Source: Marianne T.S. Holter

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Here’s a scenario that you might recognize: You’re running some qualitative user interviews as part of developing or implementing an eHealth program, and some interesting aspects about program use keeps coming up in the interviews. You have a hunch that this might be of interest to the field more in general, beyond your specific program, and wish you could explore it more thoroughly. However, although it seems to linger in the background in several interviews, not all your interviewees talk directly about it, and so you don’t really have enough data to publish anything separately on it. So, then what do you do?

A recently published Viewpoint paper published in the open access journal, Journal of Medical Internet Research, may turn out helpful, as it presents a set of methodological tools intended to focus the interviews on the aspects you’re interested in, thus generating more relevant data. The paper entitled “Qualitative Interview Studies of Working Mechanisms in Electronic Health: Tools to Enhance Study Quality” can be accessed for free at https://www.jmir.org/2019/5/e10354/.

The authors of the paper advocate that qualitative user interviews are well suited for expanding the field’s knowledge base on how eHealth programs work—knowledge that could be used for building eHealth-specific theories or framing hypotheses that may be tested in subsequent quantitative studies. However, presumably many of eHealth’s working mechanisms can be found within the user-program interaction, and program users may be less aware of how they interact with the program as they are of its’ content. Thus, this “invisible interaction” may be difficult to pursue through traditional, straight forward qualitative interviewing, possibly contributing to the problem alluded to above.

The authors sketch out five distinct challenges: first, the researcher’s interest in the person-program interaction may be under-communicated in the interview to the point that the interviewee does not fully understand what the interview is about. Furthermore, the interviewee may want to talk a lot about aspects that are not central to the topic of investigation (such as previous change efforts), and it may be difficult for the interviewer to limit the interview time spent on these contextual aspects. Adding to these difficulties, in the interview situation the participant may have difficulties remembering specific program experiences, and there may be social processes going on between the interviewer and interviewee that influences the data collection process negatively. Finally, pursuing knowledge of basic eHealth aspects in the same interviews as you are seeking more applied knowledge about your specific program may cause additional problems for data quality.

In the paper, the authors describe each of these challenges and suggest methodological tools to counteract them. The tools come from various qualitative sources, and the reader may pursue relevant tools through these other publications. Equally important, the authors hope that their paper will spur methodological reflection and inspire other researchers to tap into the resource of qualitative user interviews, for the benefit of the entire field.

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Original article

Holter, MT Johansen, AB, Ness, O, Brinkmann, S, Høybye, M, Brendryen, H. Qualitative Interview Studies of Working Mechanisms in Electronic Health: Tools to Enhance Study Quality. J Med Internet Res 2019;21(5): e10354. URL: https://www.jmir.org/2019/5/e10354/

DOI: 10.2196/10354

PMID: 31066683