W9-L9 (DSA 458) Qualitative Studies Lecture PDF

Research Methodology (DSA 4580) Step 2: Selecting a Study Approach Qualitative Studies Academic Year: 2023-2024 Fifth Year DSA 4580 WEEK 9 LECTURE 9 Abdulhamid Al Ghwainem, BDS, MSc, DClinDent Pediatric Dentistry Assistant Professor in Pediatric Dentistry [email protected] Thursday, 19 Oc...

Research Methodology (DSA 4580) Step 2: Selecting a Study Approach Qualitative Studies Academic Year: 2023-2024 Fifth Year DSA 4580 WEEK 9 LECTURE 9 Abdulhamid Al Ghwainem, BDS, MSc, DClinDent Pediatric Dentistry Assistant Professor in Pediatric Dentistry [email protected] Thursday, 19 October 2023 Copyright © 2023 by PSAU, Abdulhamid Al Ghwainem Disclaimer DISCLAIMER The information presented in this lecture is offered for educational and informational purposes and should not be construed as medical, dental, or research advice. While the amount of information in this handout is vast, and I make every effort to be as current and thorough as possible, the information cannot be taken as a reference manual or textbook. Please note that you should read the required textbooks as specified in the course curriculum and lecture references. 2 Notice WARNING Materials used in connection with this course or lecture may be subject to copyright protection. 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Do not remove this notice 3 Outline § Classifications of research designs. § How to choose a research design. § Quantitative vs qualitative research. § Qualitative research. § Mixed method research. 4 Lecture Objectives By the end of this session, you should be able to: § Identify and relate different studies approaches and designs for health research. § Select most appropriate research approaches and designs. § Differentiate between quantitative and qualitative research. § Define qualitative research and highlight its importance, key features, advantages and disadvantages. § Differentiate between ontology, epistemology, and axiology and how they are used in qualitative research. § Define and differentiate between theoretical perspectives that will guide qualitative research’s design, data analysis, and interpretation. 5 Research Process/Steps Research: answering questions in logical and systematic ways Question Answer Research methodology: how to get from Question to Answer 6 Research Process/Steps Research: answering questions in logical and systematic ways Question Answer Research methodology: how to get from Question to Answer Identify study question Select study approach Design study and collect data 7 Analyse data Report findings Research Process/Steps Research: answering questions in logical and systematic ways Identify study question Select study approach Design study and collect data 8 Analyse data Report findings Research Approaches and Designs § Study design refers to the methods and methodologies used in research to gather the data needed to explore a specific question. § Some research questions are best approached by statistical analysis of data. This is quantitative research. § Others are better answered by looking for patterns, features or themes in the data. This is qualitative research. Illustrates how research methodology and research method relate to each other. Source: Andiappan and Wan (2020) 9 Research Approaches and Designs Research Quantitative Research Qualitative Research Objective To quantify data and generalise results from a sample to the population of interest To measure the incidence of various views and opinions in a chosen sample To gain an understanding of the underlying reasons and motivations To uncover prevalent trends in thought and opinion Approach Deductive Measure and test Inductive Observe and interpret Design Fixed Flexible Sample : large Data collection: Quantitative data based on precise measurements Sample : small Data collection: Qualitative data such as interviews, focus groups, observations and notes Methods Data analysis: identify patterns, features and themes Data analysis: identify statistical relationships Researcher Independence Objective Subjective Outcome report with correlation, comparison of means and statistical significance of findings Narrative report with contextual description and direct quotations from respondent Adapted from Johnson and Christine (2008) 10 Mixed Methods Research Quantitative vs Qualitative Research Qualitative Quantitative Uses structured, hypothesis-driven approaches to gather data that can be statistically analyzed Quantitative Research Qualitative Research 11 Uses in-depth interviews, focus group discussions, participant observation, and other unstructured or semistructured methods to explore attitudes and perceptions, identify themes and patterns, and formulate new theories Quantitative vs Qualitative Research Qualitative Quantitative § Gathering numerical data and factual knowledge under controlled conditions § Examines relationships and sometimes the strength of relationships between variables using statistical techniques • Deductive § Measure and test § Objective § Data collection: quantitative data based on precise measurements § Data analysis: identify statistical relationships Quantitative Research Qualitative Research 12 § Exploring people’s subjective experiences and opinions in order better to understand and give meaning to social phenomena. § Examines the underlying reasons, motivations, trends and opinion using narrative report with contextual description and direct quotations from respondents • Inductive § Observe and interpret § Subjective § Data collection: qualitative data such as interviews, focus groups, observations and notes § Data analysis: identify patterns, features and themes Quantitative vs Qualitative Research 13 Research Approaches and Designs Algorithm for classifying the types of research, this scheme is intended to classify the study types as clearly as possible. Medical Research Primary Research Epidemiological Research Basic Research Theoretical § § § § Method development § (physics, chemistry § biology, § bioinformatics) § Analytical § measurement procedure Imaging procedure Test development assessment procedure Weaker evidence Secondary Research Applied Cell research Animal research Stem cell research Genetics Tissue banking Clinical Research Descriptive Case Report A report on a single patient with an outcome of interest Case Series A report on a series of patients with an outcome of interest. No control group is involved Analytical Surveillance Study Report obtained from the databases that follow and record a health problem for a certain time Qualitative Ecological Cross-sectional Examines the relationship between exposure and outcome by examining population-level data rather than individuallevel data 14 Exposure and Exposure ← Outcome outcome are at the same time Meta-analysis QuasiExperimental Research Randomised Controlled Trial Case-control Systematic Review Cohort Exposure → Outcome Stronger evidence Research Approaches and Designs Study Designs Decision Tree is not completely exhaustive but covers most basics designs All Types Of Research Designs And Approaches Secondary Research All Types of Reviews Systematic Review Metaanalysis Is it a primary research (collecting new data) or a secondary research (synthesizing already published research)? Primary Research Basic Is it a basic research (e.g.: laboratory research) or clinical research (e.g.: involving human subjects)? Clinical Is there an intervention or experimental group? Yes Yes No Analytical Study Is there a comparison or Interventional/Experi Observational Study mental Study control group? No What is the starting point for research? Randomised Controlled Trial Non-randomised Controlled Trial Descriptive Study Exposure and Outcome at the same time Survey (Crosssectional) Outcome Exposure Case-control Study Cohort Study Case Report Case Series Analytical Crosssectional Study Qualitative Study Based on the work of Grimes et al., (2002). Grimes, D. A., & Schulz, K. F. (2002). “An overview of clinical research: The lay of the land”. The Lancet, 359(9300), 57-61 15 Qualitative research: overview § Phenomenon: the central concept being studied during a qualitative research project § In the health sciences, many qualitative research projects aim to improve health promotion programs and clinical processes or to provide a foundation for social change § Other qualitative studies seek to understand how people experience health and illness as individuals and as members of communities, why they engage in or do not engage in various health-related behaviors, and how they make healthrelated decisions 16 Qualitative research: overview § Because qualitative research examines thoughts and beliefs that cannot be directly measured, researchers using qualitative methods must be aware of the ways their own thoughts, experiences, biases, and assumptions shape the design and interpretation of their research studies § The philosophical orientations that guide both quantitative and qualitative research are rooted in ontology, epistemology, and axiology 17 Qualitative research: ontology § Ontology: the study of the nature of reality and truth What is the nature of reality? 1. Singular reality, also called realism: (reject or fail to reject hypotheses) – objectivist ontology 2. Multiple realities, also called relativism: (different perspectives) –subjective ontology § Ontological perspectives extend from Realism to Relativism 18 Qualitative research: ontology 1. Singular reality, also called realism: (reject or fail to reject hypotheses) – objectivist ontology Realism assumes that one reality exists, and it can be understood – Objectivity: facts that can be evaluated without bias – A realist would say that meaning exists in an object independent of the subject investigating it – Quantitative research studies seek to make objective determinations about the world 19 Qualitative research: ontology § Singular reality, also called realism: (reject or fail to reject hypotheses) – objectivist ontology § What animal is this? 20 Qualitative research: ontology § Singular reality, also called realism: (reject or fail to reject hypotheses) – objectivist ontology 21 Qualitative research: ontology 2. Multiple realities, also called relativism: (different perspectives) –subjective ontology Relativism assumes that there are multiple realities, and they cannot be fully understood – Subjectivity: claims and experiences that are interpreted based on an evaluator’s beliefs, perceptions, and feelings – A relativist would say that a subject imposes meaning on an object – Qualitative research designs typically seek to understand subjective aspects of human existence 22 Qualitative research: ontology 2. Multiple realities, also called relativism: (different perspectives) –subjective ontology Multiple realities (different perspectives) –subjective ontology e.g.: § Reasons why people start smoking § Impact of tooth loss on older people § Experiences of patients suffering from Behçet’s syndrome § Attitudes towards wearing an orthodontic appliance 23 Qualitative research: ontology 2. Multiple realities, also called relativism: (different perspectives) –subjective ontology 24 Qualitative research: epistemology § Epistemology: the study of knowledge § Ontology explains how a researcher defines reality and truth, while epistemology explains how a researcher knows what is real and true § Theories of knowledge that underpin how research proceeds: - What can be known? - How do we know what we know? - What counts as knowledge and what are its limits? - What is the relationship between the knower and what is known? 25 Qualitative research: epistemology § Epistemology: the study of knowledge § Relationship between the researcher (knower) and that being researched (known) - Distant and impartial (e.g., researcher objectively collects data using instruments or uses laboratory procedures) - Closeness (e.g., researcher visits participants at their home sites to collect data) - Collaboration (e.g., researcher actively involves participants as collaborators in generating knowledge – study design: ethnography) 26 Qualitative research: epistemology § For example, a guiding principle for quantitative studies is empiricism, the assumption that the senses (such as seeing, hearing, and touching) are the best way to measure truth about the world 1) Empirical epistemology: All knowledge is grounded in empirical data (tested) 2) Interpretive epistemology: - Understands the human situation through meanings, intentions, actions and experiences - Requires closeness between the researcher and participant 27 Qualitative research: epistemology § Positivism § Constructivism/Interpretivism 28 Qualitative research: epistemology § Positivism: a paradigm in which researchers apply a realist perspective that assumes that reality is knowable, and that inquiry should be logical and valuefree – The word positive denotes definitiveness and certainty – Studies based on a positivist paradigm generally use empirical methods to test hypotheses and predict outcomes; they often employ quantitative experimental designs § Constructivism: a paradigm in which researchers have a relativist perspective that considers each individual’s reality to be a function of that person’s lived experiences § Interpretivism: a paradigm in which researchers consider the reality in the social world to be different from reality in the natural world 29 Qualitative research: epistemology Positivism § Science is the only reliable source of knowledge and knowledge is valid based on observations or experiments § Focus on facts gathered through direct observation and empirical measurement of observable external realities (experimental design) § Research can be conducted objectively and impartially (“value free”) § Tests hypotheses developed from existing theory or existing evidence (deductive theory) § Uses study designs to produce models that will be generalisable to explain cause and effect relationships and/or predict outcomes § Focus on standardisation, calibration, accuracy, reliability and reproducibility (random sampling, sample sizes and power) § Basis of quantitative and laboratory research 30 Qualitative research: epistemology Constructivism/Interpretivism § Interpretivism and constructivism are about understanding how various groups of people interpret reality § Knowledge is personally experienced rather than acquired from or imposed from outside Individuals and groups make sense of situations based upon their experience, memories and expectations- (emic- insider- reality is what people perceive) § Meaning is constructed and constantly reconstructed over time through experience creating multiple interpretations (dynamic/subjective, purposive sampling, thematic saturation) § Focus on discovering and understanding meanings and the contextual factors that influence, determine and affect the interpretations reached by different individuals (inductive theory) § Basis of qualitative research 31 Qualitative research: axiology § Axiology (or value theory): the study of values § Quantitative researchers usually apply an axiological perspective that assumes that rigorous procedures can eliminate the impact of values and biases on study outcomes § Qualitative researchers assume that a researcher’s values affect the study 32 Putting all this together 33 Qualitative research: overview 34 Quantitative vs Qualitative Research Deductive Approach Positivism Objectivist ontology Empirical epistemology Value-free axiology Research Question/Problem Inductive Approach Constructivism/Interpretivism Research Approach Subjectivist ontology Constructivism/Interpretivism epistemology Value-driven axiology Quantitative Research Research Methodology Qualitative Research Fixed Design Research Design Flexible Design Research Methods Interviews, focus groups, observations, identify patterns, features and themes Surveys, questionnaire, experiments, statistical analysis 35 Advantages and Disadvantages of Qualitative Research: § Disadvantages: • Time consuming • Resources constraints • Small sample size limits its generalizability • Researcher bias • Response bias • Not easily replicable • Difficult to analyse and quantify data • Lack of precision and accuracy in findings § Advantages: • Provide deep understanding pf participants experiences, perspectives and behaviours • Reveal the complexity and nuances of human behaviour • May require a small sample • Flexible design and methods • Exploratory research and hypothesis generation 36 Qualitative research: theoretical perspectives § Because the goal of qualitative research is to understand a complex phenomenon rather than to predict some observable event, qualitative researchers must select the theoretical perspectives that will guide their study design, data analysis, and interpretation § Four of the most prominent philosophical assumptions applied to health science research are positivism, constructivism/interpretivism, critical theory, and pragmatism 37 Qualitative research: theoretical perspectives § The ontological assumption of constructivism is that there are many realities, not just one reality, and realities are created as researchers and participants interact § The epistemological assumption is that researchers and participants must work together to understand reality § The axiological assumption is that beliefs and values are social constructs § These philosophical stances make constructivism the opposite of positivism 38 Qualitative research: theoretical perspectives § Critical theory: a paradigm that considers reality to be dependent on social and historical constructs and assumes that reality can be uncovered by identifying and challenging power structures –The philosophical assumption of critical theory is that participants can actively construct realities that are shaped by beliefs and values –Research conducted under a critical theory framework is change-oriented 39 Qualitative research: theoretical perspectives § Studies based on critical theory often use participatory methods that empower participants and equip them to advocate for change § In an action research approach, participants work together to solve a social problem –Action research conducted under a transformative paradigm assumes that reality can be changed when researchers collaborate with participants from marginalized populations to address a social justice issue 40 Qualitative research: theoretical perspectives § Pragmatism: a paradigm in which researchers assume that reality is situational, and it is acceptable to use any and all research tools and frameworks to try to understand a particular problem so it can be solved § The goal of pragmatic research is to solve problems, so the focus is on the outcomes of the research project rather than the theories and processes that guide it 41 Qualitative research: theoretical perspectives § The ontological assumption of pragmatism is symbolic realism, which treats individuals’ realities as being real to those individuals, because that orientation is the most useful and practical § The epistemological assumption is that reality can be known and understood using many different approaches § The axiological assumption is that beliefs and values are part of practical decisions § Pragmatists often use mixed methods in their study designs 42 Qualitative research: theoretical perspectives 43 Qualitative research: theoretical perspectives § Theoretical pluralism occurs when a researcher draws on more than one theoretical framework to guide the design, analysis, and interpretation of a research project § Researchers using two or more theoretical perspectives must carefully explain why the theories were selected, how they were implemented, and how the use of multiple theories informed the insights gained from the study 44 Qualitative Methodologies § The methodologic approaches selected for a qualitative research project must align with the goals of the study and the selected theoretical paradigm § Planning for a qualitative study often progresses from the identification of the underlying ontology and epistemology to the selection of a suitable paradigm and then the identification of methodology that aligns with the underlying theoretical perspective § In the health sciences, the most popular qualitative methodologies include phenomenology, grounded theory, ethnography, and case studies 45 Qualitative Methodologies 46 Qualitative Methodologies: Phenomenology § Phenomenology seeks to understand how individuals interpret and find meaning in their own unique life experiences and feelings § The researcher uses in-depth interviews to gather data from several people, then the transcripts of those interviews are examined so that meanings and themes can be identified and understood from the perspective of the participants § Bracketing is the process of a researcher intentionally setting aside any preconceived ideas about reality in order to be open to new meanings that might be expressed by participants 47 Qualitative Methodologies: Grounded Theory § Grounded theory is an inductive reasoning process that uses observations to develop general theories that explain human behavior or other phenomena § Data collection and data analysis occur simultaneously, so that theories can be developed and refined § Theoretical sampling uses the emerging theory to guide the selection of new data sources, with data collection continuing until data saturation has been reached 48 Qualitative Methodologies: Ethnography § Ethnography is the systematic study of people and cultures in their natural environments § Ethnography is an anthropological approach in which researchers aim to develop an insider’s view (an emic perspective), rather than an outsider’s view (an etic perspective), of how members of a particular sociocultural group understand their world § Ethnographers often use participant observation methods to understand a group’s collective experiences, values, beliefs, and behaviors 49 Qualitative Methodologies: Case Study § A case study is a qualitative research approach that uses multiple data sources to examine one person, group, event, or other situation in detail – A case study approach may be used when preparing a case report or a case series, or it may be applied to understanding an event, process, or program – Previously covered in Lecture 6 § The goal is not to develop generalizable knowledge, but to understand one event well § Multiple data sources may be used as part of a holistic examination of the case, including observations, interviews, and reviews of historic documents 50 Qualitative Methodologies 51 Qualitative Methods These are some of the most common qualitative methods: § Observations: recording what you have seen, heard, or encountered in detailed field notes. § Interviews: personally, asking people questions in one-on-one conversations. § Focus groups: asking questions and generating discussion among a group of people. § Surveys: distributing questionnaires with open-ended questions. § Secondary research: collecting existing data in the form of texts, images, audio or video recordings, etc. 52 Mixed Methods Research § Mixed methods projects use of both quantitative and qualitative methods in one research study –Some mixed methods projects use a convergent parallel design to collect quantitative and qualitative data concurrently and then compare the results and interpret them –Some studies collect the data sequentially, completing one type of study first and then designing and implementing the other type of study –Some qualitative studies are embedded within a quantitative study 53 Mixed Methods Research § Medical research can often be classified as being exploratory, descriptive, or explanatory – Exploratory research aims to discover new ideas and develop hypothesis – Descriptive research seeks to understand key characteristics of a group – Explanatory research tests hypotheses about causal relationships § A mixed-methods exploratory study might collect qualitative data first, and then use the insights from that study to design and implement a quantitative study § A mixed-methods explanatory study might collect quantitative data first, and then use a qualitative study to assist with interpretation of the results 54 Mixed Methods Research § Integration of the two strands of a mixed methods study may occur at various times during a research project – Some research protocols do not consider the interface of the qualitative and quantitative results until the very end of the project when the findings are being interpreted – Other protocols weave both strands of the study together throughout the research process from the design stage through data collection, data analysis, and interpretation 55 Qualitative research: analysis § Qualitative data can take the form of texts, photos, videos and audio. § For example, you might be working with interview transcripts, survey responses, fieldnotes, or recordings from natural settings. 56 Qualitative research: analysis Most types of qualitative data analysis share the same five steps: 1.Prepare and organize your data. This may mean transcribing interviews or typing up fieldnotes. 2.Review and explore your data. Examine the data for patterns or repeated ideas that emerge. 3.Develop a data coding system. Based on your initial ideas, establish a set of codes that you can apply to categorize your data. 4.Assign codes to the data. For example, in qualitative survey analysis, this may mean going through each participant’s responses and tagging them with codes in a spreadsheet. As you go through your data, you can create new codes to add to your system if necessary. 5.Identify recurring themes. Link codes together into cohesive, overarching themes. 57 Qualitative research: analysis There are several specific approaches to analyzing qualitative data. Although these methods share similar processes, they emphasize different concepts. • Content analysis: to describe and categorize common words, phrases, and ideas in qualitative data • Thematic analysis: to identify and interpret patterns and themes in qualitative data. • Textual analysis: to examine the content, structure, and design of texts. • Discourse analysis: to study communication and how language is used to achieve effects in specific contexts. 58 The Sources of Bias in Qualitative Research § Bias can be introduced because of the design, conduct, or analysis of studies Researcher Bias This type of bias in qualitative research occurs when the researcher intentionally or unintentionally influences their results in favor of a specific outcome. 1. Confirmation bias: interpret data in a manner that supports their hypothesis while also removing any unfavorable data 2. Question-order bias: arrange research questions in a way that could affect how the succeeding questions are answered 3. Cultural bias: formulate conclusions based on their own cultural lens 4. Make assumptions about a respondent because of a positive or negative attribute (halo/horn effect) 5. Question-wording bias: ask questions that only lead respondents in one particular direction 59 The Sources of Bias in Qualitative Research § Bias can be introduced because of the design, conduct, or analysis of studies Respondent Bias This type of bias refers to any situation wherein your participant's responses are not an accurate reflection of their thoughts or feelings. 1. Social desirability bias: occurs when the participants want to align their answers regarding sensitive or controversial questions in a socially acceptable way 2. Agreement bias: occurs when the participants want to please the interviewer or moderator, leading to answers that they think the researcher is looking for 3. Sponsor bias: occurs when the participants have opinionated views about the research sponsor and are easily influenced by their reputation 60 Critical Appraisal Tools and Checklists of Qualitative Research: • Factors to look for: § Credibility: Establishing that the results are credible from the perspective of the participant § Transferability: Degree to which results can be generalized to other contexts § Dependability: Description by the researcher of changes within the context that the research occurs and how these might affect conclusions § Confirmability: Degree to which others can confirm or corroborate the result 61 Critical Appraisal Tools and Checklists of Qualitative Research: § Consolidated criteria for reporting qualitative research (COREQ): https://cdn.elsevier.com/promis_misc/ISSM_COREQ_Checklist.pdf § Critical Appraisal Skills Programme (CASP): https://casp-uk.net/ § Joanna Briggs Institute (JBI checklist): https://jbi.global/critical-appraisal-tools § National Institute For Health And Care Excellence (NICE): https://www.nice.org.uk/process/pmg4/chapter/appendix-h-quality-appraisal-checklist-qualitative-studies § Mixed Methods Appraisal Tool (MMAT): While there is no consensus appraisal tool on mixed methods reviews, here is guidance. § Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES): Mixed methods review and evaluation guidance, standards, resources § Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) 62 Qualitative Research: example Hulin, J., Baker, S. R., Marshman, Z., Albadri, S., & Rodd, H. D. (2017). Development of a decision aid for children faced with the decision to undergo dental treatment with sedation or general anaesthesia. International journal of paediatric dentistry, 27(5), 344–355. https://doi.org/10.1111/ipd.12267 63 Break Out Session Instructions: Scan the following QR code: § Identify and explain the design of the research § What is the aim of this research? § What are the types of qualitative methods used in this research? § What are the main findings? 64 Break Out Session Feedback 65 Putting all this together 66 Research Approaches and Designs Algorithm for classifying the types of research, this scheme is intended to classify the study types as clearly as possible. Medical Research Primary Research Epidemiological Research Basic Research Theoretical § § § § Method development § (physics, chemistry § biology, § bioinformatics) § Analytical § measurement procedure Imaging procedure Test development assessment procedure Weaker evidence Secondary Research Applied Cell research Animal research Stem cell research Genetics Tissue banking Clinical Research Descriptive Case Report A report on a single patient with an outcome of interest Case Series A report on a series of patients with an outcome of interest. No control group is involved Analytical Surveillance Study Report obtained from the databases that follow and record a health problem for a certain time Qualitative Ecological Cross-sectional Examines the relationship between exposure and outcome by examining population-level data rather than individuallevel data 67 Exposure and Exposure ← Outcome outcome are at the same time Meta-analysis QuasiExperimental Research Randomised Controlled Trial Case-control Systematic Review Cohort Exposure → Outcome Stronger evidence Research Approaches and Designs Study Designs Decision Tree is not completely exhaustive but covers most basics designs All Types Of Research Designs And Approaches Secondary Research All Types of Reviews Systematic Review Metaanalysis Is it a primary research (collecting new data) or a secondary research (synthesizing already published research)? Primary Research Basic Is it a basic research (e.g.: laboratory research) or clinical research (e.g.: involving human subjects)? Clinical Is there an intervention or experimental group? Yes Yes No Analytical Study Is there a comparison or Interventional/Experi Observational Study mental Study control group? No What is the starting point for research? Randomised Controlled Trial Non-randomised Controlled Trial Descriptive Study Exposure and Outcome at the same time Survey (Crosssectional) Outcome Exposure Case-control Study Cohort Study Case Report Case Series Analytical Crosssectional Study Qualitative Study Based on the work of Grimes et al., (2002). Grimes, D. A., & Schulz, K. F. (2002). “An overview of clinical research: The lay of the land”. The Lancet, 359(9300), 57-61 68 References Required: Neale, J., 2020. Research methods for health and social care. Bloomsbury Publishing. Jacobsen, K.H., 2020. Introduction to health research methods: A practical guide. Jones & Bartlett Publishers. Additional: Bowling, A., 2014. Research methods in health: Investigating health and health services. Maidenhead, United Kingdom: Open University Press. Creswell, J.W. and Creswell, J.D., 2018. Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications. World Health Organization. Regional Office for the Western Pacific, 2001. Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional Office for the Western Pacific. https://apps.who.int/iris/handle/10665/206929 World Health Organization. Regional Office for the Eastern Mediterranean. (2004). A practical guide for health researchers. https://apps.who.int/iris/handle/10665/119703 References Cited references: § Andiappan, V., Wan, Y.K. Distinguishing approach, methodology, method, procedure and technique in process systems engineering. Clean Techn Environ Policy 22, 547–555 (2020). § Grimes, D. A., & Schulz, K. F. (2002). “An overview of clinical research: The lay of the land”. The Lancet, 359(9300), 57-61 § Johnson, R.B. and Christensen, L.B. (2008) Educational Research: Quantitative, Qualitative, and Mixed Approaches. 3rd Edition, Sage Publications, Inc., Lose Angeles Next Lecture: Step 3: Designing a Study and Collecting Data Identify study question Select study approach Design study and collect data Thank you! Any questions [email protected] Analyse data Report findings