Qualitative Research Group

The CTR Qualitative Research Group (QRG) is a group of experienced qualitative health and social care researchers from varied backgrounds including sociology and psychology.

Qualitative Research Group (QRG)

We have expertise in:

Process evaluations of complex interventions
Implementation and adapting interventions
Standalone qualitative studies (particularly addressing the experiences of under-served populations)
Methods and theory
Optimising trial methods (e.g. recruitment challenges and solutions)

We work nationally and internationally within interdisciplinary teams, working alongside patient and public researchers, health and social care professionals, statisticians, and health economists, to carry out mixed methods research. We have an excellent track record of securing funding from major funders including NIHR, MRC and HCRW. We have extensive experience supervising PhD students and are interested in supervising new students.

The team is always keen to work with new collaborators. Contact the Qualitative Research Group Lead for an informal discussion Dr Lucy Brookes-Howell, CTR-Qualitative@cardiff.ac.uk.

Qualitative research methods

Doing research using qualitative methods allows us to look below the surface. We can focus more closely on ‘how’ and ‘why’ questions relating to trial research, and we can both examine and highlight the trial research participants’ points of view. To gather the kind of information we need to do this, we use a wide range of data-gathering methods including, for example:

observations, conducted as a participant or non-participant observer
interviews, conducted via telephone or face-to-face, sometimes using visual methods
focus group discussions
audio or video-recorded interactions
diaries, blogs and forum contributions
public discourse, as available on TV and radio, newspapers and magazines, or policy documents

Qualitative data can be analysed in various ways, with the particular method depending on the aim of the study and the specific research questions we are trying to answer. Below is a small selection of the approaches used in current and planned Centre for Trials Research trials and studies:

content analysis
framework analysis
grounded theory
narrative analysis
discourse analysis

These are often combined with quantitative data analysis within the same study, using a mixed methods approach.

Benefits of qualitative methods

We use qualitative methods in trials because they allow us to “reach the parts that other methods cannot reach” (Pope and Mays 1995). They can help us to address questions which are not easily or completely answered by quantitative methods.

Qualitative methods can enhance, elaborate or clarify trial findings and help us address questions relating to issues such as:

unusual or unexpected trial results
participants’ refusal to enrol in a trial
participants’ early withdrawal from a trial
non-compliance to a trial methodology

When used within process evaluations, they allow us to develop a more complete picture of what went on during a trial, enriching our understanding and bringing greater credibility to trials research.

Snapshots of our work

1. Process Evaluations of Complex Interventions

Confidence in Care

The Confidence in Care (CiC) Evaluation tested whether the ‘Fostering Changes’ training course for foster and kinship carers produced better outcomes than standard support and advice. We carried out a qualitative process evaluation of the Fostering Changes program to enhance understanding of trial results, and to specify a Fostering Changes logic model, thus identifying potential mechanisms of impact.

Read more: S Channon et al. 2020. Qualitative process evaluation of the Fostering Changes program for foster carers as part of the Confidence in Care randomized controlled trial Child Abuse and Neglect 109, article number: 104768.

2. Implementation and adapting interventions

PUMA

Aiming to improve the detection of deterioration in paediatric hospital patients, the NIHR-commissioned PUMA Study produced an evidence-based, theoretically informed, paediatric early warning system improvement programme (The PUMA Programme) for use in acute paediatric settings. The study drew centrally on qualitative methods: ethnographic observations of clinical practice and interviews with staff and parents were used to inform theory and intervention development, evaluate the impact of the programme on clinical practice across four study sites, and to produce a process evaluation of the study. Qualitative findings were further used to inform quantitative (interrupted time series) analysis.

Read more: D Allen et al. 2022. Development, implementation and evaluation of an evidence-based paediatric early warning system improvement programme: the PUMA mixed methods study BMC Health Services Research 22(1), article number: 9. (10.1186/s12913-021-07314-2)

ADAPT

We worked on the ADAPT Study to provide guidance on how to adapt and transfer existing interventions to new contexts, e.g. a new healthcare system, or to improve impact for population subgroups.

Read more: G Moore et al. 2021. Adapting interventions to new context - the ADAPT guidance The BMJ 374, article number: n1679. (10.1136/bmj.n1679)

3. Qualitative studies understanding the experiences of under-served populations

SenITA

The SenITA Study focused on children with autism and sensory processing difficulties (SPD), looking at the clinical effectiveness of sensory integration therapy. As part of this study, we used semi-structured, timeline-assisted interviews with parents/carers to explore their experiences of and access to support for families of children with autism and SPD.

Read more: S Milosevic et al. 2022.Understanding the support experiences of families of children with autism and sensory processing difficulties: A qualitative study Health Expectations 25 (3) , pp. 1118-1130. 10.1111/hex.13465

PHACT

The PHACT Trial focuses on getting people into settled housing and improving health for people leaving prison. It uses interviews with participants, prison staff and intervention staff to understand the experiences of taking part in the trial.

4. Methods and theory

PEACH

The PEACH study developed a people-led triangulation protocol with the study patient and public representative, clinicians, qualitative researchers, and statisticians to integrate qualitative and quantitative results on how a blood test infection marker influenced the use of antibiotics in Emergency Care during the COVID pandemic.

Read more: Euden, J. et al. 2022. Procalcitonin evaluation of antibiotic use in COVID-19 hospitalised patients (PEACH): protocol for a retrospective observational study. Methods and Protocols 5(6), article number: 95. (10.3390/mps5060095)

Project SFP Cymru

The Process Evaluation of the Strengthening Families Programme used the Extended Normalisation Process Theory to examine how the intervention interacted with local delivery systems to influence the delivery of the programme, dose, recruitment and reach.

5. Optimising trials methods

Talking Trials

The Talking Trials project brought together a group of co-researchers from diverse ethnic backgrounds to discuss health research and clinical trials. Combining a deliberative democratic approach with participatory art methodology the group developed a set of practical guidelines to address the underrepresentation of people from minority ethnic communities in trials and change practices within the clinical trials unit.

Read more: Talking Trials

ABACus3

The ABACus 3 trial tested the effectiveness of a cancer awareness intervention for adults living in deprived communities in both healthcare and community settings. Recognising that recruitment of research participants poses particular challenges within socioeconomically deprived areas, we identified a range of strategies that were successful in engaging local organisations and residents. These included community-based recruitment, liaising with local gatekeepers, and using a personalised follow-up approach.

Read more: V Kolovou et al. 2020. Recruitment and retention of participants from socioeconomically deprived communities: lessons from the awareness and beliefs about cancer (ABACus3) randomised controlled trial. BMC Med Res Methodology 20, 272 (10.1186/s12874-020-01149-x)

CONSULT

As part of CONSULT, we carried out interviews with researchers and healthcare professionals to identify barriers and facilitators to conducting trials involving adults lacking the capacity to consent. We produced several recommendations for research practice and future research aimed at funders, research ethics committees, policy/governance/infrastructure leads, trial teams, and research staff who recruit participants

Read more: Shepherd, V., Hood, K. and Wood, F. 2022. Unpacking the 'black box of horrendousness': a qualitative exploration of the barriers and facilitators to conducting trials involving adults lacking capacity to consent. Trials 23, article number: 471. (10.1186/s13063-022-06422-6)

Qualitative Research Network (QRN) Meetings

The QRG run a Qualitative Research Network (QRN) open to staff and students from across Cardiff University and external organisations. The Network meets online every two months. Members are invited to use this informal, collaborative space to present research findings, share ideas or questions relating to the broad field of qualitative research, and receive feedback and advice on study design or methodological approaches.

In previous meetings we have discussed research on patient experiences of dementia, explored the use of qualitative research methods during the COVID-19 pandemic (in collaboration with the Medicine, Science and Culture group), discussed the social impact of diagnostic labels in psychiatry, and helped inform the design of research on communication in neonatal care.

The network is open to anyone with an interest in qualitative research. To join the network and receive information on future meetings, contact the network lead, Dr Heather Strange. CTR-Qualitative@cardiff.ac.uk.