Qualitative epidemiology III

A significant feature of what I would call qualitative epidemiology is that the subjects’ interaction with the researchers provides an opportunity for empowerment or a sense of agency.  That happens to a small degree in quantitative epidemiology when, for example, people recruited into a study begin to pay better attention to their health.  That happens, it seems, because they feel that someone—the researchers—are paying attention to them.  Generally, however, it is not an empowering experience to supply one’s weight, blood pressure, cholesterol levels, etc. or to answer a bank of survey questions.

In qualitative epidemiology subjects are given a space and a structure in which to reflect on their experiences.  Such reflection can allow people to move ahead in new directions, not simply to continue along previous lines. Indeed, the design of the interviews in, say, a Brown or Dervin style could be evaluated and refined not only with respect to coding of responses for quantitative analysis, but also with respect to their effect on reflection-based empowerment.

Even when there is not a direct empowerment effect, the coding and quantitative analysis of Brown and Dervin-style interviews allows categories and relationships to emerge that have a closer relation to variables that people can act on than do the typical risk factors of quantitative epidemiology.  Instead of single versus married, for example, we might find “partner to confide in” or “has relatives and friends close at hand in time of need.”  Or whatever—what emerges obviously depends on the particular situation and group of subjects.  This situation-specificity can well lead to concerns about extrapolation and generalizability of findings.  The response of researchers to such concerns cannot be to claim that the same factors will apply in other cases, but instead to suggest that what they have found might stimulate someone else’s thinking about what to look into in other situations. In other words, there’s no need for the researchers in the new situation to start from scratch.

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