qualitative research strength and weaknesses

23 Advantages and Disadvantages of Qualitative Research

Investigating methodologies. Taking a closer look at ethnographic, anthropological, or naturalistic techniques. Data mining through observer recordings. This is what the world of qualitative research is all about. It is the comprehensive and complete data that is collected by having the courage to ask an open-ended question.

Print media has used the principles of qualitative research for generations. Now more industries are seeing the advantages that come from the extra data that is received by asking more than a “yes” or “no” question.

The advantages and disadvantages of qualitative research are quite unique. On one hand, you have the perspective of the data that is being collected. On the other hand, you have the techniques of the data collector and their own unique observations that can alter the information in subtle ways.

That’s why these key points are so important to consider.

What Are the Advantages of Qualitative Research?

1. Subject materials can be evaluated with greater detail. There are many time restrictions that are placed on research methods. The goal of a time restriction is to create a measurable outcome so that metrics can be in place. Qualitative research focuses less on the metrics of the data that is being collected and more on the subtleties of what can be found in that information. This allows for the data to have an enhanced level of detail to it, which can provide more opportunities to glean insights from it during examination.

2. Research frameworks can be fluid and based on incoming or available data. Many research opportunities must follow a specific pattern of questioning, data collection, and information reporting. Qualitative research offers a different approach. It can adapt to the quality of information that is being gathered. If the available data does not seem to be providing any results, the research can immediately shift gears and seek to gather data in a new direction. This offers more opportunities to gather important clues about any subject instead of being confined to a limited and often self-fulfilling perspective.

3. Qualitative research data is based on human experiences and observations. Humans have two very different operating systems. One is a subconscious method of operation, which is the fast and instinctual observations that are made when data is present. The other operating system is slower and more methodical, wanting to evaluate all sources of data before deciding. Many forms of research rely on the second operating system while ignoring the instinctual nature of the human mind. Qualitative research doesn’t ignore the gut instinct. It embraces it and the data that can be collected is often better for it.

4. Gathered data has a predictive quality to it. One of the common mistakes that occurs with qualitative research is an assumption that a personal perspective can be extrapolated into a group perspective. This is only possible when individuals grow up in similar circumstances, have similar perspectives about the world, and operate with similar goals. When these groups can be identified, however, the gathered individualistic data can have a predictive quality for those who are in a like-minded group. At the very least, the data has a predictive quality for the individual from whom it was gathered.

5. Qualitative research operates within structures that are fluid. Because the data being gathered through this type of research is based on observations and experiences, an experienced researcher can follow-up interesting answers with additional questions. Unlike other forms of research that require a specific framework with zero deviation, researchers can follow any data tangent which makes itself known and enhance the overall database of information that is being collected.

6. Data complexities can be incorporated into generated conclusions. Although our modern world tends to prefer statistics and verifiable facts, we cannot simply remove the human experience from the equation. Different people will have remarkably different perceptions about any statistic, fact, or event. This is because our unique experiences generate a different perspective of the data that we see. These complexities, when gathered into a singular database, can generate conclusions with more depth and accuracy, which benefits everyone.

7. Qualitative research is an open-ended process. When a researcher is properly prepared, the open-ended structures of qualitative research make it possible to get underneath superficial responses and rational thoughts to gather information from an individual’s emotional response. This is critically important to this form of researcher because it is an emotional response which often drives a person’s decisions or influences their behavior.

8. Creativity becomes a desirable quality within qualitative research. It can be difficult to analyze data that is obtained from individual sources because many people subconsciously answer in a way that they think someone wants. This desire to “please” another reduces the accuracy of the data and suppresses individual creativity. By embracing the qualitative research method, it becomes possible to encourage respondent creativity, allowing people to express themselves with authenticity. In return, the data collected becomes more accurate and can lead to predictable outcomes.

9. Qualitative research can create industry-specific insights. Brands and businesses today need to build relationships with their core demographics to survive. The terminology, vocabulary, and jargon that consumers use when looking at products or services is just as important as the reputation of the brand that is offering them. If consumers are receiving one context, but the intention of the brand is a different context, then the miscommunication can artificially restrict sales opportunities. Qualitative research gives brands access to these insights so they can accurately communicate their value propositions.

10. Smaller sample sizes are used in qualitative research, which can save on costs. Many qualitative research projects can be completed quickly and on a limited budget because they typically use smaller sample sizes that other research methods. This allows for faster results to be obtained so that projects can move forward with confidence that only good data is able to provide.

11. Qualitative research provides more content for creatives and marketing teams. When your job involves marketing, or creating new campaigns that target a specific demographic, then knowing what makes those people can be quite challenging. By going through the qualitative research approach, it becomes possible to congregate authentic ideas that can be used for marketing and other creative purposes. This makes communication between the two parties to be handled with more accuracy, leading to greater level of happiness for all parties involved.

12. Attitude explanations become possible with qualitative research. Consumer patterns can change on a dime sometimes, leaving a brand out in the cold as to what just happened. Qualitative research allows for a greater understanding of consumer attitudes, providing an explanation for events that occur outside of the predictive matrix that was developed through previous research. This allows the optimal brand/consumer relationship to be maintained.

What Are the Disadvantages of Qualitative Research?

1. The quality of the data gathered in qualitative research is highly subjective. This is where the personal nature of data gathering in qualitative research can also be a negative component of the process. What one researcher might feel is important and necessary to gather can be data that another researcher feels is pointless and won’t spend time pursuing it. Having individual perspectives and including instinctual decisions can lead to incredibly detailed data. It can also lead to data that is generalized or even inaccurate because of its reliance on researcher subjectivisms.

2. Data rigidity is more difficult to assess and demonstrate. Because individual perspectives are often the foundation of the data that is gathered in qualitative research, it is more difficult to prove that there is rigidity in the information that is collective. The human mind tends to remember things in the way it wants to remember them. That is why memories are often looked at fondly, even if the actual events that occurred may have been somewhat disturbing at the time. This innate desire to look at the good in things makes it difficult for researchers to demonstrate data validity.

3. Mining data gathered by qualitative research can be time consuming. The number of details that are often collected while performing qualitative research are often overwhelming. Sorting through that data to pull out the key points can be a time-consuming effort. It is also a subjective effort because what one researcher feels is important may not be pulled out by another researcher. Unless there are some standards in place that cannot be overridden, data mining through a massive number of details can almost be more trouble than it is worth in some instances.

4. Qualitative research creates findings that are valuable, but difficult to present. Presenting the findings which come out of qualitative research is a bit like listening to an interview on CNN. The interviewer will ask a question to the interviewee, but the goal is to receive an answer that will help present a database which presents a specific outcome to the viewer. The goal might be to have a viewer watch an interview and think, “That’s terrible. We need to pass a law to change that.” The subjective nature of the information, however, can cause the viewer to think, “That’s wonderful. Let’s keep things the way they are right now.” That is why findings from qualitative research are difficult to present. What a research gleans from the data can be very different from what an outside observer gleans from the data.

5. Data created through qualitative research is not always accepted. Because of the subjective nature of the data that is collected in qualitative research, findings are not always accepted by the scientific community. A second independent qualitative research effort which can produce similar findings is often necessary to begin the process of community acceptance.

6. Researcher influence can have a negative effect on the collected data. The quality of the data that is collected through qualitative research is highly dependent on the skills and observation of the researcher. If a researcher has a biased point of view, then their perspective will be included with the data collected and influence the outcome. There must be controls in place to help remove the potential for bias so the data collected can be reviewed with integrity. Otherwise, it would be possible for a researcher to make any claim and then use their bias through qualitative research to prove their point.

7. Replicating results can be very difficult with qualitative research. The scientific community wants to see results that can be verified and duplicated to accept research as factual. In the world of qualitative research, this can be very difficult to accomplish. Not only do you have the variability of researcher bias for which to account within the data, but there is also the informational bias that is built into the data itself from the provider. This means the scope of data gathering can be extremely limited, even if the structure of gathering information is fluid, because of each unique perspective.

8. Difficult decisions may require repetitive qualitative research periods. The smaller sample sizes of qualitative research may be an advantage, but they can also be a disadvantage for brands and businesses which are facing a difficult or potentially controversial decision. A small sample is not always representative of a larger population demographic, even if there are deep similarities with the individuals involve. This means a follow-up with a larger quantitative sample may be necessary so that data points can be tracked with more accuracy, allowing for a better overall decision to be made.

9. Unseen data can disappear during the qualitative research process. The amount of trust that is placed on the researcher to gather, and then draw together, the unseen data that is offered by a provider is enormous. The research is dependent upon the skill of the researcher being able to connect all the dots. If the researcher can do this, then the data can be meaningful and help brands and progress forward with their mission. If not, there is no way to alter course until after the first results are received. Then a new qualitative process must begin.

10. Researchers must have industry-related expertise. You can have an excellent researcher on-board for a project, but if they are not familiar with the subject matter, they will have a difficult time gathering accurate data. For qualitative research to be accurate, the interviewer involved must have specific skills, experiences, and expertise in the subject matter being studied. They must also be familiar with the material being evaluated and have the knowledge to interpret responses that are received. If any piece of this skill set is missing, the quality of the data being gathered can be open to interpretation.

11. Qualitative research is not statistically representative. The one disadvantage of qualitative research which is always present is its lack of statistical representation. It is a perspective-based method of research only, which means the responses given are not measured. Comparisons can be made and this can lead toward the duplication which may be required, but for the most part, quantitative data is required for circumstances which need statistical representation and that is not part of the qualitative research process.

The advantages and disadvantages of qualitative research make it possible to gather and analyze individualistic data on deeper levels. This makes it possible to gain new insights into consumer thoughts, demographic behavioral patterns, and emotional reasoning processes. When a research can connect the dots of each information point that is gathered, the information can lead to personalized experiences, better value in products and services, and ongoing brand development.

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5 Strengths and 5 Limitations of Qualitative Research

Lauren Christiansen

Insight into qualitative research.

Anyone who reviews a bunch of numbers knows how impersonal that feels. What do numbers really reveal about a person's beliefs, motives, and thoughts? While it's critical to collect statistical information to identify business trends and inefficiencies, stats don't always tell the full story. Why does the customer like this product more than the other one? What motivates them to post this particular hashtag on social media? How do employees actually feel about the new supply chain process? To answer more personal questions that delve into the human experience, businesses often employ a qualitative research process.

10 Key Strengths and Limitations of Qualitative Research

Qualitative research helps entrepreneurs and established companies understand the many factors that drive consumer behavior. Because most organizations collect and analyze quantitative data, they don't always know exactly how a target market feels and what it wants. It helps researchers when they can observe a small sample size of consumers in a comfortable environment, ask questions, and let them speak. Research methodology varies depending on the industry and type of business needs. Many companies employ mixed methods to extract the insights they require to improve decision-making. While both quantitative research and qualitative methods are effective, there are limitations to both. Quantitative research is expensive, time-consuming, and presents a limited understanding of consumer needs. However, qualitative research methods generate less verifiable information as all qualitative data is based on experience. Businesses should use a combination of both methods to overcome any associated limitations.

Strengths of Qualitative Research

• Captures New Beliefs - Qualitative research methods extrapolate any evolving beliefs within a market. This may include who buys a product/service, or how employees feel about their employers.
• Fewer Limitations - Qualitative studies are less stringent than quantitative ones. Outside the box answers to questions, opinions, and beliefs are included in data collection and data analysis.
• More Versatile - Qualitative research is much easier at times for researchers. They can adjust questions, adapt to circumstances that change or change the environment to optimize results.
• Greater Speculation - Researchers can speculate more on what answers to drill down into and how to approach them. They can use instinct and subjective experience to identify and extract good data.
• More Targeted - This research process can target any area of the business or concern it may have. Researchers can concentrate on specific target markets to collect valuable information. This takes less time and requires fewer resources than quantitative studies.

Limitations of Qualitative Research

• Sample Sizes - Businesses need to find a big enough group of participants to ensure results are accurate. A sample size of 15 people is not enough to show a reliable picture of how consumers view a product. If it is not possible to find a large enough sample size, the data collected may be insufficient.
• Bias - For internal qualitative studies, employees may be biased. For example, workers may give a popular answer that colleagues agree with rather than a true opinion. This can negatively influence the outcome of the study.
• Self-Selection Bias - Businesses that call on volunteers to answer questions worry that the people who respond are not reflective of the greater group. It is better if the company selects individuals at random for research studies, particularly if they are employees. However, this changes the process from qualitative to quantitative methods.
• Artificial - It isn't typical to observe consumers in stores, gather a focus group together, or ask employees about their experiences at work. This artificiality may impact the findings, as it is outside the norm of regular behavior and interactions.
• Quality - Questions It's hard to know whether researcher questions are quality or not because they are all subjective. Researchers need to ask how and why individuals feel the way they do to receive the most accurate answers.

Key Takeaways on Strengths and Limitations of Qualitative Research

• Qualitative research helps entrepreneurs and small businesses understand what drives human behavior. It is also used to see how employees feel about workflows and tasks.
• Companies can extract insights from qualitative research to optimize decision-making and improve products or services.
• Qualitative research captures new beliefs, has fewer limitations, is more versatile, and is more targeted. It also allows researchers to speculate and insert themselves more into the research study.
• Qualitative research has many limitations which include possible small sample sizes, potential bias in answers, self-selection bias, and potentially poor questions from researchers. It also can be artificial because it isn't typical to observe participants in focus groups, ask them questions at work, or invite them to partake in this type of research method.

Must-Read Content

The Top Qualitative Research Methods for Business Success

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What is Qualitative Research, Really?

ReviseSociology

A level sociology revision – education, families, research methods, crime and deviance and more!

Qualitative Data – Strengths and Limitations

Table of Contents

Last Updated on September 1, 2021 by Karl Thompson

A summary of the theoretical, practical and ethical strengths and weaknesses of qualitative data sources such as unstructured interviews, participant observation and documents.

Examples of Qualitative Data

• Open question questionnaires
• Unstructured interviews
• Participant observation
• Public and private documents such as newspapers and letters.

Theoretical strengths

• Better validity than for quantitative data
• More insight (Verstehen)
• More in-depth data
• More respondent-led, avoids the imposition problem.
• Good for exploring issues the researcher knows little about.
• Preferred by Interpretivists

Practical strengths

• A useful way of accessing groups who don’t like formal methods/ authority

Ethical strengths

• Useful for sensitive topics
• Allows respondents to ‘speak for themselves’
• Treats respondents as equals

Theoretical limitations

• Difficult to make comparisons
• No useful for finding trends, finding correlations.
• Typically small samples, low representativeness
• Low reliability as difficult to repeat the exact context of research.
• Subjective bias of researcher may influence data (interviewer bias)
• Disliked by Positivists

Practical limitations

• Time consuming
• Expensive per person researched compared to qualitative data
• Difficult to gain access (PO)
• Analyzing data can be difficult

Ethical limitations

• Close contact means more potential for harm
• Close contact means more difficult to guarantee anonymity and confidentiality
• Informed consent can be an issue with PO.

Nature of Topic – When would you use it, when would you avoid using it?

• Useful for complex topics you know little about
• Not necessary for simple topics.

Signposting

This post has been written as a revision summary for students revising the research methods aspect of A-level sociology.

More in-depth versions of qualitative data topics can be found below…

Covert and Covert  Participant Observation   

The strengths and limitations of covert participant observation  

Interviews in Social Research  

Secondary Qualitative Data Analysis in Sociology  

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Qualitative Study

Affiliations.

• 1 University of Nebraska Medical Center
• 2 GDB Research and Statistical Consulting
• 3 GDB Research and Statistical Consulting/McLaren Macomb Hospital
• PMID: 29262162
• Bookshelf ID: NBK470395

Qualitative research is a type of research that explores and provides deeper insights into real-world problems. Instead of collecting numerical data points or intervene or introduce treatments just like in quantitative research, qualitative research helps generate hypotheses as well as further investigate and understand quantitative data. Qualitative research gathers participants' experiences, perceptions, and behavior. It answers the hows and whys instead of how many or how much. It could be structured as a stand-alone study, purely relying on qualitative data or it could be part of mixed-methods research that combines qualitative and quantitative data. This review introduces the readers to some basic concepts, definitions, terminology, and application of qualitative research.

Qualitative research at its core, ask open-ended questions whose answers are not easily put into numbers such as ‘how’ and ‘why’. Due to the open-ended nature of the research questions at hand, qualitative research design is often not linear in the same way quantitative design is. One of the strengths of qualitative research is its ability to explain processes and patterns of human behavior that can be difficult to quantify. Phenomena such as experiences, attitudes, and behaviors can be difficult to accurately capture quantitatively, whereas a qualitative approach allows participants themselves to explain how, why, or what they were thinking, feeling, and experiencing at a certain time or during an event of interest. Quantifying qualitative data certainly is possible, but at its core, qualitative data is looking for themes and patterns that can be difficult to quantify and it is important to ensure that the context and narrative of qualitative work are not lost by trying to quantify something that is not meant to be quantified.

However, while qualitative research is sometimes placed in opposition to quantitative research, where they are necessarily opposites and therefore ‘compete’ against each other and the philosophical paradigms associated with each, qualitative and quantitative work are not necessarily opposites nor are they incompatible. While qualitative and quantitative approaches are different, they are not necessarily opposites, and they are certainly not mutually exclusive. For instance, qualitative research can help expand and deepen understanding of data or results obtained from quantitative analysis. For example, say a quantitative analysis has determined that there is a correlation between length of stay and level of patient satisfaction, but why does this correlation exist? This dual-focus scenario shows one way in which qualitative and quantitative research could be integrated together.

Examples of Qualitative Research Approaches

Ethnography

Ethnography as a research design has its origins in social and cultural anthropology, and involves the researcher being directly immersed in the participant’s environment. Through this immersion, the ethnographer can use a variety of data collection techniques with the aim of being able to produce a comprehensive account of the social phenomena that occurred during the research period. That is to say, the researcher’s aim with ethnography is to immerse themselves into the research population and come out of it with accounts of actions, behaviors, events, etc. through the eyes of someone involved in the population. Direct involvement of the researcher with the target population is one benefit of ethnographic research because it can then be possible to find data that is otherwise very difficult to extract and record.

Grounded Theory

Grounded Theory is the “generation of a theoretical model through the experience of observing a study population and developing a comparative analysis of their speech and behavior.” As opposed to quantitative research which is deductive and tests or verifies an existing theory, grounded theory research is inductive and therefore lends itself to research that is aiming to study social interactions or experiences. In essence, Grounded Theory’s goal is to explain for example how and why an event occurs or how and why people might behave a certain way. Through observing the population, a researcher using the Grounded Theory approach can then develop a theory to explain the phenomena of interest.

Phenomenology

Phenomenology is defined as the “study of the meaning of phenomena or the study of the particular”. At first glance, it might seem that Grounded Theory and Phenomenology are quite similar, but upon careful examination, the differences can be seen. At its core, phenomenology looks to investigate experiences from the perspective of the individual. Phenomenology is essentially looking into the ‘lived experiences’ of the participants and aims to examine how and why participants behaved a certain way, from their perspective . Herein lies one of the main differences between Grounded Theory and Phenomenology. Grounded Theory aims to develop a theory for social phenomena through an examination of various data sources whereas Phenomenology focuses on describing and explaining an event or phenomena from the perspective of those who have experienced it.

Narrative Research

One of qualitative research’s strengths lies in its ability to tell a story, often from the perspective of those directly involved in it. Reporting on qualitative research involves including details and descriptions of the setting involved and quotes from participants. This detail is called ‘thick’ or ‘rich’ description and is a strength of qualitative research. Narrative research is rife with the possibilities of ‘thick’ description as this approach weaves together a sequence of events, usually from just one or two individuals, in the hopes of creating a cohesive story, or narrative. While it might seem like a waste of time to focus on such a specific, individual level, understanding one or two people’s narratives for an event or phenomenon can help to inform researchers about the influences that helped shape that narrative. The tension or conflict of differing narratives can be “opportunities for innovation”.

Research Paradigm

Research paradigms are the assumptions, norms, and standards that underpin different approaches to research. Essentially, research paradigms are the ‘worldview’ that inform research. It is valuable for researchers, both qualitative and quantitative, to understand what paradigm they are working within because understanding the theoretical basis of research paradigms allows researchers to understand the strengths and weaknesses of the approach being used and adjust accordingly. Different paradigms have different ontology and epistemologies . Ontology is defined as the "assumptions about the nature of reality” whereas epistemology is defined as the “assumptions about the nature of knowledge” that inform the work researchers do. It is important to understand the ontological and epistemological foundations of the research paradigm researchers are working within to allow for a full understanding of the approach being used and the assumptions that underpin the approach as a whole. Further, it is crucial that researchers understand their own ontological and epistemological assumptions about the world in general because their assumptions about the world will necessarily impact how they interact with research. A discussion of the research paradigm is not complete without describing positivist, postpositivist, and constructivist philosophies.

Positivist vs Postpositivist

To further understand qualitative research, we need to discuss positivist and postpositivist frameworks. Positivism is a philosophy that the scientific method can and should be applied to social as well as natural sciences. Essentially, positivist thinking insists that the social sciences should use natural science methods in its research which stems from positivist ontology that there is an objective reality that exists that is fully independent of our perception of the world as individuals. Quantitative research is rooted in positivist philosophy, which can be seen in the value it places on concepts such as causality, generalizability, and replicability.

Conversely, postpositivists argue that social reality can never be one hundred percent explained but it could be approximated. Indeed, qualitative researchers have been insisting that there are “fundamental limits to the extent to which the methods and procedures of the natural sciences could be applied to the social world” and therefore postpositivist philosophy is often associated with qualitative research. An example of positivist versus postpositivist values in research might be that positivist philosophies value hypothesis-testing, whereas postpositivist philosophies value the ability to formulate a substantive theory.

Constructivist

Constructivism is a subcategory of postpositivism. Most researchers invested in postpositivist research are constructivist as well, meaning they think there is no objective external reality that exists but rather that reality is constructed. Constructivism is a theoretical lens that emphasizes the dynamic nature of our world. “Constructivism contends that individuals’ views are directly influenced by their experiences, and it is these individual experiences and views that shape their perspective of reality”. Essentially, Constructivist thought focuses on how ‘reality’ is not a fixed certainty and experiences, interactions, and backgrounds give people a unique view of the world. Constructivism contends, unlike in positivist views, that there is not necessarily an ‘objective’ reality we all experience. This is the ‘relativist’ ontological view that reality and the world we live in are dynamic and socially constructed. Therefore, qualitative scientific knowledge can be inductive as well as deductive.”

So why is it important to understand the differences in assumptions that different philosophies and approaches to research have? Fundamentally, the assumptions underpinning the research tools a researcher selects provide an overall base for the assumptions the rest of the research will have and can even change the role of the researcher themselves. For example, is the researcher an ‘objective’ observer such as in positivist quantitative work? Or is the researcher an active participant in the research itself, as in postpositivist qualitative work? Understanding the philosophical base of the research undertaken allows researchers to fully understand the implications of their work and their role within the research, as well as reflect on their own positionality and bias as it pertains to the research they are conducting.

Data Sampling

The better the sample represents the intended study population, the more likely the researcher is to encompass the varying factors at play. The following are examples of participant sampling and selection:

Purposive sampling- selection based on the researcher’s rationale in terms of being the most informative.

Criterion sampling-selection based on pre-identified factors.

Convenience sampling- selection based on availability.

Snowball sampling- the selection is by referral from other participants or people who know potential participants.

Extreme case sampling- targeted selection of rare cases.

Typical case sampling-selection based on regular or average participants.

Data Collection and Analysis

Qualitative research uses several techniques including interviews, focus groups, and observation. [1] [2] [3] Interviews may be unstructured, with open-ended questions on a topic and the interviewer adapts to the responses. Structured interviews have a predetermined number of questions that every participant is asked. It is usually one on one and is appropriate for sensitive topics or topics needing an in-depth exploration. Focus groups are often held with 8-12 target participants and are used when group dynamics and collective views on a topic are desired. Researchers can be a participant-observer to share the experiences of the subject or a non-participant or detached observer.

While quantitative research design prescribes a controlled environment for data collection, qualitative data collection may be in a central location or in the environment of the participants, depending on the study goals and design. Qualitative research could amount to a large amount of data. Data is transcribed which may then be coded manually or with the use of Computer Assisted Qualitative Data Analysis Software or CAQDAS such as ATLAS.ti or NVivo.

After the coding process, qualitative research results could be in various formats. It could be a synthesis and interpretation presented with excerpts from the data. Results also could be in the form of themes and theory or model development.

Dissemination

To standardize and facilitate the dissemination of qualitative research outcomes, the healthcare team can use two reporting standards. The Consolidated Criteria for Reporting Qualitative Research or COREQ is a 32-item checklist for interviews and focus groups. The Standards for Reporting Qualitative Research (SRQR) is a checklist covering a wider range of qualitative research.

Examples of Application

Many times a research question will start with qualitative research. The qualitative research will help generate the research hypothesis which can be tested with quantitative methods. After the data is collected and analyzed with quantitative methods, a set of qualitative methods can be used to dive deeper into the data for a better understanding of what the numbers truly mean and their implications. The qualitative methods can then help clarify the quantitative data and also help refine the hypothesis for future research. Furthermore, with qualitative research researchers can explore subjects that are poorly studied with quantitative methods. These include opinions, individual's actions, and social science research.

A good qualitative study design starts with a goal or objective. This should be clearly defined or stated. The target population needs to be specified. A method for obtaining information from the study population must be carefully detailed to ensure there are no omissions of part of the target population. A proper collection method should be selected which will help obtain the desired information without overly limiting the collected data because many times, the information sought is not well compartmentalized or obtained. Finally, the design should ensure adequate methods for analyzing the data. An example may help better clarify some of the various aspects of qualitative research.

A researcher wants to decrease the number of teenagers who smoke in their community. The researcher could begin by asking current teen smokers why they started smoking through structured or unstructured interviews (qualitative research). The researcher can also get together a group of current teenage smokers and conduct a focus group to help brainstorm factors that may have prevented them from starting to smoke (qualitative research).

In this example, the researcher has used qualitative research methods (interviews and focus groups) to generate a list of ideas of both why teens start to smoke as well as factors that may have prevented them from starting to smoke. Next, the researcher compiles this data. The research found that, hypothetically, peer pressure, health issues, cost, being considered “cool,” and rebellious behavior all might increase or decrease the likelihood of teens starting to smoke.

The researcher creates a survey asking teen participants to rank how important each of the above factors is in either starting smoking (for current smokers) or not smoking (for current non-smokers). This survey provides specific numbers (ranked importance of each factor) and is thus a quantitative research tool.

The researcher can use the results of the survey to focus efforts on the one or two highest-ranked factors. Let us say the researcher found that health was the major factor that keeps teens from starting to smoke, and peer pressure was the major factor that contributed to teens to start smoking. The researcher can go back to qualitative research methods to dive deeper into each of these for more information. The researcher wants to focus on how to keep teens from starting to smoke, so they focus on the peer pressure aspect.

The researcher can conduct interviews and/or focus groups (qualitative research) about what types and forms of peer pressure are commonly encountered, where the peer pressure comes from, and where smoking first starts. The researcher hypothetically finds that peer pressure often occurs after school at the local teen hangouts, mostly the local park. The researcher also hypothetically finds that peer pressure comes from older, current smokers who provide the cigarettes.

The researcher could further explore this observation made at the local teen hangouts (qualitative research) and take notes regarding who is smoking, who is not, and what observable factors are at play for peer pressure of smoking. The researcher finds a local park where many local teenagers hang out and see that a shady, overgrown area of the park is where the smokers tend to hang out. The researcher notes the smoking teenagers buy their cigarettes from a local convenience store adjacent to the park where the clerk does not check identification before selling cigarettes. These observations fall under qualitative research.

If the researcher returns to the park and counts how many individuals smoke in each region of the park, this numerical data would be quantitative research. Based on the researcher's efforts thus far, they conclude that local teen smoking and teenagers who start to smoke may decrease if there are fewer overgrown areas of the park and the local convenience store does not sell cigarettes to underage individuals.

The researcher could try to have the parks department reassess the shady areas to make them less conducive to the smokers or identify how to limit the sales of cigarettes to underage individuals by the convenience store. The researcher would then cycle back to qualitative methods of asking at-risk population their perceptions of the changes, what factors are still at play, as well as quantitative research that includes teen smoking rates in the community, the incidence of new teen smokers, among others.

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Strengths and weaknesses

Strengths of qualitative research.

• Qualitative methods tend to collect very rich data in an efficient manner: rather than being limited to the responders to a set of pre-defined questions, it is possible to explore interesting concepts that can lead to novel theory by analysing the entirety of a participant’s interview/story/interaction.
• Qualitative methods can lead to the generation of new theory from unexpected findings that go against “conventional” public health understanding
• When combined with quantitative methods, qualitative research can provide a much more complete picture. For example, a well-designed process evaluation of a trial may provide important insights into participant attitudes, beliefs, and thoughts about the intervention and its acceptability, which may not be evident from the quantitative outcome evaluation.

Weaknesses of qualitative research

• It is important that qualitative researchers adhere to robust methodology in order to ensure high quality research. Poor quality qualitative work can lead to misleading findings.
• Qualitative research alone is often insufficient to make population-level summaries. The research is not designed for this purpose, as the aim is not to generate summaries generalisable to the wider population.
• Policy makers may not understand or value the interpretive position and therefore may not recognize the importance of qualitative research.
• Qualitative research can be time and labour-intensive. Conducting multiple interviews and focus groups can be logistically difficult to arrange and time consuming. Furthermore, tranalysanscription and analysis of the data (comparing, coding, and inducting) requires intense concentration and full immersion in the data – a process that can be far more time-consuming than a descriptive statistical analysis.

© I Crinson & M Leontowitsch 2006, G Morgan 2016

Qualitative vs Quantitative Research Methods & Data Analysis

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

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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Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

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What is the difference between quantitative and qualitative?

The main difference between quantitative and qualitative research is the type of data they collect and analyze.

Quantitative research collects numerical data and analyzes it using statistical methods. The aim is to produce objective, empirical data that can be measured and expressed in numerical terms. Quantitative research is often used to test hypotheses, identify patterns, and make predictions.

Qualitative research, on the other hand, collects non-numerical data such as words, images, and sounds. The focus is on exploring subjective experiences, opinions, and attitudes, often through observation and interviews.

Qualitative research aims to produce rich and detailed descriptions of the phenomenon being studied, and to uncover new insights and meanings.

Quantitative data is information about quantities, and therefore numbers, and qualitative data is descriptive, and regards phenomenon which can be observed but not measured, such as language.

What Is Qualitative Research?

Qualitative research is the process of collecting, analyzing, and interpreting non-numerical data, such as language. Qualitative research can be used to understand how an individual subjectively perceives and gives meaning to their social reality.

Qualitative data is non-numerical data, such as text, video, photographs, or audio recordings. This type of data can be collected using diary accounts or in-depth interviews and analyzed using grounded theory or thematic analysis.

Qualitative research is multimethod in focus, involving an interpretive, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them. Denzin and Lincoln (1994, p. 2)

Interest in qualitative data came about as the result of the dissatisfaction of some psychologists (e.g., Carl Rogers) with the scientific study of psychologists such as behaviorists (e.g., Skinner ).

Since psychologists study people, the traditional approach to science is not seen as an appropriate way of carrying out research since it fails to capture the totality of human experience and the essence of being human.  Exploring participants’ experiences is known as a phenomenological approach (re: Humanism ).

Qualitative research is primarily concerned with meaning, subjectivity, and lived experience. The goal is to understand the quality and texture of people’s experiences, how they make sense of them, and the implications for their lives.

Qualitative research aims to understand the social reality of individuals, groups, and cultures as nearly as possible as participants feel or live it. Thus, people and groups are studied in their natural setting.

Some examples of qualitative research questions are provided, such as what an experience feels like, how people talk about something, how they make sense of an experience, and how events unfold for people.

Research following a qualitative approach is exploratory and seeks to explain ‘how’ and ‘why’ a particular phenomenon, or behavior, operates as it does in a particular context. It can be used to generate hypotheses and theories from the data.

Qualitative Methods

There are different types of qualitative research methods, including diary accounts, in-depth interviews , documents, focus groups , case study research , and ethnography.

The results of qualitative methods provide a deep understanding of how people perceive their social realities and in consequence, how they act within the social world.

The researcher has several methods for collecting empirical materials, ranging from the interview to direct observation, to the analysis of artifacts, documents, and cultural records, to the use of visual materials or personal experience. Denzin and Lincoln (1994, p. 14)

Here are some examples of qualitative data:

Interview transcripts : Verbatim records of what participants said during an interview or focus group. They allow researchers to identify common themes and patterns, and draw conclusions based on the data. Interview transcripts can also be useful in providing direct quotes and examples to support research findings.

Observations : The researcher typically takes detailed notes on what they observe, including any contextual information, nonverbal cues, or other relevant details. The resulting observational data can be analyzed to gain insights into social phenomena, such as human behavior, social interactions, and cultural practices.

Unstructured interviews : generate qualitative data through the use of open questions.  This allows the respondent to talk in some depth, choosing their own words.  This helps the researcher develop a real sense of a person’s understanding of a situation.

Diaries or journals : Written accounts of personal experiences or reflections.

Notice that qualitative data could be much more than just words or text. Photographs, videos, sound recordings, and so on, can be considered qualitative data. Visual data can be used to understand behaviors, environments, and social interactions.

Qualitative Data Analysis

Qualitative research is endlessly creative and interpretive. The researcher does not just leave the field with mountains of empirical data and then easily write up his or her findings.

Qualitative interpretations are constructed, and various techniques can be used to make sense of the data, such as content analysis, grounded theory (Glaser & Strauss, 1967), thematic analysis (Braun & Clarke, 2006), or discourse analysis.

For example, thematic analysis is a qualitative approach that involves identifying implicit or explicit ideas within the data. Themes will often emerge once the data has been coded.

Key Features

• Events can be understood adequately only if they are seen in context. Therefore, a qualitative researcher immerses her/himself in the field, in natural surroundings. The contexts of inquiry are not contrived; they are natural. Nothing is predefined or taken for granted.
• Qualitative researchers want those who are studied to speak for themselves, to provide their perspectives in words and other actions. Therefore, qualitative research is an interactive process in which the persons studied teach the researcher about their lives.
• The qualitative researcher is an integral part of the data; without the active participation of the researcher, no data exists.
• The study’s design evolves during the research and can be adjusted or changed as it progresses. For the qualitative researcher, there is no single reality. It is subjective and exists only in reference to the observer.
• The theory is data-driven and emerges as part of the research process, evolving from the data as they are collected.

Limitations of Qualitative Research

• Because of the time and costs involved, qualitative designs do not generally draw samples from large-scale data sets.
• The problem of adequate validity or reliability is a major criticism. Because of the subjective nature of qualitative data and its origin in single contexts, it is difficult to apply conventional standards of reliability and validity. For example, because of the central role played by the researcher in the generation of data, it is not possible to replicate qualitative studies.
• Also, contexts, situations, events, conditions, and interactions cannot be replicated to any extent, nor can generalizations be made to a wider context than the one studied with confidence.
• The time required for data collection, analysis, and interpretation is lengthy. Analysis of qualitative data is difficult, and expert knowledge of an area is necessary to interpret qualitative data. Great care must be taken when doing so, for example, looking for mental illness symptoms.

Advantages of Qualitative Research

• Because of close researcher involvement, the researcher gains an insider’s view of the field. This allows the researcher to find issues that are often missed (such as subtleties and complexities) by the scientific, more positivistic inquiries.
• Qualitative descriptions can be important in suggesting possible relationships, causes, effects, and dynamic processes.
• Qualitative analysis allows for ambiguities/contradictions in the data, which reflect social reality (Denscombe, 2010).
• Qualitative research uses a descriptive, narrative style; this research might be of particular benefit to the practitioner as she or he could turn to qualitative reports to examine forms of knowledge that might otherwise be unavailable, thereby gaining new insight.

What Is Quantitative Research?

Quantitative research involves the process of objectively collecting and analyzing numerical data to describe, predict, or control variables of interest.

The goals of quantitative research are to test causal relationships between variables , make predictions, and generalize results to wider populations.

Quantitative researchers aim to establish general laws of behavior and phenomenon across different settings/contexts. Research is used to test a theory and ultimately support or reject it.

Quantitative Methods

Experiments typically yield quantitative data, as they are concerned with measuring things.  However, other research methods, such as controlled observations and questionnaires , can produce both quantitative information.

For example, a rating scale or closed questions on a questionnaire would generate quantitative data as these produce either numerical data or data that can be put into categories (e.g., “yes,” “no” answers).

Experimental methods limit how research participants react to and express appropriate social behavior.

Findings are, therefore, likely to be context-bound and simply a reflection of the assumptions that the researcher brings to the investigation.

There are numerous examples of quantitative data in psychological research, including mental health. Here are a few examples:

Another example is the Experience in Close Relationships Scale (ECR), a self-report questionnaire widely used to assess adult attachment styles .

The ECR provides quantitative data that can be used to assess attachment styles and predict relationship outcomes.

Neuroimaging data : Neuroimaging techniques, such as MRI and fMRI, provide quantitative data on brain structure and function.

This data can be analyzed to identify brain regions involved in specific mental processes or disorders.

For example, the Beck Depression Inventory (BDI) is a clinician-administered questionnaire widely used to assess the severity of depressive symptoms in individuals.

The BDI consists of 21 questions, each scored on a scale of 0 to 3, with higher scores indicating more severe depressive symptoms. 

Quantitative Data Analysis

Statistics help us turn quantitative data into useful information to help with decision-making. We can use statistics to summarize our data, describing patterns, relationships, and connections. Statistics can be descriptive or inferential.

Descriptive statistics help us to summarize our data. In contrast, inferential statistics are used to identify statistically significant differences between groups of data (such as intervention and control groups in a randomized control study).

• Quantitative researchers try to control extraneous variables by conducting their studies in the lab.
• The research aims for objectivity (i.e., without bias) and is separated from the data.
• The design of the study is determined before it begins.
• For the quantitative researcher, the reality is objective, exists separately from the researcher, and can be seen by anyone.
• Research is used to test a theory and ultimately support or reject it.

Limitations of Quantitative Research

• Context: Quantitative experiments do not take place in natural settings. In addition, they do not allow participants to explain their choices or the meaning of the questions they may have for those participants (Carr, 1994).
• Researcher expertise: Poor knowledge of the application of statistical analysis may negatively affect analysis and subsequent interpretation (Black, 1999).
• Variability of data quantity: Large sample sizes are needed for more accurate analysis. Small-scale quantitative studies may be less reliable because of the low quantity of data (Denscombe, 2010). This also affects the ability to generalize study findings to wider populations.
• Confirmation bias: The researcher might miss observing phenomena because of focus on theory or hypothesis testing rather than on the theory of hypothesis generation.

Advantages of Quantitative Research

• Scientific objectivity: Quantitative data can be interpreted with statistical analysis, and since statistics are based on the principles of mathematics, the quantitative approach is viewed as scientifically objective and rational (Carr, 1994; Denscombe, 2010).
• Useful for testing and validating already constructed theories.
• Rapid analysis: Sophisticated software removes much of the need for prolonged data analysis, especially with large volumes of data involved (Antonius, 2003).
• Replication: Quantitative data is based on measured values and can be checked by others because numerical data is less open to ambiguities of interpretation.
• Hypotheses can also be tested because of statistical analysis (Antonius, 2003).

Antonius, R. (2003). Interpreting quantitative data with SPSS . Sage.

Black, T. R. (1999). Doing quantitative research in the social sciences: An integrated approach to research design, measurement and statistics . Sage.

Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology . Qualitative Research in Psychology , 3, 77–101.

Carr, L. T. (1994). The strengths and weaknesses of quantitative and qualitative research : what method for nursing? Journal of advanced nursing, 20(4) , 716-721.

Denscombe, M. (2010). The Good Research Guide: for small-scale social research. McGraw Hill.

Denzin, N., & Lincoln. Y. (1994). Handbook of Qualitative Research. Thousand Oaks, CA, US: Sage Publications Inc.

Glaser, B. G., Strauss, A. L., & Strutzel, E. (1968). The discovery of grounded theory; strategies for qualitative research. Nursing research, 17(4) , 364.

Minichiello, V. (1990). In-Depth Interviewing: Researching People. Longman Cheshire.

Punch, K. (1998). Introduction to Social Research: Quantitative and Qualitative Approaches. London: Sage

Further Information

• Designing qualitative research
• Methods of data collection and analysis
• Introduction to quantitative and qualitative research
• Checklists for improving rigour in qualitative research: a case of the tail wagging the dog?
• Qualitative research in health care: Analysing qualitative data
• Qualitative data analysis: the framework approach
• Using the framework method for the analysis of
• Qualitative data in multi-disciplinary health research
• Content Analysis
• Grounded Theory
• Thematic Analysis

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Qualitative Data Collection & Analysis Methods

59 Strengths and Weaknesses of Qualitative Interviews

As the preceding sections have suggested, qualitative interviews are an excellent way to gather detailed information. Whatever topic is of interest to the researcher employing this method can be explored in much more depth than with almost any other method. Not only are participants given the opportunity to elaborate in a way that is not possible with other methods such as survey research, but they also are able share information with researchers in their own words and from their own perspectives rather than being asked to fit those perspectives into the perhaps limited response options provided by the researcher. And because qualitative interviews are designed to elicit detailed information, they are especially useful when a researcher’s aim is to study social processes, or the “how” of various phenomena. Yet another, and sometimes overlooked, benefit of qualitative interviews that occurs in person is that researchers can make observations beyond those that a respondent is orally reporting. A respondent’s body language, and even her or his choice of time and location for the interview, might provide a researcher with useful data.

Of course, all these benefits do not come without some drawbacks. As with quantitative survey research, qualitative interviews rely on respondents’ ability to accurately and honestly recall whatever details about their lives, circumstances, thoughts, opinions, or behaviours are being asked about. Further, as you may have already guessed, qualitative interviewing is time intensive and can be quite expensive. Creating an interview guide, identifying a sample, and conducting interviews are just the beginning. Transcribing interviews is labour intensive—and that is before coding even begins. It is also not uncommon to offer respondents some monetary incentive or thank-you for participating. Keep in mind that you are asking for more of the participants’ time than if you would have simply mailed them a questionnaire containing closed-ended questions. Conducting qualitative interviews is not only labour intensive but also emotionally taxing. Researchers embarking on a qualitative interview project, with a subject that is sensitive in nature, should keep in mind their own abilities to listen to stories that may be difficult to hear.

Text Attributions

• This chapter is an adaptation of Chapter 9.2 in Principles of Sociological Inquiry , which was adapted by the Saylor Academy without attribution to the original authors or publisher, as requested by the licensor. © Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License .

An Introduction to Research Methods in Sociology Copyright © 2019 by Valerie A. Sheppard is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Qualitative Research: Strengths and Weakness Coursework

Biggest ethical dilemma faced by qualitative researchers.

The biggest ethical dilemma in qualitative research is the researchers’ responsibility for disclosure of information. The decision on whether to disclose information to any interested party to research or even to conceal information from concerned individuals and groups forms the basis of the dilemma. Every research activity is aimed at finding solutions and researchers’ interest will be to find the necessary information. As a result, there may be a need to conceal some information to ensure a smooth research process. Similarly, the results of the research might be of public interest and prompt for disclosure, to the compromise of a group’s interest.

Concealing information or even the researcher’s identity has in the past been a tool for the success of major research activities. Similarly, participants in research are supposed to be informed of the nature of the research before they can consent to be part of such activities. Further, the guarantee of privacy should be offered to the participants before the research. Full disclosure of the extent of confidentiality should also be made before the commencement of the research. A researcher is therefore expected either to consider the success of the research at the expense of ethics of disclosure or to prioritize ethics (Berg and Lune, 2011).

Primary reasons for using qualitative research and questions addressed by qualitative research

Qualitative research is aimed at investigations on existing relationships. Every research initiative will, therefore, be based on goals and reasons for making conclusions and recommendations. As Flick and Steinke explain, the major reasons for qualitative research are “description, a test of hypothesis and theory development” (2004, p. 150). This is because qualitative research activities are explorative. They, as a result, seek to describe relationships, investigate the significance of such relationships, and develop a basis for explaining the identified or existing relationships.

A research initiative to investigate trends in the prevalence of AIDS rates across age groups may, for example, be undertaken with the objective of exploring descriptive statistics such as mean, mode, and median across the considered age groups. Similarly, investigating trends among or within the groups may call for a test of hypothesis for establishing confidence through tests of significance on investigated trends. Qualitative research, through validating hypothesis, is also used as a basis for establishing theories (Flick and Steinke, 2004).

Since research questions offer directions to exploring research objectives, they are supposed to be aligned to the objectives and reasons for the particular research. Qualitative research, therefore, addresses questions on descriptive statistics, tests of significance and theory development (Flick and Steinke, 2004)

Triangulation of methods and their benefits

Triangulation of methods refers to the application of many approaches towards establishing findings of the research. The method is based on the concept that the application of many methods yields more accurate conclusions. The triangulation concept is derived from surveying methods in which many lines are used in the estimation of points. The concept is therefore mapped onto statistical qualitative research to use different approaches such as sampling techniques, analytical approaches, and diversification of samples in research. Triangulation of methods may also be understood in its literal meaning as the use of a variety of methods in research activity (Berg and Lune, 2011).

There exist a variety of classes of triangulation. Data triangulation, for instance, refers to the use of approaches such as “time, space, and person” (Berg and Lune, 2011, p. 7). While time triangulation refers to the consideration of data from different time frames, space triangulation refers to physical or geographical consideration and person triangulations consider the nature and type of sample used in research. Other classes include “investigator, theory, and methodological triangulation” (Berg and Lune, 2011, p. 7). The benefits of triangulations are therefore its broader scope of research and a resultant accuracy in results and conclusions (Berg and Lune, 2011).

Sampling strategies for qualitative research

Sampling strategies form one of the distinctions between qualitative and quantitative research approaches. The most commonly used sampling strategies in qualitative research are “criterion-based” sampling and “theoretical sampling” (Ritchie and Lewis, 2003, p. 78, 80). Criterion, as a basis for sampling, is used in cases where the participants in the research posses defined properties that are relevant to the research.

The main objective of this strategy is to obtain adequate representation through the selected sample. An element will, for example, be selected to represent a particular geographical area, group, or a behavioral characteristic. Criterion based sampling is further divided into several classes which include “homogeneous sampling, heterogeneous sampling, extreme case sampling, intensive sampling, typical case sampling, stratified purposive sampling, and critical case sampling” (Ritchie and Lewis, 2003, p. 79, 80).

Since criterion-based sampling relies on the purpose of the research, the particular sampling approach for used is identified before the commencement of the research, and the decision is usually based on the objectives of the research. The theoretical sampling strategy is on the other hand based on the capacity of the participants to make significant contributions to the results of the research (Ritchie and Lewis, 2003)

Strengths and weakness of qualitative research

Qualitative research has both strengths and weaknesses. One of the strengths is its extensive understanding that it offers to the subject of research. The explorative nature of qualitative research that involves extensive analysis of background information as well as collected data offers a basis for understanding. Further, a summary of the research results through descriptive statistics facilitates a deeper understanding.

The nature of the research that induces confidence through the reliable test of hypothesis also draws interest for closer attention and understanding. Another advantage of qualitative research is its flexible nature. The numerous strategies and techniques at different stages of research are easily interchangeable. As a result, approaches and methods can be substituted at any stage of the research (Rubbin and Babbie, 2009).

Weaknesses that have been associated with qualitative research include generalization in presentation and biasness due to formed opinion or conflict of interest on the part of a researcher. Generalization of reports, for instance, leads to loss of precision especially in cases where varying opinions exist across samples. Similarly, a researcher may be biased at any point in the research to influence an outcome. Biasness can be induced during sample selection or data collection stages (Rubbin and Babbie, 2009).

Possible problems faced in qualitative research

There are several problems faced in qualitative research. These problems range from the research process to the research environment. One of the already identified problems is the researcher’s ability to “adopt and adapt” to different research strategies and methods (Barbour, 2007). The main reason why the availability of many options is a challenge to many researchers is the intersection of concepts in research strategies. This particularly makes it difficult for a researcher to identify the most suitable approach to use.

Another significant challenge in qualitative research is a conflict of interest in which a researcher’s motive shifts to exalting himself instead of paying attention to the subject of research. When attention is shifted, the chances of biasness become higher. The financial interest of researchers has also developed to be a major challenge in qualitative research. This is particularly encountered in sponsored research activities where a researcher is dependent on and is subjected to forces from other interested parties. As a result, a researcher may be influenced by compromising and being biased to favor the parties. Researchers are therefore expected to be strong enough and independent to shun down such forces leading to biasness (Barbour, 2007).

Barbour, R. (2007). Introducing Qualitative Research: A Student’s Guide to the Craft of Doing Qualitative Research. London, UK: SAGE.

Berg, B., and Lune, H. (2011). Qualitative Research Methods for the Social Sciences . New York, NY: Allyn & Bacon.

Flick, U., Kardorff, E. and Steinke, I. (2004). A companion to qualitative research. London, UK: SAGE.

Ritchie, J. and Lewis, J. (2003). Qualitative research practice: a guide for social science students and researchers. London, UK: SAGE.

Rubbin, A. and Babbie, E. (2009). Essential Research Methods for Social Work. Belmont, CA: Cengage Learning.

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Qualitative evaluation in nursing interventions—A review of the literature

Kristine rørtveit.

1 Department of Research, Nursing and Healthcare Research Group, Stavanger University Hospital, Stavanger Norway

Britt Saetre Hansen

Kirsten lode, elisabeth severinsson, associated data.

To identify and synthesize qualitative evaluation methods used in nursing interventions.

A systematic qualitative review with a content analysis. Four databases were used: MEDLINE, PsycINFO, Embase and CINAHL using pre‐defined terms. The included papers were published from 2014–2018.

We followed the guidelines of Dixon‐Woods et al., Sandelowski and Barroso, the Critical Appraisal Skills Programme qualitative checklist and The Confidence in the Evidence from Reviews of Qualitative Research Approach.

Of 103 papers, 15 were eligible for inclusion. The main theme Challenging complexity by evaluating qualitatively described processes and characteristics of qualitative evaluation. Two analytic themes emerged: Evaluating the implementation process and Evaluating improvements brought about by the programme.

Different qualitative evaluation methods in nursing are a way of documenting knowledge that is difficult to illuminate in natural settings and make an important contribution when determining the pros and cons of an intervention.

1. INTRODUCTION

During the last decade, there has been an ongoing discussion on the topic of developing and evaluating complex nursing interventions. Nursing interventions can be evaluated qualitatively, as this method enhances the significance of clinical trials and emphasizes the distinctive work and outcomes of nursing care (Sandelowski,  1996 ). However, there are few examples of detailed methodological strategies for doing so (Schumacher et al.,  2005 ). Evaluation is a positive pursuit as it provides an organization with knowledge of how to improve or verify the value of services and how to determine which elements are strong and which are in need of improvement (Stufflebeam & Shinkfield,  2007 ). Nurses should therefore develop and implement strategies aimed at creating professional practice, and furthermore, such strategies should include designing and implementing performance measurement systems (McDavid & Huse,  2006 ). Morse, Penrod, and Hupcey ( 2000 ) describes Qualitative Outcome Analysis (QOA) as a method for qualitatively identifying intervention strategies and evaluating the implementation outcomes of patient‐oriented interventions.

1.1. Background

Clinical nursing is complex, and nurses need to understand the complexity of evaluation to improve their practice. The term “complex intervention” is widely used in the academic health literature to describe both health service and public health interventions. Complex interventions are defined as consisting of several components, which can act either independently or interdependently (Campbell et al.,  2007 ; Mohler, Bartoszek, Kopke, & Meyer,  2012 , p. 455). A complex intervention is characterized by several interacting components in several dimensions such as the behaviour required by the persons involved, the number of groups or levels in the organization, variability of outcomes and/or the degree of intervention flexibility (Craig et al.,  2008 ).

The choice of evaluation method must be determined by its appropriateness for the purpose and intended use (Patton,  2015 ). Qualitative methods provide those who make decisions about the follow‐up of an intervention with access to a deeper understanding of the participants' experiences and perceptions of the intervention that goes beyond numbers and statistics (Patton,  2015 ). There are few studies about nursing intervention evaluation methods that describe the formal documentation of the content and delivery of a specific intervention in greater detail (Michie, Fixsen, Grimshaw, & Eccles,  2009 ) or factors that influence improvement in clinical nursing. Michie et al. ( 2009 , p. 3) describe eight aspects that are essential in healthcare implementation: the content of the intervention, characteristics of those delivering the intervention, characteristics of the recipients, characteristics of the setting, the mode of delivery, the intensity (e.g. contact time), the duration (e.g. number of sessions over a given period) and adherence to delivery protocols. This is in accordance with Craig et al. ( 2008 ), who argue for several aspects necessary of development and evaluation: a good theoretical understanding, implementation problems, level processes, the range of measures and strict fidelity. Thus, we expand on the existing knowledge of complex interventions by searching for studies using qualitative evaluation methods to demonstrate a variety of methods used in relation to nursing evaluation and in the following we identify and synthesize the qualitative evidence of which research methods are applied when nursing interventions are evaluated.

2. THE REVIEW

To identify and synthesize qualitative evaluation methods used in nursing interventions. The review question addressed was: What characterizes the qualitative methods applied in evaluating the implementation of nursing interventions and improvements?

2.2. Design

A systematic literature review was conducted (Dixon‐Woods, Agarwal, Jones, Young, & Sutton,  2005 ; Hansen et al.,  2012 ) on qualitative studies providing knowledge methods used in qualitative evaluation in the clinical nursing field. The qualitative review guidelines for assessing the quality of evidence presented by Sandelowski and Barroso (Sandelowski & Barroso,  2007 ) were adhered to.

2.3. Search method

A systematic search was carried out in MEDLINE, PsycINFO and Embase in October 2018. An additional search was performed in CINAHL to identify articles with nursing perspectives. Articles published in the previous 5 years (from January 2014) were included. The following search terms were used: qualitative evaluation, method* or tool* or model* or process* or strateg* or criteria or plan*, nurs* and implement* or improve* or intervention* or practice* or programme, patient*.

2.4. Search outcomes

The initial search revealed 103 articles, of which 40 were excluded due to being duplicates, 13 for not using a qualitative research method and 12 for other reasons such as not being performed by nurses, not involving nursing in the intervention or not involving patients. Appendix I shows the details and describes the identification process in accordance with PRISMA (Moher, Liberati, Tetzlaff, & Altman,  2009 ).

2.5. Inclusion and exclusion criteria

The searches were limited to peer‐reviewed journal articles in the English language on qualitative research methods applied in the evaluation of nursing interventions for adult patients (<18+ years) published within the previous 5 years. The narrow inclusion criteria stipulated articles focusing on nursing interventions in the clinical context and were from different hospital settings and community care. Articles on the family perspective, students' perspective and those employing mixed methods were excluded.

A total of 15 articles fulfilled the narrow inclusion criteria and were deemed appropriate for the review in addition to being relevant for illuminating the topics addressed by the review question. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (Moher et al.,  2009 ; PRISMA,  2018 ) and the Critical Appraisal Skills Programme (CASP,  2018 ) were used to structure the review process. The PRISMA flow diagram shows the selection process ( Appendix I ).

2.6. Quality appraisal and data extraction

Each article was initially critically appraised by two reviewers independently followed by a discussion among all five nurse researchers who finally reached consensus. All the included articles were quality checked in accordance with the checklist (CASP,  2018 ), see Appendix II and were sorted by study aim, intervention and context, method, results, qualitative evaluation and why it was performed as shown in Table  1 .

Overview of included papers

Abbreviations: AVERT, A Very Early Rehabilitation Trial; CCM, chronic care model; CMNs, certified nurse midwives; COPD, chronic obstructive pulmonary disease; DD, dementia disease; GP, general practitioner; ICU, intensive care unit; PN, practice nurses; RCT, randomized controlled trials; RN, Registered Nurses; SAM, Systematic Activation Method; VM, validation method.

2.7. Review

The qualitative review adhered to (Sandelowski & Barroso,  2007 ). The analysis was performed by a thorough reading and rereading of the articles (Dixon‐Woods et al.,  2006 ). The data were analysed stepwise following a manifest content analysis technique (Graneheim & Lundman,  2004 ). After each article had been thoroughly assessed, they were sorted and summarized. In the analysis process, the text describing the evaluation method was considered to constitute the meaning units (Graneheim & Lundman,  2004 ). The meaning units were then coded and thematized as groups of content that shared a similar meaning. The qualitative evaluation method was reflected on, discussed and finally formulated into one theme and three sub‐themes. The sub‐themes helped to describe the identified factors. The main theme and sub‐themes were created by abstraction of the categorized meaning units in a process involving all the authors. Various alternatives were discussed by the authors to reach consensus on the sorting and labelling. Research Ethics Committee approval was not required.

3.1. Characteristic of the studies

Of 103 papers, 15 were eligible for inclusion (Baron et al.,  2018 ; Bolmsjo, Edberg, & Andersson,  2014 ; Clignet, van Meijel, van Straten, & Cuijpers,  2017 ; Davisson & Swanson,  2018 ; Furler et al., 2014 ; Graves, Garrett, Amiel, Ismail, & Winkley,  2016 ; Hahne, Lundstrom, Levealahti, Winnhed, & Ohlen,  2017 ; Halcomb et al.,  2015 ; Hanifa, Glaeemose, & Laursen,  2018 ; Helmle, Edwards, Kushniruk, & Borycki,  2018 ; Hill et al.,  2016 ; Iyer, Koziel, & Langhan,  2015 ; Kang, Moyle, Cooke, & O'Dwyer,  2017 ; Luker et al.,  2016 ; Soderlund, Cronqvist, Norberg, Ternestedt, & Hansebo,  2016 ) and the PRISMA flow diagram shows the selection process ( Appendix I I). The 15 included articles are presented in Table 1 , and there is an example of the questions, while Appendix II contains the criteria from the CASP checklist. Overall, we found that the included articles had a high score, although adequate consideration of the relationship between the researcher and participants was lacking in several articles. The most common methodology was interviews, either individual or in focus groups. Educational programmes were the most frequently used intervention, and thematic analysis was the methodology most often employed. Two analytic themes emerged: Evaluating the implementation process and Evaluating improvements brought about by the programme (Table 2 ). One main theme was developed from this process: Challenging complexity by evaluating qualitatively . The main theme outlined how the design of an evaluation of the intervention was influenced by the inherent complexity.

3.2. Theme 1: Evaluating the implementation process

This theme described the different types of evaluation design used in the implementation processes, data characteristics and context as well as types and models of analysis.

3.2.1. Different types of designs

The theme different types of design was based on the sub‐category aims and types of data , where we found a great variation in the descriptions employed. Some of the studies aimed to report and evaluate the intervention from the staff perspectives , while others described and evaluated the patients' perspectives or reported both perspectives (Baron et al.,  2018 ). Changes associated with the interventions were examined by some, while others explored experiences of care or evaluated experiences and perceptions of an intervention. Several of the aims concerned contributing to a deeper knowledge in staff members' daily practice; to better understand their experiences and explore perceptions and perspectives of an intervention (Graves et al.,  2016 ; Iyer et al.,  2015 ; Luker et al.,  2016 ). Other examples from staff members' perspectives aimed at exploring the use of drama as a tool (Bolmsjo et al.,  2014 ) or developing a model of care (Furler et al.,  2014 ).

Examples of more detailed formulations of the aims were: to improve a programme (Davisson & Swanson,  2018 ), evaluate a programme's impact on staff's knowledge and attitude (Kang et al.,  2017 ) or to evaluate effect on practice (Helmle et al.,  2018 ). Some studies aimed to evaluate the effect of workflow and practice and to examine the strength and weaknesses of a programme (Helmle et al.,  2018 ; Kang et al.,  2017 ). The various aims demonstrated ways of detecting the knowledge sought by the evaluation, and all of them were grounded in a design with a qualitative tradition.

The types of data pointed to a variety of different data collection methods in qualitative evaluations. They all included some form of in‐depth interviews, and semi‐structured interviews were common (Baron et al.,  2018 ; Graves et al.,  2016 ; Halcomb et al.,  2015 ; Hanifa et al.,  2018 ; Helmle et al.,  2018 ; Luker et al.,  2016 ). Several studies employed one or several focus group interviews (Baron et al.,  2018 ; Bolmsjo et al.,  2014 ; Furler et al.,  2014 ; Hahne et al.,  2017 ; Hill et al.,  2016 ), and there were several examples of combined methods, such as evaluation interviews, focus group and telephone interviews (Furler et al.,  2014 ), telephone interviews, voice Internet or face to face (Luker et al.,  2016 ), observations and tape recordings during sessions, focus group interview and written reflections (Bolmsjo et al.,  2014 ). Other examples of data collection were related to the time the data were collected: for instance, a process evaluation conducted by means of qualitative data collected 3 and 12 months postintervention (Furler et al.,  2014 ).

We found no explicit explanations of or reflections on why the specific design was chosen in any of the articles, although an implicit understanding was present.

3.2.2. Data characteristics and context

The different data and context of problems pertaining to the evaluations varied, illuminating the range of fields where qualitative evaluation methods can be valuable in an implementation process. This category describes the types of setting, problem and diagnosis. The data represent a variety of clinical settings and were collected in natural healthcare contexts. Several evaluations were performed in a typical somatic hospital setting such as acute stroke, paediatric, surgical ICU or obstetric departments (Baron et al.,  2018 ; Hahne et al.,  2017 ; Hanifa et al.,  2018 ; Iyer et al.,  2015 ; Luker et al.,  2016 ). In addition, community settings such as elder and dementia care (Bolmsjo et al.,  2014 ) and diabetes care (Furler et al.,  2014 ) were evaluated. The settings of the various studies represented different clinical contexts; acute and emergency care, long‐term care and general practice, community settings and hospital units, all of which were representative of a complex intervention .

3.2.3. Types and models of analysis

All the reviewed articles presented established models of analysis in the methodological section, which provided a detailed description of how the analysis was performed. In addition to traditional qualitative analysis, the articles described more advanced models of analysis such as thematic content analysis, the hermeneutic phenomenological approach, grounded theory, conventional inductive content analysis (Clignet et al.,  2017 ; Hanifa et al.,  2018 ; Iyer et al.,  2015 ) and several forms of content analysis. This summary shows the variety of methods that can be chosen.

The question of whether the evaluation of the detailed intervention was performed inductively or deductively was addressed in some of the articles (Bolmsjo et al.,  2014 ; Furler et al.,  2014 ; Iyer et al.,  2015 ; Luker et al.,  2016 ) but only when explicitly stating that an inductive approach was used. In several of the studies, it seemed as if the reason for choosing a qualitative design was to capture the complexity.

3.3. Theme 2: Evaluating improvements brought about by the programme

This theme analyses the improvements as they were described in the studies that is, the intervention process; types of intervention and characteristics of those who deliver the intervention. The implementation processes were complex, but the qualitative analysis and highlights of the articles made the outcome of the interventions visible.

3.3.1. Clinical benefits

The outcomes were connected to the clinical benefits . For instance, important themes that provided more insight into clinical implementation in complex care settings were described (Luker et al.,  2016 ). These included the fact that the implementation required extra work but was rewarding; that team practices changed; that challenges such as the lack of established interdisciplinary teamwork and inadequate staffing levels arose at some sites; that there were various organizational barriers, the impact of staff attitudes and beliefs and patient‐related barriers; and that enthusiastic team leadership was crucial for success. Another example was described by Clignet et al. ( 2017 ), who studied the implementation process to find which implementation factors are most relevant to this population and to identify facilitators and barriers relating to the characteristics and contextual factors of patients and nurses (Clignet et al.,  2017 ).

One study revealed that although the participants considered the intervention safe, they did not use it (Iyer et al.,  2015 ). Another result revealed that the intervention could be a means to enhance reflection on daily caring practice among nursing staff (Bolmsjo et al.,  2014 ), while one found that the RN led model increased patient satisfaction and gave RNs greater autonomy (Baron et al.,  2018 ). Positive changes in palliative care were described, such as working methods, team collaboration, collegial support, discussions about diagnosis, symptoms at the end of life and the patient's family members (Hahne et al.,  2017 ). Involving relatives was found to be essential in the rehabilitation of former intensive care patients (Hanifa et al.,  2018 ). A study on fall prevention described that an education programme created a positive culture whereby patients and staff worked together to address falls prevention and gained awareness about creating a safe ward environment (Hill et al.,  2016 ).

The study on a 1‐year training programme on validation communication for nurses described the reactions of patients with dementia and found that actions such as not treating the patient as an adult constitute a barrier to communication or talking more freely about what is on one's mind (Soderlund et al.,  2016 ). In one study on a care model for insulin initiation, a long‐standing relationship with and knowledge of patients was described as essential for providing information, education and addressing concerns in a timely manner that suited patients (Furler et al.,  2014 ). In a study on psychological skill training to support patients with diabetes‐2, nurses described a sense of overstepping their professional role when dealing with emotive consultations as they did not feel qualified and had to adjust their role to facilitate the use of the new skills (Graves et al.,  2016 ).

One article described how important the chronic disease management programme was despite a lack of commitment to it. There was an overreliance on coordinators to manage all aspects of the programme and that more efficient communication was necessary when identifying appropriate patients to refer to the programme (Davisson & Swanson,  2018 ). We found that the outcome in all articles was of benefit to clinical practice, despite the fact that no numerical or statistical data were presented.

3.3.2. Types of intervention

As we did not limit the type of clinical implementation when selecting the articles, the types of intervention included in this review were broad. The models and programmes implemented were thoroughly described in the articles. Most of the interventions comprised programmes involving models or guidelines such as drama as a tool (Bolmsjo et al.,  2014 ) and the care model for insulin initiation (Furler et al.,  2014 ). Few of the studies described procedures in detail, with the exception of one study on sedation during the capnography procedure (Iyer et al.,  2015 ). The patient nurse perspective and the intensity and duration of the intervention were thoroughly described in each article. The utility of the intervention and why such interventions were necessary were also outlined.

3.3.3. Characteristics of those who deliver the intervention

In the articles, several professional categories were involved in the implementation process and described in accordance with the mode of delivery and the organizational level of the intervention. Some articles involved only nursing staff, either with one specified nursing specialty or with different types of nursing specialty . Other articles described a multidisciplinary combination of nurses and other professionals, for instance physiotherapists, personal trainer assistants and speech pathologists, paediatric emergency medicine professionals, general practitioners (GPs) and endocrinologists (Furler et al.,  2014 ; Iyer et al.,  2015 ; Luker et al.,  2016 ).

The organizational level did not vary as much as the professional categories. However, some of the articles combined more than one unit, for instance several clinical units for old age psychiatry, adult care facilities or different medical wards in a regional hospital (Clignet et al.,  2017 ; Helmle et al.,  2018 ; Kang et al.,  2017 ). The evaluation studies were performed in their natural setting, and the mode and description of the delivery and the organizational level of the intervention provided important information that illuminated the complexity of the actual clinical setting.

4. DISCUSSION

The aim of this review was to identify and synthesize qualitative evaluation methods used in nursing interventions, and the review question was What characterizes the qualitative methods applied in evaluating the implementation of nursing interventions and improvements? This review illuminates how evaluating the implementation of nursing interventions and improvements i s challenging because of the complexity involved, which is described by the variety of different methods included in the qualitative evaluation of interventions. The review states that different perspectives of the qualitative evaluation designs highlight the variation and benefits of such evaluation.

The implementation process perspective illuminates the obvious reasons for performing the actual evaluation based on the design, the problems revealed, and the analysis methods employed. The evaluation perspective demonstrates how improvements based on concrete benefits are crucial. The actual evaluation of the intervention shows the importance of thorough descriptions of the implementation strategies, those who deliver the intervention and the level of the activity.

From the methodological perspective, we were surprised to detect such different modes and creative ways of handling the need to evaluate complex situations in clinical practice. Although several of the included articles aim to explore , we hold that the concept exploring experiences is continuous and needs to be considered a little further. According to van Manen, qualitative methods explore a variety of issues such as empirical questions or perceptions (p. 811). Qualitative methodology focuses on individuals, and the clinical evaluations as unique examples are under the spotlight in the current review. Therefore, What ‐questions are crucial as they provide insight. However, only a few articles explicitly aimed to gain insight. The concept explore is typically used in phenomenological approaches, but only one article in the present review claims to adopt a hermeneutic phenomenological approach; as the authors study the patients' perspective they combine observations, interviews and a hermeneutic phenomenological approach to analyse the data (Hanifa et al.,  2018 ). The original meaning of a phenomenon is captured by phenomenology; to bring experience we lived through to our awareness retrospectively; and to be able to reflect on the lived meaning of the experience (van Manen,  2017 ). While these approaches may be of benefit, they are more commonly used in studies at a theoretical level than the empirical studies included in the present review. It is obvious that the data collection method is guided by the research question. However, our review also reveals that the clinical field influences how the data are collected and analysed and that the method may lead to new methods for evaluating clinics.

In the qualitative evaluation checklist guidelines, Patton ( 2015 ) emphasizes the importance of the evaluator's knowledge of methodological issues and preparedness to argue for the credibility of the findings. Qualitative evaluations are most often performed in accordance with established methodological guidelines. According to Patton ( 2015 ), the quality of qualitative data and analysis depends on skilful interviews, systematic and rigorous observations as well as the sensitivity and integrity of the evaluator (Patton,  2015 ).

Our review detected that content analysis is common. According to Graneheim, Lindgren, and Lundman ( 2017 ), qualitative content analysis typically focuses on subject and context. It emphasizes variation and offers opportunities to perform a manifest descriptive and latent interpretative content analysis (Graneheim & Lundman,  2004 ). Research using qualitative content analysis is grounded in ontological assumptions, epistemology and methodology. It is important to be aware that the ontological assumptions are open and may vary according to the researchers' standpoint. Another explicit issue is that the epistemological basis of qualitative content analysis should guide the way that data are interpreted: as cocreations of the interviewee and the interviewer. Furthermore, the interpretation method is viewed as a cocreation of the researchers and the text. Graneheim et al. ( 2017 ) state that one methodological issue is the difficulties involved in keeping the levels of abstraction and degree of interpretation logical and congruent throughout the analysis and presentation (Graneheim et al.,  2017 ).

In the 1990s, Sandelowski ( 1996 ) viewed qualitative methods as the antithesis of clinical research and “far removed from the immediate practical aims of intervention studies and nursing practice” (Sandelowski,  1996 , p. 359). However, today we see that such methods not only benefit clinical studies, but are needed to explore, illuminate and describe the variation in the phenomenon to evaluate nursing interventions in their real‐life contexts. Therefore, we believe that the vast number of different methods in the selected articles needs to be outlined and further developed so that such methods will become more common when evaluating in different clinical contexts.

From the intervention perspective , the included articles are based on complex interventions (Mohler et al.,  2012 ). Qualitative evaluations seem appropriate when knowledge about the process of testing tools or information about established programmes is needed. It appears to be correct to evaluate any type of intervention qualitatively if the aim is the above‐mentioned knowledge. This supports arguments that the type of evaluative approach is decided by the research question, not the type of intervention.

Another important aspect is whether the intervention is designed ahead of the actual project or whether existing methods or models are to be evaluated. The former adheres to an inductive approach—when the evaluation looks for knowledge derived from the actual practice. According to Graneheim et al. ( 2017 ), such an approach is data‐ or text‐driven and characterized by a search for patterns through similarities and differences. This type of analysis is described in categories and/or themes, and the levels of abstraction and interpretation vary. Using the inductive approach, the researcher moves “from the data to a theoretical understanding—from the concrete and specific to the abstract and general” (Graneheim et al.,  2017 ). One important issue that must be addressed when employing an inductive approach is the researchers' pre‐understanding. The question that arises is whether the inductive approach is merely a result of the researchers' pre‐understanding of the studied phenomena. The challenge, according to Graneheim et al. ( 2017 ), is to avoid surface descriptions and general summaries when using an inductive approach. A deductive model is employed when data are interpreted through concepts, a model or a theory, and implications about the studied phenomenon are tested against the collected data. In these designs, the researchers move explicitly from theory to data. The challenge, according to Graneheim et al. ( 2017 ), is to avoid formulating categories that are exclusively based on established theory or models and the handling of left‐over data. The latter occurs when data are found that do not fit the explanatory model (Graneheim et al.,  2017 ).

The articles included in the present review provide a detailed description of the intervention they evaluated. According to Michie et al. ( 2009 ), formal documentation describing the content and delivery of an intervention will help to inform about what to teach new practitioners, how to transform or reorganize healthcare processes and what to include in the assessment of practitioner performance. These are all key features of successful implementation (Michie et al.,  2009 ).

Characteristics of those who deliver the intervention and characteristics that make interventions complex are the different professional categories or varying organizational levels targeted by the intervention (context of the intervention) and/or a need to tailor the intervention to specific settings (flexibility of the intervention) (Mohler et al.,  2012 ). Despite that one narrow inclusion criterion focuses on nursing interventions in a clinical context, we typically find a combination of multiple professional categories delivering nursing interventions in the included articles. Michie et al. ( 2009 ) state that description of the characteristics of the setting and of those who deliver an intervention is essential for replicating an implementation strategy.

Intervention level activity is presented as high‐level activity with multiple phases and settings. The need to tailor the intervention to specific settings seems to be the most complex component in the included articles as the evaluations were performed in a natural setting and developed by an actual need in the clinics.

Central questions in the field of evaluating complex interventions are how these interventions work in clinical practice? What are their active components? And are they effective? The answers to such questions will enable new and more effective interventions across multidisciplinary teams in live practice (Michie & Abraham,  2004 ). The Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare (CReDECI) may be of use for addressing evaluation (Craig et al.,  2008 ). In contrast to most reporting guidelines, the CReDECI does not offer criteria for a specific study design, but on the process of developing, piloting and evaluating complex interventions (Craig et al.,  2008 ).

Planning is crucial for the implementation of an intervention. According to Morse (Morse et al.,  2000 ), by examining current practice by means of QOA, researchers can contribute to generating increased clinical knowledge. This kind of evaluation can provide a detailed description of local processes in an intervention programme. Morse et al. ( 2000 ) claims that QOA may bridge the gap between research and practice. The same could probably be said about the qualitative evaluation method, as it may bring nursing research and practice closer together, and qualitative research methods more accurately describe complex nursing practice. Furthermore, Morse et al. ( 2000 ) emphasizes that as nursing is a practice‐based discipline, the development of QOA methodology is critical. We genuinely believe that the same applies to the qualitative evaluation method, which often highlights experiences of a process. As nursing practice is comprehensive and individual, these important characteristics should be emphasized when evaluating it.

The implementation method requires thorough planning, and we assume that such planning is common in clinical nursing. However, the planning of the evaluation seems to be less important compared with the planning of the actual implementation. This may be a result of a dynamic, real‐life situation, which is very much dependent on resources. However, if a new intervention is not evaluated, how will we know what effect it has? We assume that qualitative evaluation is performed at a clinical level—those who receive the intervention are observed and asked at an open level: what was your experience of this intervention? We suggest that these evaluations should be systemized; the responses to open‐ended questions can be collected and analysed with the aim of improving practice. Continuous evaluation during the implementation process is crucial for success.

4.1. Strengths and limitations

The strengths and limitations were assessed by the Confidence in the Evidence from Reviews of Qualitative Research Approach (CERQual) (Lewin et al.,  2015 ), which helps assess the confidence in qualitative reviews. CERQual comprises four components, which contribute to assessment of confidence: methodological considerations, relevance, coherence and adequacy of data. We believe that we have thoroughly described the relevance, coherence and adequacy of the data by documenting the review process, the body of evidence and outlining the primary studies. The methodological considerations are the extent to which potential problems in the design are reflected on. The five nurse researchers who conducted the/present review worked in different areas at a University hospital on the West coast of Norway and represent different clinical nursing contexts. We consider this a strength, as we based the analysis and discussion section on rich and deep reflection resulting in the understanding of the review question.

Despite that mixed method evaluations are available, the present review only included qualitative studies. Such a design would illuminate other aspects of evaluation than/that were not a part of the present study.

5. CONCLUSION

This review presents a summary of different ways to perform qualitative evaluation in a range of clinical nursing areas and illuminates the complexity involved in evaluation of interventions in naturalistic settings. To the best of our knowledge, no previous review has focused on qualitative evaluation of the implementation of nursing interventions.

The review highlights the fact that to be able to say anything about the needs of nursing in the health field, we must evaluate how nursing functions and nurses act. When caring for the individual patient, qualitative methods are a natural choice for revealing the unique and specific qualities of the experiences of the individual nursing context.

CONFLICT OF INTEREST

All authors declare that there are no conflicts of interest with regard to this study.

AUTHOR CONTRIBUTIONS

KR was responsible for writing the manuscript. All authors contributed to the critical revision of the intellectual content, provided feedback on the draft manuscript and approved the final version. They all adhered to the criteria pertaining to roles and responsibilities in the research process recommended by the International Committee of Medical Journal Editors (ICMJE) ( http://www.icmje.org/recommendations ).

Overview of identified factors

Supporting information

Appendix I: Flow diagram

Appendix II: CASP checklist

ACKNOWLEDGEMENT

The authors would like to thank Monique Federsel for proofreading the English language and the specialized librarian at Stavanger University Hospital, Norway, for valuable help with the electronic search for articles.

Rørtveit K, Saetre Hansen B, Joa I, Lode K, Severinsson E. Qualitative evaluation in nursing interventions—A review of the literature . Nursing Open . 2020; 7 :1285–1298. 10.1002/nop2.519 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

We acknowledge that the study was supported by grants from Stavanger University Hospital, Stavanger, Norway.

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Strengths and Weaknesses of Quantitative and Qualitative Research

There are many types of research taking place, which results in the evolution of something new and unique. Traditional Marketing Research has two options to conduct its research: Quantitative and Qualitative methods .  

What is Quantitative Research

Quantitative research is defined as an organized analysis of occurrences by collecting measurable data and applying statistical, mathematical, and computational methodologies. It is the process of gathering information from existing and potential customers by sampling methods and the distribution of online surveys, questionnaires, online polls, and so on. The results of these polls or surveys are represented numerically. 

Quantitative research is dependent on the creation of a Hypothesis followed by an accurate analysis of the statistics in order to understand and explain the research findings. It focuses more on the quantity of things and their statistical patterns. Using the number comes to analysis so as to come to a conclusion.

After gaining a thorough understanding of these figures, it is possible to forecast the future of a product or service and make modifications as needed.

Strengths of Quantitative Research

The quantitative research method has proven to be beneficial in the following ways

• It provides an allowance for the formulation of statistically sound
• Quantitative data provides a macro view with all the required details and comparatively larger samples.
• Larger sample sizes enable the conclusion to be generalized.
• Evaluation of the multiple data sets can be done at once and that too at a faster pace and accurately.
• This method is called to be appropriate when there is a need for systematic and standardized comparisons.
• The manual implementations of ideas can be automated completely which can save time.

Weaknesses of Quantitative Data

Here are some of the weaknesses of quantitative research:

• The quantitative method reveals what and to what extent but often fails to answer more on why and how.
• This type of research requires the model performance to be monitored on a constant basis in order to ensure its compliance with the original hypotheses.
• The impression of homogeneity in a sample may turn out to be fake in this method.
• This method involves a limited number of Quants supply and also involves complex disciplines which are hard to master.

Types of Quantitative Research Methods

When it comes to gathering information, quantitative research comes in handy. It provides you with a wide range of options. Each has its own set of pros and cons. Hence, it is advised to use a combination of them to get the best outcomes. Here are the four commonly used quantitative research methods that you can consider employing:

Conducting surveys is one of the most common quantitative research methods that most marketers utilize. In this method, marketers distribute surveys to their target audience in order to gather information, followed by statistical analysis of the results in order to develop conclusions and insights. 

In addition to being a short turnaround method, it is an excellent approach to better understand your target customers or explore a new market. Here are the best ways to conduct surveys: 

• a. Survey via Email: The use of email to communicate with a large number of individuals is quick and can be more cost-effective than the other methods outlined in this section.
• b. Phone Campaign : Not everyone has access to the internet, so if you want to reach a specific audience that may find it difficult to interact in this manner (for example, older consumers), a telephone campaign may be a more effective strategy. However, phone campaigns can be expensive endeavours as you’ll have to employ teams for calling your consumers and taking their answers. Also, there will be increased telephone bills as well as a result.
• c. Postal Surveys : like the phone, it allows you to contact a large portion of the population, but it is expensive and takes a long time to complete the task. As businesses strive to discover and respond to changes in consumer behaviour as quickly as possible, postal surveys have grown increasingly out of date.
• d. Distribution through social media: Social media handles are another wonderful ways to conduct surveys. By distributing the survey through social media, you can collect a greater number of replies from those who are familiar with the brand.

Related: Quantitative And Qualitative Research Tools And Techniques

• e. QR codes: You can use QR codes by printing or publishing them in magazines, on signs, business cards, or on almost any other object or medium you like.
• f. SMS-based survey: SMS-based surveys can help you collect a large number of responses quickly and efficiently in a short amount of time.
• g. In-person quantitative research : doing quantitative research in person makes sense in particular situations. However, this is not the solution for all types of research. In-person quantitative research works well when you need to capture quantifiable data about a customer’s experience in the present, or intercepts, where you need customers to physically engage with a product in order to provide relevant feedback. However, know that these kinds of research are costly affairs, as well as time-consuming and challenging to organize and carry out logistically.

In this approach, you’ll be able to collect information that may be categorized and analyzed in a quantitative, numerical manner.

2. Correlation Research

Correlation research examines the effects of one entity on another and the changes that result. This quantitative research method requires a minimum of two different groups or entities to establish the relationship.

This quantitative research strategy uses mathematical analysis to correlate two or more variables. The original patterns, correlations, and trends between variables are finished. Impact of one variable on the other and how it affects the interaction between them are observed. To achieve desired findings, researchers often modify one of the variables.

It is best not to draw conclusions just from correlational data. Because two variables that are in sync are not necessarily connected.

3. Causal-Comparative Research

This strategy relies heavily on comparison. This quantitative research method is used to determine the cause-effect relationship between two or more variables, where one variable is dependent on the other. 

In this step, the independent variable is established but not changed. The variables or groupings must be formed as in nature. Because dependent and independent variables always exist in a group, it is prudent to draw conclusions carefully considering all elements.

Causal-comparative research examines how distinct variables or groups change as a result of the same changes. This study is undertaken regardless of the relationship between two or more variables. Statistical analysis is used to clearly present the results of quantitative research.

4. Experimental Research

True experimentation is based on a theory. Experimental research, as the name implies, tests one or more hypotheses. This theory is unproven and only a supposition. In experimental research, the statement is tested to see if it is true. Experiment research might have numerous theories. One can verify or deny a theory.

RESULT ANALYSIS

Once you’ve obtained your data, the next step is to categorize and evaluate the information. There are numerous approaches that can be used to do this. However, 

Cross-tabulation is a powerful technique that categorizes your results depending on demographic subgroups, which is very useful. 

For example, how many of the persons who answered ‘yes’ to a question were adults and how many were youngsters can be calculated.

Take the time to clean the data (for example, deleting respondents who rushed through the survey and repeatedly selected the same answer) to ensure that you can draw confident inferences from it. All of this can be handled by a competent group of professionals.

Pointers to Keep in Mind While Constructing Surveys

• Make it crystal clear what you want to accomplish with your survey. 
• This will assist you in determining your target audience and in developing relevant queries for them.
• Make use of easy and simple language that people from a variety of backgrounds may easily comprehend.
• Make sure your questions and answers are concise and easy to understand.
• Use acronyms only if you are confident that your audience will understand what you are trying to say.
• Make sure not to over-survey your participants. Instead, make an effort to obtain as much information as possible in the first instance—excessive surveying results in survey weariness, which results in a poor response rate.
• Make certain that all critical questions have been marked as obligatory.
• Avoid using double negatives in your questions. Participants may become confused if you utilize double negatives in your questions, and they may misinterpret your queries.
• Providing a ‘not applicable’ response option will assist you in collecting correct information.
• Instead of a four-point scale, a five-point scale should be used because the latter does not provide a neutral answer choice.
• Include closed-ended questions rather than open-ended questions. An ideal survey should primarily include closed-ended questions, with a few open-ended questions thrown in for good measure.
• Example: instead of asking, “Can you tell us about your experience with our food delivery services?” You should ask, “How happy are you with our food delivery services?” 
• Your options may include the following: “Very Happy / Satisfied / Don’t know / Dissatisfied / Very Dissatisfied” 

Why is quantitative research important to business?

Quantitative research is an extremely useful tool for anyone who wants to have a better understanding of their market and clients. The ability to acquire trustworthy, objective insights from data and clearly identify trends and patterns is enabled by this technology.

Quantitative research is a critical component of market research; it depends on hard facts and numerical data to create an objective picture of people’s ideas as possible to obtain an understanding of their preferences. There are numerous reasons why quantitative research is essential in any market research plan , including the following:

• It makes it possible to conduct research on a large scale.
• It assists organizations in determining the scale of a new opportunity.
• It allows marketers to quickly and simply compare distinct groups (e.g., by age, gender, or market) in order to discover the similarities and variations between them.
• It can be useful when trying to simplify a complicated problem or topic into a small number of variables.

Importance of quantitative research in marketing

The quantitative study is mainly concerned with numbers. It makes use of mathematical analysis and data to throw light on vital facts pertaining to your company and the market in general. This type of information, obtained using techniques such as multiple-choice questionnaires or surveys, can be used to generate buzz in your organization and its products and services.

Related: How to Use Customer Data Analytics for Higher ROI

What is Qualitative Research

The methodologies utilized in qualitative research may appear ineffectual to individuals who are more experienced with quantitative research approaches at first glance. 

It is more focused on exploring the issues, understanding the actual problem, and enabling oneself to answer all the questions. The qualitative Research Method is more dependent on deriving the value of variables in their natural setting. 

In a nutshell, qualitative research differs from quantitative research in that it emphasizes words rather than statistics and depth rather than breadth. 

Its approaches are exploratory in nature, intending to uncover the opinions, thoughts, and feelings of those who participate.  It is most frequently used to inform the development of new concepts, theories, and products. Qualitative research, which was originally designed for use in the social sciences, is now commonly utilized to inform market research by acquiring unique consumer insight from a large amount of available data.

Strengths of Qualitative Research

Qualitative research can be beneficial in the following ways

• All the problems and the topics covered in this research are in detail.
• This method majorly focuses on small groups which ultimately do not require more expenses when compared to quantitative research.
• With the emergence of new developed information and findings, the revision, direction and framework of the data can be done easily and quickly.
• The data is collected from a small group which bounds it to be universal for a large population.
• The data with this method is collected based on genuine efforts and gives a clear vision of what can be expected.

Weaknesses of Qualitative Research

• As the data is collected for a small group, which assumptions cannot be made beyond the small group of people.
• It becomes difficult to demonstrate, maintain and assess the rigidity of the data.
• The collection of statistical data is not easy and cannot be done solely by using this method.
• As the data is in big quantity, analysis and interpretation of the data take much time.
• The responses of the subjects might be affected as the researchers are bound to be present during the process of data gathering.

Types of Qualitative Research Method

There are 8 types of Qualitative Methods; take a look…

1. One-on-one Interview

In-depth interviews are a typical qualitative research method. It involves a one-on-one interview with one respondent. This is essentially a conversational strategy that allows for detailed responses.

This strategy allows for exact data collection regarding people’s beliefs and motivations. Asking the appropriate questions can help a researcher acquire valuable data. If the researchers require further information, they should ask follow-up questions.

One-on-one interviews can be conducted in person or over the phone and can last from 30 minutes to two hours. Face-to-face interviews allow for better reading of respondents’ body language and matching of responses.

2. Focus Groups

A focus group is yet another popular qualitative data collection strategy. It typically includes 6-10 people from your target market. The focus group’s major goal is to answer “why,” “what,” and “how.” 

Focus groups have the advantage of not requiring face-to-face interaction. Focus groups can now be issued online surveys on multiple devices, and responses can be collected instantly. 

However, know that this is one of the more costly online qualitative research approaches. They usually explain complex processes. This strategy is great for market research and concept testing.

3. Discussion Boards

Similar to focus groups, discussion boards effectively collect dynamic data over time. Like an online forum , the researcher can initiate a debate and invite participants to add and expand on one other’s ideas. Using prompts and probes, the researcher can have as much or as little input as needed. A forum can be active for days or weeks.

Marketers can use these approaches to get feedback on a new product. Also, these techniques can help marketers grasp different perspectives on the product and can get to know their customers.

4. Case-study

In recent years, the case study approach has evolved into a robust qualitative research method. This is considered one of the best methods to describe an organization or entity.

This research strategy is employed in fields like education and social sciences. This method may appear complex, but it is one of the simplest to use because it requires a complete understanding of data gathering methods and data inference.

5. Pictures and Videos 

Pictures and videos are also interactive qualitative approaches. This is, in fact, one of the most popular qualitative research strategies today. Respondents can contribute photographs or videos to illustrate their stories. Respondents could, for example, give video footage together with a written evaluation of a product.

6. Record-Keeping or Logging

This strategy uses existing reputable documents and information sources as data sources. One can look through books and other reference material to gather data for the research in this method.

7. Ethnographic study

It is the most in-depth approach to studying people in their natural habitat. An organization, a city, or a remote place could be the target audience for this strategy. 

Cultures, difficulties, motivations, and contexts are studied in this study. Geographical constraints can affect data collection. Instead of interviews and debates, you get to see the natural environment.

This type of research might range from a few days to a few years because it includes close observation and data collection. It is a time-consuming and challenging strategy that relies on the researcher’s ability to examine, observe, and deduce the data.

8. Observation Method

Lastly, in the list, we have the observation method. This is a method of collecting data using subjective methods. Researchers use subjective approaches to gather qualitative data to obtain information or data. Qualitative observation is used to compare quality.

It involves characteristics, not measures. Sight, smell, touch, taste, and hearing are all examples of qualitative observation.

It is necessary to do an in-depth analysis of your qualitative data after it has been collected in order to identify the essential themes and insights from your research.

Once the qualitative research is completed and the essential insights have been identified, the next step is to utilize the same insights in the subsequent stages of developing a product or marketing strategy. Moreover, you can use these insights to narrow down your target audience.

Aside from that, your research may have elicited some new ideas and notions that you would like to investigate further, forming the basis for quantitative analysis to determine whether these viewpoints represent the general public.

Related Post: Key Difference Between Database and Data Warehouse

Why Do You Need Qualitative Research?

In contrast to a closed question survey, qualitative procedures provide a unique level of information that is impossible to obtain via a quantitative survey. Respondents are free to share their own experiences, opinions, and feelings without feeling compelled to do so

Qualitative methods provide a more dynamic approach to research because they allow the researcher to follow up on responses given by respondents in real-time, resulting in valuable conversation around a topic that would not otherwise be possible with a structured survey. 

When it comes to capturing accurate and in-depth insights, qualitative research methodologies are the go-to method for researchers. 

It is extremely beneficial to record “factual facts.” Here are some examples of when qualitative research should be conducted.

• When developing a new product or producing a new concept
• Evaluating your product, brand, or service in order to improve your marketing approach
• To better understand how your target audience reacts to marketing campaigns and other communications.
• To recognize your own personal strengths and flaws
• Understanding customers’ purchase behavior  
• To explore market demographics, segments, and customer groups. 
• To obtain information on the public’s perception of a brand, company, or product.

The Bottom Line

So, this is all about qualitative research and quantitative research. Based on the above discussion, it is safe to say that Qualitative research makes up for what quantitative research lacks in terms of meaning depth. Having access to both types of research methods allows for the fulfilment of all research needs. 

In a nutshell, qualitative methods complement quantitative research approaches perfectly. Together, they present a once-in-a-lifetime chance for businesses to gather detailed information on their customers, which they can use to better their marketing efforts and increase their bottom line.

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• Open access
• Published: 25 March 2024

A great way to bring up health behaviour topics at playgroup: a qualitative evaluation of the Healthy Conversations @ Playgroup program

• Georgia Middleton 1 ,
• Brittany J. Johnson 1 ,
• Dimity Dutch 1 ,
• Stewart G. Trost 2 ,
• Rebecca Byrne 3 ,
• Hayley E. Christian 4 , 5 ,
• Anna Henry 4 ,
• Caroline O. Terranova 3 ,
• Kate E. Williams 6 ,
• Li Kheng Chai 3 , 7 ,
• Denise S. K. Brookes 3 ,
• Kate Simon 3 &
• Rebecca K. Golley 1  

BMC Public Health volume  24 , Article number:  890 ( 2024 ) Cite this article

190 Accesses

Metrics details

The early years is a critical stage to establish optimal nutrition and movement behaviours. Community playgroups are a relaxed environment for parents with a focus on social connection and supporting parents in their role as ‘First Teachers’. Playgroups are therefore an opportunistic setting to promote health behaviours in the early years. To support parents with young children around healthy lifestyle behaviours, the Healthy Conversations @ Playgroup program was delivered in urban and regional areas, across three Australian jurisdictions between 2021–2023.

This qualitative evaluation aimed to understand how the Healthy Conversations @ Playgroup program was experienced by parents, playgroup coordinators and peer facilitators.

Semi-structured virtual interviews and focus groups were conducted with parents, playgroup coordinators (i.e., person responsible for coordinating the playgroup) and peer facilitators (i.e., trained facilitator for the program) that participated in the Healthy Conversations @ Playgroup study. Transcripts were analysed following a thematic analysis approach.

Twenty-eight playgroup parents, coordinators or peer facilitators participated in one of 8 focus groups or 5 interviews. Four themes were developed: Program strengths and challenges; Setting strengths and challenges; Factors that impact program delivery; Participant’s suggestions for future program delivery.

Conclusions

The Healthy Conversations @ Playgroup program was valued by parents, providing validation and normalisation of parenting practices, and fostering a shared experience of parenting. Playgroups are a convenient setting for families to attend. The dynamic and distracting nature of the playgroup setting were carefully considered when designing the program. Strategies to further enhance program engagement could include use of coordinator or parent champions, tailored delivery, and extending the reach to other family members.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12621000055808, registered 22 January 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380890

Peer Review reports

The early years of life are critical for establishing health-promoting behaviours to support optimal health, growth, and development [ 1 , 2 ]. Health-promoting behaviours include regular physical activity, limited screen time, healthy eating, and adequate sleep [ 1 ]. However, recent population-level surveys indicate that only 28% of Australian children aged 2–3 years are meeting both fruit and vegetable recommendations [ 3 ], and only 17% of Australian children aged 2–5 years are meeting both physical activity and sedentary behaviour recommendations [ 4 ]. Health behaviours established in the early years can track into adolescence and adulthood, influencing health across the life course [ 2 , 5 , 6 ]. Therefore, it is important to intervene early and establish healthy behaviours in childhood [ 7 , 8 , 9 , 10 , 11 ].

Parents are children’s first teachers, and their parenting practices are instrumental in shaping children’s eating, movement, and sleep behaviours [ 12 , 13 , 14 ]. Parenting practices are specific, observable parenting actions such as creating a safe, interesting environment, setting limits and rules, having realistic expectations, and using appropriate feedback and consequences [ 15 , 16 ]. Supportive parenting practices and the family environment are integral for developing child autonomy [ 17 ]. Autonomy supporting parenting practices, where parents encourage thoughtful child decision-making, have been shown to support the development of healthy behaviours in children [ 18 ]. However, previous research has indicated that parents require knowledge, skills, and confidence to effectively use autonomy supportive practices to promote child health behaviours [ 14 , 19 ].

Parent involvement has been recognised as integral for improving child health behaviour outcomes that support healthy growth [ 20 , 21 , 22 ]. However, programs delivered through Early Childhood Education and Care settings, while suitable for reaching a large proportion of preschool-aged children, are not necessarily conducive to parental participation and engagement as parents time at the setting is limited [ 23 , 24 ]. Programs delivered in community settings where parents already attend with their child may have a higher likelihood of success, particularly where there are existing mechanisms for parent support [ 25 ]. Community playgroups are one such setting, offering a unique model of informal family support by bringing together groups of families with young children in local settings for shared play and socialising. Community playgroups offer a low- or no-cost, safe, and relaxed environment where existing social networks exist among attending parents, they enable shared learning and support, and are facilitated by a playgroup coordinator who is often a parent volunteer [ 26 ]. Despite playgroups existing internationally, including in the United Kingdom and United States, few child health promotion programs have been delivered and evaluated in community settings such as playgroups [ 27 ].

In 2018, Fuller and colleagues conducted focus groups with parents attending community playgroups in Brisbane, Australia, to determine what parents would find acceptable in a program delivered in playgroups [ 28 ]. The findings indicated that parents did not want to be ‘educated’ but desired strategies and support for dealing with parenting challenges. This aligns with previous reports that programs supporting parents commonly provide education, advice, and strategies [ 16 , 29 , 30 ] but parents also require support for increased capability and confidence [ 7 , 28 , 31 , 32 ]. Additionally, parents did not want to lose their valuable playgroup time to an external program and felt the support and guidance received from other parents at playgroup facilitated autonomy supporting parenting practices [ 28 ].

The Healthy Conversations @ Playgroup program was designed to support parents to use autonomy promoting parenting practices to improve children’s eating, movement, screen time and sleep behaviours [ 26 ]. The program was designed to be suitable to embed in the universal care system. The program was evaluated in community playgroups, hereafter referred to as playgroups, in three Australian jurisdictions (South Australia, Western Australia, Queensland; urban and regional areas) as a multi-site randomised controlled trial (ACTRN12621000055808) [ 26 ]. Recruitment, program delivery and evaluation occurred between 2021–2023, over three waves (due to COVID-19). Playgroup associations in each state promoted the program to all registered playgroups, who self-selected to participate ( n  = 51 total playgroups participated in the evaluation). In brief, the H ealthy Conversations @ Playgroup program comprises 10 conversations delivered by a peer facilitator (a parent external to the playgroup, employed and trained to deliver the program) over five fortnightly sessions within the usual playgroup schedule [ 26 ]. The conversations were designed to increase parents’ capability and self-efficacy to implement autonomy-supportive parenting practices . Conversation topics included: reducing stress at mealtimes, limiting screens without tantrums, supporting movement skills in children, bedtime activities and routines to support sleep, and celebrating achievements. Further details of the program design and quantitative evaluation are reported in Trost et al. [ 26 ]. This qualitative study aimed to understand how the Healthy Conversations @ Playgroup program was experienced by parents, playgroup coordinators, and peer facilitators.

Study design

This study aligns with a critical qualitative approach, informed by critical realism ontology and an epistemological orientation of contextualism [ 33 ]. Through this position, we acknowledge that human practices shape the way we experience and know about reality and the world, and that human experiences cannot be studied in isolation from the contexts in which they exist [ 33 ]. This is well suited to understanding the shared experiences of participating in or delivering the Healthy Conversations @ Playgroup program. A thematic analysis approach guided the collection and analysis of data for this study [ 33 , 34 ].

Recruitment

Parents who participated in the Healthy Conversations @ Playgroup trial were eligible to participate in this qualitative study. As contact information of participating parents was collected for the broader program, this information was available to recruit parents into this qualitative study. Parents were invited via phone by a member of the research team to participate in a virtual focus group, between November 2022 to February 2023. Each playgroup in the program had a playgroup coordinator, a contact person who was typically a parent or community volunteer. Their contact information was also collected for the broader program and thus available to the research team to recruit into the qualitative study. Playgroup coordinators were invited via email or phone by a member of the research team to participate in a virtual focus group. Contact details of the peer facilitators who were responsible for delivering the Healthy Conversations @ Playgroup program were also available to the research team for this qualitative study. Peer facilitators were invited via email by a member of the research team to participate in a virtual one-on-one interview. Potential participants were provided with an information sheet, allocated to a suitable focus group or interview time, and asked to provide verbal (parents) or written consent (peer facilitators and playgroup coordinators) to participate.

Data collection

Two semi-structured focus group/interview guides were developed, one for parents, and one for playgroup coordinators and peer facilitators (Additional file 1 ). Both guides were pilot tested with participants, and as they required no major changes their data were used in analysis. The guides were designed based on those used in Fuller et al.’s focus groups [ 28 ], and other qualitative explorations of parenting practices [ 35 , 36 ]. The questions aimed to explore participants’ experiences of the program, what they perceived as program strengths and weaknesses, and what they would recommend for future iterations. Focus groups were chosen because they encourage group reflection and exploration of potentially sensitive issues by creating a safe space where similar experiences or views can be shared, and a shared experience can be created [ 37 ]. One-on-one interviews were chosen for the peer facilitators to encourage depth of responses, and to maintain their confidentiality as they were known to one another [ 37 ]. Peer facilitators were offered copies of their transcripts for review; none took up the offer. Due to the nature of focus groups, this was not possible for other participants.

All focus groups and interviews were conducted via video call using Microsoft Teams Version 1.6.00.11166, and were audio recorded and transcribed verbatim by professional transcription agency OutScribe Transcription, a human transcription service. GM (PhD), an experienced qualitative researcher, conducted all focus groups and interviews, and another member of the research team acted as notetaker (DD or research assistant). GM conducted the qualitative exploration as an independent party to the Healthy Conversations @ Playgroup program. They were not involved in the design, delivery, or evaluation of the program, and had no prior relationship to participants. This potentially helped reduce social desirability bias and protected participants from feeling pressured to provide a socially acceptable response to the designers or deliverers of the program.

The data collection and analysis team, comprising of GM, DD, BJJ, and a research assistant are white females with no children and approached this research from a background in public health and dietetics. All work in the space of child and family health and nutrition and have varying degrees of experience and knowledge working with this population group and researching childhood health behaviours and related parenting practices. GM had no prior experience with playgroups; however, BJJ, DD and the research assistant were involved in other aspects of the broader program, excluding program delivery. DD and the research assistant had minimal qualitative research experience prior to this study, but were supported and guided by GM.

Data analysis

The basic principles of thematic analysis were followed, as seen in Fig.  1 . This involved following the six steps of thematic analysis as laid out by Braun and Clarke [ 33 , 34 ]. GM coded all transcripts, and DD coded 70% of the transcripts, to familiarise themselves with the data and the coding structure, and to incorporate alternative perspectives. NVivo 12Pro qualitative analysis software (QSR International Pty Ltd. 2018) was used for organisation and management. Team analysis meetings were held regularly (GM, DD, BJJ), and DD and GM maintained reflexive journals across all stages of data analysis to bracket assumptions, reflect on findings and document analytical queries for future discussion. This study was limited to sampling participants from the Healthy Conversations @ Playgroup trial, and thus data saturation did not guide recruitment. However, the themes developed through analysis were analytically robust and well supported by the data, and the team are confident that saturation of the themes presented in this article was achieved, as new data was not producing new or conflicting findings.

The six steps of thematic analysis [ 33 , 34 ] and how they were applied in the current study

Sample and participant characteristics

Twenty-eight individuals participated in this qualitative evaluation: 17 parents, 6 playgroup coordinators, and 5 peer facilitators (Additional Fig. 1 ). Six focus groups were conducted with parents ( n  = 2–5 per group), two focus groups were conducted with playgroup coordinators ( n  = 3 per group), and five individual interviews were conducted with peer facilitators, lasting approximately 46 min (range 36–60 min). Participants were from South Australia ( n  = 10), Western Australia ( n  = 10), and Queensland ( n  = 8). Full demographic characteristics of participants are described in Table  1 . Peer facilitators were parents themselves, often familiar with the playgroup setting from personal or professional experience.

Four main themes were derived across parent, playgroup coordinator, and peer facilitator transcript data: 1) Program strengths and challenges, 2) Setting strengths and challenges, 3) Factors impacting program delivery, and 4) Participant’s suggestions for future program delivery. All participants have been given pseudonyms. See Additional Fig.  2 for analysis coding tree.

Theme 1: Program strengths and challenges

Within this theme, there are four subthemes: 1) Relevant, helpful conversations, 2) Reducing parenting pressures, 3) Fostering peer support, and 4) Ever-changing challenges of parenting. See Table  2 for participant quotes against each subtheme.

Relevant, helpful conversations

Parents described their involvement in the Healthy Conversations @ Playgroup program as a positive experience and described the opportunity to have conversations about relevant topics as a strength of the program. Parents commented that while it is not unusual for these topics to be discussed between parents at playgroup, they welcomed the dedicated time to have these conversations. Peer facilitators and playgroup coordinators echoed these sentiments and noted the importance of having the peer facilitator start the conversation and keep it on track. They reflected on the importance of the conversational, rather than stand-and-deliver style.

Reducing parenting pressures

Parents described not feeling judged by peer facilitators and other parents in the program and felt the program fostered an environment of open-mindedness. There was a shared understanding at the playgroups that what works for one family may not work for another, and that no parent is perfect. Parents also described that the program reaffirmed their choice of parenting practices and boosted their confidence. This sentiment was echoed by peer facilitators, who described intentionally approaching the conversations in a way that would not increase pressure on parents. Both peer facilitators and playgroup coordinators described the program facilitated a safe environment for parents to share their experiences and fostered an understanding that all families were different.

Fostering peer support

Participants identified peer support as a core strength of the program, fostered by peer facilitators and other parents. The value of having a ‘peer’ facilitate the conversations, as someone who had ‘been through it’ and could speak to their own experiences, was evident across participant responses and viewed as a strength of the program. Parents provided peer support through connecting with one another and sharing their own experiences and strategies. This was particularly helpful for first-time parents who could learn from parents who had older children and had dealt with similar challenges in the past. The peer-sharing provided an opportunity for parents to identify with one another and learn from each other. The program normalised the challenges parents often face at this stage of child development, and a common shared parenting experience was fostered.

Ever-changing challenges of parenting

Although the program topics were thought to be relevant, participants noted that some topics were of more interest than others. Some parents felt that they had already overcome the challenges associated with some topics, and others did not find the topics of relevance to their child at the time of the program. The ever-changing nature of the challenges parents face as children grow was generally cited as why topics were not always viewed as relevant for parents.

Theme 2: Setting strengths and challenges

Within this theme, there are three subthemes: 1) Playgroups are a suitable setting for programs supporting parents, 2) Playgroup environments can be distracting, and 3) Playgroups have varied attendance. See Table  3 for participant quotes against each subtheme.

Playgroups are a suitable setting for programs supporting parents

Playgroups were described as a suitable setting for a child health promotion program supporting parents, as they were familiar, casual, relaxed, and safe environments. Peer facilitators and playgroup coordinators described playgroups as providing a receptive audience with the potential for broad reach in the community. Aligning with the design and intention of the program, attending playgroup was already part of parents’ routine, and therefore attendance at the program was viewed by many as convenient. Parents valued not having to make additional time to attend the program outside of their existing activities and appreciated being able to attend with their children, thus confirming the thinking behind the program design.

Playgroup environments can be distracting

Although playgroups were identified as a suitable and convenient setting for delivery of the program, participants acknowledged the playgroup environment as one with frequent distractions for parents and peer facilitators, due to competing demands on attention. Distractions largely came from children requesting their parent’s attention. This could pose a challenge for parents attempting to engage in the conversations, and for peer facilitators trying to facilitate the conversations. Peer facilitators and playgroup coordinators also noted the challenges of different layouts of playgroups. The way the playgroups were set-up in the space, and the way they were coordinated were noted as impacting parents’ ability to engage with the conversations.

Playgroups have varied attendance

Another challenge presented by the playgroup setting was the varied attendance of parents from week to week. This could impact parents’ ability to engage in conversations not just through their own attendance, but through the inconsistent presence of others. The varied attendance meant group size and dynamics changed frequently, which impacted the engagement of parents and the quality of conversations. The COVID-19 pandemic further exacerbated issues with attendance at the time.

Theme 3: Factors that impact program delivery

Within this theme, there are five subthemes: 1) Each playgroup is unique, 2) Timing of and between sessions, 3) Group dynamics, 4) Perceived engagement with the program, and 5) Competence of peer facilitator. This theme is composed exclusively of peer facilitator and playgroup coordinator data, as it relates to how the program was run and the questions that were asked of these population groups. See Table  4 for participant quotes against each subtheme.

Each playgroup is unique

It was evident from participant descriptions that each playgroup runs differently, depending on the parents, the playgroup coordinators, and the physical space and environment. Peer facilitators noted that these components impacted their delivery of the program, and how easy it was for parents to engage. From peer facilitator’s perspectives, the playgroup coordinators were integral to the program’s success. If playgroup coordinators were supportive and valued the program, and set-up the playgroup to be conducive to participation, this increased the likelihood that parents could engage.

Timing of and between sessions

Sessions were intended to be delivered every two weeks, but because of personal illness, or COVID-19 disruptions, some peer facilitators ran sessions weekly or had longer breaks between sessions. The shorter distance between sessions was viewed positively by some peer facilitators, who found it easier to engage parents when sessions were delivered in close succession. The timing of the sessions over the year also appeared to impact parents’ engagement, with peer facilitators noting better parental participation when the program was provided further along in the school term compared to the first weeks of term, where parents were more likely wanting to ‘catch up’ after the break from playgroups over the holidays.

Group dynamics

Peer facilitators and program coordinators described group dynamics impacting parents’ engagement in the program. Peer facilitators described conversations as easier to facilitate when parents were confident and relaxed with each other. When the dynamics were not as constructive, facilitating the conversations was more challenging, particularly when parents were not as open to sharing or contributing to discussion. Playgroups with an established group of parents led to constructive conversations, especially compared with new groups where parents were not as familiar with one another. However, peer-facilitators observed established friendship groups within a playgroup could make it difficult for those who were not part of the friendship group to contribute.

Perceived engagement with the program

Playgroup coordinators and peer facilitators noted that a number of the parents who were involved in the program appeared to already be very confident and familiar with the topics, and thus were not as interested in participating in the conversations. Some parents were also more interested in catching up with one another or spending time with their child(ren) than engaging in the conversations. Peer facilitators noted that parents’ interest or engagement in the topics often determined how easy or challenging the conversations were to facilitate. When parents were engaged, facilitators felt they barely had to drive the conversation at all, but when parents were not interested, facilitators could feel as though they were talking to an empty room. Playgroup coordinators and peer facilitators also observed the opportunity the conversations brought to engage newer parents or those with minimal established connections at playgroup, noting that engagement could change over time from passively observing, to more actively contributing as time went on.

Competence of peer facilitator

Due to the dynamic nature of playgroups, it was important that the person delivering the program could adapt to each playgroup environment. The importance of peer facilitators being competent, flexible, and confident in their delivery to accommodate the playgroup environment was acknowledged in participant’s responses. As anticipated in the design of Healthy Conversations @ Playgroup , this was integral to program delivery, due to the varied nature of playgroups, and factors that impacted parents’ engagement in the conversations.

Theme 4: Participant’s suggestions for future program delivery

Within this theme, there are three subthemes: 1) Who and how of program delivery, 2) Program content, and 3) Tailoring to meet playgroup needs. These are participant’s suggestions for the program based on their perceptions and experiences, and many sit in contradiction to the strengths and benefits of the program they expressed. See Table  5 for participant quotes against each subtheme.

Who and how of program delivery

Due to the distracting nature of playgroups, participants suggested offering the program in a setting that more easily allows parents to concentrate, such as at a time and place away from children, or where child-supervision was provided. Participants described flexibility for delivery, including drop-in, once-off or follow-up sessions, virtual delivery of sessions, and increased opportunities for co-parent involvement. These suggestions sit in contrast to the benefits and strengths of the current delivery and setting of the Healthy Conversations @ Playgroup program described by participants, and it is clear that there needs to be balance between the benefits of the playgroup setting against its challenges.

These participants were asked how they envisioned long-term program delivery. Playgroup coordinators and peer facilitators suggested that support from playgroups at the jurisdiction level was required to ensure delivery of the program could be maintained through playgroups on an ongoing basis. Alternatively, they suggested other service providers who could potentially deliver the program instead. For sustainable delivery of the program, peer facilitators discussed the option for the program to be delivered by playgroup coordinators or champions.

Program content

Participants suggested additional topics for the program. Common suggestions were behaviour management and regulation, child development, sibling relationships, speech and language development, and toileting. Parents also suggested topics related to engaging with specialists, parenting roles and support, child developmental transitions, and further information on using screen time positively. Playgroup coordinators and peer facilitators also suggested introduction of solids, parent self-care, and toothbrushing.

Peer facilitators and playgroup coordinators suggested providing more practical tips, more resources or handouts for parents to revisit, and opportunities for notetaking. However, these suggestions contradict the strength of the relaxed, informal conversation-style format of the program, which parents explicitly preferred over stand-and-deliver lecture-style programs. Participants also suggested providing practical activities for children and/or parents during the conversations that aligned with the conversation topics for each session, to keep the children busy and parents engaged.

Tailoring to meet playgroup needs

Some participants suggested splitting the program by child age, so that only information relevant to child age and stage was being discussed. Others disputed this suggestion, as they felt this would negatively impact the peer support provided by parents with different experiences. Peer facilitators indicated that it would be helpful to have more involvement with the playgroup prior to delivering the program, to support specific tailoring of the program to individual playgroup environments and parent characteristics.

The study aim was to understand how the Healthy Conversations @ Playgroup program was experienced by parents, playgroup coordinators, and peer facilitators. Through qualitative analysis of focus group and interview data, peer support and normalising parenting challenges were found to be key program strengths. Playgroups were suitable for delivering this type of program, but the setting presented a dynamic environment that required flexibility and cooperation for successful program delivery.

Social support was a strength of the Healthy Conversations @ Playgroup program. The support provided by peers helped to normalise and create a shared experience of parenting. Peer support was facilitated by having parents of children of different ages and stages and having a ‘peer’ facilitate the sessions. The program helped parents feel more confident and assured in their parenting practices, which is an important aspect of parent capacity and likelihood of participating in positive parenting practices [ 38 ]. Research has shown that capacity building is an integral component of successful behaviour change [ 31 ], and without this feeling of confidence and capability, it is less likely parents would make behaviour changes at home [ 7 , 28 , 32 ]. Many programs in the child health promotion space provide education, advice and strategies, and the fostering of parenting support and capacity is often overlooked [ 7 , 28 , 31 , 32 ]. For parents to be able to effectively support health behaviours in children, they need to feel supported themselves.

The Healthy Conversations @ Playgroup program was unique in using an existing community setting with social connection. It has been established that the health and wellbeing of caregivers, including parents, is integral to being able to care for others [ 39 ]. This sentiment was discussed by parents in the present study, “for the kids to be healthy, their mummy’s need to be healthy as well”. Parenting is challenging and too often parents feel alone in the challenges they face [ 40 ], especially first-time parents [ 41 ]. Mothers in particular bear the brunt of social expectation for their children’s health status [ 42 , 43 ], and feelings of shame and stigma at not being ‘good enough’ can lead to poor outcomes for both parents and children [ 43 ]. The Healthy Conversations @ Playgroup program drew on the strengths of the playgroup setting, as an environment that provides social support, a sense of belonging and feelings of reassurance and validation [ 44 , 45 ]. The finding that the program was able to provide this support to parents as a novel way to improve child health behaviours was reassuring, as it was an intention of the program as informed by the focus groups that preceded the program design [ 28 ].

The playgroup setting provided an optimal environment for fostering support and was considered convenient and comfortable for parents and children. Delivering the program in a setting where parents already attend is another core strength of Healthy Conversations @ Playgroup , and a facilitator to parental engagement in a program such as this, as it did not require transport or attendance to an additional setting [ 20 , 46 ]. However, playgroups were also described as a dynamic and potentially distracting environment by all participant groups. The dynamic and distracting nature of playgroups was anticipated [ 28 ] and strategies were incorporated into the program design by having facilitators who could embrace the complexity of the environment, work constructively with enthusiastic playgroup coordinators, and engage in flexible delivery to ensure the conversations suited parents in their playgroup environment. This flexibility of delivery aligns with the emphasis on effective facilitation for successful program implementation [ 47 ]. To further strengthen program delivery in the playgroup setting, participants suggested the facilitator attend each playgroup prior to the program to understand the contexts, parent needs, and group dynamics and tailor their delivery accordingly.

While the program was viewed positively by most participants in this study, some parents felt that they were already addressing the topics presented in the Healthy Conversations @ Playgroup program at home. However, population-representative health survey data indicates that majority of households are still not meeting recommendations for these health behaviours [ 3 , 4 , 48 , 49 , 50 ], presenting an incongruence between what parents say they do at home, and what actually occurs. Additionally, parents valued hearing other’s experiences, but few acknowledged their role in helping others through sharing their own experiences. Playgroups pose a convenient, safe, and supportive environment for programs that aim to foster parent capacity building for promoting health behaviours in children. Program champions could be used to enhance the delivery of these programs through playgroups, helping to increase participation, reach and engagement, and motivate change.

Strengths and considerations

This qualitative study allowed an in-depth evaluation of the Healthy Conversations @ Playgroup program and is one of the first qualitative evaluations of a health promotion program set in a community playgroup setting. GM, who conducted the focus groups and interviews, was independent to the program and had no part in its design or delivery, reducing the potential for social desirability bias to impact the findings. Most transcripts were coded by two members of the research team, which strengthened the interpretation of the findings and the depth of the analytical discussions with the broader team. Participants were sampled from those already attending playgroups, and had self-selected to both be a part of the Healthy Conversations @ Playgroup program, and this qualitative evaluation, therefore may not reflect the views and profiles of broader parent population. Finally, as this was an opportunistic evaluation of the program, many parents had received the program over 12 months prior to participating in the focus group and therefore the results presented in this study may be impacted by recall bias.

Implications for research and practice

The Healthy Conversations @ Playgroup program is a first step in supporting positive child health behaviours in a playgroup setting. Many of the program strengths aligned with the intention of the program design, as informed by the focus groups with parents [ 28 ], confirming consultation with the target population as an integral step in program design. Building from these strengths, future iterations of the program could look at reach and engagement with support networks such as co-parents and other caregivers to strengthen practices at home. The use of champions to increase reach and engagement is also worth exploring. Some parents in this study did not recognise the value they had in supporting others who were struggling, which is an underutilised opportunity in the supportive environment fostered at playgroups. The scalability of the program, including how it’s delivered, and how much it’s tailored to the individual setting, is an area for future research.

The Healthy Conversations @ Playgroup program was valued by participants and provided social support, confidence, reassurance, validation of parenting practices, and fostered normalisation and a shared experience of parenting. It provided opportunities for sharing strategies and learning from others on how to engage in autonomy supporting parenting practices at home. Playgroups are a convenient and safe setting for children and their families and are ideal for delivering health promotion programs such as Healthy Conversations @ Playgroup . Potential opportunities to support future delivery of the program in playgroups to help reach a broader parent population include engaging broader support networks including co-parents and grandparents, and enlisting program champions, to increase reach and engagement, motivate change, and strengthen practices at home.

Availability of data and materials

The datasets generated and/or analysed during the current study are not publicly available due to the nature of the data, the conditions of ethics approval, and privacy concerns, but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank playgroup partners including Play Matters Australia (in Queensland), Playgroup South Australia and Playgroup Western Australia for their collaboration and assistance with recruiting playgroups and facilitating recruitment of participants and delivery of the program. We especially wish to acknowledge the work and support of Penny Allen, Alana Hitchcock, Nicole Walker, Melissa Luhrman and Andrew McMahon from Play Matters Australia; Craig Bradbrook, Rebecca Blunn, and Alicia Beames from Playgroup SA; and David Zarb and Caroline Ince from Playgroup WA.

We would also like to thank the parents, peer facilitators and playgroup coordinators who participated in this qualitative evaluation, for their time and sharing their experiences. Finally, we would like to thank Samantha Morgillo, Research Assistant at Flinders University, who supported this work.

This project is funded by the Australian Government Medical Research Future Fund Preventative Public Health Research Initiative (2019; GNT1200764). HC is supported by a National Heart Foundation Future Leader Fellowship (#102549) and partially by the Australian Government through the Australian Research Council's Centre of Excellence for Children and Families over the Life Course (Project ID CE200100025). BJJ is supported by an Early- Mid Career Researcher Fellowship from The Hospital Research Foundation Group (2022-CF-EMCR-008-QA25323). RB is supported by an Australian Research Council Discovery Early Career Researcher Award (DE230101053). No funders contributed to the design of the study, nor had a role in data collection, management, analysis, and interpretation, nor in the dissemination of findings.

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Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia

Georgia Middleton, Brittany J. Johnson, Dimity Dutch & Rebecca K. Golley

School of Human Movement and Nutrition Sciences, The University of Queensland Australia, Brisbane, QLD, Australia

Stewart G. Trost

Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia

Rebecca Byrne, Caroline O. Terranova, Li Kheng Chai, Denise S. K. Brookes & Kate Simon

Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia

Hayley E. Christian & Anna Henry

School of Population and Global Health, The University of Western Australia, Perth, WA, Australia

Hayley E. Christian

Centre for Child and Family Studies, School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, QLD, Australia

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Health and Wellbeing Queensland, Queensland Government, Brisbane, QLD, Australia

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Contributions

GM, BJJ, RKG and SGT conceived the study, with assistance from LKC, COT, HEC, KEW, AH and DSKB. DD and GM recruited participants with assistance from BJJ, HEC, SGT, and AH. GM conducted focus groups and interviews and DD supported as note-taker. GM led data analysis and BJJ and DD assisted, with support from all co-authors. GM drafted the manuscript, with assistance from DD, BJJ, and RKG. All authors contributed to synthesis of results, reviewing, editing, and approving the final version of the paper.

Corresponding authors

Correspondence to Brittany J. Johnson or Rebecca K. Golley .

Ethics declarations

Ethics approval and consent to participate.

This project was performed in accordance with the ethical standards laid down in the Declaration of Helsinki and was approved by the Human Research Ethics Committee of Children’s Health Queensland (HREC/19/QCHQ/66486), The Queensland University of Technology (2000000576), Flinders University (2586) and The University of Western Australia (RA/4/20/6386). All participants provided informed consent prior to participating.

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Not applicable.

Competing interests

AH and KS were site coordinators for the Healthy Conversations @ Playgroup trial and acted as peer facilitators in some instances. All other authors declare that they have no competing interests.

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Supplementary Information

Additional file 1..

 Interview/focus group schedules. Interview/focus group schedules containing the questions that guided the focus group and interview discussions.

Additional file 2.

 Participant flow through Healthy Conversations @ Playgroup qualitative evaluation study. Figure of the flow through the study of the three population groups included in the qualitative evaluation.

Additional file 3.

 Coding tree for thematic analysis of interview and focus group data. Description: Figure of the coding tree that sits behind the results presented in the paper

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Middleton, G., Johnson, B.J., Dutch, D. et al. A great way to bring up health behaviour topics at playgroup: a qualitative evaluation of the Healthy Conversations @ Playgroup program. BMC Public Health 24 , 890 (2024). https://doi.org/10.1186/s12889-024-17703-x

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Received : 05 October 2023

Accepted : 08 January 2024

Published : 25 March 2024

DOI : https://doi.org/10.1186/s12889-024-17703-x

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• Early childhood
• Peer-led program
• Healthy eating

BMC Public Health

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