Found in Translation: Reflections and Lessons for Qualitative Research Collaborations Across Language and Culture

Pratt B.

To promote social justice and equity, global health research should meaningfully engage communities throughout projects: from setting agendas onwards. But communities, especially those that are considered disadvantaged or marginalised, rarely have a say in the priorities of the research projects that aim to help them. So far, there remains limited ethical guidance and resources on how to share power with communities in health research priority-setting. This paper presents an “ethical toolkit” for academic researchers and their community partners to use to design priority-setting processes that meaningfully include the communities impacted by their projects. An empirical reflective equilibrium approach was employed to develop the toolkit. Conceptual work articulated ethical considerations related to sharing power in g0l0o0bal health research priority-setting, developed guidance on how to address them, and created an initial version of the toolkit. Empirical work (51 in-depth interviews, 1 focus group, 2 case studies in India and the Philippines) conducted in 2018 and 2019 then tested those findings against information from global health research practice. The final ethical toolkit is a reflective project planning aid. It consists of 4 worksheets (Worksheet 1- Selecting Partners; Worksheet 2- Deciding to Partner; Worksheet 3- Deciding to Engage with the Wider Community; Worksheet 4- Designing Priority-setting) and a Companion Document detailing how to use them. Reflecting on and discussing the questions in Worksheets 1 to 4 before priority-setting will help deliver priority-setting processes that share power with communities and projects with research topics and questions that more accurately reflect their healthcare and system needs.

Zaman M., Afridi G., Ohly H., McArdle H.J., Lowe N.M.

Abstract The Oxford Handbook of Qualitative Research, second edition, presents a comprehensive retrospective and prospective review of the field of qualitative research. Original, accessible chapters written by interdisciplinary leaders in the field make this a critical reference work. Filled with robust examples from real-world research; ample discussion of the historical, theoretical, and methodological foundations of the field; and coverage of key issues including data collection, interpretation, representation, assessment, and teaching, this handbook aims to be a valuable text for students, professors, and researchers. This newly revised and expanded edition features up-to-date examples and topics, including seven new chapters on duoethnography, team research, writing ethnographically, creative approaches to writing, writing for performance, writing for the public, and teaching qualitative research.

Byskov M.F.

Rodriguez Espinosa P., Chen Y., Sun C., You S., Lin J., Chen K., Hsing A.W., Heaney C.A.

Our aim was to explore the concepts of health and well-being from the point of view of the people experiencing them. Most of the efforts to understand these concepts have focused on disease prevention and treatment. Less is known about how individuals achieve health and well-being, and their roles in the pursuit of a good life. We hoped to identify important components of these concepts that may provide new targets and messages to strengthen existing public health programs. An improved understanding of health and well-being - or what it means to be well - can guide interventions that help people lead healthier, more fulfilling lives. Using a grounded qualitative approach drawing from narrative inquiry, we interviewed 24 Taiwanese adults. Thematic inductive coding was employed to explore the nature of health and well-being. Eight constituent domains emerged regarding well-being and health. While the same domains were found for both constructs, important frequency differences were found when participants discussed health versus well-being. Physical health and lifestyle behaviors emerged as key domains for health. Disease-related comments were the most frequently mentioned sub-category within the physical health domain, along with health care use and aging-related changes. For well-being, family and finances emerged as key domains. Family appears to be a cornerstone element of well-being in this sample, with participants often describing their personal well-being as closely tied to - and often indistinguishable from - their family. Other domains included work-life, sense of self, resilience, and religion/spirituality. Health and well-being are complex and multifaceted constructs, with participants discussing their constituent domains in a very interconnected manner. Programs and policies intended to promote health and well-being may benefit from considering these domains as culturally-appropriate leverage points to bring about change. Additionally, while the domains identified in this study are person-centered (i.e., reflecting the personal experiences of participants), the stories that participants offered provided insights into how well-being and health are influenced by structural, societal and cultural factors. Our findings also offer an opportunity for future refinement and rethinking of existing measurement tools surrounding these constructs.

Vujčić M.T., Brajša-Žganec A., Franc R.

The main purpose of the present study was to examine children and young people’s (CYP) perspectives on well-being. In order to gain an in-depth understanding of the mechanisms through which CYP can flourish, it is necessary to examine the positive indicators of well-being in addition to negative aspects of childhood and adolescence. In doing so, it is important to understand the meanings CYP attach to well-being. We performed 10 semi-structured interviews and 2 focus groups with children (10–12 years old) and adolescents (15–16 years old) in 2 contrasting schools (different types with different background pupils). We also performed 10 semi-structured interviews and 2 focus groups with young people (16–19 years old) who are representative of different social groups and different levels of civic engagement. The participants of the study were gender balanced. The study strictly followed all of the relevant ethical standards related to research involving CYP. The results of this qualitative study provided a better insight into CYP’s global understanding of well-being, happiness, and life satisfaction by revealing how CYP themselves experience different aspects of well-being, and what they think are the most relevant factors that determine their well-being. The study also demonstrated how the CYP’s family, friends, school, environment, health, and material issues determine their well-being. These findings can be used to address and optimized specific difficulties and challenges of investigating children’s and young people’s well-being.

Pelzang R., Hutchinson A.M.

This article contributes to the growing body of literature on the methods and techniques that might be used to help ensure the cultural integrity and rigor of research that has a cross-cultural dimension. Drawing upon our experiences while conducting a study investigating patient safety concerns in Bhutan, we will reflect on how the study was conceptualized and framed around the elements of the Bhutanese traditional cultural values; how the researchers were positioned; and how the intercultural perceptions, representations, languages, and attitudes influenced the fieldwork processes. It is anticipated that the approach described in this article will help qualitative researchers to understand how important it is to recognize and be responsive to the cultural and linguistic nuances of given research settings to achieve cultural integrity.

Chiumento A., Rahman A., Machin L., Frith L.

Given increasing globalisation, the continuing prevalence of emergencies, and the importance of rigorous research to ensure the mental health needs of populations exposed to emergencies are effectively met, cross-language research will continue to arise. Drawing upon the lead author’s experience of conducting a cross-language qualitative study in three post-conflict settings in South Asia, this article discusses methodological considerations raised when interviewing with interpreters. These include considering interpreter positionality and matching; the approach to cross-language mediation during interviews; and assessing the quality of interpreter facilitated interviews. Drawing upon approaches taken in this study, the important choices researchers face about how these are managed are examined, considering the roles of researcher and interpreter positionality, the research context, and the epistemological underpinnings of the research. The discussion further illuminates the interrelated methodological, practical and ethical considerations for other researchers embarking upon similar research.

Parker M., Kingori P.

There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much discussion of these in the literature. Little, if any, attention has been paid, however, to the factors identified by scientists and other research actors as important to successful research collaboration. This is surprising given that their decisions are likely to play a key role in the sustainability and effectiveness of global health research initiatives. In this paper, we report on qualitative research with leading scientists involved in major international research collaborations about their views on good and bad collaborations and the factors that inform their decision-making about joining and participating actively in research networks. We identify and discuss eight factors that researchers see as essential in judging the merits of active participation in global health research collaborations: opportunities for active involvement in cutting-edge, interesting science; effective leadership; competence of potential partners in and commitment to good scientific practice; capacity building; respect for the needs, interests and agendas of partners; opportunities for discussion and disagreement; trust and confidence; and, justice and fairness in collaboration. Our findings suggest that the sustainability and effectiveness of global health research collaborations has an important ethical or moral dimension for the research actors involved.

Suwankhong D., Liamputtong P.

The status of the insider and outsider is an important concept for cross-cultural research. Being a cultural insider is recognized as a strength that allows the researcher to take part in the everyday lives of local people and to get closer to the participants. We explore these issues using examples from our own research with Thai people in southern Thailand and in Melbourne, Australia. We suggest that insider status has an impact on whether the researchers can conduct successful fieldwork and obtain in-depth understanding of the phenomenon being investigated. Being an insider enables a researcher to conduct research more sensitively. It helps in gaining a deeper understanding of the sociocultural contexts of the research setting. However, there are also challenges associated with insider status. These include the need to reestablish our position in a community, our assumptions about what the participants tell us, and participants’ expectations about us. This article provides case examples for researchers who are interested in conducting research, particularly within the Thai context. It should contribute to a conceptual understanding of real life experiences in a cross-cultural context in general.

Behr D.

Open-ended probing questions in cross-cultural surveys help uncover equivalence problems in cross-cultural survey research. For languages that a project team does not understand, probe answers need to be translated into a common project language. This article presents a case study on translating open-ended, that is, narrative answers. It describes how the translation can be approached to obtain high-quality translations and how translation, coding of answers, and analysis of codes are all deeply interwoven. While the translation of narrative answers is a small field of application, the article’s content is also relevant for those who are increasingly setting up cross-cultural cognitive interviewing or for qualitative researchers in general who pay increased attention to the translation of qualitative research data.

Braun V., Clarke V.

The field of health and wellbeing scholarship has a strong tradition of qualitative research*and rightly so. Qualitative research offers rich and compelling insights into the real worlds, experiences, and perspectives of patients and health care professionals in ways that are completely different to, but also sometimes complimentary to, the knowledge we can obtain through quantitative methods. (Published: 16 October 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 26152 - http://dx.doi.org/10.3402/qhw.v9.26152

Thrasher J.F., Quah A.C., Dominick G., Borland R., Driezen P., Awang R., Omar M., Hosking W., Sirirassamee B., Boado M.

This study examined and compared results from two questionnaire pretesting methods (i.e., behavioral coding and cognitive interviewing [CI]) to assess systematic measurement bias in survey questions for adult smokers across six countries (United States, Australia, Uruguay, Mexico, Malaysia, and Thailand). Protocol development and translation involved multiple bilingual partners in each linguistic/cultural group. The study was conducted with convenience samples of 20 adult smokers in each country. Behavioral coding and CI methods produced similar conclusions regarding measurement bias for some questions; however, CI was more likely to identify potential response errors than behavioral coding. Coordinated qualitative pretesting of survey questions (or postsurvey evaluation) is feasible across cultural groups and can provide important information on comprehension and comparability. The CI appears to be a more robust technique than behavioral coding, although combinations of the two might be even better.

Liamputtong P.

Cross-cultural research is rife with ethical and methodological challenges but, despite the increased demand for such research, discussions on 'culturally sensitive methodologies' are still largely neglected. Consequently, researchers often find themselves faced with difficulties but lack information on how to deal with them. This text provides an in-depth discussion on how to perform qualitative research in cross-cultural contexts with an emphasis on a more ethical, sensible and responsible approach. Pranee Liamputtong suggests culturally sensitive and appropriate research methods that would work well with cultural groups. She offers thought-provoking perspectives and diverse cultural examples which will be of value to both novice and experienced cross-cultural researchers. Throughout the volume there are references to the excellent work of many cross-cultural researchers who have paved the way in different social and cultural settings.

Wong J.P., Poon M.K.

Translation is an integral component of cross-cultural research that has remained invisible. It is commonly assumed that translation is an objective and neutral process, in which the translators are “technicians” in producing texts in different languages. Drawing from the field of translation studies and the findings of a translation exercise conducted with three bilingual Cantonese-English translators, the authors highlight some of the methodological issues about translation in cross-cultural qualitative research. They argue that only by making translation visible and through open dialogue can researchers uncover the richness embedded in the research data and facilitate multiple ways of knowing.

Glasdam S., Cathaoir K.Ó., Stjernswärd S.

International research collaborations engage multiple countries, researchers, and universities. This enhances the magnitude of contextual challenges, including legal and ethical dimensions across various jurisdictions, that must be bridged in qualitative research regardless of discipline, also in the construction of informed consents. From a Scandinavian perspective, this discussion paper explores challenges pertaining to the construction of informed consents related to EU data protection legislation, to which research institutions are subject when processing data related to EU residents. Next, it discusses challenges related to different traditions in terms of handling informed consent and research participants’ integrity, including the possibilities to waive anonymity in research. In international, multidisciplinary studies where researchers also operate in relatively ‘unknown territory’, it is especially important to be aware of and reflect on (inter)national possibilities and limitations related to laws, ethics, and culture/traditions in societies and within the academic fields. The variations in laws, ethical guidelines, and traditions in different countries demand that researchers are up to date with laws and ethical guidelines in the studied countries. Their practical implementation in the countries at stake in international, collaborative research endeavours are important, especially since such regulations and guidelines are far from static and change over time. The implementation of good ethical research practice requires democratic, reflexive, and responsive processes in all phases of research. Especially the preparation phase functions as a period to increase and ensure the knowledge and legal/ethical competences of the entire research team to meet the demands in the countries at stake.

Suavansri P., Pichayayothin N., Espinosa P.R., Areekit P., Nilchantuk C., Jones T.S., French J.J., Mam E., Moore J.B., Heaney C.A.

Well-being has long been recognized as a key construct in human history. Quantitative studies have been limited in their ability to uncover contextual and cultural nuances that can be leveraged to inform the promotion of well-being. The present study employed a qualitative approach informed by narrative inquiry to understand how individuals in a rapidly developing Asian country experience what it means to be well and what contributes to or detracts from their well-being. A purposeful sample of 50 Thai adults living in Bangkok shared their personal stories of times when they experienced high and low levels of well-being. Data were inductively coded and analysed to identify key domains of participants’ well-being and their inter-connections. The results reflect three layers of well-being. Social relationships (i.e., family, friends and acquaintances, and relationships at work or education) are at the center of well-being in Thailand, connecting and supporting a second layer of eight constituent domains of well-being (experience of emotions, sense of self, finances, self-care, demands and responsibilities, thoughts and feelings about the future, personal health, spirituality). The third layer is composed of the societal and physical contexts that are formative for well-being. Our findings suggest both universal and culturally unique components of well-being among Thai adults. Implications for the promotion of well-being in Thailand are discussed.