So I just want to introduce Cassie briefly.
Cassie is a reader at the Department for Health Sciences at the University of Bath at the moment.
But we'll be moving to Durham later in the year, and I'll let Cassie introduce what she does research for herself.
Okay, perfect. Well, thank you for having me.
It's a real pleasure to be here. And I realise at the end of the day, at the end of the week as well.
So definitely appreciate you being here. The title of The Talk, I was sort of doing it in a little bit of a rush.
I look back to see what the name of the unit was and I was like, Oh, we could just sort of flip that, make it into a little bit of a question.
So I feel so slightly wedded to it now, but what I want to achieve through this talk is really just to create space over the next,
you know, 45 minutes for us to ask ourselves this question, really, and have more of a dialogue about it.
My research spans sport and health sciences, social gerontology and health geography as well.
And you'll see examples kind of coming from those three areas as we go through.
So without further ado, are we really advancing methods in qualitative health research when we think of the methods available to us?
Okay. So the tools, the techniques we can use to go out and collect qualitative data, there are many there are lots of things that we can do.
There's obviously some overlap on some of those, and that will dictate the type of data that we get and the meanings that we can then draw from that.
But when we focus in on health research in particular,
it's perhaps received a little bit of a hard time in the sense that the focus seems to be mainly on interviews and focus groups.
That's the kind of bread and butter being used and certainly that is has been termed the gold standard of qualitative research.
I kind of think that that's not discounted is really, really important.
But it was back in 2002 that the assertion was made that, you know,
by discounting these perhaps other three broad categories of research data we're using that we're
sort of relying on the precariousness of a one legged stool rather than the stability of all four.
We're just focusing on one area, and I don't know that too much has changed really since 2002.
Certainly there has been a growth in other forms of data collection are the techniques of the methods being utilised.
But I think we could agree that focus groups and interviews still dominate.
And as a consequence, I think our tool kit that we carry around with us as qualitative researchers can start to look and feel a little bit light.
There's been almost sort of a growing backlash, as may be too strong a word, but definitely kind of a critique growing, I think, around this.
This was a quote taken from a recent paper by Mminele and Davis.
They were focusing purely on how qualitative methods are being used within our cities.
So that was certainly the context. But I just thought it was interesting that when they were doing their search,
they wanted to kind of explore how qualitative methods are being used and how they could be improved.
And when they did their search, they purposefully wanted to focus on innovative methods, and that led them to exclude standard interviews.
And the thing that drew upon focus groups and I thought, that's kind of interesting, isn't it?
Now those two methods are not considered innovative.
If you want to talk about innovation within qualitative research, we need to push those two things to the side.
And often I don't know who tweets here, but a tweet here from an ethnographer, Michael Atkinson, over in the University of Toronto just recently,
I think this last week or so for interviewing has become to qualitative research methods what McDonald's is to culinary culture.
So is it time maybe for us to adopt a new toolbox and push this one around with us a little more,
be more, have our new techniques more readily available to draw upon when we go into these settings?
And what could that bring for us? But I don't know that we need to kind of necessarily discard the old and bring in the new to this regard,
but certainly a kind of a culture of newness.
And Travis has described this as a cultural problem.
I know some of the students were just involved in a session around research funding, gathering research funding.
And certainly as a qualitative researcher, I think we're perhaps aware of a pressure to promote our work as something that's innovative,
that's going to bring something different, bring something useful.
And this idea of newness, innovation has been drawn upon within the marketing world.
So you see, I mean, how long this has been around for.
But if you can rebrand something as new, as innovative, as fresh, as moving something forward, then it's more catchy, it's more appealing.
But actually, when we think about that exploding toolbox with all the new methods in it, you know there's nothing new about photography.
Anthropologists have been using anthropology. Anthropologists have been using photography for a very long time.
Same with video. What is new, perhaps, is the way the ease in which we can bring this into our research now,
the mobile equipment that we can use with it, the databases that we might use to store and manage that kind of data.
So it's a lot more readily available, a lot more user friendly, you might say.
But how new are some of these methods that are framed as being innovative?
So I rather like this quote here from Latham, who's kind of saying,
rather than ditching the methodological skills that had been so painfully accumulated,
you know, over years and years, we've been trying to refine, interviewing focus groups, making them work really well.
Let's not discount them. Let's not be dazzled and tempted by, you know, the sort of lure of innovation.
But let's think about how we can make these methods dance a little.
How can we bring creativity into the methods that we're already using, the kind of the bread and butter, the gold standard?
Let's not discount them out with the old and with the new.
So what I really want to just go through now is the ways in which I've tried to make my methods dance a little bit as I've gone along.
Sometimes it's been more successful than others.
And then perhaps hear from some of you as as the presentation goes on into how you may have done the same.
So let's start with focusing on the visual and thinking about why imagery is so important within visual culture.
Well, we live in an ocular society everywhere we go. We're being bombarded by visual images.
So the tube station, bus stations, television, anywhere and everywhere.
It's all around us. We also understand information and communicate information through visual means as well.
I think more and more now we're seeing in these kind of infographics to
communicate complex information to people in a more sort of digestible fashion.
And then, of course, there's the selfie stick. Who would have ever known that a selfie stick would be invented and sell as much as it does?
There's tweeting, there's Twitter, there's Instagram. So imagery photography, drawings, etc. is all around us and significantly important.
So it would make sense for us to perhaps start to incorporate that into some of our work.
The images are also important because they help us to know our world, the world in which we're living in.
And I really like this example from the Charlie Hebdo shooting in Paris back in 2015,
where the response to those shootings at the French satirical newspaper was for illustrators around the world to come up with images such as these.
And what those images took on the meaning of is solidarity.
You know, having a free voice not not kind of caving in to the attacks and all the rest of it.
And that took off on Twitter, on Instagram became really big,
the social sweet Charlie phrase, and also the images and drawings that went alongside it.
And then more recently, we have other sort of iconic images coming up out here.
So that's how we start to know the world around us through the visual imagery.
It's also how we start to understand or not start to understand, but how we continue to understand our bodies.
So we might, for example, look at the images on the front of games, DVDs.
This one here aimed at teenage girls. If you just take a moment to think about the bodily proportions of the character on the front there,
that's being projected onto a sort of female, young, female market, incredibly thin waist.
I mean, the body's just kind of not. Not realistic.
Not representative of a normal body. Oops.
Sorry. The sign there for elderly people of being a social gerontologist.
This is what I can't believe is still up on the rose. Very stereotypical image there of what an older body is.
It's bent over. It has a walking aids and an image here from the Invictus Games,
which is a large sporting event aimed at military veterans who have been injured while in action.
And clearly sort of images of a sort of heroic comeback of how one is expected to respond in the light of of injuries such as those.
We might also start to think about how certain groups are represented by the media.
So as I say, do some work within sort of sport and health sciences.
And obviously the differences in how the media represent male athletes and female athletes can be really quite striking.
So you just have a look, the classic kind of representations of females versus males,
females, you tend to get a lot more emotion, a lot more passive shots.
Research has shown that when it comes to representing males, all right, oh, it's going the wrong way.
And when we go to male shots, much more active, showing strength, achievement, power, etc.,
hopefully I've kind of cherry picked those images to make the point in this presentation, but there's certainly research supporting that.
And another don't know whether to say favourite or bugbear,
the kind of wrinkly hand image you also see a lot whenever there's anything around older adults in the media.
But I think what's interesting about this is how it's created a kind of a response
to the do more wrinkly hands hashtag that you now see on Twitter as well.
So people being called out about this use of an image that just reduces the life of an older adults to just a pair of wrinkly hands.
And trust me, once you start looking out for this image, you're going to see it everywhere it comes up all the time.
But I like that kind of call to action that people are responding to the images that they see as well.
I just put a search into Google Images under the word cancer.
This is cancer. I don't know if any of you are kind of working in this area,
but you can see it just a very sort of unique dimensional projection of what having cancer kind of means and how we understand it.
It's worth thinking as well about how the meaning of images can change over time.
So the Red Bus is certainly an image that's talked about time and time again,
and the meaning of that has changed from pre prefab referendum to to now.
And same with people or groups of people. So for those of you who aren't familiar in the middle,
there is kind of champion road cyclist Lance Armstrong who'd won multiple Tour de France is another elite races.
He'd also experience testicular cancer,
very advanced testicular cancer through the course of his career and had undergone treatment to then come back.
You know, the heroic comeback narrative again that we see so often in sports to go on and win more or more races.
So he was a real figurehead for many people. You know, he stood for, you know, kind of determination, beating disease, disciplining the body.
Of course, denying allegations throughout his career of blood doping.
And that's since very much called into question. I'm sure you're all aware.
So I think images like this, the meanings change over time as well.
And this is important that's being work done on what these kind of stories associated
with these images and also autobiographies associated with these sports people can do.
So certainly looking at the example of Lance Armstrong, what was the kind of narrative around his cancer diagnosis,
how he lived with cancer, how he made the comeback from cancer and went on to excel in his sporting career?
Let's just a little tangent there as well to sort of like the use of autobiographies and qualitative
researchers and treating them as kind of narrative maps that people turn to when they're trying to navigate.
And your condition or a condition that's new to them, I should say.
Okay. So those are all the ways that I think images of proliferate are everyday lives.
Why are they useful then to use as a form of data collection, they can slow down the observer.
I think sometimes when you're in conversation, you're kind of reacting back and forth, back and forth, back and forth,
but having a pile of images and having to kind of really look deeply at them and go back and forth slows you down.
That kind of interpretation stage encourages a deeper reflection,
and where I've tried to use them in particular is in capturing that kind of elusive sensory embodiment,
really trying to encourage people to talk about how their bodies feel in fleeting moments, which can be pretty tricky for most people.
It doesn't often come through that well in a life history interview, for example, circumvents that as well.
So as a consequence, I try not to look at these as a replacement,
but just as an additional layer of understanding that we can kind of layer on top of an existing method that we might be using.
Okay. So just to draw upon one of the projects that I was leading where I used quite a lot of visual methods prior to this,
I'm not going to talk about that particular project today, but I used Photo Forest where you give the camera to the participants and allow
them to take images and produce images that they believe are important to them.
So you might say, you know, take five, ten images that represent what you who you think you are, you know,
your sort of identity construction that's been used, that's a kind of a really good technique you should be happy to talk about afterwards.
But we didn't do that in this particular project. We were more trying to understand how people responded to the images that they were shown.
So the design of this project was we interviewed 54 self-identified physically active older adults.
We also, as part of those interviews, went around with them to the places where they were active and took photographs
and then undertook a second interview with them where they were looking to talk to
you about that moment where they were looking at the images and trying to try to
describe how their bodies felt in that moment when that image had been produced.
We also used their stories and some of the photographs and feelings that we produced to produce a short film,
which I'll share with you in a moment, which we shared in focus groups to try and understand people's responses to the moving stories.
It's called Moving Stories because it was basically stories about moving.
We were trying to understand not just older adults experiences of physical activity,
but also how other people responded to stories and images of older adults being physically active.
So that was just a little background on the design that. These are the kinds of things that were produced.
These weren't elite athletes, obviously, that we were working with you kind of every day exercise the.
On the go slow again. Well, she had a range of activities.
I've just put a few in here swimming, golf, badminton, walking, all kinds of things.
What we found, first of all, so you hit this is a caution.
I suppose the original plan was to go and take these images back to people and then have this kind of interview and we'd sit down and discuss them.
We found that became really challenging for a number of reasons. Often people finish their activity and then they just wanted to go.
They didn't want to sit and then trawl through a load of photographs.
The other thing is, obviously now we've got the easy means of collecting digital photographs.
Click, click, click, click, click, click, click. It's really easy to simply end up with, like, 100 odd photographs of a single exercise session.
Then you find yourself sat there with scrolling on an iPad, trying to kind of.
How did you feel when you were doing this?
Kind of it was a method we were testing out, and we learned pretty quickly that this was not the type that worked well.
So what we did is just add it into an email interview where we would select a much smaller number
of images showing people in diverse positions and different periods within the exercise session.
And then with this kind of short interpretation of it, through the photographs that we've taken of you being active,
use them to help you respond in your own way, in your own words. The question What is it like to dance, play, badminton, heel, walk, etc.?
And it was kind of drawing upon a sort of phenomenological approach to a certain extent,
just really trying to get to that basic understanding of what does it feel like?
What's it like to do this? And these are the kinds of responses we get.
So here's a lady I can hear loud cracking from my knees.
I like to try and it's really difficult here. I blame the smooth stacking chairs as I can do better at home.
So you can see we're starting to get some of that sensory experience there.
Some of the responses were much longer. Some were just a line.
I think that was fairly typical. We became quite conscious.
You know, certain people find this much easier to do this task much easier to do than others.
Here's an example from one of our sea swimmers.
Again, the feeling of buoyancy, talking about the pressure of the water around her body, but also situating herself within space and place.
And this is something else that I've become increasingly interested in.
So talking much more now about the environments around to the formation of clouds,
how blue the sky is talking about wanting to go out on her own again,
the water looking at the sea life, Accenture and tension within her body disappearing.
So this was important for us because by this point, we'd already done really long life history interviews with these people.
And we could see quite clearly that this type of information hadn't been forthcoming in those settings.
But I think the images encouraging that kind of slow reflection and really asking people to focus in on what did your body feel like at this moment,
kind of opened the door a little bit on some of that information.
So as I mentioned, the other way in which we use this was to produce a short film, which I'm going to I'm going to share with you now.
It's only 10 minutes of those videos of a little lighter on a Thursday afternoon.
And the purpose of this film was to share and focus groups with what we did, focus groups with young people,
people in midlife and also older adults as well, to understand their responses to physically active older adults.
And there are some questions at the end which then obviously formed the discussion that followed.
The the video had two purposes, as I say, on the one hand, it was another means of collecting data.
We used it to elicit discussion within a focus group setting, but we've also used it as a way to communicate our research findings.
So a lot of the issues that were being picked up there had come through from the analysis of our data.
A particularly light for us, it was an opportunity to show counter-narratives around physical activity in older age,
though I think so often just awful. Lots of assumed older adults are just involved in physical activity for health benefits where, you know,
certainly Gordon on his bike is still old, but the exhilaration and the thrill of it, I think that's quite unusual.
Derek with his badminton, had a very competitive edge and then there were issues around confidence,
the kind of life history aspect of having negative experiences and coming to sport and physical activity quite later on in life,
and also overcoming challenges, hip replacements and periods of, you know, feeling quite depressed, etc.
So all of that had come through in our email and we were very kind of deliberate and specific
in placing it in the film to try and communicate that and elicit discussion as well.
And we drew on Arthur Frank's social and our autophagy kind of framework approach to understand this data,
really thinking about not just stories as a kind of a portal into somebodies mind and how they experience their world.
But what is the power of stories and what can stories do to the people that hear them?
And we've written a chapter around that. I won't go through those.
I mean, those are the kind of a certain power and effectiveness, I think,
to sort of stories that are presented on film connected people are also disconnected them.
One of the comments that we had from an older gentleman was, if you've produced this film to try and counter negative,
negative stereotypes of ageing, I don't know why you've put the seated exercise classes in there.
I felt really kind of strongly that that didn't belong in there at all.
So yeah, some really interesting discussions that came through from the focus group by using that as a tool.
Okay. So the second way that we send in, it's always a team effort.
These things is we've tried to make our methods dance, if you like,
is by introducing movement and space and this is calling much more of sort of bonds, geography, literature, etc. through the use of mobile methods.
So go along interviews when you might be walking with someone as you're interviewing them.
There's people using head mounted cameras and cycling alongside people and interviewing them kind of in situ very much in the moment to try and get,
I think, those more subtle aspects of being active and being movement that you might not
necessarily talk about so easily in a more rehearsed story that you tell in an interview.
So again, I think useful at least from the my interest at trying to reach this kind of more sensory aspects of activity.
It's been a rather nice day out on the Helford River and perks of the job.
Okay, so a lot of this work has been done around projects looking at the interactions between nature, health and wellbeing.
So there is a growing body of literature now looking at health and wellbeing outcomes for people who are spending time in green spaces,
blue spaces call them what you will. Nature's.
But certainly I think a critique of that literature has been the assumption that if that if those spaces are available,
people will use them and then people will access those health and wellbeing outcomes.
And we kind of can see that that's not really the case. So certainly these mobile methods, I think,
lend themselves to understanding the more everyday or situated practices and habits that
people are building up around their kind of movement patterns and the sense of emplacement,
if you like. So for this, we used this message called narratives.
This is very much led by my PhD student, Sarah Bell and Ben Wheeler, who was also involved in the supervisory team.
Who is the kind of quantitative guy? This is an interesting kind of mixed method project.
Where we used accelerometer tree data. Global positioning systems, one on the wrist and then map based interviews as well.
So people would walk.
We pick up, kind of see where they had gone, the speed at which they were travelling, which is indicated through the spacing of the dots there.
And again, within an interview setting, this became a really useful discussion device to think about where do people kind of linger?
Where do they walk fast? Where are the places that they avoid?
Are there any places that are missed that they are missing kind of within their local environments, etc.?
And then a subset of the sample is quite a large group. We then conducted a go along interviews with so again,
walking with them on a route or a place that they had identified as being particularly impactful
on their sense of well-being and just trying to kind of tease out the specifics of that.
So again, a kind of a really interesting study.
I think the challenge of doing something like that is just the volume of data you get, know, you end up with lots of maps,
lots of transcription and trying to kind of like anything when you have those data like order it and manage it and make sense of it is is tricky.
But I think the layering and introducing that movement and the use of the environment around people is kind of really useful there.
So as I started off by saying this kind of, you know, always advancing methods within qualitative health research,
there has been so much emphasis on interviews, on focus groups.
There is a little bit of a backlash or a critique, at least because of that.
There's certainly a plethora of other techniques of the methods that we can use to gather data.
Do we need to then discard interviews? I don't think so.
You can see we still use them very much in our work, but we're just trying to bring in some of this creativity on top.
But there's obviously other things that we need to consider along the way.
And I think a really interesting point that's been made by Nettleton and GREENE,
certainly others are not the only people is what have we when we're talking about innovation.
It's we don't necessarily need more data. We don't need to collect more data in more fancy ways with the fads and fashions.
We have incredibly rich data through our interviews, through our focus groups.
What we need is kind of innovation through theory and not to keep using our data to just reconfirm kind of what we already know, but actually build,
advance, understand more fully how people are doing things, why people are doing things, where people are doing things and the consequences.
A similar point can be made in relation to analysis. So again, there are challenges.
As soon as you start to use different techniques, you end up with these different forms of data and are we lagging behind a little in
understanding how we might then analyse it when we end up with all this fancy stuff photos,
maps, plots on our desk, just as there's been a kind of critique, I suppose,
of a focus on interviews from focus groups, so too, has there been a critique on the overuse of a thematic analysis?
There are lots of other ways of analysing data. Brian Clark You've obviously written a lot around this method.
Make the point that your thematic analysis can be your starting point, you know?
Yes, certainly use that to make sense of your data, the kind of broad brush approach of what what is the state telling me.
But then where might we build from when we've done that?
What other things can we do on top to bring in these additional interpretations?
There's also innovations, you might call it, to be made in terms of how we represent our data.
So for ourselves, using film has been really useful.
We've also, you know, alongside the journal articles and what have you, which are important produce key findings, booklets.
There's some at the back of the room which are welcome to take at the end, but there's drama, poetry, dance, a real range there.
And if you're not familiar with it and you're interested in the area,
certainly the work of peer contacts in Canada around dementia I think has been really forward thinking in relation to this.
But then of course how do we appraise, how do we judge the quality of this innovation of these new forms of data?
So I had to obviously plug Veronica's backpack because it's a it's a valid question, isn't it?
It's not the case that anything goes, oh, it's new, it's shiny, it's novel.
I've got a fancy bit of kit, therefore it's good and it's helpful.
But are we lacking a little bit in terms of how we appraise,
how we understand the different ways in which we might understand the quality of these different forms of data?
And then to go back to that idea of, you know, the culture of newness and the pressure to be innovative,
whether it's on an A grant application or whether it's when you're pitching a new book
and you make in the case of why this is different to all the other books on this topic,
and Travis notes that we've kind of responded to this pressure to innovate into very sort of different ways.
On the one hand, it's a cause for celebration. There are all these other things available at our fingertips now that we can draw from.
It's a very exciting time to be doing qualitative research.
Then there's also the the response where people become very defensive of their disciplines and, you know, almost don't want to over celebrate it.
And I think that's very real connections with the there is nothing new here.
This has been done before. It's just old wine in new bottles.
And alongside those that kind of response of defending one's discipline, I think there's certainly been the critique of, you know,
almost getting so caught up in the glitz of a new technique that you're trivialising the real issues
underpinning a research area and the long standing problems that are perhaps more difficult to tackle.
And certainly when we're thinking about older adults and when we're thinking
about trying to encourage or support older adults and becoming more active,
I always like to bring these statistics from the age UK later life in the UK report.
We shouldn't forget, you know, 1 million cut back on food shopping to cover their utility bills.
25,000 can die of the cold each year. 2.9 million older adults feel they have no one to turn to for help and support.
And, you know,
just really emphasising the importance of remembering that when you just sort of consider these issues as an individual issue and that a sort
of fancy film and a few photographs that are going to make people stop and think are going to address these problems are certainly not.
So it's really overdue. Are we really advancing qualitative methods within health research?
What would that involve? What does advancing actually mean?
Is it necessary? And what's at stake if we take it on board?
How would you respond to these kind of new the pressure to innovate?
And that's really all I had to say. So thank you very much for listening.