Literature Review
Professor Somerville
LIBR 285 – Week 2
Patricia Ayame Thomson
The peer-reviewed article, “Using a Mixed-Methods Approach to Identify Health Concerns in an African American Community” from the November, 2011 issue of the publication, American Journal of Public Health succeeds in stating the focus of the research clearly and concisely, and describes the sound methodology used to identity the central issue. The article describes multiple strengths and some limitations regarding the use of mixed-methods in studies, as well as, suggesting ways to compensate for them.
In his book, Creswell (2014) states, “the working or draft title becomes a major road sign in research” (pp. 25-26). The title, “Using a Mixed-Methods Approach to Identify Health Concerns in an African American Community” is appropriate in encapsulating the key topic, purpose, and methodology of the study. In addition, the article is written in keeping with Creswell’s recommendation to write in a language that is “straightforward, uncomplicated, and easy to read and understand” (p. 26).
For the study, four communities in Philadelphia, Pennsylvania and researchers at the University of Pennsylvania established the West Philadelphia Consortium. The consortium was formed to address disparities among minorities with funding from the National Center on Minority Health and Health Disparities. The research was a collaborative process where the academic and African American communities in West Philadelphia worked together, “using a community-based participatory framework” (Weathers, Barg, Bowman, Briggs, Delmoore, Kumanyika, Johnson, Purneli, Rogers, & Halbert, 2011, p. 2087).
The purpose of the research is to identify the most important health concerns in the African American community using a mixed-method study, incorporating both qualitative and quantitative approaches to develop interventions and improve the health of community residents. After three sequential phases of study, the results were coded and analyzed for the purpose of finding commonalities and consistencies across the studies. The article mentions that “We used the constant comparative method to compare themes across groups and key informants and to determine relationships among them” (Weathers, Barg, Bowman, et al., 2011, p. 2087).
The researchers used a sequential mixed-method approach, namely, two qualitative methods consisting of focus groups and key informant interviews, followed by a single quantitative approach. The researchers’ conducted nine focus groups with a total participation of 51 African American residents from the West Philadelphia community, and 27 key informant interviews. In addition, the quantitative approach was applied during the third phase of the study in the form of fixed choice community health surveys (CHS), with 201 respondents representing a random sample of the entire population of the community.
Creswell (2014) explains, “In qualitative research . . . the researcher seeks to listen to participants and build an understanding based on what is heard.”
The study was exploratory in a sense that the group of researchers were attempting to “identify the central issues in a field” (Creswell, 2014, p. 28). In the article, the study’s central issue was to identify the most pressing health concerns within the African American residents in West Philadelphia. Based on the collected data, using both qualitative and quantitative methods, the researchers can develop, plan, and implement interventions for the most urgent and predominant diseases and health issues in the community.
A literature map is included in the article that is presented in “a hierarchical structure with a top-down presentation of the literature, ending at the bottom with the proposed study” (Creswell, 2014, p. 36). A literature map is “a visual picture (or figure) of groupings of the literature on the topic,” explains Creswell (p. 32). In addition, Creswell describes the value of a literature map stating, “this organization enables a person to understand how the proposed study adds to, extends, or replicates research already completed” (p. 36). ). The fact that the researchers took the time and effort to construct a literature map is further evidence their sound, logical, and organized research design.
The participants for the focus groups were recruited from newspaper advertisements. In the article, the method of recruitment is mentioned as a weakness because “the generalizability of data obtained from theses methods may be limited because individuals may self-select for participation in focus groups” (Weathers, Barg, Bowman, et al., 2011, p. 2087). The implication being that the goal of unbiased research is to collect data from a random sample size. The focus groups were conducted over a period of seven months from April to October 2006. The focus groups lasted between one and a half to two hours in duration, with the participation of 15 to 20 people per group.
In this academic-community collaboration research, the research process is inductive and emerging. For example, if the end results of a study are unknown, without a predetermined hypothesis to support or refute, the exploratory process is inductive and continually emerging. Consequently, the key topic, including the “title of the study, the problem statement, the purpose statement, the research questions, literature review” and the other research plans emerge as the study unfolds (Creswell, 2014, p. 43).
In an inductive process, focus groups and interviews are particularly useful. Focus groups and interviews are helpful in obtaining in-depth, detailed, and specific information about the participants’ personal views, their needs, and concerns about the central issue. Thus, open-ended questions are an effective tool in gathering qualitative data, since it provides participants the opportunity to share openly, and elaborate on their personal experiences and opinions about the issue in question. The study provided an effective open-ended question that facilitated collecting specific personal data from the focus group. For this research, the inquiry and open-ended question investigated was “What do you believe are the most important health issues that need to be addressed in your community?” (Weathers, Barg, Bowman, et al., 2011, p. 2088).
Further, Key Informant Interviews were conducted by a member of the consortium, using a semi-structured interview guide. The theme and interview questions were along the same lines as the ones used in the focus groups. The interviews were conducted over five months from June to October, 2006. The interviews with key informants were audio-taped and lasted between one to two hours.
The recruitment method of the study’s participants is described as follows, “We selected a purposive sample of key informants that members of the executive council had identified and recruited” (Weathers, Barg, Bowman, et al., 2011, p. 2089). Again, whether the method of recruitment of the key informants identified and selected for the study was biased or not came into question. In order to counter the dilemma of bias, the researchers’ recommend that it is important to use quantitative methods as well, along with qualitative approaches, in order to assure that the central focus of the study is properly identified and addressed.
Therefore, the quantitative approach is incorporated in the study in the form of surveys. Population based random surveys are an effective way “to generalize results to a population” (Creswell, 2014, p. 19). Participants for the survey were randomly selected from residents in the telephone directory, and 20% of residents in the community responded to complete the survey over the phone. More specifically, the “Center for Survey Research staff generated a random-digit dial sample of telephone numbers in the four zip codes for West Philadelphia” (Weathers, Barg, Bowman, et al., 2011, p. 2089). The article points out that the quantitative approach may be unbiased, but participation from the community is usually lower.
The phone interviews were semi-structured, using fixed choice community health surveys (CHS), and one open-ended question as follows, “If you could improve one health issue in your community, what would it be?” (Weathers, Barg, Bowman, et al., 2011, p. 2089). The interviews with respondents over the phone were recorded, and lasted about 20 to 30 minutes. Then, the respondents were asked to rate their concern about various diseases and health conditions, and the obtained ratings were incorporated in the overall data analysis.
In the data analysis phase, the researchers’ state, “We used grounded theory to code the qualitative data and elicit key themes” (Weathers, Barg, Bowman, et al., 2011, p. 2088). Trained research assistants coded the data from the focus groups and key informant interviews, “using N6, 2006 version (QSR International, Melbourne, Australia) for analyzing qualitative data” (Weathers, Barg, Bowman, et al., 2011, p. 2088).
Regarding the use of qualitative methodologies, the article explains, “We used Key Informant Interviews to get at a range of issues and, within the focus group discussions, we used the nominal group technique to arrive at consensus on the issued that emerged” (Weathers, Barg, Bowman, et al., 2011, p. 2088).
The study found a major overlap between primary health concerns that emerged from the focus groups and key informant interviews. However, researchers’ also discovered a significant discrepancy between the health concerns obtained from the random CHS survey, and the focus groups participants and key informant interviews. “For example, focus group participants and key informants gave priority to cancer and cardiovascular disease, but most respondents in the CHS indicated that STDs, substance abuse, and obesity were conditions in need of intervention” (Weathers, Barg, Bowman, et al., 2011, p. 2091).
In conclusion, the researchers’ report the study using the mixed-method approach successfully identified the most prevalent health concerns in the African American community in West Philadelphia. The consortium’s research makes a significant contribution in adding to the existing literature in the field. Although the article explains that using only one approach has its own inherent limitations, the intersection of data using both the qualitative and quantitative approaches mixed methods design is the best way to identify the most critical health concerns of the community. The researchers eloquently assert that the data obtained from multiple sources can be extremely valuable and useful in developing strategies, plan interventions, and improve health conditions. The researchers conclude by stating, “However, limited empirical data exist on the congruence of data obtained using different methods” (Weathers, Barg, Bowman, et al., 2011, p. 2091).
Reference
Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches. (4th ed.). Thousand Oaks, CA: Sage Publications.
Weathers, B., Barg, F. K. Bowman, M., Briggs, V., Deimoor, E., Kumanyika, S., Johnson, J. C., Pumeli, J., Rogers, R., Haibert, C. H. (2011). Using a mixed-methods approach to identify health concerns in an African American Community. American Journal of Public Health, 101(11), 2087-2092. Doi: 10.2105/AJPH.2010.191775
Weathers, B. (2011). Using a Mixed-Methods Approach to Identify Health Concerns in an African American Community. American Journal Of Public Health, 101(11), 2087. doi:10.2105/AJPH.2010.191775
Benita Weathers, MPH, Frances K, Barg, PhD, Marjorle Bowman, MD, Vanessa Briggs, MBA, Ernestine Deimoor, MPH, Shiriki Kumanyika, PhD,
Jerry C, Johnson, MD, Joseph Pumeli, Rodney Rogers, MDiv, and Chanita Hughes Haibert, PhD