenges, and desires of users. Interviews explored participants’ experiences with cervical cancer screening and perspectives on novel screening strategies (i.e.,HPV self-sampling and rapid testing) with the goal of informing an HCD workshop to further guide intervention development. Data collection was completed once reaching information saturation, determined when no new themes emerged from subsequent interviews. Interviews lasted between 20 and 60 minutes and were completed over a three-month period. People eligible for interviews included adults experiencing homelessness assigned female sex at birth and between ages 18 and 70. Aiding the transition to the ideation phase of HCD in which ideas are further explored and refined to create solutions, RQA began approximately two months into data collection in May 2024 to prepare for an HCD workshop with PEH in July 2024, and continued as new interviews were completed through August 2024, to incorporate updated findings into community partner meetings for intervention development. This study was reviewed and approved by the Purdue University Institutional Review Board (IRB-2023-940).
Existing guidelines from the literature, particularly the process presented by Hamilton, guided our approach to RQA. This included implementing the following steps: 1) create domains of interest to sort interview data; 2) design a summary template, assess feasibility of the summary template for further analysis, and establish consistency amongst reviewers; and 3) summarize audio recordings of interviews into summary template and reach consensus between reviewers in order to establish a final compilation of summarized data into a matrix for final synthesis (Hamilton, 2013).
A total of six study team members were assigned as RQA analysts, which included research staff as well as graduate and undergraduate research assistants with prior training in qualitative research. Two lead analysts of the RQA were selected based on their extensive experience in qualitative research and involvement in the overall study (i.e.,as a lead researcher/project manager and lead researcher/community health worker). Their role was to oversee the entire RQA process, including developing the team’s RQA strategy, training the remaining analysts in this process, and resolving consensus between analysts as needed. Analysts continued to reference these training materials throughout the study.
This study is situated within a larger community-based participatory research (CBPR) project with a local homeless engagement center that identified the need for women’s health and cervical cancer screening in the community and used an HCD approach to co-design a screening intervention in the shelter. Co-design is a socially embedded approach, particularly recommended in marginalized populations, such as PEH, to directly engage them in decision-making throughout a design process (Jagtap, 2022; Rodriguez et al., 2023; Sanders & Stappers, 2008). In this study, we operationalize co-design by meaningfully engaging with direct users (PEH) and indirect users (healthcare providers/community health workers, researchers, and organizational representatives who serve PEH) throughout intervention design and implementation. Notably, the HCD workshop enabled hands-on collaboration with PEH to shape intervention materials and design during HCD’s ideation phase.
A pragmatic orientation to qualitative inquiry was adopted for interviews, which prioritizes producing timely, actionable knowledge in direct response to community-identified needs. RQA was selected as the analytic approach because its structure and efficiency are well-suited to the iterative, time-sensitive demands of community-engaged and HCD research. Data were summarized using descriptive rather than interpretive language to stay close to participants’ expressed perspectives, with interpretation reserved for the synthesis stage.
The research team reflects a range of disciplinary backgrounds and community ties, including one lead analyst who previously worked as a community health worker at one of the study sites, and another with extensive experience collaborating with the PI and community partners in public health research. The lead analysts’ deep embeddedness in the broader project, including their longstanding relationships with shelter staff and familiarity with the study context, informed their oversight of the RQA process and strengthened the credibility of the findings. The team maintained awareness of how these positionalities may have shaped data interpretation, particularly during the consensus and synthesis stages, and used the structured RQA process, including paired review and consensus protocols, as a procedural safeguard against individual interpretive bias.
Step 1: Create Domains of Interest
Domain Development Based on Study Aims and Interview Questions
*Novel screening strategies.
These domains were derived from the interview guide (Supplemental Material), which itself was developed collaboratively with community partners and informed by the broader CBPR project that identified cervical cancer screening access among PEH as a priority area. The purpose of establishing domains was to structure data extraction for RQA, consistent with best practices outlined by Hamilton (2013) and others (Hamilton, 2013).
Step 2: Design a Summary Template, Assess Feasibility of the Summary Template for Further Analysis, and Establish Consistency Amongst Reviewers
Lead analysts developed a draft summary template in Microsoft Word to summarize each individual interview by domains of interest. This template was tested by other analysts on the team to determine the usability and efficiency of the template within a subset of interview audio recordings. Reviewers assigned to this step excluded those who contributed to the summary template development in order to reduce bias in the final determination of feasibility.
The template was approved when analysts deemed that each domain was identifiable within the dataset, distinct, easy to use, relevant, and ensured no domains were missing. The final approved summary template consisted of the 12 domains, along with a designated section for demographics, and three optional sections for additional information (i.e., other, important quotes, and notes/reflections).
Step 3: Summarize Audio Recordings of Interviews Into Summary Template and Reach Consensus Between Reviewers
Analysts used the structured summary template to standardize data extraction from interview audio recordings. Summarizing data from audio recordings as opposed to written transcripts was chosen to facilitate the timeliness of the analysis, as the written transcription process was not yet complete and because completing it would be time consuming and ultimately not essential for our purposes.
Each interview was assigned to a pair of analysts from the research team – a summarizer and a reviewer. To maintain rigor, at least one member of each analyst had substantial research experience and familiarity with the study. The summarizer first listened to the audio recording in full. Responses were extracted and placed into the corresponding sections of the summary template based on the predefined domains, using descriptive (not interpretive) language.
Summaries were limited to 1-2 pages per interview, per Hamilton’s (2013) guidance, as a best practice to ensure summaries remained concise, focused, and feasible to produce quickly and consistent with the timeliness goals of RQA. This limit encouraged analysts to prioritize the most relevant information and helped standardize summaries across the team (Hamilton, 2013). All 12 domains and the demographics section were requested to complete, while the “other”, “important quotes”, and “notes/reflections” sections were optional. If a question was not asked during an interview or if the participant declined to answer, analysts included a brief note indicating the absence in that domain (e.g., “interviewer did not ask if participant felt at risk for HPV”). When participants shared content outside the original 12 domains, this was categorized under the “other” section. Quotes were used sparingly, only when they added essential information or supported a theme, or when they aided in using descriptive language (e.g., Participant would feel “bummed out” if she received a positive HPV result). Any interpretations of what participants explicitly said were only permitted in the notes/reflections section. Comments and timestamps were occasionally recorded alongside summarized content to reference specific moments in the audio recordings if additional context was needed.
When the summarizer completed an interview, the reviewer independently listened to the same interview recording. The reviewer cross-checked the summarizer’s work to ensure that all domains and required sections were completed and information was correctly summarized using descriptive language. When necessary, reviewers suggested modifications and addressed comments made by the summarizer. The inclusion of timestamps allowed the reviewer to quickly locate and verify points within the audio recording. Any discrepancies or uncertainties were discussed between the summarizer and reviewer. A summary was considered final when both the summarizer and reviewer reached consensus of its content. All final summaries were organized into a qualitative data matrix, as discussed in the results section.
Results
The following results describe the outputs generated through each step of the RQA process, illustrating how structured rapid analysis produced actionable findings that directly informed iterative intervention development and community partner engagement.
As Figure 1 demonstrates, results from RQA included a qualitative data matrix, which was synthesized into key themes related to PEH experiences with cervical cancer screening and perspectives on novel screening strategies, and a summary report for information dissemination to community partners and intervention modifications. RQA process and outputs
Qualitative Data Matrix
Qualitative Data Matrix Sample
*Novel screening strategy.
Key Themes, Information Dissemination, and Intervention Modifications
After reviewing matrix data, the research team synthesized the findings into four key themes: 1) Cervical Cancer and Screening Experiences, 2) Knowledge, Attitudes, and Beliefs, 3) Screening Barriers and Facilitators, and 4) Self-Sampling Willingness. Each theme provided high-level summaries that were shared during the larger study’s community health advisory board meetings in real time, as data were being collected. This information was also compiled into a 10-page summary report (Figure 2) that included an overview of the larger study, background on cervical cancer and novel screening strategies, a description of the interview data collection and RQA process, main findings from the RQA (i.e.,key themes and summaries), and intervention recommendations derived from the findings. Summary report title page
To move from the matrix to themes and summary report content, lead analysts reviewed the compiled matrix across all participants and domains, grouping domains into thematic areas that were most relevant to the intervention design and HCD workshop; these decisions were reviewed by the PI. For example, the interview guide included questions about general health, however, it was not included as a final theme in the summary report because it was not deemed necessary to inform the co-design intervention session. For domains that were included in the final themes, content was synthesized descriptively, capturing the range of participant responses and broad patterns (e.g., most, some, or few participants expressed willingness to try HPV self-sampling), rather than deep or interpretive qualitative insights. This approach reflects RQA’s ‘telescoped’ approach, prioritizing pragmatic, actionable, study-specific explorations over formal thematic analysis (Hamilton, 2013).
The report was initially shared with our immediate community and academic partners, including facilitators of the HCD workshop, to assist with activity development and session planning. It was continuously updated as the study progressed to include any new information and to make more accessible to broader audiences and later shared with other stakeholders or potential collaborators (i.e.,a local community health center).
Intervention Modifications Based on RQA Process
*Novel screening strategy.
Discussion
Rapid qualitative analysis facilitated the iterative human-centered design of a cervical cancer screening intervention for people experiencing homelessness. While generating the matrix was an expected outcome of RQA, its ability to provide high-level understandings of interview data and facilitate communication with community partners was extremely valuable in ensuring human-centered intervention development.
RQA allowed us to present real-time updates during community partner meetings. Insights gleaned from RQA were presented to a women’s health advisory board consisting of shelter staff, senior researchers, the principal investigator (PI), leaders of community clinics, and people experiencing homelessness. By incorporating their insights, we collaboratively refined the intervention to align with the lived experiences of the target population. While this marked the first iteration of our intervention, we plan to continue to incorporate ongoing feedback from participants and community members in order to further shape its design. The iterative and ongoing nature of our case study aligns with existing literature that discusses RQA’s ability to inform HCD interventions and enhance community engagement (Suchman et al., 2023).
RQA’s efficiency in enabling real-time sharing of findings was largely due to our ability to bypass the transcription process by directly analyzing from interviews—a benefit of RQA and strategy we recommend if feasible for your study (Vindrola-Padros & Johnson, 2020). Traditional qualitative analysis, which typically requires completed verbatim transcription followed by iterative coding, member checking, and theme development, can extend months beyond the close of data collection. In contrast, by summarizing directly from audio recordings using a structured template, our team began disseminating preliminary findings to community partners while data collection was still ongoing. Specifically, RQA was initiated approximately two months into a three-month data collection period, enabling findings to directly inform an HCD co-design session planned for July 2024, just two months after RQA began. This timeline would not have been feasible using traditional qualitative methods.
For RQA to be timely, efficient, and responsive to community perspectives, our RQA process was structured to maintain scientific rigor. In addition to following the RQA process presented by Hamilton (Hamilton, 2013), we implemented several measures to ensure rigor. Specifically, two senior members of the research team were selected as lead analysts. One lead analyst had been a key member of the research team for years, working closely with the PI on numerous HCD and public health studies to ensure projects are successfully brought to completion. For this specific study, the lead analyst was essential in assisting the PI in all aspects of study design; including early meetings with stakeholders, defining study aims, designing methodologies, developing timelines, and grant writing. Her deep involvement in the study allowed her to establish strong relationships with shelter staff at both locations, providing valuable contextual knowledge to the research team, which was essential in leading the RQA process and enhancing rigor (Gale et al., 2019). Additionally, her leadership experience in the lab and history of overseeing research projects positioned her as a natural leader within the research team, streamlining workflow and expediting the RQA process. The second lead analyst worked previously as a community health worker at one of the shelter locations before joining the research team while pursuing her PhD. Her firsthand experience navigating the shelter’s care and workflow systems was extremely valuable to the study. When she joined the team, she was already viewed as a familiar and trusted figure within the target population which aided her ability to facilitate interviews effectively.
Consistent with prior research advocating for embedded researchers in RQA, the study was enriched by the contextual expertise of both lead analysts (Kowalski et al., 2024; Lewinski et al., 2021; Taylor et al., 2018). Their contributions—from conducting interviews to supervising final reviews of summary templates and reports—were invaluable in ensuring research rigor. One’s clinical knowledge complemented the other’s strategic oversight, making them ideal lead analysts for the study. However, while embedded researchers can strengthen RQA, our process suggests that their presence is beneficial but not necessarily essential as sole contributors to RQA. Our approach demonstrates that RQA is an accessible tool for teams with varying research experience and that implementing a hierarchy of expertise within the team structure can also build rigor. By having less experienced researchers supervised by and learning from lead analysts, scientific rigor was upheld while creating valuable mentorship opportunities. This process highlights how RQA not only deepens engagement with research and community partners but also creates opportunities for collaboration and mentorship within research teams. Future studies should consider using RQA with teams that have varying levels of qualitative research experience.
Existing literature also demonstrates how specific frameworks can enhance rigor in RQA. Previously, RQA has been notably applied within the Consolidated Framework for Implementation Research (CFIR) to guide qualitative data collection and analysis (Lewinski et al., 2021; Nevedal et al., 2021). However, instead of relying on a pre-existing framework like CFIR, we structured our summary template around study aims that directly informed our interview guide, aligning with the best practices outlined in Hamilton’s approach (Hamilton, 2013; Nevedal et al., 2021).
Other guidelines, such as the Planning for and Assessing Rigor in Rapid Qualitative Analysis (PAARQA) Framework, discuss using study aims to structure the RQA process as a strategy to maintain rigor. The PAARQA specifically outlines the importance of identifying a guiding framework for RQA, offering a checklist of best practices to ensure methodological rigor throughout the process. Although we did not use PAARQA in our study approach, we recommend that future research consider incorporating it to enhance the rigor of RQA planning and implementation (Kowalski et al., 2024).
Conclusion
Ultimately, RQA was essential in delivering tangible, timely, and thorough findings for our research and community partners. However, its impact extended beyond our initial expectations. Beyond reducing the typical time for qualitative analysis, this approach was crucial in ensuring that the HCD process was grounded in participant perspectives. By integrating RQA into our research process, we successfully enhanced stakeholder engagement, maintained scientific rigor, and established a strong foundation for a responsive intervention rooted in human-centered design.
Any iterative, time-sensitive, community-engaged research, such as HCD, should consider RQA due to its rigor, structure, and efficiency. Future RQA studies should establish their systematic process early, using at minimum their specific research questions as guidance or adapting existing frameworks like CFIR and PAARQA to their needs. We also encourage referencing case studies such as ours as models for implementing RQA.
Supplemental Material
Supplemental material - Tangible, Timely, and Thorough: A Case Study on Using Rapid Qualitative Analysis to Inform Human-Centered Intervention Design
Supplemental material for Tangible, Timely, and Thorough: A Case Study on Using Rapid Qualitative Analysis to Inform Human-Centered Intervention Design by Abigail Higgins, Lara Balian, Lauren Hopkins, Arshia Rama, Rebecca Ziolkowski, Natalia M. Rodriguez in International Journal of Qualitative Methods.
Supplemental Material
Supplemental material - Tangible, Timely, and Thorough: A Case Study on Using Rapid Qualitative Analysis to Inform Human-Centered Intervention Design
Supplemental material for Tangible, Timely, and Thorough: A Case Study on Using Rapid Qualitative Analysis to Inform Human-Centered Intervention Design by Abigail Higgins, Lara Balian, Lauren Hopkins, Arshia Rama, Rebecca Ziolkowski, Natalia M. Rodriguez in International Journal of Qualitative Methods.
Footnotes
Acknowledgements
The authors wish to thank Dr. Janelle Tipton, Graylin Skates, and members of the Women’s Health Advisory Board for their guidance and collaboration.
Ethical Considerations
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Purdue University (IRB-2023-940).
Consent to Participate
All participants gave signed informed consent.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported by the Office of the Director (OD) and the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health (NIH) under Award Number DP2MD019356. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
Data, coding schemes, and interview guides are available by request. Please email Natalia Rodriguez at
Supplemental Material
Supplemental material for this article is available online.
References
Supplementary Material
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