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Nature Reviews Methods Primers volume 2 , Article number: 73 ( 2022 ) Cite this article
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In-depth interviews are a versatile form of qualitative data collection used by researchers across the social sciences. They allow individuals to explain, in their own words, how they understand and interpret the world around them. Interviews represent a deceptively familiar social encounter in which people interact by asking and answering questions. They are, however, a very particular type of conversation, guided by the researcher and used for specific ends. This dynamic introduces a range of methodological, analytical and ethical challenges, for novice researchers in particular. In this Primer, we focus on the stages and challenges of designing and conducting an interview project and analysing data from it, as well as strategies to overcome such challenges.
Introduction.
In-depth interviews are a qualitative research method that follow a deceptively familiar logic of human interaction: they are conversations where people talk with each other, interact and pose and answer questions 1 . An interview is a specific type of interaction in which — usually and predominantly — a researcher asks questions about someone’s life experience, opinions, dreams, fears and hopes and the interview participant answers the questions 1 .
Interviews will often be used as a standalone method or combined with other qualitative methods, such as focus groups or ethnography, or quantitative methods, such as surveys or experiments. Although interviewing is a frequently used method, it should not be viewed as an easy default for qualitative researchers 2 . Interviews are also not suited to answering all qualitative research questions, but instead have specific strengths that should guide whether or not they are deployed in a research project. Whereas ethnography might be better suited to trying to observe what people do, interviews provide a space for extended conversations that allow the researcher insights into how people think and what they believe. Quantitative surveys also give these kinds of insights, but they use pre-determined questions and scales, privileging breadth over depth and often overlooking harder-to-reach participants.
In-depth interviews can take many different shapes and forms, often with more than one participant or researcher. For example, interviews might be highly structured (using an almost survey-like interview guide), entirely unstructured (taking a narrative and free-flowing approach) or semi-structured (using a topic guide ). Researchers might combine these approaches within a single project depending on the purpose of the interview and the characteristics of the participant. Whatever form the interview takes, researchers should be mindful of the dynamics between interviewer and participant and factor these in at all stages of the project.
In this Primer, we focus on the most common type of interview: one researcher taking a semi-structured approach to interviewing one participant using a topic guide. Focusing on how to plan research using interviews, we discuss the necessary stages of data collection. We also discuss the stages and thought-process behind analysing interview material to ensure that the richness and interpretability of interview material is maintained and communicated to readers. The Primer also tracks innovations in interview methods and discusses the developments we expect over the next 5–10 years.
We wrote this Primer as researchers from sociology, social policy and political science. We note our disciplinary background because we acknowledge that there are disciplinary differences in how interviews are approached and understood as a method.
Here we address research design considerations and data collection issues focusing on topic guide construction and other pragmatics of the interview. We also explore issues of ethics and reflexivity that are crucial throughout the research project.
Participant selection.
Participants can be selected and recruited in various ways for in-depth interview studies. The researcher must first decide what defines the people or social groups being studied. Often, this means moving from an abstract theoretical research question to a more precise empirical one. For example, the researcher might be interested in how people talk about race in contexts of diversity. Empirical settings in which this issue could be studied could include schools, workplaces or adoption agencies. The best research designs should clearly explain why the particular setting was chosen. Often there are both intrinsic and extrinsic reasons for choosing to study a particular group of people at a specific time and place 3 . Intrinsic motivations relate to the fact that the research is focused on an important specific social phenomenon that has been understudied. Extrinsic motivations speak to the broader theoretical research questions and explain why the case at hand is a good one through which to address them empirically.
Next, the researcher needs to decide which types of people they would like to interview. This decision amounts to delineating the inclusion and exclusion criteria for the study. The criteria might be based on demographic variables, like race or gender, but they may also be context-specific, for example, years of experience in an organization. These should be decided based on the research goals. Researchers should be clear about what characteristics would make an individual a candidate for inclusion in the study (and what would exclude them).
The next step is to identify and recruit the study’s sample . Usually, many more people fit the inclusion criteria than can be interviewed. In cases where lists of potential participants are available, the researcher might want to employ stratified sampling , dividing the list by characteristics of interest before sampling.
When there are no lists, researchers will often employ purposive sampling . Many researchers consider purposive sampling the most useful mode for interview-based research since the number of interviews to be conducted is too small to aim to be statistically representative 4 . Instead, the aim is not breadth, via representativeness, but depth via rich insights about a set of participants. In addition to purposive sampling, researchers often use snowball sampling . Both purposive and snowball sampling can be combined with quota sampling . All three types of sampling aim to ensure a variety of perspectives within the confines of a research project. A goal for in-depth interview studies can be to sample for range, being mindful of recruiting a diversity of participants fitting the inclusion criteria.
The total number of interviews depends on many factors, including the population studied, whether comparisons are to be made and the duration of interviews. Studies that rely on quota sampling where explicit comparisons are made between groups will require a larger number of interviews than studies focused on one group only. Studies where participants are interviewed over several hours, days or even repeatedly across years will tend to have fewer participants than those that entail a one-off engagement.
Researchers often stop interviewing when new interviews confirm findings from earlier interviews with no new or surprising insights (saturation) 4 , 5 , 6 . As a criterion for research design, saturation assumes that data collection and analysis are happening in tandem and that researchers will stop collecting new data once there is no new information emerging from the interviews. This is not always possible. Researchers rarely have time for systematic data analysis during data collection and they often need to specify their sample in funding proposals prior to data collection. As a result, researchers often draw on existing reports of saturation to estimate a sample size prior to data collection. These suggest between 12 and 20 interviews per category of participant (although researchers have reported saturation with samples that are both smaller and larger than this) 7 , 8 , 9 . The idea of saturation has been critiqued by many qualitative researchers because it assumes that meaning inheres in the data, waiting to be discovered — and confirmed — once saturation has been reached 7 . In-depth interview data are often multivalent and can give rise to different interpretations. The important consideration is, therefore, not merely how many participants are interviewed, but whether one’s research design allows for collecting rich and textured data that provide insight into participants’ understandings, accounts, perceptions and interpretations.
Sometimes, researchers will conduct interviews with more than one participant at a time. Researchers should consider the benefits and shortcomings of such an approach. Joint interviews may, for example, give researchers insight into how caregivers agree or debate childrearing decisions. At the same time, they may be less adaptive to exploring aspects of caregiving that participants may not wish to disclose to each other. In other cases, there may be more than one person interviewing each participant, such as when an interpreter is used, and so it is important to consider during the research design phase how this might shape the dynamics of the interview.
Semi-structured interviews are typically organized around a topic guide comprised of an ordered set of broad topics (usually 3–5). Each topic includes a set of questions that form the basis of the discussion between the researcher and participant (Fig. 1 ). These topics are organized around key concepts that the researcher has identified (for example, through a close study of prior research, or perhaps through piloting a small, exploratory study) 5 .
a | Elaborated topics the researcher wants to cover in the interview and example questions. b | An example topic arc. Using such an arc, one can think flexibly about the order of topics. Considering the main question for each topic will help to determine the best order for the topics. After conducting some interviews, the researcher can move topics around if a different order seems to make sense.
One common way to structure a topic guide is to start with relatively easy, open-ended questions (Table 1 ). Opening questions should be related to the research topic but broad and easy to answer, so that they help to ease the participant into conversation.
After these broad, opening questions, the topic guide may move into topics that speak more directly to the overarching research question. The interview questions will be accompanied by probes designed to elicit concrete details and examples from the participant (see Table 1 ).
Abstract questions are often easier for participants to answer once they have been asked more concrete questions. In our experience, for example, questions about feelings can be difficult for some participants to answer, but when following probes concerning factual experiences these questions can become less challenging. After the main themes of the topic guide have been covered, the topic guide can move onto closing questions. At this stage, participants often repeat something they have said before, although they may sometimes introduce a new topic.
Interviews are especially well suited to gaining a deeper insight into people’s experiences. Getting these insights largely depends on the participants’ willingness to talk to the researcher. We recommend designing open-ended questions that are more likely to elicit an elaborated response and extended reflection from participants rather than questions that can be answered with yes or no.
Questions should avoid foreclosing the possibility that the participant might disagree with the premise of the question. Take for example the question: “Do you support the new family-friendly policies?” This question minimizes the possibility of the participant disagreeing with the premise of this question, which assumes that the policies are ‘family-friendly’ and asks for a yes or no answer. Instead, asking more broadly how a participant feels about the specific policy being described as ‘family-friendly’ (for example, a work-from-home policy) allows them to express agreement, disagreement or impartiality and, crucially, to explain their reasoning 10 .
For an uninterrupted interview that will last between 90 and 120 minutes, the topic guide should be one to two single-spaced pages with questions and probes. Ideally, the researcher will memorize the topic guide before embarking on the first interview. It is fine to carry a printed-out copy of the topic guide but memorizing the topic guide ahead of the interviews can often make the interviewer feel well prepared in guiding the participant through the interview process.
Although the topic guide helps the researcher stay on track with the broad areas they want to cover, there is no need for the researcher to feel tied down by the topic guide. For instance, if a participant brings up a theme that the researcher intended to discuss later or a point the researcher had not anticipated, the researcher may well decide to follow the lead of the participant. The researcher’s role extends beyond simply stating the questions; it entails listening and responding, making split-second decisions about what line of inquiry to pursue and allowing the interview to proceed in unexpected directions.
The ideal place for an interview will depend on the study and what is feasible for participants. Generally, a place where the participant and researcher can both feel relaxed, where the interview can be uninterrupted and where noise or other distractions are limited is ideal. But this may not always be possible and so the researcher needs to be prepared to adapt their plans within what is feasible (and desirable for participants).
Another key tool for the interview is a recording device (assuming that permission for recording has been given). Recording can be important to capture what the participant says verbatim. Additionally, it can allow the researcher to focus on determining what probes and follow-up questions they want to pursue rather than focusing on taking notes. Sometimes, however, a participant may not allow the researcher to record, or the recording may fail. If the interview is not recorded we suggest that the researcher takes brief notes during the interview, if feasible, and then thoroughly make notes immediately after the interview and try to remember the participant’s facial expressions, gestures and tone of voice. Not having a recording of an interview need not limit the researcher from getting analytical value from it.
As soon as possible after each interview, we recommend that the researcher write a one-page interview memo comprising three key sections. The first section should identify two to three important moments from the interview. What constitutes important is up to the researcher’s discretion 9 . The researcher should note down what happened in these moments, including the participant’s facial expressions, gestures, tone of voice and maybe even the sensory details of their surroundings. This exercise is about capturing ethnographic detail from the interview. The second part of the interview memo is the analytical section with notes on how the interview fits in with previous interviews, for example, where the participant’s responses concur or diverge from other responses. The third part consists of a methodological section where the researcher notes their perception of their relationship with the participant. The interview memo allows the researcher to think critically about their positionality and practice reflexivity — key concepts for an ethical and transparent research practice in qualitative methodology 11 , 12 .
All elements of an in-depth interview can raise ethical challenges and concerns. Good ethical practice in interview studies often means going beyond the ethical procedures mandated by institutions 13 . While discussions and requirements of ethics can differ across disciplines, here we focus on the most pertinent considerations for interviews across the research process for an interdisciplinary audience.
Before conducting interviews, researchers should consider harm minimization, informed consent, anonymity and confidentiality, and reflexivity and positionality. It is important for the researcher to develop their own ethical sensitivities and sensibilities by gaining training in interview and qualitative methods, reading methodological and field-specific texts on interviews and ethics and discussing their research plans with colleagues.
Researchers should map the potential harm to consider how this can be minimized. Primarily, researchers should consider harm from the participants’ perspective (Box 1 ). But, it is also important to consider and plan for potential harm to the researcher, research assistants, gatekeepers, future researchers and members of the wider community 14 . Even the most banal of research topics can potentially pose some form of harm to the participant, researcher and others — and the level of harm is often highly context-dependent. For example, a research project on religion in society might have very different ethical considerations in a democratic versus authoritarian research context because of how openly or not such topics can be discussed and debated 15 .
The researcher should consider how they will obtain and record informed consent (for example, written or oral), based on what makes the most sense for their research project and context 16 . Some institutions might specify how informed consent should be gained. Regardless of how consent is obtained, the participant must be made aware of the form of consent, the intentions and procedures of the interview and potential forms of harm and benefit to the participant or community before the interview commences. Moreover, the participant must agree to be interviewed before the interview commences. If, in addition to interviews, the study contains an ethnographic component, it is worth reading around this topic (see, for example, Murphy and Dingwall 17 ). Informed consent must also be gained for how the interview will be recorded before the interview commences. These practices are important to ensure the participant is contributing on a voluntary basis. It is also important to remind participants that they can withdraw their consent at any time during the interview and for a specified period after the interview (to be decided with the participant). The researcher should indicate that participants can ask for anything shared to be off the record and/or not disseminated.
In terms of anonymity and confidentiality, it is standard practice when conducting interviews to agree not to use (or even collect) participants’ names and personal details that are not pertinent to the study. Anonymizing can often be the safer option for minimizing harm to participants as it is hard to foresee all the consequences of de-anonymizing, even if participants agree. Regardless of what a researcher decides, decisions around anonymity must be agreed with participants during the process of gaining informed consent and respected following the interview.
Although not all ethical challenges can be foreseen or planned for 18 , researchers should think carefully — before the interview — about power dynamics, participant vulnerability, emotional state and interactional dynamics between interviewer and participant, even when discussing low-risk topics. Researchers may then wish to plan for potential ethical issues, for example by preparing a list of relevant organizations to which participants can be signposted. A researcher interviewing a participant about debt, for instance, might prepare in advance a list of debt advice charities, organizations and helplines that could provide further support and advice. It is important to remember that the role of an interviewer is as a researcher rather than as a social worker or counsellor because researchers may not have relevant and requisite training in these other domains.
Social: researchers should avoid causing any relational detriment to anyone in the course of interviews, for example, by sharing information with other participants or causing interview participants to be shunned or mistreated by their community as a result of participating.
Economic: researchers should avoid causing financial detriment to anyone, for example, by expecting them to pay for transport to be interviewed or to potentially lose their job as a result of participating.
Physical: researchers should minimize the risk of anyone being exposed to violence as a result of the research both from other individuals or from authorities, including police.
Psychological: researchers should minimize the risk of causing anyone trauma (or re-traumatization) or psychological anguish as a result of the research; this includes not only the participant but importantly the researcher themselves and anyone that might read or analyse the transcripts, should they contain triggering information.
Political: researchers should minimize the risk of anyone being exposed to political detriment as a result of the research, such as retribution.
Professional/reputational: researchers should minimize the potential for reputational damage to anyone connected to the research (this includes ensuring good research practices so that any researchers involved are not harmed reputationally by being involved with the research project).
The task here is not to map exhaustively the potential forms of harm that might pertain to a particular research project (that is the researcher’s job and they should have the expertise most suited to mapping such potential harms relative to the specific project) but to demonstrate the breadth of potential forms of harm.
Researchers should consider how interview data are stored, analysed and disseminated. If participants have been offered anonymity and confidentiality, data should be stored in a way that does not compromise this. For example, researchers should consider removing names and any other unnecessary personal details from interview transcripts, password-protecting and encrypting files and using pseudonyms to label and store all interview data. It is also important to address where interview data are taken (for example, across borders in particular where interview data might be of interest to local authorities) and how this might affect the storage of interview data.
Examining how the researcher will represent participants is a paramount ethical consideration both in the planning stages of the interview study and after it has been conducted. Dissemination strategies also need to consider questions of anonymity and representation. In small communities, even if participants are given pseudonyms, it might be obvious who is being described. Anonymizing not only the names of those participating but also the research context is therefore a standard practice 19 . With particularly sensitive data or insights about the participant, it is worth considering describing participants in a more abstract way rather than as specific individuals. These practices are important both for protecting participants’ anonymity but can also affect the ability of the researcher and others to return ethically to the research context and similar contexts 20 .
Reflexivity and positionality mean considering the researcher’s role and assumptions in knowledge production 13 . A key part of reflexivity is considering the power relations between the researcher and participant within the interview setting, as well as how researchers might be perceived by participants. Further, researchers need to consider how their own identities shape the kind of knowledge and assumptions they bring to the interview, including how they approach and ask questions and their analysis of interviews (Box 2 ). Reflexivity is a necessary part of developing ethical sensibility as a researcher by adapting and reflecting on how one engages with participants. Participants should not feel judged, for example, when they share information that researchers might disagree with or find objectionable. How researchers deal with uncomfortable moments or information shared by participants is at their discretion, but they should consider how they will react both ahead of time and in the moment.
Researchers can develop their reflexivity by considering how they themselves would feel being asked these interview questions or represented in this way, and then adapting their practice accordingly. There might be situations where these questions are not appropriate in that they unduly centre the researchers’ experiences and worldview. Nevertheless, these prompts can provide a useful starting point for those beginning their reflexive journey and developing an ethical sensibility.
Reflexivity and ethical sensitivities require active reflection throughout the research process. For example, researchers should take care in interview memos and their notes to consider their assumptions, potential preconceptions, worldviews and own identities prior to and after interviews (Box 2 ). Checking in with assumptions can be a way of making sure that researchers are paying close attention to their own theoretical and analytical biases and revising them in accordance with what they learn through the interviews. Researchers should return to these notes (especially when analysing interview material), to try to unpack their own effects on the research process as well as how participants positioned and engaged with them.
For reflexive engagement, and understanding the power relations being co-constructed and (re)produced in interviews, it is necessary to reflect, at a minimum, on the following.
Ethnicity, race and nationality, such as how does privilege stemming from race or nationality operate between the researcher, the participant and research context (for example, a researcher from a majority community may be interviewing a member of a minority community)
Gender and sexuality, see above on ethnicity, race and nationality
Social class, and in particular the issue of middle-class bias among researchers when formulating research and interview questions
Economic security/precarity, see above on social class and thinking about the researcher’s relative privilege and the source of biases that stem from this
Educational experiences and privileges, see above
Disciplinary biases, such as how the researcher’s discipline/subfield usually approaches these questions, possibly normalizing certain assumptions that might be contested by participants and in the research context
Political and social values
Lived experiences and other dimensions of ourselves that affect and construct our identity as researchers
In this section, we discuss the next stage of an interview study, namely, analysing the interview data. Data analysis may begin while more data are being collected. Doing so allows early findings to inform the focus of further data collection, as part of an iterative process across the research project. Here, the researcher is ultimately working towards achieving coherence between the data collected and the findings produced to answer successfully the research question(s) they have set.
The two most common methods used to analyse interview material across the social sciences are thematic analysis 21 and discourse analysis 22 . Thematic analysis is a particularly useful and accessible method for those starting out in analysis of qualitative data and interview material as a method of coding data to develop and interpret themes in the data 21 . Discourse analysis is more specialized and focuses on the role of discourse in society by paying close attention to the explicit, implicit and taken-for-granted dimensions of language and power 22 , 23 . Although thematic and discourse analysis are often discussed as separate techniques, in practice researchers might flexibly combine these approaches depending on the object of analysis. For example, those intending to use discourse analysis might first conduct thematic analysis as a way to organize and systematize the data. The object and intention of analysis might differ (for example, developing themes or interrogating language), but the questions facing the researcher (such as whether to take an inductive or deductive approach to analysis) are similar.
Data preparation is an important step in the data analysis process. The researcher should first determine what comprises the corpus of material and in what form it will it be analysed. The former refers to whether, for example, alongside the interviews themselves, analytic memos or observational notes that may have been taken during data collection will also be directly analysed. The latter refers to decisions about how the verbal/audio interview data will be transformed into a written form, making it suitable for processes of data analysis. Typically, interview audio recordings are transcribed to produce a written transcript. It is important to note that the process of transcription is one of transformation. The verbal interview data are transformed into a written transcript through a series of decisions that the researcher must make. The researcher should consider the effect of mishearing what has been said or how choosing to punctuate a sentence in a particular way will affect the final analysis.
Box 3 shows an example transcript excerpt from an interview with a teacher conducted by Teeger as part of her study of history education in post-apartheid South Africa 24 (Box 3 ). Seeing both the questions and the responses means that the reader can contextualize what the participant (Ms Mokoena) has said. Throughout the transcript the researcher has used square brackets, for example to indicate a pause in speech, when Ms Mokoena says “it’s [pause] it’s a difficult topic”. The transcription choice made here means that we see that Ms Mokoena has taken time to pause, perhaps to search for the right words, or perhaps because she has a slight apprehension. Square brackets are also included as an overt act of communication to the reader. When Ms Mokoena says “ja”, the English translation (“yes”) of the word in Afrikaans is placed in square brackets to ensure that the reader can follow the meaning of the speech.
Decisions about what to include when transcribing will be hugely important for the direction and possibilities of analysis. Researchers should decide what they want to capture in the transcript, based on their analytic focus. From a (post)positivist perspective 25 , the researcher may be interested in the manifest content of the interview (such as what is said, not how it is said). In that case, they may choose to transcribe intelligent verbatim . From a constructivist perspective 25 , researchers may choose to record more aspects of speech (including, for example, pauses, repetitions, false starts, talking over one another) so that these features can be analysed. Those working from this perspective argue that to recognize the interactional nature of the interview setting adequately and to avoid misinterpretations, features of interaction (pauses, overlaps between speakers and so on) should be preserved in transcription and therefore in the analysis 10 . Readers interested in learning more should consult Potter and Hepburn’s summary of how to present interaction through transcription of interview data 26 .
The process of analysing semi-structured interviews might be thought of as a generative rather than an extractive enterprise. Findings do not already exist within the interview data to be discovered. Rather, researchers create something new when analysing the data by applying their analytic lens or approach to the transcripts. At a high level, there are options as to what researchers might want to glean from their interview data. They might be interested in themes, whereby they identify patterns of meaning across the dataset 21 . Alternatively, they may focus on discourse(s), looking to identify how language is used to construct meanings and therefore how language reinforces or produces aspects of the social world 27 . Alternatively, they might look at the data to understand narrative or biographical elements 28 .
A further overarching decision to make is the extent to which researchers bring predetermined framings or understandings to bear on their data, or instead begin from the data themselves to generate an analysis. One way of articulating this is the extent to which researchers take a deductive approach or an inductive approach to analysis. One example of a truly inductive approach is grounded theory, whereby the aim of the analysis is to build new theory, beginning with one’s data 6 , 29 . In practice, researchers using thematic and discourse analysis often combine deductive and inductive logics and describe their process instead as iterative (referred to also as an abductive approach ) 30 , 31 . For example, researchers may decide that they will apply a given theoretical framing, or begin with an initial analytic framework, but then refine or develop these once they begin the process of analysis.
Interviewer : Maybe you could just start by talking about what it’s like to teach apartheid history.
Ms Mokoena : It’s a bit challenging. You’ve got to accommodate all the kids in the class. You’ve got to be sensitive to all the racial differences. You want to emphasize the wrongs that were done in the past but you also want to, you know, not to make kids feel like it’s their fault. So you want to use the wrongs of the past to try and unite the kids …
Interviewer : So what kind of things do you do?
Ms Mokoena : Well I normally highlight the fact that people that were struggling were not just the blacks, it was all the races. And I give examples of the people … from all walks of life, all races, and highlight how they suffered as well as a result of apartheid, particularly the whites… . What I noticed, particularly my first year of teaching apartheid, I noticed that the black kids made the others feel responsible for what happened… . I had a lot of fights…. A lot of kids started hating each other because, you know, the others are white and the others were black. And they started saying, “My mother is a domestic worker because she was never allowed an opportunity to get good education.” …
Interviewer : I didn’t see any of that now when I was observing.
Ms Mokoena : … Like I was saying I think that because of the re-emphasis of the fact that, look, everybody did suffer one way or the other, they sort of got to see that it was everybody’s struggle … . They should now get to understand that that’s why we’re called a Rainbow Nation. Not everybody agreed with apartheid and not everybody suffered. Even all the blacks, not all blacks got to feel what the others felt . So ja [yes], it’s [pause] it’s a difficult topic, ja . But I think if you get the kids to understand why we’re teaching apartheid in the first place and you show the involvement of all races in all the different sides , then I think you have managed to teach it properly. So I think because of my inexperience then — that was my first year of teaching history — so I think I — maybe I over-emphasized the suffering of the blacks versus the whites [emphasis added].
Reprinted with permission from ref. 24 , Sage Publications.
Coding data is a key building block shared across many approaches to data analysis. Coding is a way of organizing and describing data, but is also ultimately a way of transforming data to produce analytic insights. The basic practice of coding involves highlighting a segment of text (this may be a sentence, a clause or a longer excerpt) and assigning a label to it. The aim of the label is to communicate some sort of summary of what is in the highlighted piece of text. Coding is an iterative process, whereby researchers read and reread their transcripts, applying and refining their codes, until they have a coding frame (a set of codes) that is applied coherently across the dataset and that captures and communicates the key features of what is contained in the data as it relates to the researchers’ analytic focus.
What one codes for is entirely contingent on the focus of the research project and the choices the researcher makes about the approach to analysis. At first, one might apply descriptive codes, summarizing what is contained in the interviews. It is rarely desirable to stop at this point, however, because coding is a tool to move from describing the data to interpreting the data. Suppose the researcher is pursuing some version of thematic analysis. In that case, it might be that the objects of coding are aspects of reported action, emotions, opinions, norms, relationships, routines, agreement/disagreement and change over time. A discourse analysis might instead code for different types of speech acts, tropes, linguistic or rhetorical devices. Multiple types of code might be generated within the same research project. What is important is that researchers are aware of the choices they are making in terms of what they are coding for. Moreover, through the process of refinement, the aim is to produce a set of discrete codes — in which codes are conceptually distinct, as opposed to overlapping. By using the same codes across the dataset, the researcher can capture commonalities across the interviews. This process of refinement involves relabelling codes and reorganizing how and where they are applied in the dataset.
Data analysis is also an iterative process in which researchers move closer to and further away from the data. As they move away from the data, they synthesize their findings, thus honing and articulating their analytic insights. As they move closer to the data, they ground these insights in what is contained in the interviews. The link should not be broken between the data themselves and higher-order conceptual insights or claims being made. Researchers must be able to show evidence for their claims in the data. Figure 2 summarizes this iterative process and suggests the sorts of activities involved at each stage more concretely.
As well as going through steps 1 to 6 in order, the researcher will also go backwards and forwards between stages. Some stages will themselves be a forwards and backwards processing of coding and refining when working across different interview transcripts.
At the stage of synthesizing, there are some common quandaries. When dealing with a dataset consisting of multiple interviews, there will be salient and minority statements across different participants, or consensus or dissent on topics of interest to the researcher. A strength of qualitative interviews is that we can build in these nuances and variations across our data as opposed to aggregating them away. When exploring and reporting data, researchers should be asking how different findings are patterned and which interviews contain which codes, themes or tropes. Researchers should think about how these variations fit within the longer flow of individual interviews and what these variations tell them about the nature of their substantive research interests.
A further consideration is how to approach analysis within and across interview data. Researchers may look at one individual code, to examine the forms it takes across different participants and what they might be able to summarize about this code in the round. Alternatively, they might look at how a code or set of codes pattern across the account of one participant, to understand the code(s) in a more contextualized way. Further analysis might be done according to different sampling characteristics, where researchers group together interviews based on certain demographic characteristics and explore these together.
When it comes to writing up and presenting interview data, key considerations tend to rest on what is often termed transparency. When presenting the findings of an interview-based study, the reader should be able to understand and trace what the stated findings are based upon. This process typically involves describing the analytic process, how key decisions were made and presenting direct excerpts from the data. It is important to account for how the interview was set up and to consider the active part that the researcher has played in generating the data 32 . Quotes from interviews should not be thought of as merely embellishing or adding interest to a final research output. Rather, quotes serve the important function of connecting the reader directly to the underlying data. Quotes, therefore, should be chosen because they provide the reader with the most apt insight into what is being discussed. It is good practice to report not just on what participants said, but also on the questions that were asked to elicit the responses.
Researchers have increasingly used specialist qualitative data analysis software to organize and analyse their interview data, such as NVivo or ATLAS.ti. It is important to remember that such software is a tool for, rather than an approach or technique of, analysis. That said, software also creates a wide range of possibilities in terms of what can be done with the data. As researchers, we should reflect on how the range of possibilities of a given software package might be shaping our analytical choices and whether these are choices that we do indeed want to make.
This section reviews how and why in-depth interviews have been used by researchers studying gender, education and inequality, nationalism and ethnicity and the welfare state. Although interviews can be employed as a method of data collection in just about any social science topic, the applications below speak directly to the authors’ expertise and cutting-edge areas of research.
When it comes to the broad study of gender, in-depth interviews have been invaluable in shaping our understanding of how gender functions in everyday life. In a study of the US hedge fund industry (an industry dominated by white men), Tobias Neely was interested in understanding the factors that enable white men to prosper in the industry 33 . The study comprised interviews with 45 hedge fund workers and oversampled women of all races and men of colour to capture a range of experiences and beliefs. Tobias Neely found that practices of hiring, grooming and seeding are key to maintaining white men’s dominance in the industry. In terms of hiring, the interviews clarified that white men in charge typically preferred to hire people like themselves, usually from their extended networks. When women were hired, they were usually hired to less lucrative positions. In terms of grooming, Tobias Neely identifies how older and more senior men in the industry who have power and status will select one or several younger men as their protégés, to include in their own elite networks. Finally, in terms of her concept of seeding, Tobias Neely describes how older men who are hedge fund managers provide the seed money (often in the hundreds of millions of dollars) for a hedge fund to men, often their own sons (but not their daughters). These interviews provided an in-depth look into gendered and racialized mechanisms that allow white men to flourish in this industry.
Research by Rao draws on dozens of interviews with men and women who had lost their jobs, some of the participants’ spouses and follow-up interviews with about half the sample approximately 6 months after the initial interview 34 . Rao used interviews to understand the gendered experience and understanding of unemployment. Through these interviews, she found that the very process of losing their jobs meant different things for men and women. Women often saw job loss as being a personal indictment of their professional capabilities. The women interviewed often referenced how years of devaluation in the workplace coloured their interpretation of their job loss. Men, by contrast, were also saddened by their job loss, but they saw it as part and parcel of a weak economy rather than a personal failing. How these varied interpretations occurred was tied to men’s and women’s very different experiences in the workplace. Further, through her analysis of these interviews, Rao also showed how these gendered interpretations had implications for the kinds of jobs men and women sought to pursue after job loss. Whereas men remained tied to participating in full-time paid work, job loss appeared to be a catalyst pushing some of the women to re-evaluate their ties to the labour force.
In a study of workers in the tech industry, Hart used interviews to explain how individuals respond to unwanted and ambiguously sexual interactions 35 . Here, the researcher used interviews to allow participants to describe how these interactions made them feel and act and the logics of how they interpreted, classified and made sense of them 35 . Through her analysis of these interviews, Hart showed that participants engaged in a process she termed “trajectory guarding”, whereby they sought to monitor unwanted and ambiguously sexual interactions to avoid them from escalating. Yet, as Hart’s analysis proficiently demonstrates, these very strategies — which protect these workers sexually — also undermined their workplace advancement.
Drawing on interviews, these studies have helped us to understand better how gendered mechanisms, gendered interpretations and gendered interactions foster gender inequality when it comes to paid work. Methodologically, these studies illuminate the power of interviews to reveal important aspects of social life.
Traditionally, nationalism has been studied from a top-down perspective, through the lens of the state or using historical methods; in other words, in-depth interviews have not been a common way of collecting data to study nationalism. The methodological turn towards everyday nationalism has encouraged more scholars to go to the field and use interviews (and ethnography) to understand nationalism from the bottom up: how people talk about, give meaning, understand, navigate and contest their relation to nation, national identification and nationalism 36 , 37 , 38 , 39 . This turn has also addressed the gap left by those studying national and ethnic identification via quantitative methods, such as surveys.
Surveys can enumerate how individuals ascribe to categorical forms of identification 40 . However, interviews can question the usefulness of such categories and ask whether these categories are reflected, or resisted, by participants in terms of the meanings they give to identification 41 , 42 . Categories often pitch identification as a mutually exclusive choice; but identification might be more complex than such categories allow. For example, some might hybridize these categories or see themselves as moving between and across categories 43 . Hearing how people talk about themselves and their relation to nations, states and ethnicities, therefore, contributes substantially to the study of nationalism and national and ethnic forms of identification.
One particular approach to studying these topics, whether via everyday nationalism or alternatives, is that of using interviews to capture both articulations and narratives of identification, relations to nationalism and the boundaries people construct. For example, interviews can be used to gather self–other narratives by studying how individuals construct I–we–them boundaries 44 , including how participants talk about themselves, who participants include in their various ‘we’ groupings and which and how participants create ‘them’ groupings of others, inserting boundaries between ‘I/we’ and ‘them’. Overall, interviews hold great potential for listening to participants and understanding the nuances of identification and the construction of boundaries from their point of view.
Scholars of social stratification have long noted that the school system often reproduces existing social inequalities. Carter explains that all schools have both material and sociocultural resources 45 . When children from different backgrounds attend schools with different material resources, their educational and occupational outcomes are likely to vary. Such material resources are relatively easy to measure. They are operationalized as teacher-to-student ratios, access to computers and textbooks and the physical infrastructure of classrooms and playgrounds.
Drawing on Bourdieusian theory 46 , Carter conceptualizes the sociocultural context as the norms, values and dispositions privileged within a social space 45 . Scholars have drawn on interviews with students and teachers (as well as ethnographic observations) to show how schools confer advantages on students from middle-class families, for example, by rewarding their help-seeking behaviours 47 . Focusing on race, researchers have revealed how schools can remain socioculturally white even as they enrol a racially diverse student population. In such contexts, for example, teachers often misrecognize the aesthetic choices made by students of colour, wrongly inferring that these students’ tastes in clothing and music reflect negative orientations to schooling 48 , 49 , 50 . These assessments can result in disparate forms of discipline and may ultimately shape educators’ assessments of students’ academic potential 51 .
Further, teachers and administrators tend to view the appropriate relationship between home and school in ways that resonate with white middle-class parents 52 . These parents are then able to advocate effectively for their children in ways that non-white parents are not 53 . In-depth interviews are particularly good at tapping into these understandings, revealing the mechanisms that confer privilege on certain groups of students and thereby reproduce inequality.
In addition, interviews can shed light on the unequal experiences that young people have within educational institutions, as the views of dominant groups are affirmed while those from disadvantaged backgrounds are delegitimized. For example, Teeger’s interviews with South African high schoolers showed how — because racially charged incidents are often framed as jokes in the broader school culture — Black students often feel compelled to ignore and keep silent about the racism they experience 54 . Interviews revealed that Black students who objected to these supposed jokes were coded by other students as serious or angry. In trying to avoid such labels, these students found themselves unable to challenge the racism they experienced. Interviews give us insight into these dynamics and help us see how young people understand and interpret the messages transmitted in schools — including those that speak to issues of inequality in their local school contexts as well as in society more broadly 24 , 55 .
In-depth interviews have also proved to be an important method for studying various aspects of the welfare state. By welfare state, we mean the social institutions relating to the economic and social wellbeing of a state’s citizens. Notably, using interviews has been useful to look at how policy design features are experienced and play out on the ground. Interviews have often been paired with large-scale surveys to produce mixed-methods study designs, therefore achieving both breadth and depth of insights.
In-depth interviews provide the opportunity to look behind policy assumptions or how policies are designed from the top down, to examine how these play out in the lives of those affected by the policies and whose experiences might otherwise be obscured or ignored. For example, the Welfare Conditionality project used interviews to critique the assumptions that conditionality (such as, the withdrawal of social security benefits if recipients did not perform or meet certain criteria) improved employment outcomes and instead showed that conditionality was harmful to mental health, living standards and had many other negative consequences 56 . Meanwhile, combining datasets from two small-scale interview studies with recipients allowed Summers and Young to critique assumptions around the simplicity that underpinned the design of Universal Credit in 2020, for example, showing that the apparently simple monthly payment design instead burdened recipients with additional money management decisions and responsibilities 57 .
Similarly, the Welfare at a (Social) Distance project used a mixed-methods approach in a large-scale study that combined national surveys with case studies and in-depth interviews to investigate the experience of claiming social security benefits during the COVID-19 pandemic. The interviews allowed researchers to understand in detail any issues experienced by recipients of benefits, such as delays in the process of claiming, managing on a very tight budget and navigating stigma and claiming 58 .
These applications demonstrate the multi-faceted topics and questions for which interviews can be a relevant method for data collection. These applications highlight not only the relevance of interviews, but also emphasize the key added value of interviews, which might be missed by other methods (surveys, in particular). Interviews can expose and question what is taken for granted and directly engage with communities and participants that might otherwise be ignored, obscured or marginalized.
There is a robust, ongoing debate about reproducibility in qualitative research, including interview studies. In some research paradigms, reproducibility can be a way of interrogating the rigour and robustness of research claims, by seeing whether these hold up when the research process is repeated. Some scholars have suggested that although reproducibility may be challenging, researchers can facilitate it by naming the place where the research was conducted, naming participants, sharing interview and fieldwork transcripts (anonymized and de-identified in cases where researchers are not naming people or places) and employing fact-checkers for accuracy 11 , 59 , 60 .
In addition to the ethical concerns of whether de-anonymization is ever feasible or desirable, it is also important to address whether the replicability of interview studies is meaningful. For example, the flexibility of interviews allows for the unexpected and the unforeseen to be incorporated into the scope of the research 61 . However, this flexibility means that we cannot expect reproducibility in the conventional sense, given that different researchers will elicit different types of data from participants. Sharing interview transcripts with other researchers, for instance, downplays the contextual nature of an interview.
Drawing on Bauer and Gaskell, we propose several measures to enhance rigour in qualitative research: transparency, grounding interpretations and aiming for theoretical transferability and significance 62 .
Researchers should be transparent when describing their methodological choices. Transparency means documenting who was interviewed, where and when (without requiring de-anonymization, for example, by documenting their characteristics), as well as the questions they were asked. It means carefully considering who was left out of the interviews and what that could mean for the researcher’s findings. It also means carefully considering who the researcher is and how their identity shaped the research process (integrating and articulating reflexivity into whatever is written up).
Second, researchers should ground their interpretations in the data. Grounding means presenting the evidence upon which the interpretation relies. Quotes and extracts should be extensive enough to allow the reader to evaluate whether the researcher’s interpretations are grounded in the data. At each step, researchers should carefully compare their own explanations and interpretations with alternative explanations. Doing so systematically and frequently allows researchers to become more confident in their claims. Here, researchers should justify the link between data and analysis by using quotes to justify and demonstrate the analytical point, while making sure the analytical point offers an interpretation of quotes (Box 4 ).
An important step in considering alternative explanations is to seek out disconfirming evidence 4 , 63 . This involves looking for instances where participants deviate from what the majority are saying and thus bring into question the theory (or explanation) that the researcher is developing. Careful analysis of such examples can often demonstrate the salience and meaning of what appears to be the norm (see Table 2 for examples) 54 . Considering alternative explanations and paying attention to disconfirming evidence allows the researcher to refine their own theories in respect of the data.
Finally, researchers should aim for theoretical transferability and significance in their discussions of findings. One way to think about this is to imagine someone who is not interested in the empirical study. Articulating theoretical transferability and significance usually takes the form of broadening out from the specific findings to consider explicitly how the research has refined or altered prior theoretical approaches. This process also means considering under what other conditions, aside from those of the study, the researcher thinks their theoretical revision would be supported by and why. Importantly, it also includes thinking about the limitations of one’s own approach and where the theoretical implications of the study might not hold.
In an article explaining how unemployed men frame their job loss as a pervasive experience, Rao writes the following: “Unemployed men in this study understood unemployment to be an expected aspect of paid work in the contemporary United States. Robert, a white unemployed communications professional, compared the economic landscape after the Great Recession with the tragic events of September 11, 2001:
Part of your post-9/11 world was knowing people that died as a result of terrorism. The same thing is true with the [Great] Recession, right? … After the Recession you know somebody who was unemployed … People that really should be working.
The pervasiveness of unemployment rendered it normal, as Robert indicates.”
Here, the link between the quote presented and the analytical point Rao is making is clear: the analytical point is grounded in a quote and an interpretation of the quote is offered 34 .
When deciding which research method to use, the key question is whether the method provides a good fit for the research questions posed. In other words, researchers should consider whether interviews will allow them to successfully access the social phenomena necessary to answer their question(s) and whether the interviews will do so more effectively than other methods. Table 3 summarizes the major strengths and limitations of interviews. However, the accompanying text below is organized around some key issues, where relative strengths and weaknesses are presented alongside each other, the aim being that readers should think about how these can be balanced and optimized in relation to their own research.
Achieving an overall breadth of insight, in a statistically representative sense, is not something that is possible or indeed desirable when conducting in-depth interviews. Instead, the strength of conducting interviews lies in their ability to generate various sorts of depth of insight. The experiences or views of participants that can be accessed by conducting interviews help us to understand participants’ subjective realities. The challenge, therefore, is for researchers to be clear about why depth of insight is the focus and what we should aim to glean from these types of insight.
Interviews make use of a form of interaction with which people are familiar 64 . By replicating a naturalistic form of interaction as a tool to gather social science data, researchers can capitalize on people’s familiarity and expectations of what happens in a conversation. This familiarity can also be a challenge, as people come to the interview with preconceived ideas about what this conversation might be for or about. People may draw on experiences of other similar conversations when taking part in a research interview (for example, job interviews, therapy sessions, confessional conversations, chats with friends). Researchers should be aware of such potential overlaps and think through their implications both in how the aims and purposes of the research interview are communicated to participants and in how interview data are interpreted.
Further, some argue that a limitation of interviews is that they are an artificial form of data collection. By taking people out of their daily lives and asking them to stand back and pass comment, we are creating a distance that makes it difficult to use such data to say something meaningful about people’s actions, experiences and views. Other approaches, such as ethnography, might be more suitable for tapping into what people actually do, as opposed to what they say they do 65 .
Interviews following a semi-structured format offer flexibility both to the researcher and the participant. As the conversation develops, the interlocutors can explore the topics raised in much more detail, if desired, or pass over ones that are not relevant. This flexibility allows for the unexpected and the unforeseen to be incorporated into the scope of the research.
However, this flexibility has a related challenge of replicability. Interviews cannot be reproduced because they are contingent upon the interaction between the researcher and the participant in that given moment of interaction. In some research paradigms, replicability can be a way of interrogating the robustness of research claims, by seeing whether they hold when they are repeated. This is not a useful framework to bring to in-depth interviews and instead quality criteria (such as transparency) tend to be employed as criteria of rigour.
Interviews have been recognized for their strength in accessing private, personal issues, which participants may feel more comfortable talking about in a one-to-one conversation. Furthermore, interviews are likely to take a more personable form with their extended questions and answers, perhaps making a participant feel more at ease when discussing sensitive topics in such a context. There is a similar, but separate, argument made about accessing what are sometimes referred to as vulnerable groups, who may be difficult to make contact with using other research methods.
There is an associated challenge of anonymity. There can be types of in-depth interview that make it particularly challenging to protect the identities of participants, such as interviewing within a small community, or multiple members of the same household. The challenge to ensure anonymity in such contexts is even more important and difficult when the topic of research is of a sensitive nature or participants are vulnerable.
Increasingly, researchers are collaborating in large-scale interview-based studies and integrating interviews into broader mixed-methods designs. At the same time, interviews can be seen as an old-fashioned (and perhaps outdated) mode of data collection. We review these debates and discussions and point to innovations in interview-based studies. These include the shift from face-to-face interviews to the use of online platforms, as well as integrating and adapting interviews towards more inclusive methodologies.
Qualitative researchers have long worked alone 66 . Increasingly, however, researchers are collaborating with others for reasons such as efficiency, institutional incentives (for example, funding for collaborative research) and a desire to pool expertise (for example, studying similar phenomena in different contexts 67 or via different methods). Collaboration can occur across disciplines and methods, cases and contexts and between industry/business, practitioners and researchers. In many settings and contexts, collaboration has become an imperative 68 .
Cheek notes how collaboration provides both advantages and disadvantages 68 . For example, collaboration can be advantageous, saving time and building on the divergent knowledge, skills and resources of different researchers. Scholars with different theoretical or case-based knowledge (or contacts) can work together to build research that is comparative and/or more than the sum of its parts. But such endeavours also carry with them practical and political challenges in terms of how resources might actually be pooled, shared or accounted for. When undertaking such projects, as Morse notes, it is worth thinking about the nature of the collaboration and being explicit about such a choice, its advantages and its disadvantages 66 .
A further tension, but also a motivation for collaboration, stems from integrating interviews as a method in a mixed-methods project, whether with other qualitative researchers (to combine with, for example, focus groups, document analysis or ethnography) or with quantitative researchers (to combine with, for example, surveys, social media analysis or big data analysis). Cheek and Morse both note the pitfalls of collaboration with quantitative researchers: that quality of research may be sacrificed, qualitative interpretations watered down or not taken seriously, or tensions experienced over the pace and different assumptions that come with different methods and approaches of research 66 , 68 .
At the same time, there can be real benefits of such mixed-methods collaboration, such as reaching different and more diverse audiences or testing assumptions and theories between research components in the same project (for example, testing insights from prior quantitative research via interviews, or vice versa), as long as the skillsets of collaborators are seen as equally beneficial to the project. Cheek provides a set of questions that, as a starting point, can be useful for guiding collaboration, whether mixed methods or otherwise. First, Cheek advises asking all collaborators about their assumptions and understandings concerning collaboration. Second, Cheek recommends discussing what each perspective highlights and focuses on (and conversely ignores or sidelines) 68 .
A different way to engage with the idea of collaboration and mixed methods research is by fostering greater collaboration between researchers in the Global South and Global North, thus reversing trends of researchers from the Global North extracting knowledge from the Global South 69 . Such forms of collaboration also align with interview innovations, discussed below, that seek to transform traditional interview approaches into more participatory and inclusive (as part of participatory methodologies).
The ongoing COVID-19 pandemic has centred the question of technology within interview-based fieldwork. Although conducting synchronous oral interviews online — for example, via Zoom, Skype or other such platforms — has been a method used by a small constituency of researchers for many years, it became (and remains) a necessity for many researchers wanting to continue or start interview-based projects while COVID-19 prevents face-to-face data collection.
In the past, online interviews were often framed as an inferior form of data collection for not providing the kinds of (often necessary) insights and forms of immersion face-to-face interviews allow 70 , 71 . Online interviews do tend to be more decontextualized than interviews conducted face-to-face 72 . For example, it is harder to recognize, engage with and respond to non-verbal cues 71 . At the same time, they broaden participation to those who might not have been able to access or travel to sites where interviews would have been conducted otherwise, for example people with disabilities. Online interviews also offer more flexibility in terms of scheduling and time requirements. For example, they provide more flexibility around precarious employment or caring responsibilities without having to travel and be away from home. In addition, online interviews might also reduce discomfort between researchers and participants, compared with face-to-face interviews, enabling more discussion of sensitive material 71 . They can also provide participants with more control, enabling them to turn on and off the microphone and video as they choose, for example, to provide more time to reflect and disconnect if they so wish 72 .
That said, online interviews can also introduce new biases based on access to technology 72 . For example, in the Global South, there are often urban/rural and gender gaps between who has access to mobile phones and who does not, meaning that some population groups might be overlooked unless researchers sample mindfully 71 . There are also important ethical considerations when deciding between online and face-to-face interviews. Online interviews might seem to imply lower ethical risks than face-to-face interviews (for example, they lower the chances of identification of participants or researchers), but they also offer more barriers to building trust between researchers and participants 72 . Interacting only online with participants might not provide the information needed to assess risk, for example, participants’ access to a private space to speak 71 . Just because online interviews might be more likely to be conducted in private spaces does not mean that private spaces are safe, for example, for victims of domestic violence. Finally, online interviews prompt further questions about decolonizing research and engaging with participants if research is conducted from afar 72 , such as how to include participants meaningfully and challenge dominant assumptions while doing so remotely.
A further digital innovation, modulating how researchers conduct interviews and the kinds of data collected and analysed, stems from the use and integration of (new) technology, such as WhatsApp text or voice notes to conduct synchronous or asynchronous oral or written interviews 73 . Such methods can provide more privacy, comfort and control to participants and make recruitment easier, allowing participants to share what they want when they want to, using technology that already forms a part of their daily lives, especially for young people 74 , 75 . Such technology is also emerging in other qualitative methods, such as focus groups, with similar arguments around greater inclusivity versus traditional offline modes. Here, the digital challenge might be higher for researchers than for participants if they are less used to such technology 75 . And while there might be concerns about the richness, depth and quality of written messages as a form of interview data, Gibson reports that the reams of transcripts that resulted from a study using written messaging were dense with meaning to be analysed 75 .
Like with online and face-to-face interviews, it is important also to consider the ethical questions and challenges of using such technology, from gaining consent to ensuring participant safety and attending to their distress, without cues, like crying, that might be more obvious in a face-to-face setting 75 , 76 . Attention to the platform used for such interviews is also important and researchers should be attuned to the local and national context. For example, in China, many platforms are neither legal nor available 76 . There, more popular platforms — like WeChat — can be highly monitored by the government, posing potential risks to participants depending on the topic of the interview. Ultimately, researchers should consider trade-offs between online and offline interview modalities, being attentive to the social context and power dynamics involved.
Continuing to integrate (ethically) this technology will be among the major persisting developments in interview-based research, whether to offer more flexibility to researchers or participants, or to diversify who can participate and on what terms.
Pushing the idea of inclusion even further is the potential for integrating interview-based studies within participatory methods, which are also innovating via integrating technology. There is no hard and fast line between researchers using in-depth interviews and participatory methods; many who employ participatory methods will use interviews at the beginning, middle or end phases of a research project to capture insights, perspectives and reflections from participants 77 , 78 . Participatory methods emphasize the need to resist existing power and knowledge structures. They broaden who has the right and ability to contribute to academic knowledge by including and incorporating participants not only as subjects of data collection, but as crucial voices in research design and data analysis 77 . Participatory methods also seek to facilitate local change and to produce research materials, whether for academic or non-academic audiences, including films and documentaries, in collaboration with participants.
In responding to the challenges of COVID-19, capturing the fraught situation wrought by the pandemic and the momentum to integrate technology, participatory researchers have sought to continue data collection from afar. For example, Marzi has adapted an existing project to co-produce participatory videos, via participants’ smartphones in Medellin, Colombia, alongside regular check-in conversations/meetings/interviews with participants 79 . Integrating participatory methods into interview studies offers a route by which researchers can respond to the challenge of diversifying knowledge, challenging assumptions and power hierarchies and creating more inclusive and collaborative partnerships between participants and researchers in the Global North and South.
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The authors are grateful to the MY421 team and students for prompting how best to frame and communicate issues pertinent to in-depth interview studies.
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Eleanor Knott, Aliya Hamid Rao, Kate Summers & Chana Teeger
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A pre-written interview outline for a semi-structured interview that provides both a topic structure and the ability to adapt flexibly to the content and context of the interview and the interaction between the interviewer and participant. Others may refer to the topic guide as an interview protocol.
Here we refer to the participants that take part in the study as the sample. Other researchers may refer to the participants as a participant group or dataset.
This involves dividing a population into smaller groups based on particular characteristics, for example, age or gender, and then sampling randomly within each group.
A sampling method where the guiding logic when deciding who to recruit is to achieve the most relevant participants for the research topic, in terms of being rich in information or insights.
Researchers ask participants to introduce the researcher to others who meet the study’s inclusion criteria.
Similar to stratified sampling, but participants are not necessarily randomly selected. Instead, the researcher determines how many people from each category of participants should be recruited. Recruitment can happen via snowball or purposive sampling.
A method for developing, analysing and interpreting patterns across data by coding in order to develop themes.
An approach that interrogates the explicit, implicit and taken-for-granted dimensions of language as well as the contexts in which it is articulated to unpack its purposes and effects.
A form of transcription that simplifies what has been said by removing certain verbal and non-verbal details that add no further meaning, such as ‘ums and ahs’ and false starts.
The analytic framework, theoretical approach and often hypotheses, are developed prior to examining the data and then applied to the dataset.
The analytic framework and theoretical approach is developed from analysing the data.
An approach that combines deductive and inductive components to work recursively by going back and forth between data and existing theoretical frameworks (also described as an iterative approach). This approach is increasingly recognized not only as a more realistic but also more desirable third alternative to the more traditional inductive versus deductive binary choice.
A theoretical apparatus that emphasizes the role of cultural processes and capital in (intergenerational) social reproduction.
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Methodology
Published on January 27, 2022 by Tegan George . Revised on June 22, 2023.
An unstructured interview is a data collection method that relies on asking participants questions to collect data on a topic. Also known as non-directive interviewing , unstructured interviews do not have a set pattern and questions are not arranged in advance.
In research, unstructured interviews are usually qualitative in nature, and can be very helpful for social science or humanities research focusing on personal experiences.
An unstructured interview can be a particularly useful exploratory research tool. Known for being very informal and flexible, they can yield captivating responses from your participants.
What is an unstructured interview, when to use an unstructured interview, advantages of unstructured interviews, disadvantages of unstructured interviews, unstructured interview questions, how to conduct an unstructured interview, how to analyze an unstructured interview, presenting your results, other interesting articles, frequently asked questions about unstructured interviews.
An unstructured interview is the most flexible type of interview, with room for spontaneity. In contrast to a structured interview , the questions and the order in which they are presented are not set. Instead, the interview proceeds based on the participant’s previous answers.
Unstructured interviews are open-ended. This lack of structure can help you gather detailed information on your topic, while still allowing you to observe patterns in the analysis stage.
It can be challenging to know what type of interview best fits your subject matter. Unstructured interviews can be very challenging to conduct, and may not always be the best fit for your research question . Unstructured interviews are best used when:
Even more so than in structured or semi-structured interviews, it is critical that you remain organized and develop a system for keeping track of participant responses. Since the questions are not set beforehand, the data collection and analysis becomes more complex.
Make sure to choose the type of interview that suits your research best. This table shows the most important differences between the four types.
Fixed questions | ||||
---|---|---|---|---|
Fixed order of questions | ||||
Fixed number of questions | ||||
Option to ask additional questions |
Unstructured interviews have a few advantages compared to other types of interviews.
Respondents are more at ease, reduced risk of bias, more detail and nuance.
Unstructured interviews also have a few downsides compared to other data collection methods.
Risk of leading questions, very time-consuming, risk of low internal validity.
It can be challenging to ask unstructured interview questions that get you the information you seek without biasing your responses. You will have to rely on the flow of the conversation and the cues you pick up from your participants.
Here are a few tips:
Here are a few possibilities for how your conversation could proceed:
Conversation A:
Since the participant hinted that going to the gym is important for their mental health, proceed with questions in that vein, such as:
Conversation B:
Since the participant seems to have strong feelings against the gym, you can probe deeper.
Once you’ve determined that an unstructured interview is the right fit for your research topic , you can proceed with the following steps.
As you conceptualize your research question, consider starting with some guiding questions, such as:
While you do not need to plan your questions ahead of time for an unstructured interview, this does not mean that no advanced planning is needed. Unstructured interviews actually require extensive planning ahead to ensure that the interview stage will be fruitful.
Once you are feeling really solid about your research question, you can start brainstorming categories of questions you may ask. You can start with one broad, overarching question and brainstorm what paths the conversation could take.
There are a few sampling methods you can use to recruit your interview participants, such as:
You should decide ahead of time whether your interview will be conducted in-person, over the phone, or via video conferencing.
In-person, phone, or video interviews each have their own advantages and disadvantages.
As you conduct your interviews, pay special attention to any environmental conditions that could bias your responses. This includes noises, temperature, and setting, but also your body language. Be careful to moderate your tone of voice and any responses to avoid interviewer effects.
Remember that one of the biggest challenges with unstructured interviews is to keep your questions neutral and unbiased. Strive for open-ended phrasing, and allow your participants to set the pace, asking follow-up questions that flow naturally from their last answer.
After you’re finished conducting your interviews, you move into the analysis phase. Don’t forget to assign each participant a pseudonym (such as a number or letter) to be sure you stay organized.
First, transcribe your recorded interviews. You can then conduct content or thematic analysis to create your categories, seeking patterns that stand out to you among your responses and testing your hypotheses .
The transcription process can be quite lengthy for unstructured interviews due to their more detailed nature. One decision that can save you quite a bit of time before you get started is whether you will be conducting verbatim transcription or intelligent verbatim transcription.
Transcribing has the added benefit of being a great opportunity for cleansing your data . While you listen, you can take notes of questions or inconsistencies that come up.
Note that in some cases, your supervisor may ask you to add the finished transcriptions in the appendix of your research paper .
After you’re finished transcribing, you can begin your thematic or content analysis . Here, you separate words, patterns, or recurring responses that stand out to you into labels or categories for later analysis. This process is called “coding.”
Due to the open-ended nature of unstructured interviews, you will most likely proceed with thematic analysis, rather than content analysis. In thematic analysis, you draw preliminary conclusions about your participants through identifying common topics, ideas, or patterns in their responses.
Once you’re confident with your preliminary thoughts, you can take either an inductive or a deductive approach in your analysis.
Thematic analysis is quite subjective, which can lead to issues with the reliability of your results. The unstructured nature of this type of interview leads to greater dependence on your judgment and interpretations. Be extra vigilant about remaining objective here.
After your data analysis, you’re ready to combine your findings into a research paper .
Let’s say you are a history student particularly interested in the history of the town around your campus. The town has a long history dating back to the early 1600s, but town census data shows that many long-term residents have been moving away in recent years.
You identify a few potential reasons for this shift:
Anecdotally, you hypothesize that the increased cost of living is the predominant factor in driving away long-time residents. However, you cannot rule out the possibility of the other options, specifically the lack of job options coupled with the university’s expansionist aims.
You feel very comfortable with this topic and oral histories in general. Since it is exploratory in nature but has the potential to become sensitive or emotional, you decide to conduct unstructured interviews with long-term residents of your town. Multi-generational residents are of particular interest.
To find the right mix of participants, you post in the Facebook group for town residents, as well as in the town’s NextDoor forum. You also post flyers in local coffee shops and even some mailboxes.
Once you’ve assembled your participants, it’s time to proceed with your interviews. Consider starting out with an icebreaker, such as:
You can then proceed with the interview, asking follow-up questions relevant to your participants’ responses, probing their family history, ties to the community, or any stories they have to share– whether funny, touching, or sentimental.
Establishing rapport with your participants helps you delve into the reasoning behind the choice to stay or leave, and competing thoughts and feelings they may have as the interview goes on. Remember to try to structure it like a conversation, to put them more at ease with the emotional topics.
After conducting your interviews and transcribing your data, you can then conduct thematic analysis, coding responses into different categories. Since you began your research with several theories for why residents may be leaving that all seemed plausible, you would use the inductive approach.
After identifying the relevant themes from your data, you can draw inferences and conclusions. Your results section usually addresses each theme or pattern you found, describing each in turn, as well as how often you came across them in your analysis.
Perhaps one reason in particular really jumped out from responses, or maybe it was more of a mixed bag. Explain why you think this could be the case, and feel free to include lots of (properly anonymized) examples from the data to better illustrate your points.
If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.
Research bias
An unstructured interview is the most flexible type of interview, but it is not always the best fit for your research topic.
Unstructured interviews are best used when:
The four most common types of interviews are:
There are various approaches to qualitative data analysis , but they all share five steps in common:
The specifics of each step depend on the focus of the analysis. Some common approaches include textual analysis , thematic analysis , and discourse analysis .
The interviewer effect is a type of bias that emerges when a characteristic of an interviewer (race, age, gender identity, etc.) influences the responses given by the interviewee.
There is a risk of an interviewer effect in all types of interviews , but it can be mitigated by writing really high-quality interview questions.
Social desirability bias is the tendency for interview participants to give responses that will be viewed favorably by the interviewer or other participants. It occurs in all types of interviews and surveys , but is most common in semi-structured interviews , unstructured interviews , and focus groups .
Social desirability bias can be mitigated by ensuring participants feel at ease and comfortable sharing their views. Make sure to pay attention to your own body language and any physical or verbal cues, such as nodding or widening your eyes.
This type of bias can also occur in observations if the participants know they’re being observed. They might alter their behavior accordingly.
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Shazia jamshed.
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan Campus, Pahang, Malaysia
Buckley and Chiang define research methodology as “a strategy or architectural design by which the researcher maps out an approach to problem-finding or problem-solving.”[ 1 ] According to Crotty, research methodology is a comprehensive strategy ‘that silhouettes our choice and use of specific methods relating them to the anticipated outcomes,[ 2 ] but the choice of research methodology is based upon the type and features of the research problem.[ 3 ] According to Johnson et al . mixed method research is “a class of research where the researcher mixes or combines quantitative and qualitative research techniques, methods, approaches, theories and or language into a single study.[ 4 ] In order to have diverse opinions and views, qualitative findings need to be supplemented with quantitative results.[ 5 ] Therefore, these research methodologies are considered to be complementary to each other rather than incompatible to each other.[ 6 ]
Qualitative research methodology is considered to be suitable when the researcher or the investigator either investigates new field of study or intends to ascertain and theorize prominent issues.[ 6 , 7 ] There are many qualitative methods which are developed to have an in depth and extensive understanding of the issues by means of their textual interpretation and the most common types are interviewing and observation.[ 7 ]
This is the most common format of data collection in qualitative research. According to Oakley, qualitative interview is a type of framework in which the practices and standards be not only recorded, but also achieved, challenged and as well as reinforced.[ 8 ] As no research interview lacks structure[ 9 ] most of the qualitative research interviews are either semi-structured, lightly structured or in-depth.[ 9 ] Unstructured interviews are generally suggested in conducting long-term field work and allow respondents to let them express in their own ways and pace, with minimal hold on respondents’ responses.[ 10 ]
Pioneers of ethnography developed the use of unstructured interviews with local key informants that is., by collecting the data through observation and record field notes as well as to involve themselves with study participants. To be precise, unstructured interview resembles a conversation more than an interview and is always thought to be a “controlled conversation,” which is skewed towards the interests of the interviewer.[ 11 ] Non-directive interviews, form of unstructured interviews are aimed to gather in-depth information and usually do not have pre-planned set of questions.[ 11 ] Another type of the unstructured interview is the focused interview in which the interviewer is well aware of the respondent and in times of deviating away from the main issue the interviewer generally refocuses the respondent towards key subject.[ 11 ] Another type of the unstructured interview is an informal, conversational interview, based on unplanned set of questions that are generated instantaneously during the interview.[ 11 ]
In contrast, semi-structured interviews are those in-depth interviews where the respondents have to answer preset open-ended questions and thus are widely employed by different healthcare professionals in their research. Semi-structured, in-depth interviews are utilized extensively as interviewing format possibly with an individual or sometimes even with a group.[ 6 ] These types of interviews are conducted once only, with an individual or with a group and generally cover the duration of 30 min to more than an hour.[ 12 ] Semi-structured interviews are based on semi-structured interview guide, which is a schematic presentation of questions or topics and need to be explored by the interviewer.[ 12 ] To achieve optimum use of interview time, interview guides serve the useful purpose of exploring many respondents more systematically and comprehensively as well as to keep the interview focused on the desired line of action.[ 12 ] The questions in the interview guide comprise of the core question and many associated questions related to the central question, which in turn, improve further through pilot testing of the interview guide.[ 7 ] In order to have the interview data captured more effectively, recording of the interviews is considered an appropriate choice but sometimes a matter of controversy among the researcher and the respondent. Hand written notes during the interview are relatively unreliable, and the researcher might miss some key points. The recording of the interview makes it easier for the researcher to focus on the interview content and the verbal prompts and thus enables the transcriptionist to generate “verbatim transcript” of the interview.
Similarly, in focus groups, invited groups of people are interviewed in a discussion setting in the presence of the session moderator and generally these discussions last for 90 min.[ 7 ] Like every research technique having its own merits and demerits, group discussions have some intrinsic worth of expressing the opinions openly by the participants. On the contrary in these types of discussion settings, limited issues can be focused, and this may lead to the generation of fewer initiatives and suggestions about research topic.
Observation is a type of qualitative research method which not only included participant's observation, but also covered ethnography and research work in the field. In the observational research design, multiple study sites are involved. Observational data can be integrated as auxiliary or confirmatory research.[ 11 ]
Research can be visualized and perceived as painstaking methodical efforts to examine, investigate as well as restructure the realities, theories and applications. Research methods reflect the approach to tackling the research problem. Depending upon the need, research method could be either an amalgam of both qualitative and quantitative or qualitative or quantitative independently. By adopting qualitative methodology, a prospective researcher is going to fine-tune the pre-conceived notions as well as extrapolate the thought process, analyzing and estimating the issues from an in-depth perspective. This could be carried out by one-to-one interviews or as issue-directed discussions. Observational methods are, sometimes, supplemental means for corroborating research findings.
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Daniel W. Turner III and Nicole Hagstrom-Schmidt
Qualitative research design can be complicated depending upon the level of experience a researcher may have with a particular type of methodology. As researchers, many aspire to grow and expand their knowledge and experiences with qualitative design in order to better utilize a variety of research paradigms. One of the more popular areas of interest in qualitative research design is that of the interview protocol. Interviews provide in-depth information pertaining to participants’ experiences and viewpoints of a particular topic. Oftentimes, interviews are coupled with other forms of data collection in order to provide the researcher with a well-rounded collection of information for analyses. This paper explores the effective ways to conduct in-depth, qualitative interviews for novice investigators by expanding upon the practical components of each interview design.
As common with quantitative analyses, there are various forms of interview design that can be developed to obtain thick, rich data utilizing a qualitative investigational perspective. [1] For the purpose of this examination, there are three formats for interview design that will be explored which are summarized by Gall, Gall, and Borg:
In addition, I will expand on some suggestions for conducting qualitative interviews which includes the construction of research questions as well as the analysis of interview data. These suggestions come from both my personal experiences with interviewing as well as the recommendations from the literature to assist novice interviewers.
The informal conversational interview is outlined by Gall, Gall, and Borg for the purpose of relying “…entirely on the spontaneous generation of questions in a natural interaction, typically one that occurs as part of ongoing participant observation fieldwork.” [3] I am curious when it comes to other cultures or religions and I enjoy immersing myself in these environments as an active participant. I ask questions in order to learn more about these social settings without having a predetermined set of structured questions. Primarily the questions come from “in the moment experiences” as a means for further understanding or clarification of what I am witnessing or experiencing at a particular moment. With the informal conversational approach, the researcher does not ask any specific types of questions, but rather relies on the interaction with the participants to guide the interview process. [4] Think of this type of interview as an “off the top of your head” style of interview where you really construct questions as you move forward. Many consider this type of interview beneficial because of the lack of structure, which allows for flexibility in the nature of the interview. However, many researchers view this type of interview as unstable or unreliable because of the inconsistency in the interview questions, thus making it difficult to code data. [5] If you choose to conduct an informal conversational interview, it is critical to understand the need for flexibility and originality in the questioning as a key for success.
The general interview guide approach is more structured than the informal conversational interview although there is still quite a bit of flexibility in its composition. [6] The ways that questions are potentially worded depend upon the researcher who is conducting the interview. Therefore, one of the obvious issues with this type of interview is the lack of consistency in the way research questions are posed because researchers can interchange the way he or she poses them. With that in mind, the respondents may not consistently answer the same question(s) based on how they were posed by the interviewer. [7] During research for my doctoral dissertation, I was able to interact with alumni participants in a relaxed and informal manner where I had the opportunity to learn more about the in-depth experiences of the participants through structured interviews. This informal environment allowed me the opportunity to develop rapport with the participants so that I was able to ask follow-up or probing questions based on their responses to pre-constructed questions. I found this quite useful in my interviews because I could ask questions or change questions based on participant responses to previous questions. The questions were structured, but adapting them allowed me to explore a more personal approach to each alumni interview.
According to McNamara, the strength of the general interview guide approach is the ability of the researcher “…to ensure that the same general areas of information are collected from each interviewee; this provides more focus than the conversational approach, but still allows a degree of freedom and adaptability in getting information from the interviewee.” [8] The researcher remains in the driver’s seat with this type of interview approach, but flexibility takes precedence based on perceived prompts from the participants.
You might ask, “What does this mean anyway?” The easiest way to answer that question is to think about your own personal experiences at a job interview. When you were invited to a job interview in the past, you might have prepared for all sorts of curve ball-style questions to come your way. You desired an answer for every potential question. If the interviewer were asking you questions using a general interview guide approach, he or she would ask questions using their own unique style, which might differ from the way the questions were originally created. You as the interviewee would then respond to those questions in the manner in which the interviewer asked which would dictate how the interview continued. Based on how the interviewer asked the question(s), you might have been able to answer more information or less information than that of other job candidates. Therefore, it is easy to see how this could positively or negatively influence a job candidate if the interviewer were using a general interview guide approach.
The standardized open-ended interview is extremely structured in terms of the wording of the questions. Participants are always asked identical questions, but the questions are worded so that responses are open-ended. [9] This open-endedness allows the participants to contribute as much detailed information as they desire and it also allows the researcher to ask probing questions as a means of follow-up. Standardized open-ended interviews are likely the most popular form of interviewing utilized in research studies because of the nature of the open-ended questions, allowing the participants to fully express their viewpoints and experiences. If one were to identify weaknesses with open-ended interviewing, they would likely identify the difficulty with coding the data. [10] Since open-ended interviews in composition call for participants to fully express their responses in as much detail as desired, it can be quite difficult for researchers to extract similar themes or codes from the interview transcripts as they would with less open-ended responses. Although the data provided by participants are rich and thick with qualitative data, it can be a more cumbersome process for the researcher to sift through the narrative responses in order to fully and accurately reflect an overall perspective of all interview responses through the coding process. However, according to Gall, Gall, and Borg, this reduces researcher biases within the study, particularly when the interviewing process involves many participants. [11]
Now that we know a few of the more popular interview designs that are available to qualitative researchers, we can more closely examine various suggestions for conducting qualitative interviews based on the available research. These suggestions are designed to provide the researcher with the tools needed to conduct a well constructed, professional interview with their participants. Some of the most common information found within the literature relating to interviews, according to Creswell [12] :
Probably the most helpful tip with the interview process is that of interview preparation. This process can help make or break the process and can either alleviate or exacerbate the problematic circumstances that could potentially occur once the research is implemented. McNamara suggests the importance of the preparation stage in order to maintain an unambiguous focus as to how the interviews will be erected in order to provide maximum benefit to the proposed research study. [14] Along these lines Chenail provides a number of pre-interview exercises researchers can use to improve their instrumentality and address potential biases. [15] McNamara applies eight principles to the preparation stage of interviewing which includes the following ingredients:
Creswell discusses the importance of selecting the appropriate candidates for interviews. He asserts that the researcher should utilize one of the various types of sampling strategies such as criterion based sampling or critical case sampling (among many others) in order to obtain qualified candidates that will provide the most credible information to the study. [17] Creswell also suggests the importance of acquiring participants who will be willing to openly and honestly share information or “their story.” [18] It might be easier to conduct the interviews with participants in a comfortable environment where the participants do not feel restricted or uncomfortable to share information.
Another important element to the interview preparation is the implementation of a pilot test. The pilot test will assist the research in determining if there are flaws, limitations, or other weaknesses within the interview design and will allow him or her to make necessary revisions prior to the implementation of the study. [19] A pilot test should be conducted with participants that have similar interests as those that will participate in the implemented study. The pilot test will also assist the researchers with the refinement of research questions, which will be discussed in the next section.
Creating effective research questions for the interview process is one of the most crucial components to interview design. Researchers desiring to conduct such an investigation should be careful that each of the questions will allow the examiner to dig deep into the experiences and/or knowledge of the participants in order to gain maximum data from the interviews. McNamara suggests several recommendations for creating effective research questions for interviews which includes the following elements:
To assist the novice interviewer with the preparation of research questions, I will propose a useful research question and a not so useful research question. Based on McNamara’s suggestion, it is important to ask an open-ended question. [21] So for the useful question, I will propose the following: “How have your experiences as a kindergarten teacher influenced or not influenced you in the decisions that you have made in raising your children”? As you can see, the question allows the respondent to discuss how his or her experiences as a kindergarten teacher have or have not affected their decision-making with their own children without making the assumption that the experience has influenced their decision-making. On the other hand, if you were to ask a similar question, but from a less than useful perspective, you might construct the same question in this manner: “How has your experiences as a kindergarten teacher affected you as a parent”? As you can see, the question is still open-ended, but it makes the assumption that the experiences have indeed affected them as a parent. We as the researcher cannot make this assumption in the wording of our questions.
Creswell also makes the suggestion of being flexible with research questions being constructed. [22] He makes the assertion that respondents in an interview will not necessarily answer the question being asked by the researcher and, in fact, may answer a question that is asked in another question later in the interview. Creswell believes that the researcher must construct questions in such a manner to keep participants on focus with their responses to the questions. In addition, the researcher must be prepared with follow-up questions or prompts in order to ensure that they obtain optimal responses from participants. When I was an Assistant Director for a large division at my University a couple of years ago, I was tasked with the responsibility of hiring student affairs coordinators at our off-campus educational centers. Throughout the interviewing process, I found that interviewees did indeed get off topic with certain questions because they either misunderstood the question(s) being asked or did not wish to answer the question(s) directly. I was able to utilize Creswell’s suggestion [23] by reconstructing questions so that they were clearly assembled in a manner to reduce misunderstanding and was able to erect effective follow-up prompts to further understanding. This alleviated many of the problems I had and assisted me in extracting the information I needed from the interview through my follow-up questioning.
As with other sections of interview design, McNamara makes some excellent recommendations for the implementation stage of the interview process. He includes the following tips for interview implementation:
The final constituent in the interview design process is that of interpreting the data that was gathered during the interview process. During this phase, the researcher must make “sense” out of what was just uncovered and compile the data into sections or groups of information, also known as themes or codes. [25] These themes or codes are consistent phrases, expressions, or ideas that were common among research participants. [26] How the researcher formulates themes or codes vary. Many researchers suggest the need to employ a third party consultant who can review codes or themes in order to determine the quality and effectiveness based on their evaluation of the interview transcripts. [27] This helps alleviate researcher biases or potentially eliminate where over-analyzing of data has occurred. Many researchers may choose to employ an iterative review process where a committee of nonparticipating researchers can provide constructive feedback and suggestions to the researcher(s) primarily involved with the study.
From choosing the appropriate type of interview design process through the interpretation of interview data, this guide for conducting qualitative research interviews proposes a practical way to perform an investigation based on the recommendations and experiences of qualified researchers in the field and through my own personal experiences. Although qualitative investigation provides a myriad of opportunities for conducting investigational research, interview design has remained one of the more popular forms of analyses. As the variety of qualitative research methods become more widely utilized across research institutions, we will continue to see more practical guides for protocol implementation outlined in peer reviewed journals across the world.
This text was derived from
Turner, Daniel W., III. “Qualitative Interview Design: A Practical Guide for Novice Investigators.” The Qualitative Report 15, no. 3 (2010): 754-760. https://doi.org/10.46743/2160-3715/2010.1178 . Licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License .
It is edited and reformatted by Nicole Hagstrom-Schmidt.
Appendix: Qualitative Interview Design Copyright © 2022 by Daniel W. Turner III and Nicole Hagstrom-Schmidt is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.
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Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
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Interviews involve a conversation with a purpose, but have some distinct features compared to ordinary conversation, such as being scheduled in advance, having an asymmetry in outcome goals between interviewer and interviewee, and often following a question-answer format.
Interviews are different from questionnaires as they involve social interaction. Unlike questionnaire methods, researchers need training in interviewing (which costs money).
Researchers can ask different types of questions, generating different types of data . For example, closed questions provide people with a fixed set of responses, whereas open questions allow people to express what they think in their own words.
The researcher will often record interviews, and the data will be written up as a transcript (a written account of interview questions and answers) which can be analyzed later.
It should be noted that interviews may not be the best method for researching sensitive topics (e.g., truancy in schools, discrimination, etc.) as people may feel more comfortable completing a questionnaire in private.
There are different types of interviews, with a key distinction being the extent of structure. Semi-structured is most common in psychology research. Unstructured interviews have a free-flowing style, while structured interviews involve preset questions asked in a particular order.
A structured interview is a quantitative research method where the interviewer a set of prepared closed-ended questions in the form of an interview schedule, which he/she reads out exactly as worded.
Interviews schedules have a standardized format, meaning the same questions are asked to each interviewee in the same order (see Fig. 1).
Figure 1. An example of an interview schedule
The interviewer will not deviate from the interview schedule (except to clarify the meaning of the question) or probe beyond the answers received. Replies are recorded on a questionnaire, and the order and wording of questions, and sometimes the range of alternative answers, is preset by the researcher.
A structured interview is also known as a formal interview (like a job interview).
Unstructured interviews do not use any set questions, instead, the interviewer asks open-ended questions based on a specific research topic, and will try to let the interview flow like a natural conversation. The interviewer modifies his or her questions to suit the candidate’s specific experiences.
Unstructured interviews are sometimes referred to as ‘discovery interviews’ and are more like a ‘guided conservation’ than a strictly structured interview. They are sometimes called informal interviews.
Unstructured interviews are most useful in qualitative research to analyze attitudes and values. Though they rarely provide a valid basis for generalization, their main advantage is that they enable the researcher to probe social actors’ subjective points of view.
Interviewer self-disclosure involves the interviewer revealing personal information or opinions during the research interview. This may increase rapport but risks changing dynamics away from a focus on facilitating the interviewee’s account.
In unstructured interviews, the informal conversational style may deliberately include elements of interviewer self-disclosure, mirroring ordinary conversation dynamics.
Interviewer self-disclosure risks changing the dynamics away from facilitation of interviewee accounts. It should not be ruled out entirely but requires skillful handling informed by reflection.
Focus group interview is a qualitative approach where a group of respondents are interviewed together, used to gain an in‐depth understanding of social issues.
This type of interview is often referred to as a focus group because the job of the interviewer ( or moderator ) is to bring the group to focus on the issue at hand. Initially, the goal was to reach a consensus among the group, but with the development of techniques for analyzing group qualitative data, there is less emphasis on consensus building.
The method aims to obtain data from a purposely selected group of individuals rather than from a statistically representative sample of a broader population.
The role of the interview moderator is to make sure the group interacts with each other and do not drift off-topic. Ideally, the moderator will be similar to the participants in terms of appearance, have adequate knowledge of the topic being discussed, and exercise mild unobtrusive control over dominant talkers and shy participants.
A researcher must be highly skilled to conduct a focus group interview. For example, the moderator may need certain skills, including the ability to establish rapport and know when to probe.
For example, group interviews may sometimes lack validity as participants may lie to impress the other group members. They may conform to peer pressure and give false answers.
To avoid these pitfalls, the interviewer needs to have a good understanding of how people function in groups as well as how to lead the group in a productive discussion.
Semi-structured interviews lie between structured and unstructured interviews. The interviewer prepares a set of same questions to be answered by all interviewees. Additional questions might be asked during the interview to clarify or expand certain issues.
In semi-structured interviews, the interviewer has more freedom to digress and probe beyond the answers. The interview guide contains a list of questions and topics that need to be covered during the conversation, usually in a particular order.
Semi-structured interviews are most useful to address the ‘what’, ‘how’, and ‘why’ research questions. Both qualitative and quantitative analyses can be performed on data collected during semi-structured interviews.
Face-to-face interviews raise methodological problems. These stem from the fact that interviewers are themselves role players, and their perceived status may influence the replies of the respondents.
Because an interview is a social interaction, the interviewer’s appearance or behavior may influence the respondent’s answers. This is a problem as it can bias the results of the study and make them invalid.
For example, the gender, ethnicity, body language, age, and social status of the interview can all create an interviewer effect. If there is a perceived status disparity between the interviewer and the interviewee, the results of interviews have to be interpreted with care. This is pertinent for sensitive topics such as health.
For example, if a researcher was investigating sexism amongst males, would a female interview be preferable to a male? It is possible that if a female interviewer was used, male participants might lie (i.e., pretend they are not sexist) to impress the interviewer, thus creating an interviewer effect.
The interactional nature of interviews means the researcher fundamentally shapes the discourse, rather than just neutrally collecting it. This shapes what is talked about and how participants can respond.
First, you must choose whether to use a structured or non-structured interview.
Next, you must consider who will be the interviewer, and this will depend on what type of person is being interviewed. There are several variables to consider:
The location of a research interview can influence the way in which the interviewer and interviewee relate and may exaggerate a power dynamic in one direction or another. It is usual to offer interviewees a choice of location as part of facilitating their comfort and encouraging participation.
However, the safety of the interviewer is an overriding consideration and, as mentioned, a minimal requirement should be that a responsible person knows where the interviewer has gone and when they are due back.
The COVID-19 pandemic necessitated remote interviewing for research continuity. However online interview platforms provide increased flexibility even under normal conditions.
They enable access to participant groups across geographical distances without travel costs or arrangements. Online interviews can be efficiently scheduled to align with researcher and interviewee availability.
There are practical considerations in setting up remote interviews. Interviewees require access to internet and an online platform such as Zoom, Microsoft Teams or Skype through which to connect.
Certain modifications help build initial rapport in the remote format. Allowing time at the start of the interview for casual conversation while testing audio/video quality helps participants settle in. Minor delays can disrupt turn-taking flow, so alerting participants to speak slightly slower than usual minimizes accidental interruptions.
Keeping remote interviews under an hour avoids fatigue for stare at a screen. Seeking advanced ethical clearance for verbal consent at the interview start saves participant time. Adapting to the remote context shows care for interviewees and aids rich discussion.
However, it remains important to critically reflect on how removing in-person dynamics may shape the co-created data. Perhaps some nuances of trust and disclosure differ over video.
The interviewer must ensure that they take special care when interviewing vulnerable groups, such as children. For example, children have a limited attention span, so lengthy interviews should be avoided.
An interview schedule is a list of pre-planned, structured questions that have been prepared, to serve as a guide for interviewers, researchers and investigators in collecting information or data about a specific topic or issue.
The key is balancing preparation with the flexibility to adapt questions based on each interview interaction. With practice, you’ll gain skills to conduct productive interviews that obtain rich qualitative data.
Strategic use of silence is a key technique to generate interviewee-led data, but it requires judgment about appropriate timing and duration to maintain mutual understanding.
By understanding the unique challenges and employing these solutions, interviewers can create a more child-friendly and effective interview process, promoting accurate and reliable information gathering from young witnesses.
Design choices.
Design choices around recording and engaging closely with transcripts influence analytic insights, as well as practical feasibility. Weighing up relevant tradeoffs is key.
Here are the steps for transcribing interviews:
The goal is to produce a formatted written record of the verbal interview exchange that captures the meaning and highlights important passages ready for the coding process. Careful transcription is the vital first step in analysis.
The goal of transcription and coding is to systematically transform interview responses into a set of codes and themes that capture key concepts, experiences and beliefs expressed by participants. Taking care with transcription and coding procedures enhances the validity of qualitative analysis .
Informed consent.
The participant information sheet must give potential interviewees a good idea of what is involved if taking part in the research.
This will include the general topics covered in the interview, where the interview might take place, how long it is expected to last, how it will be recorded, the ways in which participants’ anonymity will be managed, and incentives offered.
It might be considered good practice to consider true informed consent in interview research to require two distinguishable stages:
Some groups, like those with mental health issues, extreme views, or criminal backgrounds, risk being discredited – treated skeptically by researchers.
This creates tensions with qualitative approaches, often having an empathetic ethos seeking to center subjective perspectives. Analysis should balance openness to offered accounts with critically examining stakes and motivations behind them.
Potter, J., & Hepburn, A. (2005). Qualitative interviews in psychology: Problems and possibilities. Qualitative research in Psychology , 2 (4), 281-307.
Houtkoop-Steenstra, H. (2000). Interaction and the standardized survey interview: The living questionnaire . Cambridge University Press
Madill, A. (2011). Interaction in the semi-structured interview: A comparative analysis of the use of and response to indirect complaints. Qualitative Research in Psychology, 8 (4), 333–353.
Maryudi, A., & Fisher, M. (2020). The power in the interview: A practical guide for identifying the critical role of actor interests in environment research. Forest and Society, 4 (1), 142–150
O’Key, V., Hugh-Jones, S., & Madill, A. (2009). Recruiting and engaging with people in deprived locales: Interviewing families about their eating patterns. Social Psychological Review, 11 (20), 30–35.
Puchta, C., & Potter, J. (2004). Focus group practice . Sage.
Schaeffer, N. C. (1991). Conversation with a purpose— Or conversation? Interaction in the standardized interview. In P. P. Biemer, R. M. Groves, L. E. Lyberg, & N. A. Mathiowetz (Eds.), Measurement errors in surveys (pp. 367–391). Wiley.
Silverman, D. (1973). Interview talk: Bringing off a research instrument. Sociology, 7 (1), 31–48.
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Implementation Science volume 19 , Article number: 66 ( 2024 ) Cite this article
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Communication is considered an inherent element of nearly every implementation strategy. Often it is seen as a means for imparting new information between stakeholders, representing a Transaction orientation to communication. From a Process orientation, communication is more than information-exchange and is acknowledged as being shaped by (and shaping) the individuals involved and their relationships with one another. As the field of Implementation Science (IS) works to strengthen theoretical integration, we encourage an interdisciplinary approach that engages communication theory to develop richer understanding of strategies and determinants of practice.
We interviewed 28 evaluators, 12 implementors, and 12 administrators from 21 Enterprise-Wide Initiatives funded by the Department of Veteran Affairs Office of Rural Health. Semi-structured interviews focused on experiences with implementation and evaluation strategies. We analyzed the interviews using thematic analysis identifying a range of IS constructs. Then we deductively classified those segments based on a Transaction or Process orientation to communication.
We organized findings using the two IS constructs most commonly discussed in interviews: Collaboration and Leadership Buy-in. The majority of segments coded as Collaboration ( n = 34, 74%) and Leadership Buy-in ( n = 31, 70%) discussed communication from a Transaction orientation and referred to communication as synonymous with information exchange, which emphasizes the task over the relationships between the individuals performing the tasks. Conversely, when participants discussed Collaboration and Leadership Buy-in from a Process orientation, they acknowledged both constructs as the result of long-term efforts to develop positive relationships based on trust and respect, and emphasized the time costliness of such strategies. Our findings demonstrate that participants who discussed communication from a Process orientation recognized the nuance and complexity of interpersonal interactions, particularly in the context of IS.
Efficient, reliable information exchange is a critical but often overemphasized element of implementation. Practitioners and researchers must recognize and incorporate the larger role of communication in IS. Two suggestions for engaging a Process orientation to communication are to: (a) use interview probes to learn how communication is enacted, and (b) use process-oriented communication theories to develop interventions and evaluation tools.
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Communication is a vital part of implementation. Yet, predominant discussions about implementation strategies are limited to a Transactional orientation. Conversely, the Process orientation to communication acknowledges the multiple moving elements in an implementation context that influences collaboration and leadership buy-in.
Exemplars of interview segments about communication engaging a Process orientation were identified to demonstrate ways interviewers can probe to gain a deeper understanding of communication as a process.
We provide examples and suggestions for qualitatively examining communication processes to better understand the impact of implementation strategies.
Several theories with a Process orientation are identified for consideration in future research and implementation planning and evaluation.
Most implementation strategies include a communication component, particularly when evidence-based interventions are introduced and promoted throughout an organization. When implementing new programming, it is common to consider communication as simply a means through which information is imparted [ 1 , 2 ]. Implementation Science (IS) researchers have an imperative to understand the role of communication as more than a means for information exchange [ 3 ]. Yet, even as a means for information exchange, Manojlovich and colleagues recognized the lack of attention on communication in implementation research [ 1 ].
Broadly, the study of communication focuses on how messages are used to generate meanings [ 4 ], and provides perspective for moving beyond an emphasis on information exchange, thus moving beyond the task dimension and recognizing the value of the relational dimension. Despite its relatively young development both academically and professionally, the communication discipline offers valuable insight to IS research [ 5 ]. There are two predominant ways to characterize communication: (1) communication as Transaction, and (2) communication as Process. When communication is viewed as a Transaction, it is discussed as a linear one-way flow of information [ 3 ]. The materiality – the element of substantive value – of communication is found in accurate, efficient information transfer, thus putting emphasis on the task dimension and channel (e.g., phone, handout) through which information is exchanged. When practitioners focus their efforts on preparing thoughtful and detailed educational sessions intended to increase program adoption, but do not allow time for interactive questions or develop opportunities for building relationships between key personnel responsible for successful adoption, then we see a reliance on the Transaction orientation to communication. When communication is conceptualized as a Process, we emphasize its constitutive nature wherein our environments – social, organizational, political, etc. – shape and are shaped through communication [ 3 ]. From a Process orientation, the transformative properties of communication emphasize its relational dimension and bring about a materiality from the intangible elements of the process (e.g., tone of voice, relational history, contextual exigency), and concepts such as psychological safety, mutual respect, and trust foreground the mechanics of information exchange. For example, someone may schedule multiple options for the same information session to ensure real-time interactivity for questions and build in opportunities for small group breakouts and post-presentation networking for relationship-building. When understanding of communication shifts to encompass more than information exchange, we begin to recognize the role of communication in building relationships and influencing long term cultural shifts, which is often the goal for implementation scientists [ 3 ]. If the Process orientation is overlooked in favor of a Transaction orientation, we may miss opportunities for identifying evidence-based communication strategies to support implementation.
The majority of subsequent work engaging Manojlovich et al.’s assertions agree on the imperative to engage a Process orientation to communication, but they make no strides in designing approaches for exploring the characteristics of communication surrounding effective implementation strategies (e.g., [ 6 , 7 , 8 ]). As the conversation initiated by Manojlovich and colleagues about the role of communication in implementation science has progressed, recognition of communication has grown, but emphasis continues to focus on formal contexts (e.g., trainings and webinars) [ 1 ]. Further, quantitative measures that assess information accuracy like the one used in Zhao and colleagues’ work overlook the importance of informal communication (e.g., rapport-building before meetings, impromptu connections) and the nuanced influence of the relational dimension that contributes to effective implementation. Bustos et al.’s (2021) analysis acknowledges both the formal and informal strategies through which communication might occur, but the communication they refer to is discussed from a Transaction orientation (i.e., “how information… was communicated to program staff” (p. 10)) [ 9 ].
For this study, we draw on interviews with employees of the Department of Veterans Affairs (VA) who evaluated, implemented, and administered interventions focused on improving the health and well-being of rural Veterans or the clinical staff who serve them. These interviews were exploratory and wide-ranging; for the purposes of this manuscript, we treat the interviews as akin to direct observations of intervention stakeholders discussing their real-world experiences operationalizing implementation strategies. Instead of focusing on what we could learn from the communication described in the interviews, we directed our attention to what lessons could be missing because of the way participants discussed communication. In this manuscript, we provide examples of how Transaction and Process orientations to communication appear in the data when individuals described their experiences, as well as their relationships that supported IS strategies and facilitated intervention goals. We also suggest interview strategies to elicit detail about communication from a Process orientation to support ongoing learning of these informal communication processes. Though these interviews were not focused on communication, we use data from the interviews to argue that noticing communication helps us discover how to do implementation science better. Specifically, a Process orientation emphasizes the space between IS strategies and outcomes, and advances understanding of implementation challenges and solutions.
The VA’s Office of Rural Health (ORH) supports the creation of Enterprise-Wide Initiatives (EWIs) to address issues facing rural Veterans from mental health and primary care access to training and education of VA staff who serve rural Veterans. As a part of the funding cycle, EWI teams must conduct annual evaluations. The Center for the Evaluation of Enterprise-Wide Initiatives (CEEWI) was created through a 2019 partnership between ORH and the VA’s Quality Enhancement Research Initiative to support EWI evaluation and disseminate best practices. The CEEWI team, consisting of implementation science experts and qualitative data analysts, reviews the annual reports and provides feedback to EWI teams on reporting standards.
As part of the initial CEEWI project, EWI evaluators, implementors, and administrators were interviewed about effectiveness of IS strategies they used and why, in part, to assist the CEEWI team in understanding key aspects of EWI implementation and evaluation. The interview guide included questions about the participant’s role on the EWI, the core components of the EWI, implementation strategies and their impact on desired outcomes, outcome measures used for evaluation, and the evaluation process. CEEWI team members and EWI leadership identified the evaluators, implementors, and administrators to recruit for the study. While recruitment sought a purposive sample of roles from each EWI, ultimately the sample was a convenience sample based on availability and willingness to participate during the first nine months of the COVID-19 pandemic. Additional details about recruitment and data collection can be found in an earlier manuscript from this larger project [ 10 ]. We conducted 43 semi-structured interviews, which averaged 51 min (range 20–77 min), from April – December 2020 with evaluators, implementors, and administrators from 21 EWIs. While most interviews were conducted one-on-one, 8 were group interviews ranging from 2 to 4 participants [ 10 ]. This study uses these interviews as an example on how communication is described when discussing implementation strategies.
Audio-recordings were transcribed, reviewed for accuracy, and uploaded into MAXQDA, a qualitative data management software [ 11 ]. Two doctorally trained qualitative analysts (NJ & JVT) leveraged their previous IS knowledge and conducted primary-cycle inductive coding to identify IS constructs and trends in the data [ 12 ]. The analysts initially coded all transcripts together in real-time and resolved discrepancies immediately. During this first round of coding, several IS constructs were identified in participants’ discussion of their implementation strategies, including Staff Buy-in, Tailoring, Rapport, Fidelity, and Mentorship. Collaboration and Leadership Buy-in emerged as the two most discussed IS constructs among participants. For secondary-cycle deductive coding to interpret how communication was conceptualized in discussions of Collaboration and Leadership Buy-in, the lead author, a Health Communication scholar, used an iterative process to develop a codebook to identify the language representing a Process or Transaction orientation for each construct (i.e., Collaboration and Leadership Buy-in) [ 3 , 12 ]. The analysis focused on the how communication was discussed, not about the form of communication that took place.
Collaboration, a term often characterizing various levels of formal and informal partnerships between individuals, departments or organizations, is defined as a mutually beneficial and well-defined relationship between two or more parties to achieve common goals [ 13 ]. An example of discussing Collaboration from a Transaction orientation to communication would be using the term Collaboration to describe monthly meetings where the parties update one another about the status of their tasks and goals. From a Process orientation, Collaboration would be discussed in relational terms, describing the trust and rapport the team members have among one another.
Leadership Buy-in represents the role of support from individuals in leadership positions for a program’s adoption and sustainability, particularly when competing clinical and administrative demands are at play [ 7 ]. An example of discussing Leadership Buy-in using a Transaction orientation to communication would be a description of strategies for adoption that only focused on leadership education. However, someone who engaged a Process orientation to communication might: (1) discuss tailored persuasive strategies for demonstrating value to specific decision-makers, or (2) acknowledge the necessity for long-term relationships with individuals in leadership roles for sustainment.
We conducted 43 interviews with 28 evaluators, 12 implementors, and 12 administrators. We coded a total of 90 segments as Collaboration ( n = 46) and Leadership Buy-in ( n = 44) across all the interviews. Most segments coded as Collaboration ( n = 34, 74%) and Leadership Buy-in ( n = 31, 70%) discussed communication from a Transaction orientation. The following results present examples of the discussion of Collaboration and Leadership Buy-in from the Transaction and Process orientations to communication.
When communication is treated as a transaction, it is discussed as a one-way flow of information traveling from one party to another during a discrete moment in time [ 3 ]. The materiality of communication is reduced to accurate, efficient information transfer, thus putting emphasis on the channel (e.g., Teams meeting, email) through which information is exchanged and the task dimension of the interaction.
Participants sometimes discussed Collaboration in a way that missed its nuance and treated communication as merely a means for transferring information that produced Collaboration. For example, one participant implied that communication, regardless of quality, is inherently good, thus the more there is, the better. They identified “communication across the team level” as an important strategy having the most impact on desired outcomes. “The more communication there is, the more people are able (…) to divide up [responsibilities].” (1A) In this instance, communication is synonymous with information exchange. While we do not have enough information to assess the quality of communication that Participant 1A is referring to, the fact they only discussed the parties involved and quantity of communication is an example of the Transaction orientation to communication.
In another example, a participant explained what they felt did not work as well in their evaluation process. “We have excellent communication with some, but not all members of the [EWI] (…) I’m not sure they’re always on the same page with each other, and then depending on who we’re having a meeting with, we might hear one thing but then that’s not what someone else was going to do (…) that’s one of the pieces that I think is hard for us.” (2A) Again, we see the Transaction orientation, and the barometer for effective communication is accuracy. The participant went on to discuss ways to improve this lack of alignment among team members, suggesting that “even if it’s just being invited to join calls (…) [for us] to answer questions about the [evaluation] data” would improve teamwork. (2A) This passage highlights an important aspect of communication – being present for an interaction and having the opportunity to answer questions enables information exchange.
One participant described the communication that occurred during a monthly videoconference:
The learning collaborative is focused on bringing people [together] to share their experiences and how various facilitators identify ways to shape their program, but also the way that our national team gives feedback about the data (…) One call a month is right after a report (…) they do a data review on the call where they go over the numbers with the entire learning collaborative, everyone in the program, giving them feedback from a national perspective and always reminding people of the milestones of the metrics that they’ve agreed to under the ORH grant. (3A)
Here, we see another example of a participant discussing communication in terms of information exchange.
Participants also discussed Leadership Buy-in from a Transaction orientation. In the following passage, participant 4A described the benefits of the EWI leadership team visiting sites in-person:
They would do a site visit to all the hubs (…) and meet with the local leadership team and that’s where they confirmed if there were any issues that they might have. They would do like a 2–3 day site visit (…) so it helped create that structure where people knew exactly who to report to and how these programs were established and plenty of opportunities to address any concerns or any issues they might have.
There are substantial implications for local Leadership Buy-in through in-person visits, yet the only aspect of communication discussed here is information exchange and clarifying the information flow hierarchy (i.e., who to report to).
Participant 5A described their program’s efforts to obtain Leadership Buy-in:
Simple outreach and education, that was really the only things that we could do, and then as they continued, training kind of showed its usefulness. That had an impact on leadership buy-in.
Here, buy-in is attributed to education, which may account for some or even most of buy-in, but it does not recognize the relational dimension of communication.
For another EWI, leadership turnover at the facility presented a significant barrier to program sustainment, because Leadership Buy-in was perpetually reset, which exacerbated a “conflict between implementation and sustainment strategies” when the decision-maker for sustainment funding was not the same person to “sign off on it originally” (9A). Given the EWI provided seed-funding for specialty staff to implement the program, the expectation was that the facility would eventually incur the expense for sustainment, but the plan for funds was not made explicit at the time of application for the seed-funding. Participant 9A went on to explain how their program responded to the unforeseen challenge obtaining sustainment funding from sites:
Our clinical director worked really hard with the first cohort of sites prior to their funding ending to try to come up with strategies to pitch the program to leadership (…) Most sites had challenges with changing leadership priorities.
In response, the interviewer clarified their sources for funding, then changed topics: “Interviewer: Ok, alright. How about strategies that were intended to optimize the effectiveness outcomes for your EWI?” In this example, the interviewer seems to be approaching the participant’s description of Leadership Buy-in from a Transactional orientation. A Process-oriented approach that asked about the nature and details of pitching the EWI to leadership may have provided more information about implementation strategy.
From the process perspective, no single interaction serves as the cause or proof of effective Collaboration. Rather, the Process orientation recognizes the value of communication lies in the cumulative outcomes of consistent, often routine, interactions.
Collaborations require shared responsibility, mutual authority, accountability, and sharing of resources and rewards for success [ 13 ]. Collaboration in implementation has focused on strategies to enhance partners’ ability to work together to achieve mutual benefits. We identified examples from participants discussing Collaboration with a Process orientation to communication. From these examples we see that Collaboration is seen as a product of long-term efforts to develop positive relationships and establish trust and autonomy to make one’s own decisions. Many participants recognized the uniqueness and value in reaching the point of Collaboration. For example, Participant 10A shared, “The partnerships, it’s like a very special kind of relationship–, where we have to trust them, we rely on each other, but we also need to be able to make independent decisions.” Participant 6A also recognized the importance of relationships, “I would say they’re collegial but they’re not fully collaborative (…) when they’re really more deeply integrated and their role is understood and recognized (…) they are more collaborative members.”
One participant on a different EWI echoed this sentiment that individuals’ intent and motivations for the work should extend beyond the assignment to be considered Collaboration, “It’s not just trying to check off a box (…) there truly is a passion behind it, on all of our parts, and that has been wonderful.” (7B) Recognizing others’ intent for their work allows one to acknowledge how interpersonal communication is influenced by more than information exchange.
In the following exemplars, we can see how interviewers were able to elicit detail about the interactions surrounding the implementation strategies they were discussing.
Exemplar for Probing Collaboration . In Table 1 , we share an exemplar for engaging the Process orientation to communication, which led to greater explication of the role of communication in the implementation process.
Through this example, we see a more nuanced treatment of communication as a process after the interviewer probed twice to understand the participant’s use of “facilitation” as an implementation strategy. We gained description of the collaborative atmosphere within a team and how individuals’ psychological safety is manifested through authentic interactions.
It takes more than information-exchange to garner support (e.g., financial, staff) for facilitation and sustainment. One participant acknowledged the web of influence that contributes to Leadership Buy-in and effective implementation:
We reached out to all the rural sites their leadership… sort of advertising the program, so we would schedule a conference call with a director, chief of staff, emergency room chief, to sort of discuss the program (…) then we would follow up with an actual 1-day on-site visit (…) where we meet with again, leadership, but we also meet with the [staff from several departments] (…) It’s an all-day visit to further introduce our program, to the team on site, as well as learn more about their program, and how [our EWI] might incorporate itself, and what challenges (…) we might face in implementation. (2B)
Here, we see an acknowledgement of reciprocal relationship-building to learn about priorities and needs.
Several participants discussed how time costly it is to gain Leadership Buy-in to ease the burden of change on an organization and staff, particularly for a nationwide program. One participant reflected:
Ten years ago, it was a [regional] project, so the main kind of instruction came from a [regional] level down, you know. The site visit was just a medical director and the nurse manager telling you that, ‘Hey, this is what’s going to happen,’ and it happened. Now (…) it’s like a year-long process to get people familiarized (…) go live went from one day to four days long. (11B)
Despite its value, garnering Leadership Buy-in has its challenges. Sometimes identifying the right individuals who represent the relevant leadership roles is not clear cut.
Once we have identified that our program can go to that site, we ask the local (…) program manager to identify who (…) key local leaders are (…) It’s important to have the managers of those sites involved in this process from the beginning (…) We (…) set up an initial meeting (…) where we review the implementation process plan with everybody on that call, and answer questions about what we and [specialty care] services will provide as part of the training opportunity and clearly delineate what we need the site or the facility to commit to provide (…) we answer questions, alleviate concerns, things like that. (7B)
Participant 7B went on to describe the challenge of identifying the right leadership representative:
The only barrier that we’ve encountered is some challenges in getting the right leadership on the call to review this in real time and answer questions (…) whether it is due to leadership turnover at the site, even from the time that we set up the call to the time that we actually do the call, there have been some change-overs, and that has been a challenge.
Again, we see this participant engaging a strong Process orientation to communication as they emphasize the importance of relationship-building for Leadership Buy-in.
Exemplar for Probing Leadership Buy-in . In the following example, the interviewer engaged the Process orientation to communication with probes that led to greater explication of the role of communication in developing Leadership Buy-in (Table 2 ).
Results illustrate ways administrators, implementors, and evaluators characterized communication related to Collaboration and Leadership Buy-in. From the Transaction orientation, we saw that the term communication was used synonymously for information exchange. The problem of implementation lies beyond efficient and reliable information transfer, and instead centers on cooperative sensemaking and learning within and among teams situated in an organization that is influenced by its social, geographic, and political environments [ 2 , 14 , 15 ]. Communication necessary for effective implementation is based on improvisation and reciprocity and constitute relationships over time [ 2 , 15 ]. Our data indicate these processes are occurring in implementation, but we may not always be paying close enough attention to their occurrence. If most discussions about communication engage a Transaction orientation, then practitioners and evaluators will never have the insight necessary to maximize the impact of their communication efforts.
Participants often discussed Leadership Buy-in more as an outcome of education, and less as a byproduct of improvisational relationship-building, which demonstrates the predominant Transaction orientation to communication privileging rehearsed, often unidirectional, and mostly controlled interactions. Formal information exchange is undoubtedly an important element of effective implementation; the Transaction orientation aligns well with the goals of dissemination and implementation as a field [ 15 ]. However, our data point to the importance of thinking about communication from a Process orientation for improving effectiveness of implementation strategies—and show how members of implementation and evaluation teams too often focus on the transaction elements of communication. Previous work that engages the Transaction orientation and points to the benefits of reliable information exchange has paved the way for more exploratory naturalistic methods for studying IS from a Process orientation to communication [ 3 , 14 , 15 , 16 ]. As noted in our findings, the Transaction orientation overlooks the intricacies of processes that occur among individuals to build trust, cultivate buy-in, and influence team decision-making, all of which are markers of successful implementation.
Given the purpose of IS is to promote the adoption of research and evidence-based practices, it would behoove implementation scientists to tap into the richness of interdisciplinary theorizing and engage a Process orientation to communication [ 17 ]. As thinking about communication has evolved from a Transaction orientation, scholars recognized the symbolic process that humans use to create meaning through informal, improvised interactions over a period of time [ 2 ]. Recent analysis of implementation strategies for behavioral health interventions called for explicit attention to the supportive role communication may play in most, if not all, strategies [ 15 ]. The Process orientation to communication enriches theorizing and elevates scholars’ and practitioners’ understanding of how to leverage implementation strategies to be meaningfully responsive to the relationships among the interested parties [ 18 ]. However, we warn against over-characterizing communication into a ‘nebulous, global process’ [ 2 , 19 ]. For gaining insight on communication processes, we suggest two strategies: 1) interviewers focused on understanding implementation strategies could probe their interviewees to learn more about how communication is enacted; and 2) IS practitioners could utilize process-oriented communication theories in developing interventions and evaluation tools (e.g., interview guides).
The supplementary material accompanying this article includes excerpts from our interview data as examples demonstrating hypothetical ways interviewers can elicit more nuanced understanding of communication processes (see Tables S1 and S2).
Our analysis identified examples of missed opportunities for interviewers to probe about communication from a Process orientation recognizing the relational dimension of communication. Interview probes like those recommended in Tables S1 and S2 could lead to valuable understanding of the processes of communication, allowing exploration of the relational dimension of communication and implementation, and insight to individuals’ attitudes and sensemaking about those experiences. This may contribute to a more nuanced understanding of the importance of communication in implementation strategies beyond a transactional information exchange. We also provided examples highlighting the constitutive role communication plays in relationship-building. Our goal is to help attune IS researchers to the value of the processes of communication as a critical component of many implementation strategies.
Challenges to implementing any new program may be significantly varied and widespread. No single barrier serves as an intervention’s fatal flaw, but rather, implementation is affected by numerous factors shaped through informal interactions [ 17 , 20 ]. A recent study that aimed to identify which implementation strategies should be most closely considered for which determinants of practice reported one of its limitations was the heterogeneity of responses [ 21 ]. This variation in responses among administrators, implementors, and evaluators points to the value of a more nuanced understanding of the unique, context-dependent, and relationally based communication processes undergirding implementation strategies [ 21 ]. Further, in their ethnographic study on hand hygiene programs, Goedken and colleagues poignantly emphasized the importance of understanding how implementation strategies are used and defined in real-world settings for understanding determinants of practice [ 22 ]. By looking below the surface of implementation strategies and focusing on the interactions surrounding those strategies, we may begin to recognize the determinants of practices, the mechanisms for change, more precisely. Discussing communication from a Process orientation allows us to access what is happening below the surface that cannot be observed as an outsider. With greater insight on communication processes occurring throughout implementation, the field of IS would be poised to provide meaningful guidance for combining implementation strategies [ 22 ]. In a similar vein, IS researchers should consider the temporality of IS strategies and how this underscores the role of communication. The role of Leadership Buy-in at all stages of development and implementation on effectiveness cannot be overstated [ 23 ]. Albright suggests shifting away from the predominant focus of research on the active implementation period to explore activities occurring during design and preparation [ 15 ].
Most implementation strategies have a communication component representing the channel for education and promotion (e.g., workshops, webinars, brochures) [ 15 ]. Our proposed interview strategies interrogate communication in a way that recognizes the relational dimensions of interpersonal interactions, providing insight about what truly results in effective implementation. By understanding communication from a Process orientation, we may enrich our understanding of implementation strategies [ 24 ].
Theories that engage a Transaction orientation to communication often ascribe to the traditional knowledge-intention-behavior paradigm that proposes a stable, linear positive relationship between knowledge and behavior change (e.g., Theory of Reasoned Action, a predictive theory suggesting a strong relationship among individuals’ attitudes about a behavior, their intention, and their behavior [ 25 ]) and tends to overlook the nuance of communication processes. However, humans are more complicated and inconsistent than these theories acknowledge. The Process orientation to communication allows for more realistic approaches that privilege the constitutive nature of communication to co-create meaning socially. In a recent scoping review of 158 studies in implementation research on maternity care, effective communication was noted as a key factor for promoting change across the body of work, but the majority of research was atheoretical and ambiguous in operationalization of communication [ 26 ].
Health communication scholars are trained to be sensitive to the cooperative nature of establishing shared meaning, multiple interpretations of behaviors, and the challenges of coordinating interactions when studying implementation strategies. Several theories, including two that pay special attention to how meaning is created socially, Coordinated Management of Meaning (CMM) [ 27 ] and Structuration Theory [ 28 ], could highlight perspectives that recognize communication as a complex process and translate well to practice. CMM is a constructivist theory that provides a practical heuristic for interpreting interpersonal communication events that comprise larger conversations. As such, CMM informs practitioners’ decision-making by illuminating patterns of interactions to find ways of talking that could result in desired outcomes [ 29 ]. Structuration Theory, coined by sociologist Anthony Giddens in the late 1970s, describes the dynamic relationship between individuals and their environment that constrains and enables social practices [ 28 ]. Through its critical lens, Structuration Theory highlights the (lack of) agency individuals perceive for themselves and others, and the rules and resources perpetuated through social interactions. Lastly, Diffusion of Innovations, a framework well-entrenched in IS research and practice, also engages a process paradigm [ 30 , 31 ]. There is ample opportunity and an imperative to employ a Process orientation to better understand communication in implementation science.
This study has multiple limitations. We did not collection demographic data to describe our participants beyond the role they held on their EWI teams. The data represents a convenience sample of administrators, implementors, and evaluators working on EWIs funded at the time of data collection, which resulted in variability in representation across EWIs and staff roles. Further, because of the diversity of foci, designs, and timelines of EWIs, we cannot draw conclusions about effectiveness of strategies discussed in this paper. Lastly, the interviews were not conducted to assess communication explicitly. Despite these limitations, our analysis facilitates concrete suggestions for improving understanding of the role of communication in implementation.
Research analyzing the role of communication from a Process orientation would enrich the field of IS. Similar to Fishman et al.’s work comparing measurement and operationalization of attitude among IS studies and those grounded in psychology, our work emphasizes the importance of interdisciplinary collaboration [ 32 ]. The interviewees and interviewers in our study focused predominantly on a Transaction orientation to communication; more studies are needed that focus on this level of distinction, particularly how to adopt a Process orientation to communication for implementation strategy specification. There is great potential for a body of knowledge about communication processes that has been systematically developed to inform IS strategies supporting a range of aspects crucial to effectiveness including Leadership Buy-in and Collaboration. Future research may do well to conduct direct observation to characterize communication processes related to implementation strategies from a rich Process orientation. Dissemination Science, as one facet of Dissemination and Implementation Science, is firmly rooted in the mechanics of communication and would greatly benefit from engaging the Process orientation. A recent scoping review demonstrated that the field of Dissemination Science lacks insight to communication from the Process orientation; in their review of dissemination determinants, the Transaction orientation persists in focusing on imparting information from one party to the next [ 33 ].
This study described instances of two broadly accepted orientations to communication engaged by implementation scientists. The findings demonstrate opportunities – and strategies – for engaging in the Process orientation of communication to gain greater insight into the role communication plays in implementation outcomes. We hope this work inspires dialogue, new interdisciplinary collaboration, and innovative methods to highlight the utility of engaging the Process orientation to communication to undergird the value of communication theory to implementation science for improving health services. When communication is understood as a process, practitioners will be better able to prepare for the unpredictability and uniqueness of the relational dimensions of communication.
The datasets presented in this article are not readily available in accordance with federal requirements and standards and guidelines for the protection of participants’ privacy and to maintain confidentiality. Requests to access the datasets should be directed to Dr. Heather Reisinger ([email protected]).
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We would like to thank the interview participants who participated in this study for their time and insights. We would also like to acknowledge Office of Rural Health (ORH) program analysts Dr. Kelly Lora Lewis, Karyn Johnstone, Nicole Sanchez, Maura Timm, Anthony Achampong, Richard Huang, and Janice Garland for their assistance, as well as Dr. Sheila Robinson, former Deputy Director of ORH, Dr. Peter Kaboli, Executive Director of ORH, and Dr. Thomas Klobucar, former Executive Director of ORH, for their support. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
VA Office of Rural Health and QUERI Project #: PEC 19–456.
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Nicole L. Johnson, Jennifer Van Tiem, Erin Balkenende, DeShauna Jones, Julia E. Friberg, Emily E. Chasco, Jane Moeckli, Kenda S. Steffensmeier, Melissa J. A. Steffen & Heather Schacht Reisinger
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HSR, EC, JVT, NJ, EB, DJ, and JF are responsible for the concept for this manuscript. NJ drafted the initial manuscript and HSR, JVT, EC, EB, DJ, KSS, and JF contributed substantially in the form of manuscript structure and revisions. HSR developed the proposal for this project and obtained funding, with input from JVT, EB, and JM. HSR, JVT, EB, JM, and MS conducted interviews. KA and BR advised on all aspects of the project including development of the standardized evaluation reporting template and manuscript revisions.
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Johnson, N.L., Van Tiem, J., Balkenende, E. et al. Gaps in communication theory paradigms when conducting implementation science research: qualitative observations from interviews with administrators, implementors, and evaluators of rural health programs. Implementation Sci 19 , 66 (2024). https://doi.org/10.1186/s13012-024-01395-3
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There is a growing need for alternative forms of care to address citizen demands and ensure a competent healthcare workforce across municipalities and regions. One of these forms of care is the use of mobile care units. The aim of the current study was to describe physicians and nurses experiences of providing care to patients within a mobile care unit in Sweden.
Data were collected between March 2022 and January 2023 through qualitative interviews with 14 physicians and nurses employed in various mobile care units in different regions in Sweden. These interviews were transcribed verbatim and subjected to content analysis, with the study adhering to the Standards for Reporting Qualitative Research (SRQR).
The analysis resulted in two main categories: “Unlocking the potential of mobile care”, and “The challenges of moving hospitals to patients’ homes”; and seven subcategories. The respondents viewed mobile care at home as highly advantageous, positively impacting both patients and caregivers. They believed their contributions enhanced patients’ well-being, fostering a welcoming atmosphere. They also noted receiving more quality time for each patient, enabling thorough assessments, and promoting a person-centered approach, which resulted in more gratifying mutual relationships. However, they experienced that mobile care also had challenges such as geographical limitations, limited opening hours and logistical complexity, which can lead to less equitable and efficient care.
Physicians and nurses in mobile care units emphasized positive outcomes, contributing to patient well-being through a person-centered approach. They highlighted increased quality time, comprehensive assessments, and overall satisfaction, praising the mobile care unit’s unique continuity for enhancing safety and fostering meaningful relationships in the patient’s home environment. In order for mobile care to develop and become a natural part of healthcare, challenges such as geographical limitations and logistics need to be addressed.
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Shifts in population demographics and the present structure of the healthcare system prompt inquiries about the optimal care for frail older people [ 1 , 2 , 3 , 4 ]. The multifaceted health conditions and diverse requirements of these individuals result in increased healthcare appointments and recurrent hospital stays, putting pressure on the current health infrastructure [ 5 , 6 ]. In Sweden, the state oversees general healthcare policy, with the Inspectorate for Health and Care supervising. While regions ensure that all citizens have access to quality care, municipalities look after long-term health and social care for the frail older people,. Primary care serves as the initial point of contact in the healthcare system, providing basic services either at facilities or at homes. They also guide patients to the appropriate level of care as required [ 7 ].
The transition towards accessible and qualitative healthcare is underway in municipalities and regions [ 8 ]. This transition is important because some individuals may experience problems accessing healthcare due to of distance, severe illness and immobility [ 9 , 10 , 11 ]. This change, however, demands long-term commitment and perseverance, not only from the regions and municipalities, but also from the government [ 12 ]. The goal is to develop person-centered, efficient, and purposeful methods that cater to patient needs. This also means that different healthcare stakeholders, specialties, and professions need to collaborate more effectively [ 6 ]. To respond to citizens’ demands for accessible care, there’s a need for alternative forms of care, for example, mobile care, that can offer prompt and appropriate care within the available resources [ 12 ].
The terminology, i.e. the meaning of mobile care varies from country to country, but the care provided is the same, as is its purpose, to provide highly specialized care, mainly by physicians and nurses, for conditions that normally require hospital admission [ 13 , 14 ]. Examples of mobile care are geriatric “Hospital at home” programs that offer treatments typically exclusive to hospitals right in the patient’s homes, including monitoring, drug administration, nursing, and rehabilitation processes [ 13 , 15 ]. Hospital at home is defined as “a service that provides active treatment, by health care professionals, in the patient’s home for a condition that otherwise would require acute hospital in-patient care, always for a limited time period” unlike home nursing care [ 13 , 16 ]. Patients are evaluated in various settings, including by their general practitioners or in emergency rooms, before being directed to these services. This model can also support those discharged early from hospital [ 17 , 18 ]. The target group for mobile care varies, but the mobile units in the current study focus on the frail older people. The National Board of Health and Welfare defines frail frail older people as people over 65 years of age with several chronic diseases and extensive needs for both outpatient and inpatient medical care [ 17 ].
Transitioning the care of patients from hospitals to their homes poses a formidable challenge, primarily due to concerns regarding patient safety and the constraints inherent to a patient’s home environment. Previous studies show that many patients are sent to hospitals instead of being assessed for mobile care due to various circumstances, e.g., for reasons of convenience [ 14 , 19 ]. In cases where the assessment is performed, the mobile care team often rejects the patient due to lack of time, logistical reasons or that the patient is unsuitable [ 13 , 14 , 20 ]. More knowledge is needed about physicians and nurses experiences of mobile care to provide an improved and developed perspective on how it can be incorporated into the healthcare system. The aim of the current study was to describe physicians and nurses experiences of providing care to patients within a mobile care unit in Sweden.
We employed a qualitative, inductive approach and used a content analysis methodology as outlined by Hsieh & Shannon [ 21 ]. In this approach, coding and theme development were driven by the shared meaning found within the data. The design’s primary objective was to discern, analyze, and interpret patterns within the qualitative data. The study adhered to the Standards for Reporting Qualitative Research (SRQR) [ 22 ]. The study was accepted by the Ethics Review Authority, Uppsala, Sweden (reg. number: 2020–06986).
The interviews were conducted between March 2022 and January 2023 in four Swedish cities in four different regions with populations varying between 61,000 and 160,000 inhabitants. All cities were equipped with mobile care units. Five units were found through an internet search, after which contact was made with the region management. Of these, four teams agreed to participate. These units specialize in mobile care as their primary field, delivering direct care to patients and offering indirect support to other physicians and nurses involved in providing such care. Mobile care units primarily offer home-based and inpatient care, with the number of patients receiving home care varying from 5 to 15. To be eligible for inclusion, participants had to meet the following criteria: active employment in a specialized field related to internal medicine or geriatric care, a minimum of 2 years of professional experience in the domain of the mobile care unit, and master the Swedish language. Invitation to participate in the study was issued by either the department head or a senior supervising physician within the healthcare facility. All physicians and nurses working in the included mobile care units who fulfilled the inclusion criteria were invited to participate, and all agreed to participate (Table 1 ).
Due to the COVID-19 pandemic, interviews were performed using telephone ( n = 11) and Microsoft Teams© (Microsoft Corporation, California, U.S.A) ( n = 3). Participants were given the opportunity to propose a suitable time for the interview. The interview began with the participant introducing themselves and describing their experience with mobile care. The semi-structured interview guide was created by the authors with open-ended questions and was followed up by probing questions (See supplementary file). One pilot interview was conducted and did not result in any changes to the interview guide and was therefore included in the analysis. All interviews were performed by the first author (CT). CT is a registered nurse working within the field of emergency care and with previous experience in qualitative interviewing. CT had no prior care relationship with the study participants. Participants were encouraged to engage in open discussion, with occasional probing queries aimed at enhancing clarity, such as requests for further elaboration, explanations, and exploration of the how and why aspects. The interviews lasted between 25 and 55 min, were audio-recorded and then transcribed verbatim by CT. Before the study commenced, physicians and nurses were briefed on the study through both verbal and written communication. The participants were assured of confidentiality, and solely the researchers associated with the project could access the data, in line with The Swedish Research Council’s protocols [ 23 ].
The analysis of the transcribed interviews was conducted according to conventional content analysis based on Hsieh & Shannon [ 21 ]. All authors individually read four transcripts to gain both depth and breadth in understanding the material. Then, units of meaning in the text that were perceived to capture key thoughts or concepts were marked directly in the text. After this, notes were made in the margins describing the first impression, thereby conducting an initial analysis. To increase the trustworthiness of the study, all authors individually coded four transcripts and then mutually discussed the findings to employ a consistent coding scheme. Based on this coding scheme, CT coded the rest of the transcripts. The codes were then sorted into subcategories based on how the different codes were related and linked to each other. These subcategories were thereafter used to organize and group codes into meaningful clusters, which formed the basis for the emerging subcategories. Depending on how the subcategories were related to each other, they were afterwards divided into a smaller number of categories. These steps were mutually discussed by all authors. The findings of the research were strengthened and clarified by using specific quotations. These selected pieces, derived directly from the initial dataset, were eventually translated into English. Table 2 provides examples representing different stages of the analysis.
The results are derived from interviews with physicians and nurses, who were actively employed in specialized fields related to internal medicine or geriatric care. Each participant had at least two years of professional experience in the mobile care unit and was proficient in the Swedish language. Analysis of the interviews resulted in two main categories and seven subcategories according to Table 3 . The main categories were: Unlocking the potential of mobile care and The challenges of moving hospitals to patients’ homes.
Physicians and nurses described that mobile care promotes person-centered care based on mutual equality. Caring for the patient in their home increases transparency and safety for patients. Cooperation with different treatment units ensures comprehensive and safe care. It is a healthy work environment that gives professional pride.
Physicians and nurses described that it was rewarding to observe the patient in their natural environment. Physicians and nurses who had previously worked in a hospital setting experienced a shift in the balance of power when care had taken place in the patient’s home. The healthcare staff described that they felt that they were not in a position of power and called it “mutual equality”, and that this led to patients being more inclined to open up and share their opinions. This contributed to a more accurate assessment that aligned with a person-centered care approach. In an assessment of the patient in their living environment, physicians and nurses had been able to identify potential obstacles and complications more effectively. Such obstacles might have been, for example, thresholds in the dwelling that could potentially have been a fall risk. A significant distance between the toilet and bedroom might have resulted in the patient avoiding diuretics due to concerns about incontinence. Physicians and nursesdescribed that it is of central importance to not only identify existing shortcomings but also to anticipate potential vulnerabilities that might have arisen during the period when the patient was enrolled in the mobile care unit. Proactively working on prevention had been essential to ensure the patient’s overall well-being.
“I find it very rewarding to enter their home environment. You sort of get on the same wavelength , and it feels , what should I say , more human to sit with them at home. You get a sense of how this patient operates in their home environment , and it’s important information that we lack when the patient is in their hospital room” [ 7 ].
Physicians and nurses described that patients are satisfied with being cared for at home. The care can be planned collaboratively to a greater extent, ensuring continuous patient involvement. It facilitates conducting examinations and treatments at home rather than needing transportation. Physicians and nurses shared their experiences of safety of care and that a factor for increased safety of care was to enable a care plan with the patients. They expressed that this form of care offers a different type of continuity compared to hospital care where there is variability in the staff. Knowing the patient and their history increased the safety of care. According to physicians and nurses, communication was a key factor. It was essential to inform patients about the reason for the unit’s visit and the necessary treatments Additionally, informing relatives was highlighted as a aspect of care. Physicians and nurses described that relative need to be involved and aware of the plan for the patients, especially since this form of care might be new to some. Furthermore, it was important for physicians and nurses that they provide information to both relatives and the patient on how to contact healthcare if required as this leads to increased security for them.
“Sometimes , they may need an injection to reduce fluid retention for a week , and then the nurse will work together with the patient to develop a plan so that they feel confident in saying , ‘Yes , now we’re going to do it like this” [ 10 ].
To ensure high-quality care, collaboration within different healthcare organizations was essential according to physicians and nurses. They conveyed that frequent interaction between various healthcare entities and professions enhanced the sense of security for physicians and nurses, which in turn positively affected the patients. When the mobile unit was aware that home care services assisted or that home healthcare was responsible for the patient at night, the unit felt an increased sense of security in providing care in the patient’s home.
“But the idea and the goal are that patients who do not require inpatient care should be able to stay with our assistance and in collaboration with home healthcare , as well as with , for example , occupational therapists and physiotherapists” [ 11 ].
The perceived benefit of collaborating with hospital specialists, who are not directly part of the mobile unit, was perceived to facilitate the unit’s care delivery. A contributing factor to effective collaboration was that the facility was a smaller hospital, and the mobile unit was stationed close to the hospital’s departments.
“We are a very small hospital , so we have the advantage of being close at hand. We have cooperation among all in.” [ 9 ].
Physicians and nurses experienced that they were doing something good for the frail older people. They provided good healthcare in a place where the patient wanted to be. Physicians and nurses believed that care in a patient’s home environment surpassed the care that was provided in hospitals. They felt that they had a meaningful profession and that they had a impact on the patients’ lives, but they also perceived that they contributed to the patient’s well-being. Physicians and nurses perceived that they contributed to the patient’s well-being. Physicians and nurses described that they had more time for each patient and did not have to move between patients as they did in the hospital. This led to less stress. It also allowed for a thorough assessment and promoted the establishment of a more rewarding mutual relationship.
“I believe that it’s necessary for us to fulfill a role and make a contribution for the elderly. I see that the unit is needed and that we serve a purpose” [ 3 ].
Physicians and nurses describe that geographical differences and the limited operating hours of mobile care teams lead to unequal care. They face logistical challenges, such as transporting equipment and navigating different administrative systems, which need improvement. Additionally, maintaining good hygiene in less clean home environments can be difficult.
Physicians and nurses emphasized the limitations of a mobile care unit compared to traditional hospital care. They often used expressions such as: “compared to the hospital or the emergency room”.
Some of the physicians and nurses highlighted that this type of care is limited to geographical boundaries. Within a municipality, there is often a higher concentration of resources and opportunities compared to areas outside the central parts of the municipality. Physicians and nurses described that if the patients live within the area of the unit, they will be offered this type of care, otherwise not, leading to inequality in care. Furthermore, mobile care was perceived as insufficient as the number of scheduled visits must be reduced if the travel time becomes too long. At most, physicians and nurses need to travel up to 60 minutes for a visit.
“There are still quite significant differences in the care one receives when living inside the city as opposed to living outside the municipality.” [ 1 ]. “The furthest locations. It’s travel time and such. Considering that , we are not very efficient.” [ 3 ].
According to physicians and nurses, the mobile unit usually consists of a fixed number of employees who are not replaced when illness occurs, making the unit fragile. The units’ operations include both scheduled and emergency visits, and emergency visits can be limited due to lack of necessary resources, e.g. due to illness in the unit members. In such situations, the common alternative is to call for ambulance transportation that brings the patient to nearest hospital for an emergency assessment.
Another aspect is that the mobile unit is only available during office hours. If the patient experiences an emergency with their health outside the office hours, they could speak to a healthcare professional who works in a hospital. Physicians and nurses perceived this opportunity as positive, that it provided an extra security for patients connected to mobile care, while others were more negative to the limited opening hours compared to the hospital.
“We work regular office hours , Monday to Friday. Then during other times , they can call us , and we leave a brochure. And if we don’t answer the phone , they are redirected to the department , so they can get in touch with the doctor. It has never really become a problem.” [ 8 ].
Physicians and nurses described that conducting home visits required extensive preparation, especially concerning the equipment that needed to be brought along. Technical complications can arise, which may be difficult to address in the patient’s home, underscoring the importance of reliable equipment. Another challenge highlighted by physicians and nurses was the incompatibility in record-keeping systems across different forms of care. Standardizing these systems could optimize the workflow. Moreover, physicians and nurses emphasized that some medical equipment cannot be easily implemented in the home environment. These were for example monitoring equipment, including the tracking of vital functions, and infusion systems that administer intravenous drugs safely.
“It requires quite a bit of logistics. You have to bring things with you. I realized it now when I was about to leave. It demands logistics , and you have to be organized.” [ 9 ].
Som physicians and nurses made it clear that not all patients are suitable for a specific treatment at home. In situations where the patient’s condition requires intravenous treatment, but the patient lacks supervision or municipal interventions, the unit need to make an assessment. If the unit can be present during the entire treatment period, then it is safe for the patient to receive the treatment at home, otherwise the alternative is to go to hospital.
Another issue was hygiene problems experienced by physicians and nurses. For example, in wound dressings, it is difficult to maintain cleanliness if the home is already dirty, which normally is not a problem in the hospital environment.
“First , it’s about how the home looks and what possibilities there are. If the home is in disarray , it’s impossible to keep it clean. I know , I was sewing today , and when I compare it to the healthcare center , it’s quite sterile in comparison to a bedroom” [ 2 ].
To our knowledge, this is the first study describing physicians and nurses’ experiences with providing care to patients within a mobile care unit in Sweden. The study contributes valuable knowledge and insights into how Physicians and nurses experience this type of highly specialized care in the patients’ homes, which differs from home care nursing which mainly offers basic medical treatment such as health monitoring, medication administration, wound dressing, and overall patient health support. Physicians and nurses considered that mobile care in the home environment offers advantages that have a positive impact on both the patient and physicians and nurses themselves. However, they also expressed some challenges connected with mobile care.
Physicians and nurses described mobile care as a person-centered approach, where caring for patients in their own home has several positive aspects that benefit not only the patient but also physicians and nurses. They perceived it as gratifying to witness patients in their natural surroundings and noted a power shift during home care, fostering mutual equality, which they felt was difficult to achieve when they worked in hospitals. Physicians and nurses described that patients experience satisfaction when they receive care at home. They emphasized that mobile care is characterized by collaborative planning, which ensures continuous patient participation. Although person-centered care emphasizes the importance of patient involvement in decision-making [ 24 ], earlier research has shown that not all patients prefer active participation. [ 25 , 26 ]. This is mainly due to health-related limitations, lack of support from physicians and nurses, or unfamiliarity with the possibility of participate actively. However, in cases where patients want to participate actively, they feel opposed by physicians and nurses. In those moments, they might feel like they don’t have much say or control, and it can make them feel less powerful and independent [ 27 , 28 ]. This suggests that physicians and nurses should pay attention to patients’ needs and wishes for participation in their care. It is also valuable to address non-active participation through targeted efforts such as patient education and empowerment initiatives to facilitate a smooth transition to acceptance of person-centered care in the home environment [ 26 ]. Through these efforts, we believe that it is possible to further promote and implement a person-centered approach in mobile care.
Physicians and nurses described that they received more quality time for each patient, enabling a more comprehensive assessment and fostering a more satisfying person-centered care. Specifically, they believed that their contributions had a substantial impact on the patient’s overall well-being and perceived a consistent sense of welcome, receiving affirmative responses regarding their endeavors. Physicians and nurses experience that the mobile care unit provides a unique continuity compared to hospital care, where staff turnover can introduce variability. Getting to know the patient and their medical history contributes to enhanced safety in care delivery. Previous research [ 11 , 12 , 13 ] has shown that building and maintaining relationships with the frail older people with physicians and nurses can be challenging due to the specialized and fragmented healthcare system. A limited number of staff meeting patients in their home environment usually means consistent contact that promotes the quality of care, affecting patients’ feelings of safety and comfort. However, other studies show that patients receiving medical care at home tend to report higher levels of satisfaction with their treating physician compared to patients receiving care in a traditional acute hospital environment [ 12 , 13 , 14 ]. Physicians and nurses in this study advocate for the mobile care unit, citing its unique continuity compared to hospitals. We therefore assume that consistent contact with a limited number of staff promotes relational continuity, positively impacting patient satisfaction.
Healthcare professional described that they provided good healthcare in a place where the patient wanted to be. They believed that care in a patients’ home environment surpassed the care that was provided in hospitals and had an impact on the patients’ lives. Physicians and nursesalso described having more time for each individual patient. This allowed for a thorough assessment and promoted the establishment of a more rewarding mutual relationship. This suggests that physicians and nurses appreciated the work environment in the mobile care team. Previous studies have shown a positive correlation between a healthy work environment and better patient experiences [ 29 , 30 ]. This implicates that a positive work environment in mobile care has far-reaching implications that extend beyond just the well-being of physicians and nurses. It also positively influences patient satisfaction, quality of care, staff engagement, and the overall efficiency of healthcare delivery in the mobile setting.
Physicians and nurses also described challenges in the work environment including unsanitary living conditions that can worsen a patient’s medical condition and make infection control more difficult. Previous studies confirm that there is an increased risk associated with certain types of treatment at home and that it is important to make a careful assessment of whether the patient and the environment are suitable for care [ 14 ]. On the other hand, being hospitalized, increases the risk ofnosocomial infections [ 31 , 32 , 33 ].
Physicians and nurses described that the mobile care units have limitations in terms of accessibility. This mostly concerns geographic accessibility, where patients in rural areas do not have the same opportunity for mobile care as in the cities. They also described that the units’ working hours and travelling distances was a limiting factor. The availability of mobile care, both geographically and in terms of restricted opening hours, is not in line with the Healthcare Act in Sweden [ 17 ], which stipulates that healthcare should be provided on equal terms for the entire population. Geographical accessibility can however be challenging to fulfill as Sweden is sparsely populated compared to many other European countries [ 34 ]. Proximity to patients in rural areas is a crucial factor affecting access to primary care [ 19 , 20 ]. To address this issue, the Ministry of Social Affairs has been tasked by the government to investigate and propose changes to increase access to healthcare in rural areas [ 21 ]. Global observations indicate a variety of essential approaches for enhancing accessibility to primary healthcare services in rural areas. These encompass reinforcing the healthcare financing system, enhancing the availability of medicines and supplies, collaborating with diverse partners and communities, implementing a robust evaluation system, and fostering dedicated leadership [ 35 , 36 , 37 ]. This indicates that follow-up healthcare appointments, digital solutions may become more relevant in the future to minimize transportation for the mobile care units.
Mobile care is not yet widely adopted as a working method in Sweden. Consequently, a geographic spread could not be achieved, and the number of participants was limited. Nevertheless, the findings in this study are based on data collected from a relatively high number of physicians and nurses in Sweden with experiences of working in different mobile care units. According to Malterud [ 38 ], this indicates that the study has achieved sufficient information power, as all physicians and nurses working in the mobile care units participated in this study. They contributed with their unique experience and provided valuable knowledge to answer the aim of the study. Furthermore, the interviews yielded consistent data since no new information appeared in the last interviews, and this data was analyzed using an established analysis strategy by Hsieh & Shannon [ 21 ].
Eleven of the interviews were carried out via telephone and three via video using Microsoft Teams©. This might be considered as a limitation as telephone interviews may have impacted the richness of interview content compared with video interviews. However, research shows that the difference between telephone and video interviews is modest [ 39 , 40 ]. One strength is that the first author (CT) conducted all interviews, which may have influenced the quality of the interviews positively as the interviewer’s interview technique improved with each interview. Another strength is that all authors individually coded four transcripts and mutually discussed the findings to employ a consistent coding scheme, that CT used to code the rest of the transcripts afterwards. Furthermore, all authors participated in forming subcategories and categories to ensure credibility. Dependability was established by maintaining a comprehensive audit trail, ensuring consistent coding procedures, and involving multiple analysts to verify the stability and reliability of the findings, with every step of the research process thoroughly documented in the methods section.Variations were discussed among the authors during the meetings for the data analysis to enhance the confirmability of the study. The authors have different backgrounds and expertise, i.e. nursing, medicine and biomedicine and this can be seen as an “investigator triangulation” and thus a strength [ 41 ].
Although other mobile care units may work differently and have other experiences, our findings may demonstrate transferability to this context as care is delivered to patients in their homes, even though this could differ in content and delivery mode.
Physicians and nurses experience mobile care as a person-centered approach, promoting holistic care and collaborative planning. It emphasizes ongoing patient participation and eliminated transportation needs. On the other hand, mobile care poses challenges such as inequality of care if patients live outside the units’ areas, incompatible record-keeping, and difficulty implementing the use of certain medical devices. Despite this, mobile care is considered a a good alternative to traditional hospital care, where physicians and nurses felt they had a meaningful profession that positively affects the lives and well-being of the patients, and thus fostering rewarding mutual relationships. The challenge for the future is to engage at a national level with physicians, managers, and politicians to achieve improvements. Failing to come together to develop care pathways relevant to rural communities, for example, could be missing an opportunity to improve the nation’s health.
The datasets used and/or analysed during the current study cannot be shared openly but are available on request from authors.
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We thank all the physicians and nurses for sharing their experiences in the interviews for this study.
No funding was received for conducting this study.
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Christofer Teske, Ghassan Mourad & Micha Milovanovic
Department of Emergency medicine in Norrköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Christofer Teske
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CT collected and analyzed all data. Also contributed to writing - review and editing of the manuscript. GM contributed to study design, analysis of data via triangulation, reviewing and editing of the manuscript. MM contributed to discussion regarding all data of the study. Also contributed to writing - review and editing of the manuscript. All authors read and approved the final manuscript.
Correspondence to Christofer Teske .
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Teske, C., Mourad, G. & Milovanovic, M. Physicians and nurses experiences of providing care to patients within a mobile care unit – a qualitative interview study. BMC Health Serv Res 24 , 1065 (2024). https://doi.org/10.1186/s12913-024-11517-8
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Abstract. The aim of this paper is to promote a greater use of informal conversations in qualitative research. Although not a new innovation, we posit that they are a neglected innovation and a method that should become more widely employed. We argue that these conversations create a greater ease of communication and often produce more ...
Informal, or unstructured, conversations formed the basis of many early classic ethnographies from. slums (Wirth, 1927), homeless people (Anderson, 1923), life histories (Thomas & Znaniecki, 1918), institutions like the family (Mowrer, 1932) and recreational pursuits and urban life styles (Cressey, 1932).
An unstructured interview is a little like this informal conversation, except that one of the parties to the conversation (you, the researcher) ... Britten, Nicky. 1995. "Qualitative Interviews in Medical Research." BMJ: British Medical Journal 31(6999):251-253. A good basic overview of interviewing particularly useful for students of ...
Informal conversations have been used in qualitative research for over 100 years. Whilst originally identified as a minor part of ethnographic study, scholarly literature in the 2020s has aimed to promote a greater use of the informal conversation method in qualitative research.
The researcher engages in fieldwork - observation and informal interviewing - to develop an understanding of the setting and to build rapport. Informal interviewing may also be used to uncover new topics of interest that may have been overlooked by previous research. Recording Informal Interviews. Since informal interviews occur 'on the fly ...
Abstract. The aim of this paper is to promote a greater use of informal conversations in qualitative research. Although not a new innovation, we posit that they are a neglected innovation and a ...
2 [email protected], 0000-0002-8957-6000, Correspondent. 3 [email protected], 0000-0002-2962-3864. the ice and touch upon the topic briefly to prepare the interviewee for more challenging questions. Additionally, the interviewer develops follow up questions based on the answers or the conversation with the interviewee(s).
There is a robust, ongoing debate about reproducibility in qualitative research, including interview studies. In some research paradigms, reproducibility can be a way of interrogating the rigour ...
qualitative interviews for novice investigators by employing a step-by-step process for implementation. Key Words: Informal Conversational Interview, General Interview Guide, and Open-Ended Interviews. Qualitative research design can be complicated depending upon the level of experience a researcher may have with a particular type of methodology.
There are several types of interviews, often differentiated by their level of structure. Structured interviews have predetermined questions asked in a predetermined order. Unstructured interviews are more free-flowing. Semi-structured interviews fall in between. Interviews are commonly used in market research, social science, and ethnographic ...
2.2 The role of informal conversations in qualitative research. Talking to people is a constituent element of qualitative research and, for example, informal conversations formed the basis of many early "classic" ethnographies from anthropologists such as Frank Hamilton CUSHING, Margaret MEAD and Bronislaw MALINOWSKI.
In research, unstructured interviews are usually qualitative in nature, and can be very helpful for social science or humanities research focusing on personal experiences. An unstructured interview can be a particularly useful exploratory research tool. Known for being very informal and flexible, they can yield captivating responses from your ...
Interviewing. This is the most common format of data collection in qualitative research. According to Oakley, qualitative interview is a type of framework in which the practices and standards be not only recorded, but also achieved, challenged and as well as reinforced.[] As no research interview lacks structure[] most of the qualitative research interviews are either semi-structured, lightly ...
Kvale defines qualitative research interviews as "attempts to understand the world from the subjects' point of view, to unfold the meaning of peoples' experiences, to uncover their lived world prior to scientific explanations." Interviews for research or evaluation purposes differ in some important ways from other familiar kinds of interviews ...
Interviews provide in-depth information pertaining to participants' experiences and viewpoints of a particular topic. Oftentimes, interviews are coupled with other forms of data collection in order to provide the researcher with a well-rounded collection of information for analyses. This paper explores the effective ways to conduct in-depth ...
Unstructured interviews are sometimes referred to as 'discovery interviews' and are more like a 'guided conservation' than a strictly structured interview. They are sometimes called informal interviews. Unstructured interviews are most useful in qualitative research to analyze attitudes and values. Though they rarely provide a valid ...
Return to Article Details The Role of Informal Conversations in Generating Data, and the Ethical and Methodological Issues The Role of Informal Conversations in Generating Data, and the Ethical and Methodological Issues
The aim of this paper is to promote a greater use of informal conversations in qualitative research. Although not a new innovation, we posit that they are a neglected innovation and a method that should become more widely employed. We argue that these conversations create a greater ease of communication and often produce more naturalistic data.
An in‐depth interview is a qualitative research technique that is used to conduct detailed interviews with a small number of participants. ... interview structures are: 1) informal ...
Patton (2002) characterizes three approaches to qualitative interviewing: (a) the informal conversational interview; (b) the interview guide; and (c) the standardized, open-ended interview. In the informal conversational interview (unstructured interviewing), there is no predetermined set of questions.
Gaps in communication theory paradigms when conducting implementation science research: qualitative observations from interviews with administrators, implementors, and evaluators of rural health programs ... Zhao and colleagues' work overlook the importance of informal communication (e.g., rapport-building before meetings, impromptu ...
Qualitative interviews - ranging from unstructured to open-ended and to provocative - are methodologically well-established tools of social-scientific data gathering (see i.e. Kvale and Brinkmann, 2009; Roulston, 2010). They are very common in social sciences when it comes to studying the perspectives, experiences, explanations and ...
Data were collected between March 2022 and January 2023 through qualitative interviews with 14 physicians and nurses employed in various mobile care units in different regions in Sweden. These interviews were transcribed verbatim and subjected to content analysis, with the study adhering to the Standards for Reporting Qualitative Research (SRQR).
Key Words: Informal Conversational Interview, General Interview Guide, and Open-Ended Interviews Qualitative research design can be complicated depending upon the level of experience a researcher may have with a particular type of methodology. As researchers, many aspire to grow and expand their knowledge and experiences with qualitative design ...