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So I just want to introduce Cassie briefly.

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Cassie is a reader at the Department for Health Sciences at the University of Bath at the moment.

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But we'll be moving to Durham later in the year, and I'll let Cassie introduce what she does research for herself.

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Okay, perfect. Well, thank you for having me.

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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.

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So definitely appreciate you being here. The title of The Talk, I was sort of doing it in a little bit of a rush.

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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.

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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,

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you know, 45 minutes for us to ask ourselves this question, really, and have more of a dialogue about it.

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My research spans sport and health sciences, social gerontology and health geography as well.

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And you'll see examples kind of coming from those three areas as we go through.

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So without further ado, are we really advancing methods in qualitative health research when we think of the methods available to us?

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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.

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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.

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But when we focus in on health research in particular,

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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.

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That's the kind of bread and butter being used and certainly that is has been termed the gold standard of qualitative research.

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I kind of think that that's not discounted is really, really important.

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But it was back in 2002 that the assertion was made that, you know,

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by discounting these perhaps other three broad categories of research data we're using that we're

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sort of relying on the precariousness of a one legged stool rather than the stability of all four.

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We're just focusing on one area, and I don't know that too much has changed really since 2002.

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Certainly there has been a growth in other forms of data collection are the techniques of the methods being utilised.

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But I think we could agree that focus groups and interviews still dominate.

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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.

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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.

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This was a quote taken from a recent paper by Mminele and Davis.

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They were focusing purely on how qualitative methods are being used within our cities.

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So that was certainly the context. But I just thought it was interesting that when they were doing their search,

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they wanted to kind of explore how qualitative methods are being used and how they could be improved.

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And when they did their search, they purposefully wanted to focus on innovative methods, and that led them to exclude standard interviews.

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And the thing that drew upon focus groups and I thought, that's kind of interesting, isn't it?

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Now those two methods are not considered innovative.

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If you want to talk about innovation within qualitative research, we need to push those two things to the side.

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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,

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I think this last week or so for interviewing has become to qualitative research methods what McDonald's is to culinary culture.

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So is it time maybe for us to adopt a new toolbox and push this one around with us a little more,

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be more, have our new techniques more readily available to draw upon when we go into these settings?

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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,

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but certainly a kind of a culture of newness.

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And Travis has described this as a cultural problem.

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I know some of the students were just involved in a session around research funding, gathering research funding.

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And certainly as a qualitative researcher, I think we're perhaps aware of a pressure to promote our work as something that's innovative,

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that's going to bring something different, bring something useful.

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And this idea of newness, innovation has been drawn upon within the marketing world.

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So you see, I mean, how long this has been around for.

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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.

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But actually, when we think about that exploding toolbox with all the new methods in it, you know there's nothing new about photography.

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Anthropologists have been using anthropology. Anthropologists have been using photography for a very long time.

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Same with video. What is new, perhaps, is the way the ease in which we can bring this into our research now,

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the mobile equipment that we can use with it, the databases that we might use to store and manage that kind of data.

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So it's a lot more readily available, a lot more user friendly, you might say.

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But how new are some of these methods that are framed as being innovative?

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So I rather like this quote here from Latham, who's kind of saying,

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rather than ditching the methodological skills that had been so painfully accumulated,

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you know, over years and years, we've been trying to refine, interviewing focus groups, making them work really well.

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Let's not discount them. Let's not be dazzled and tempted by, you know, the sort of lure of innovation.

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But let's think about how we can make these methods dance a little.

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How can we bring creativity into the methods that we're already using, the kind of the bread and butter, the gold standard?

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Let's not discount them out with the old and with the new.

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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.

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Sometimes it's been more successful than others.

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And then perhaps hear from some of you as as the presentation goes on into how you may have done the same.

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So let's start with focusing on the visual and thinking about why imagery is so important within visual culture.

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Well, we live in an ocular society everywhere we go. We're being bombarded by visual images.

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So the tube station, bus stations, television, anywhere and everywhere.

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It's all around us. We also understand information and communicate information through visual means as well.

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I think more and more now we're seeing in these kind of infographics to

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communicate complex information to people in a more sort of digestible fashion.

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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?

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There's tweeting, there's Twitter, there's Instagram. So imagery photography, drawings, etc. is all around us and significantly important.

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So it would make sense for us to perhaps start to incorporate that into some of our work.

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The images are also important because they help us to know our world, the world in which we're living in.

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And I really like this example from the Charlie Hebdo shooting in Paris back in 2015,

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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.

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And what those images took on the meaning of is solidarity.

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You know, having a free voice not not kind of caving in to the attacks and all the rest of it.

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And that took off on Twitter, on Instagram became really big,

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the social sweet Charlie phrase, and also the images and drawings that went alongside it.

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And then more recently, we have other sort of iconic images coming up out here.

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So that's how we start to know the world around us through the visual imagery.

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It's also how we start to understand or not start to understand, but how we continue to understand our bodies.

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So we might, for example, look at the images on the front of games, DVDs.

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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,

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that's being projected onto a sort of female, young, female market, incredibly thin waist.

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I mean, the body's just kind of not. Not realistic.

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Not representative of a normal body. Oops.

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Sorry. The sign there for elderly people of being a social gerontologist.

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This is what I can't believe is still up on the rose. Very stereotypical image there of what an older body is.

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It's bent over. It has a walking aids and an image here from the Invictus Games,

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which is a large sporting event aimed at military veterans who have been injured while in action.

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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.

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We might also start to think about how certain groups are represented by the media.

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So as I say, do some work within sort of sport and health sciences.

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And obviously the differences in how the media represent male athletes and female athletes can be really quite striking.

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So you just have a look, the classic kind of representations of females versus males,

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females, you tend to get a lot more emotion, a lot more passive shots.

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Research has shown that when it comes to representing males, all right, oh, it's going the wrong way.

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And when we go to male shots, much more active, showing strength, achievement, power, etc.,

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hopefully I've kind of cherry picked those images to make the point in this presentation, but there's certainly research supporting that.

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And another don't know whether to say favourite or bugbear,

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the kind of wrinkly hand image you also see a lot whenever there's anything around older adults in the media.

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But I think what's interesting about this is how it's created a kind of a response

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to the do more wrinkly hands hashtag that you now see on Twitter as well.

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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.

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And trust me, once you start looking out for this image, you're going to see it everywhere it comes up all the time.

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But I like that kind of call to action that people are responding to the images that they see as well.

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I just put a search into Google Images under the word cancer.

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This is cancer. I don't know if any of you are kind of working in this area,

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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.

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It's worth thinking as well about how the meaning of images can change over time.

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So the Red Bus is certainly an image that's talked about time and time again,

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and the meaning of that has changed from pre prefab referendum to to now.

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And same with people or groups of people. So for those of you who aren't familiar in the middle,

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there is kind of champion road cyclist Lance Armstrong who'd won multiple Tour de France is another elite races.

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He'd also experience testicular cancer,

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very advanced testicular cancer through the course of his career and had undergone treatment to then come back.

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You know, the heroic comeback narrative again that we see so often in sports to go on and win more or more races.

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So he was a real figurehead for many people. You know, he stood for, you know, kind of determination, beating disease, disciplining the body.

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Of course, denying allegations throughout his career of blood doping.

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And that's since very much called into question. I'm sure you're all aware.

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So I think images like this, the meanings change over time as well.

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And this is important that's being work done on what these kind of stories associated

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with these images and also autobiographies associated with these sports people can do.

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So certainly looking at the example of Lance Armstrong, what was the kind of narrative around his cancer diagnosis,

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how he lived with cancer, how he made the comeback from cancer and went on to excel in his sporting career?

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Let's just a little tangent there as well to sort of like the use of autobiographies and qualitative

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researchers and treating them as kind of narrative maps that people turn to when they're trying to navigate.

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And your condition or a condition that's new to them, I should say.

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Okay. So those are all the ways that I think images of proliferate are everyday lives.

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Why are they useful then to use as a form of data collection, they can slow down the observer.

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I think sometimes when you're in conversation, you're kind of reacting back and forth, back and forth, back and forth,

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but having a pile of images and having to kind of really look deeply at them and go back and forth slows you down.

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That kind of interpretation stage encourages a deeper reflection,

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and where I've tried to use them in particular is in capturing that kind of elusive sensory embodiment,

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really trying to encourage people to talk about how their bodies feel in fleeting moments, which can be pretty tricky for most people.

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It doesn't often come through that well in a life history interview, for example, circumvents that as well.

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So as a consequence, I try not to look at these as a replacement,

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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.

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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,

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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

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them to take images and produce images that they believe are important to them.

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So you might say, you know, take five, ten images that represent what you who you think you are, you know,

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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.

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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.

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So the design of this project was we interviewed 54 self-identified physically active older adults.

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We also, as part of those interviews, went around with them to the places where they were active and took photographs

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and then undertook a second interview with them where they were looking to talk to

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you about that moment where they were looking at the images and trying to try to

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describe how their bodies felt in that moment when that image had been produced.

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We also used their stories and some of the photographs and feelings that we produced to produce a short film,

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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.

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It's called Moving Stories because it was basically stories about moving.

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We were trying to understand not just older adults experiences of physical activity,

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but also how other people responded to stories and images of older adults being physically active.

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So that was just a little background on the design that. These are the kinds of things that were produced.

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These weren't elite athletes, obviously, that we were working with you kind of every day exercise the.

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On the go slow again. Well, she had a range of activities.

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I've just put a few in here swimming, golf, badminton, walking, all kinds of things.

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What we found, first of all, so you hit this is a caution.

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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.

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We found that became really challenging for a number of reasons. Often people finish their activity and then they just wanted to go.

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They didn't want to sit and then trawl through a load of photographs.

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The other thing is, obviously now we've got the easy means of collecting digital photographs.

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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.

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Then you find yourself sat there with scrolling on an iPad, trying to kind of.

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How did you feel when you were doing this?

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Kind of it was a method we were testing out, and we learned pretty quickly that this was not the type that worked well.

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So what we did is just add it into an email interview where we would select a much smaller number

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of images showing people in diverse positions and different periods within the exercise session.

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And then with this kind of short interpretation of it, through the photographs that we've taken of you being active,

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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.?

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And it was kind of drawing upon a sort of phenomenological approach to a certain extent,

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just really trying to get to that basic understanding of what does it feel like?

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What's it like to do this? And these are the kinds of responses we get.

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So here's a lady I can hear loud cracking from my knees.

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I like to try and it's really difficult here. I blame the smooth stacking chairs as I can do better at home.

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So you can see we're starting to get some of that sensory experience there.

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Some of the responses were much longer. Some were just a line.

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I think that was fairly typical. We became quite conscious.

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You know, certain people find this much easier to do this task much easier to do than others.

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Here's an example from one of our sea swimmers.

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Again, the feeling of buoyancy, talking about the pressure of the water around her body, but also situating herself within space and place.

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And this is something else that I've become increasingly interested in.

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So talking much more now about the environments around to the formation of clouds,

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how blue the sky is talking about wanting to go out on her own again,

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the water looking at the sea life, Accenture and tension within her body disappearing.

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So this was important for us because by this point, we'd already done really long life history interviews with these people.

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And we could see quite clearly that this type of information hadn't been forthcoming in those settings.

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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,

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kind of opened the door a little bit on some of that information.

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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.

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It's only 10 minutes of those videos of a little lighter on a Thursday afternoon.

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And the purpose of this film was to share and focus groups with what we did, focus groups with young people,

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people in midlife and also older adults as well, to understand their responses to physically active older adults.

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And there are some questions at the end which then obviously formed the discussion that followed.

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The the video had two purposes, as I say, on the one hand, it was another means of collecting data.

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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.

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So a lot of the issues that were being picked up there had come through from the analysis of our data.

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A particularly light for us, it was an opportunity to show counter-narratives around physical activity in older age,

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though I think so often just awful. Lots of assumed older adults are just involved in physical activity for health benefits where, you know,

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certainly Gordon on his bike is still old, but the exhilaration and the thrill of it, I think that's quite unusual.

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Derek with his badminton, had a very competitive edge and then there were issues around confidence,

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the kind of life history aspect of having negative experiences and coming to sport and physical activity quite later on in life,

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and also overcoming challenges, hip replacements and periods of, you know, feeling quite depressed, etc.

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So all of that had come through in our email and we were very kind of deliberate and specific

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in placing it in the film to try and communicate that and elicit discussion as well.

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And we drew on Arthur Frank's social and our autophagy kind of framework approach to understand this data,

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really thinking about not just stories as a kind of a portal into somebodies mind and how they experience their world.

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But what is the power of stories and what can stories do to the people that hear them?

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And we've written a chapter around that. I won't go through those.

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I mean, those are the kind of a certain power and effectiveness, I think,

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to sort of stories that are presented on film connected people are also disconnected them.

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One of the comments that we had from an older gentleman was, if you've produced this film to try and counter negative,

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negative stereotypes of ageing, I don't know why you've put the seated exercise classes in there.

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I felt really kind of strongly that that didn't belong in there at all.

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So yeah, some really interesting discussions that came through from the focus group by using that as a tool.

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Okay. So the second way that we send in, it's always a team effort.

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These things is we've tried to make our methods dance, if you like,

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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.

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So go along interviews when you might be walking with someone as you're interviewing them.

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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,

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I think, those more subtle aspects of being active and being movement that you might not

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necessarily talk about so easily in a more rehearsed story that you tell in an interview.

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So again, I think useful at least from the my interest at trying to reach this kind of more sensory aspects of activity.

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It's been a rather nice day out on the Helford River and perks of the job.

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Okay, so a lot of this work has been done around projects looking at the interactions between nature, health and wellbeing.

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So there is a growing body of literature now looking at health and wellbeing outcomes for people who are spending time in green spaces,

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blue spaces call them what you will. Nature's.

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But certainly I think a critique of that literature has been the assumption that if that if those spaces are available,

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people will use them and then people will access those health and wellbeing outcomes.

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And we kind of can see that that's not really the case. So certainly these mobile methods, I think,

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lend themselves to understanding the more everyday or situated practices and habits that

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people are building up around their kind of movement patterns and the sense of emplacement,

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if you like. So for this, we used this message called narratives.

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This is very much led by my PhD student, Sarah Bell and Ben Wheeler, who was also involved in the supervisory team.

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Who is the kind of quantitative guy? This is an interesting kind of mixed method project.

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Where we used accelerometer tree data. Global positioning systems, one on the wrist and then map based interviews as well.

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So people would walk.

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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.

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And again, within an interview setting, this became a really useful discussion device to think about where do people kind of linger?

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Where do they walk fast? Where are the places that they avoid?

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Are there any places that are missed that they are missing kind of within their local environments, etc.?

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And then a subset of the sample is quite a large group. We then conducted a go along interviews with so again,

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walking with them on a route or a place that they had identified as being particularly impactful

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on their sense of well-being and just trying to kind of tease out the specifics of that.

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So again, a kind of a really interesting study.

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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,

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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.

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But I think the layering and introducing that movement and the use of the environment around people is kind of really useful there.

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So as I started off by saying this kind of, you know, always advancing methods within qualitative health research,

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there has been so much emphasis on interviews, on focus groups.

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There is a little bit of a backlash or a critique, at least because of that.

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There's certainly a plethora of other techniques of the methods that we can use to gather data.

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Do we need to then discard interviews? I don't think so.

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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.

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But there's obviously other things that we need to consider along the way.

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And I think a really interesting point that's been made by Nettleton and GREENE,

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certainly others are not the only people is what have we when we're talking about innovation.

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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.

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We have incredibly rich data through our interviews, through our focus groups.

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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,

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advance, understand more fully how people are doing things, why people are doing things, where people are doing things and the consequences.

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A similar point can be made in relation to analysis. So again, there are challenges.

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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

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understanding how we might then analyse it when we end up with all this fancy stuff photos,

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maps, plots on our desk, just as there's been a kind of critique, I suppose,

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of a focus on interviews from focus groups, so too, has there been a critique on the overuse of a thematic analysis?

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There are lots of other ways of analysing data. Brian Clark You've obviously written a lot around this method.

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Make the point that your thematic analysis can be your starting point, you know?

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Yes, certainly use that to make sense of your data, the kind of broad brush approach of what what is the state telling me.

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But then where might we build from when we've done that?

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What other things can we do on top to bring in these additional interpretations?

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There's also innovations, you might call it, to be made in terms of how we represent our data.

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So for ourselves, using film has been really useful.

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We've also, you know, alongside the journal articles and what have you, which are important produce key findings, booklets.

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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.

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And if you're not familiar with it and you're interested in the area,

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certainly the work of peer contacts in Canada around dementia I think has been really forward thinking in relation to this.

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But then of course how do we appraise, how do we judge the quality of this innovation of these new forms of data?

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So I had to obviously plug Veronica's backpack because it's a it's a valid question, isn't it?

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It's not the case that anything goes, oh, it's new, it's shiny, it's novel.

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I've got a fancy bit of kit, therefore it's good and it's helpful.

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But are we lacking a little bit in terms of how we appraise,

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how we understand the different ways in which we might understand the quality of these different forms of data?

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And then to go back to that idea of, you know, the culture of newness and the pressure to be innovative,

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whether it's on an A grant application or whether it's when you're pitching a new book

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and you make in the case of why this is different to all the other books on this topic,

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and Travis notes that we've kind of responded to this pressure to innovate into very sort of different ways.

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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.

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It's a very exciting time to be doing qualitative research.

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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.

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And I think that's very real connections with the there is nothing new here.

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This has been done before. It's just old wine in new bottles.

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And alongside those that kind of response of defending one's discipline, I think there's certainly been the critique of, you know,

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almost getting so caught up in the glitz of a new technique that you're trivialising the real issues

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underpinning a research area and the long standing problems that are perhaps more difficult to tackle.

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And certainly when we're thinking about older adults and when we're thinking

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about trying to encourage or support older adults and becoming more active,

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I always like to bring these statistics from the age UK later life in the UK report.

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We shouldn't forget, you know, 1 million cut back on food shopping to cover their utility bills.

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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.

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And, you know,

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just really emphasising the importance of remembering that when you just sort of consider these issues as an individual issue and that a sort

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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.

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So it's really overdue. Are we really advancing qualitative methods within health research?

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What would that involve? What does advancing actually mean?

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Is it necessary? And what's at stake if we take it on board?

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How would you respond to these kind of new the pressure to innovate?

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And that's really all I had to say. So thank you very much for listening.