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Background : Health research capacity strengthening (HRCS) has been deemed as a complex, multifaceted, and dynamic activity. Despite this, most studies that assess the effectiveness of health research capacity strengthening programmes have not employed complexity-aware approaches and therefore, evidence on how and why such programmes work across different contexts is underdeveloped. This realist study seeks to elicit the initial programme theories (IPTs) that describe how and why the 'Developing Excellence in Leadership, Training and Science Africa' (DELTAS Africa) programme – one of the flagship research capacity strengthening programmes in Africa – works to generate research capacity outcomes specifically in the participating African universities. Methods and Analysis : A realist review of the DELTAS Africa programme documents, and relevant published papers that report on similar research capacity interventions will be carried out. This will help to both identify the outcome pathways and underlying assumptions of the DELTAS Africa programme, as well as tacit theories as postulated by other researchers. The review evidence will inform the drafting of the initial programme theories (IPTs). Interviews with the DELTAS Africa programme designing team will be conducted using a realist interviewing technique to unearth ontologically deeper insights on context, mechanism, and outcomes. Using the realist context-mechanism-outcome configurational maps, we will identify how contexts (i.e., within the African universities) shape mechanisms (the processes, reasoning, or behaviours triggered by the HRCS activities) through which the programme brings about an outcome at institutional level. Conclusion: The initial programme theories will describe how and why health research capacity strengthening works, for whom and under what circumstances across the participating African universities. The programme theories will provide policy-relevant insights on the generative causal mechanisms of HRCS; evidence that is critically needed to inform the design, implementation, and evaluation of HRCS initiatives. [ABSTRACT FROM AUTHOR]

Vulnerability has typically been addressed in the context of research ethics from the point of view of participants, with a focus on how to prevent the potential or exacerbation of existing harm caused by the power and role asymmetries between researchers and participants. However, more recent approaches to research ethics question whether researchers are, by definition, located in a privileged position during the research process and safe from any kind of vulnerability. In line with this, we reflect on the dimensions of researcher vulnerability specific to studies using a qualitative methodology in health research. Our argument is that participants and researchers should be on the receiving end of efforts to implement ethical procedures and protection from harm. Based on the autoethnographic analysis of our experiences as qualitative health researchers, this paper aims to identify dimensions of researcher vulnerability, and draw out relevant recommendations for practice. The reflections upon which this paper is based emerged during a spring school focusing on research ethics in qualitative health research, during which we discussed situations from our own research experience which left us feeling vulnerable. We identify four dimensions related to the experience of vulnerability (reciprocity; emotional labor; application of ethical standards; reversed power asymmetries) and five crosscutting aspects relating to these dimensions (researching sensitive topics; researching in contexts of vulnerability, poverty and structural violence; being a novice; lacking adequate support; insufficient time and space for ethical reflexivity). Our recommendations address particular challenges for these dimensions, and center on the role of reflexivity, as one of the cornerstones for enabling ethical qualitative research practice, requiring us to acknowledge and address our own vulnerability and positionality. Autoethnographic exercises are particularly useful for zooming in on ethically important moments in research related to researcher vulnerability and fruitful for identifying resources to respond to such challenges in the future. [ABSTRACT FROM AUTHOR]

Photo elicitation interviewing (PEI), as a visual qualitative research methodology, has been used widely in various fields with different participants. However, little has been written about using the method in public health research, especially involving men in low-income settings. In this paper, the authors reflect upon the use of PEI in a study that explored fathers' experiences in child care and feeding in a low-income neighbourhood of Addis Ababa city in Ethiopia. The reflections focus on two overarching themes; (1) how PEI worked well as an effective technique in terms of addressing the research questions posed in this low-resourced setting and (2) how it served to enhance phenomenology in qualitative public health research. The researchers also discuss the limitations and lessons from employing this methodology through continuous reflexivity, which is valuable to qualitative work. [ABSTRACT FROM AUTHOR]

Vulnerability has typically been addressed in the context of research ethics from the point of view of participants, with a focus on how to prevent the potential or exacerbation of existing harm caused by the power and role asymmetries between researchers and participants. However, more recent approaches to research ethics question whether researchers are, by definition, located in a privileged position during the research process and safe from any kind of vulnerability. In line with this, we reflect on the dimensions of researcher vulnerability specific to studies using a qualitative methodology in health research. Our argument is that participants and researchers should be on the receiving end of efforts to implement ethical procedures and protection from harm. Based on the autoethnographic analysis of our experiences as qualitative health researchers, this paper aims to identify dimensions of researcher vulnerability, and draw out relevant recommendations for practice. The reflections upon which this paper is based emerged during a spring school focusing on research ethics in qualitative health research, during which we discussed situations from our own research experience which left us feeling vulnerable. We identify four dimensions related to the experience of vulnerability (reciprocity; emotional labor; application of ethical standards; reversed power asymmetries) and five crosscutting aspects relating to these dimensions (researching sensitive topics; researching in contexts of vulnerability, poverty and structural violence; being a novice; lacking adequate support; insufficient time and space for ethical reflexivity). Our recommendations address particular challenges for these dimensions, and center on the role of reflexivity, as one of the cornerstones for enabling ethical qualitative research practice, requiring us to acknowledge and address our own vulnerability and positionality. Autoethnographic exercises are particularly useful for zooming in on ethically important moments in research related to researcher vulnerability and fruitful for identifying resources to respond to such challenges in the future. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, rapid virtual qualitative methods have gained attention in applied health research to produce timely, actionable results while complying with the pandemic restrictions. However, rigour and analytical depth may be two areas of concern for rapid qualitative methods. Methods: In this paper, we present an overview of a virtual team-based rapid qualitative method within a study that explored health care providers' perspectives of how the COVID-19 pandemic has impacted hospital-to-home transitions, lessons learned in applying this method, and recommendations for changes. Using this method, qualitative data were collected and analyzed using the Zoom Healthcare videoconferencing platform and telephone. Visual summary maps were iteratively created from the audio recordings of each interview through virtual analytic meetings with the team. Maps representing similar settings (e.g. hospital providers and community providers) and Sites were combined to form meta-maps representing that group's experience. The combinations of data that best fit together were used to form the final meta-map through discussion. Results: This case example is used to provide a description of how to apply a virtual team-based rapid qualitative method. This paper also offers a discussion of the opportunities and challenges of applying this method, in particular how the virtual team-based rapid qualitative method could be modified to produce timely results virtually while attending to rigour and depth. Conclusions: We contend that the virtual team-based rapid qualitative data collection and analysis method was useful for generating timely, rigorous, and in-depth knowledge about transitional care during the COVID-19 pandemic. The recommended modifications to this method may enhance its utility for researchers to apply to their qualitative research studies. [ABSTRACT FROM AUTHOR]

COVID-19 ushered in public health guidelines restricting face-to-face contact and movement, and encouraging social distancing, all of which had implications for conducting field-based research during the pandemic. For qualitative researchers, this meant adapting conventional face-to-face methods and resorting to virtual variations of the same in adherence to stipulated COVID-19 health protocols. Virtual qualitative research introduced new concerns and logistical challenges. This paper presents critical reflections on experiences of conducting qualitative research during the pandemic, from the perspectives of a cohort of postgraduate fellows. A critical reflection framework was utilised to explore fellows experiences and meanings ascribed to their experiences. The research findings illustrate three overarching processes which, in turn, shaped ways of thinking, doing and being. First, explicating tacit assumptions about their anticipated research journeys and interrogating these. Second, shifts in power differentials demonstrated by role reversal between researchers and participants, and between fellows and supervisors as they re-negotiated their positionalities in virtual research spaces. Third, context specific sense-making, in which - narrative accounts support the notion of knowledge as a social construct. Our findings have important implications for qualitative research practice. Our study documents methodological nuances and social implications of conducting qualitative research during COVID-19 and in a-South African context. In addition, our study exemplifies the use of critical reflection in qualitative research practice in the specific context of postgraduate academic research. Further, our study illustrates how the use of technology shapes qualitative research protocol development, data collection and analysis phases. [ABSTRACT FROM AUTHOR]

Photo elicitation interviewing (PEI), as a visual qualitative research methodology, has been used widely in various fields with different participants. However, little has been written about using themethod in public health research, especially involving men in low-income settings. In this paper, the authors reflect upon the use of PEI in a study that explored fathers' experiences in child care and feeding in a low-income neighbourhood of AddisAbaba city in Ethiopia. The reflections focus on two overarching themes; (1) howPEI worked well as an effective technique in terms of addressing the research questions posed in this low-resourced setting and (2) how it served to enhance phenomenology in qualitative public health research. The researchers also discuss the limitations and lessons from employing this methodology through continuous reflexivity, which is valuable to qualitative work. [ABSTRACT FROM AUTHOR]

COVID-19 ushered in public health guidelines restricting face-to-face contact and movement, and encouraging social distancing, all of which had implications for conducting field-based research during the pandemic. For qualitative researchers, this meant adapting conventional face-to-face methods and resorting to virtual variations of the same in adherence to stipulated COVID-19 health protocols. Virtual qualitative research introduced new concerns and logistical challenges. This paper presents critical reflections on experiences of conducting qualitative research during the pandemic, from the perspectives of a cohort of postgraduate fellows. A critical reflection framework was utilised to explore fellows experiences and meanings ascribed to their experiences. The research findings illustrate three overarching processes which, in turn, shaped ways of thinking, doing and being. First, explicating tacit assumptions about their anticipated research journeys and interrogating these. Second, shifts in power differentials demonstrated by role reversal between researchers and participants, and between fellows and supervisors as they re-negotiated their positionalities in virtual research spaces. Third, context specific sense-making, in which - narrative accounts support the notion of knowledge as a social construct. Our findings have important implications for qualitative research practice. Our study documents methodological nuances and social implications of conducting qualitative research during COVID-19 and in a-South African context. In addition, our study exemplifies the use of critical reflection in qualitative research practice in the specific context of postgraduate academic research. Further, our study illustrates how the use of technology shapes qualitative research protocol development, data collection and analysis phases. [ABSTRACT FROM AUTHOR]

Global health's persistent focus on women's health-seeking behaviour necessitates a philosophical understanding of the meaning behind women's health decision-making. In studying health-seeking behaviour, researchers use philosophical paradigms to explicate and understand complex social concepts that continue to maintain health inequities and injustices. A commonly used theory is Bourdieu's Theory of Practice. This paper examines the scholastic application of Bourdieu's theory of practice to theorize women's health-seeking behaviour in qualitative research to understand the rationale behind using health services. The theory of practice consists of four concepts: practice, habitus, field, and capital. Each concept conceptualizes the theory to find a logical meaning for social practices. The theory uses a relational approach between agency and structure to account for social life. The goal is to develop a theoretical framework from a feminist perspective to understand how women seek care with contextual factors that can inhibit or outrightly limit their agency. Researchers limit cultural capital's role in linking health-seeking behaviour to economic capital in health disparities. Additionally, in formulating women's health policies without adequate consideration of women's experiences and preferences, such policies become patriarchal, where men assume an expert knowledge of women's health, failing to recognize the diversity of experiences. In our quest to develop new theories as feminist researchers, we must acknowledge these taken-for-granted assumptions and address them. [ABSTRACT FROM AUTHOR]

Applied mixed methods research for sexual and reproductive health (SRH) issues involves multiple researchers and presents numerous responsibilities as well as unforeseen challenges. These challenges together with the often ignored and under-researched area of male sexual and reproductive health and rights (SRHR) in Bangladesh require researchers to navigate cultural stigmas associated with SRH and hostile political situations across the country. We conducted a nationwide mixed methods research study to explore the SRHR of male youth. This study is the first of its kind in the context of Bangladesh. The aim of this paper is to describe the challenges experienced and mitigation strategies undertaken to conduct research on the SRHR of young males in Bangladesh. A group of experts, practitioners, service delivery staff and researchers were consulted during the tool development stage. However, challenges in obtaining permission from community members, explanation of SRH-specific topics, and establishing respondents' trust persisted throughout the study. Mitigation strategies included spending time outside of scheduled interview hours and making repeated visits to respondents to establish trust. These strategies allowed for honest discussions over time and served to assure our study respondents that the confidentiality of their data would be protected. In addition to sourcing letters from official authorities, we had conversations with community influential people such as religious leaders and political representatives about the nature of our study and explained to them the implications of the study for the future of young men's health. Moreover, we highlight the political issues of the time and shed light on the ad hoc measures taken to overcome the challenges we faced. These reflections can provide valuable insights for researchers conducting SRHR-related studies in similar social and political settings. [ABSTRACT FROM AUTHOR]

Increasingly, social life—and accordingly, social research—is conducted in online environments. Asynchronous online focus groups (AOFGs) have emerged as an important tool to conduct remote research with geographically diverse populations. However, there remain few systematic accounts of AOFG methods to guide researchers' decision-making in designing and implementing studies. This paper seeks to address this gap by describing a recent study on body image and health among transgender and gender diverse (TGD) young adults. In this study, eight AOFGs were conducted in August-October 2019 with 66 TGD young adults residing in 25 U.S. states. Each AOFG lasted four consecutive days with two prompts posted by moderators per day. Overall, participant satisfaction with AOFGs was high: 98% reported their experience was excellent, very good, or good and 95% would be somewhat or very likely to sign up for another AOFG. This example is used to illustrate key methodological decision-points, acceptability of the method to participants, and lessons learned. The goal of this paper is to encourage other researchers, particularly health researchers, to consider using AOFGs and to engage with the method's strengths and limitations in order to develop new opportunities for online technologies to enrich the field of qualitative health research. [ABSTRACT FROM AUTHOR]

Increasingly, social life—and accordingly, social research—is conducted in online environments. Asynchronous online focus groups (AOFGs) have emerged as an important tool to conduct remote research with geographically diverse populations. However, there remain few systematic accounts of AOFG methods to guide researchers' decision-making in designing and implementing studies. This paper seeks to address this gap by describing a recent study on body image and health among transgender and gender diverse (TGD) young adults. In this study, eight AOFGs were conducted in August-October 2019 with 66 TGD young adults residing in 25 U.S. states. Each AOFG lasted four consecutive days with two prompts posted by moderators per day. Overall, participant satisfaction with AOFGs was high: 98% reported their experience was excellent, very good, or good and 95% would be somewhat or very likely to sign up for another AOFG. This example is used to illustrate key methodological decision-points, acceptability of the method to participants, and lessons learned. The goal of this paper is to encourage other researchers, particularly health researchers, to consider using AOFGs and to engage with the method's strengths and limitations in order to develop new opportunities for online technologies to enrich the field of qualitative health research. [ABSTRACT FROM AUTHOR]

Discourses of research impact shape the ways in which critical qualitative research and researchers are evaluated in contemporary academic environments. Mainstream conceptualizations of research impact arise from a positivist perspective that challenges the aims and approaches of critical qualitative research. In this paper, we propose a framework for conceptualizing the impact of critical qualitative research on policy, practice, and science. After critiquing literature that presents mainstream views on research impact, we summarize a recent framework for conceptualizing the impact of critical research specifically. We then add to the Machen framework by highlighting the impacts of critical qualitative research on the institutions and practices of science. We provide examples of ways in which researchers at the Centre for Critical Qualitative Health Research at the University of Toronto have made contributions to the impact of critical qualitative research on science, and conclude by addressing implications of this framework for the ways in which critical qualitative researchers can plan and evidence the impact of their work. [ABSTRACT FROM AUTHOR]

A growing body of literature suggests combining organizational ethnography and case study design as a new methodology for investigating complex organizational phenomena in health care contexts. However, the arguments supporting the potential of organizational ethnographic case studies to improve the process and increase the impact of qualitative research in health care is currently underdeveloped. In this article, we aim to explore the methodological potentialities and limitations of combining organizational ethnography and case study to conduct in-depth empirical health care research. We conducted a scoping review, systematically investigating seven bibliographic databases to search, screen, and select empirical articles that employed organizational ethnographic case study to explore organizational phenomena in health care contexts. We screened 573 papers, then completed full-text review of 74 papers identified as relevant based on title and abstract. A total of 18 papers were retained for analysis. Data were extracted and synthesized using a two-phase descriptive and inductive thematic analysis. We then developed a methodological matrix that positions how the impact, contextualization, credibility, and depth of this combined methodology interact to increase the generative power of in-depth qualitative empirical research in health care. Our review reveals that organizational ethnographic case studies have their own distinct methodological identity in the wider domain of qualitative health care research. We argue that by accelerating the research process, enabling various sources of reflexivity, and spreading the depth and contextualization possibilities of empirical investigation of complex organizational phenomena, this combined methodology may stimulate greater academic dynamism and increase the impact of research. Organizational ethnographic case studies appear as a new in-depth qualitative methodology that both challenges and improves the conventional ways we study the lives of organizations and the experiences of actors within the interconnected realms of health care. [ABSTRACT FROM AUTHOR]

While a growing body of research has examined immigrants' health generally, less is known specifically about the impact of immigration policy on the health of Chinese immigrants, the second-largest foreign-born population in the United States. This is due, in part, to the lack of methodologically well-trained, cross-cultural researchers who have both the cultural and linguistic expertise and health knowledge to engage with Chinese immigrant populations. This paper addresses this gap by examining Chinese cross-cultural researchers' roles in the qualitative phase of the Research on ImmiGrant HealTh and State policy (RIGHTS) project, which sought to assess how immigration policies shaped Chinese and other immigrants' experiences in healthcare and other related sectors in California. We used reflexivity to assess Chinese cross-cultural researchers' positionality of insiderness and outsiderness and its influence on the process of data collection (i.e., recruitment, conducting interviews, transcription, and translation). Our reflexivity guides the assessment of the opportunities (e.g., expanding the recruitment pool, engaging participants more effectively in interviews, ensuring data integrity, and discussing heterogeneity within the Chinese immigrant community) and challenges (e.g., the difficulty of recruiting low-income and undocumented immigrants, addressing participants' in-depth thoughts, the time-consuming nature of transcription and translation, and the assessment of power dynamics) in conducting immigrant health research with the Chinese community. These results highlight the need for cross-cultural researchers to help build trusting relationships with ethnic-minority communities, thus gaining new insights and advancing knowledge within the field of ethnic minority health research. These insights can guide future investigations of Chinese and other immigrant communities as research on immigration policy and health expands. [ABSTRACT FROM AUTHOR]

In this paper, we critically reflect on our conceptualization and operationalization of "rapid photovoice" as a close-up, emancipatory, action research methodology which has multiple, intersecting social-justice goals; and consider the methodology's potential for helping to achieve such goals. We first consider photovoice in relation to its typical use in public health research, as well as in prior research into student experiences of higher education. We then consider our pragmatic redesign of the methodology as rapid photovoice (RPV), which we conceptualized in response to the goals, parameters, and constraints inherent in our project, which studied student movement violence and wellbeing. In the third part of the article, we describe and discuss our operationalization of RPV in this study on four university campuses in South Africa. In the fourth section, we reflect on some of the ethical considerations arising from the topic and the methodology. In the final section of the article, we critically assess the interim outcomes of our use of RPV in terms of (1) psychologically empowering students to reflect on traumatic experiences in a safe space and enhancing their self-awareness of wellbeing, wellbeing resources and coping strategies; (2) the politically emancipatory potential of photovoice to represent student experiences authentically and with immediacy to higher education policy role-players, and (3) its ability to co-create artifacts of collective memory that provide authentic empirical material for making trustworthy knowledge claims. [ABSTRACT FROM AUTHOR]

The widespread privileging of children's voices in recent times has triggered expansion of differing forms of qualitative enquiry that aim to "give children a voice." Engaging children in research and eliciting their voices on matters that affect them is often showcased as being a more "authentic" way to capture children's lived realities and afford their agency. Yet, the uptake of voice in qualitative enquiry, and how it may contribute to the privileging of particular ways of knowing (some) children's lives, is rarely interrogated. Drawing on examples from our own research, in this paper we critically reflect on the frequent invoking of the term voice in qualitative health research with children. In doing so, we challenge claims of authenticity by exposing the tricky epistemological tensions and relations of power that are embedded within the production and legitimation of particular voices as being "correct" ways of knowing about health—including the ways our research intentions and methods contribute to these processes. We reflect on the methodological and epistemological value of silences, dissenting voices and other modes of expression to highlight forms of resistance to adult-led health agendas. We conclude by illustrating how dominant relations of power are (re)produced within and across research spaces, and through the mobilizing or pathologizing of particular young voices through research. Possibilities for advancing ways to harness children's preferred modes of expression in qualitative research are also considered. [ABSTRACT FROM AUTHOR]

Qualitative data-analysis methods provide thick, rich descriptions of subjects' thoughts, feelings, and lived experiences but may be time-consuming, labor-intensive, or prone to bias. Natural language processing (NLP) is a machine learning technique from computer science that uses algorithms to analyze textual data. NLP allows processing of large amounts of data almost instantaneously. As researchers become conversant with NLP, it is becoming more frequently employed outside of computer science and shows promise as a tool to analyze qualitative data in public health. This is a proof of concept paper to evaluate the potential of NLP to analyze qualitative data. Specifically, we ask if NLP can support conventional qualitative analysis, and if so, what its role is. We compared a qualitative method of open coding with two forms of NLP, Topic Modeling, and Word2Vec to analyze transcripts from interviews conducted in rural Belize querying men about their health needs. All three methods returned a series of terms that captured ideas and concepts in subjects' responses to interview questions. Open coding returned 5–10 words or short phrases for each question. Topic Modeling returned a series of word-probability pairs that quantified how well a word captured the topic of a response. Word2Vec returned a list of words for each interview question ordered by which words were predicted to best capture the meaning of the passage. For most interview questions, all three methods returned conceptually similar results. NLP may be a useful adjunct to qualitative analysis. NLP may be performed after data have undergone open coding as a check on the accuracy of the codes. Alternatively, researchers can perform NLP prior to open coding and use the results to guide their creation of their codebook. [ABSTRACT FROM AUTHOR]

Qualitative data-analysis methods provide thick, rich descriptions of subjects' thoughts, feelings, and lived experiences but may be time-consuming, labor-intensive, or prone to bias. Natural language processing (NLP) is a machine learning technique from computer science that uses algorithms to analyze textual data. NLP allows processing of large amounts of data almost instantaneously. As researchers become conversant with NLP, it is becoming more frequently employed outside of computer science and shows promise as a tool to analyze qualitative data in public health. This is a proof of concept paper to evaluate the potential of NLP to analyze qualitative data. Specifically, we ask if NLP can support conventional qualitative analysis, and if so, what its role is. We compared a qualitative method of open coding with two forms of NLP, Topic Modeling, and Word2Vec to analyze transcripts from interviews conducted in rural Belize querying men about their health needs. All three methods returned a series of terms that captured ideas and concepts in subjects' responses to interview questions. Open coding returned 5–10 words or short phrases for each question. Topic Modeling returned a series of word-probability pairs that quantified how well a word captured the topic of a response. Word2Vec returned a list of words for each interview question ordered by which words were predicted to best capture the meaning of the passage. For most interview questions, all three methods returned conceptually similar results. NLP may be a useful adjunct to qualitative analysis. NLP may be performed after data have undergone open coding as a check on the accuracy of the codes. Alternatively, researchers can perform NLP prior to open coding and use the results to guide their creation of their codebook. [ABSTRACT FROM AUTHOR]

Qualitative data-analysis methods provide thick, rich descriptions of subjects' thoughts, feelings, and lived experiences but may be time-consuming, labor-intensive, or prone to bias. Natural language processing (NLP) is a machine learning technique from computer science that uses algorithms to analyze textual data. NLP allows processing of large amounts of data almost instantaneously. As researchers become conversant with NLP, it is becoming more frequently employed outside of computer science and shows promise as a tool to analyze qualitative data in public health. This is a proof of concept paper to evaluate the potential of NLP to analyze qualitative data. Specifically, we ask if NLP can support conventional qualitative analysis, and if so, what its role is. We compared a qualitative method of open coding with two forms of NLP, Topic Modeling, and Word2Vec to analyze transcripts from interviews conducted in rural Belize querying men about their health needs. All three methods returned a series of terms that captured ideas and concepts in subjects' responses to interview questions. Open coding returned 5–10 words or short phrases for each question. Topic Modeling returned a series of word-probability pairs that quantified how well a word captured the topic of a response. Word2Vec returned a list of words for each interview question ordered by which words were predicted to best capture the meaning of the passage. For most interview questions, all three methods returned conceptually similar results. NLP may be a useful adjunct to qualitative analysis. NLP may be performed after data have undergone open coding as a check on the accuracy of the codes. Alternatively, researchers can perform NLP prior to open coding and use the results to guide their creation of their codebook. [ABSTRACT FROM AUTHOR]