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Advocates of online alternatives to face-to-face interviewing suggest online approaches save money and time, whereas others have raised concerns about the quality and content of the resulting data. These issues affect researchers designing and costing their studies and application reviewers and research funders. We conducted a scoping review of English language articles describing the range of online alternative approaches. Furthermore, we systematically identified studies directly comparing online alternatives with face-to-face approaches. Synthesis of these 11 articles (565 participants) suggests that online alternatives should not be viewed as a straightforward replacement for face-to-face, a particularly important finding given the rapid communication changes occurring in the COVID-19 pandemic. When applied with consideration of the evolving evidence on their strengths and weaknesses, online methods may increase the likelihood of obtaining the desired sample, but responses are shorter, less contextual information is obtained, and relational satisfaction and consensus development are lower.

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Despite knowledge that the larger sociocultural context contributes to the development of eating disorders, few studies have examined protective factors for women with subthreshold eating disorders. Using feminist-informed constructivist grounded theory methodology, 15 women (ages 18-25 years) with subthreshold eating disorders were interviewed. Results suggest that participants spoke of their subthreshold eating disorders in an externalized way and used protective factors to guide decision making toward their preferred values. A grounded theory model was developed to illustrate this process. Protective factors included (a) people who provide emotional and tangible support, (b) support people who challenge the eating disorder, (c) personal sense of agency, and (d) community activism and involvement. Participants experiencing subthreshold eating disorders demonstrated a capacity to distinguish their own thoughts and values from those of the "eating disorder voice," and protective factors facilitated this process. Implications for future research and practice are discussed.

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Students and clinicians with disabilities are underrepresented in the academic health programs and professional clinical settings. Disability studies foregrounds the unique ways of knowing and being that clinicians with disabilities can offer. Based on a larger grounded theory study of the experiences of students and clinicians with disabilities, this article examines the role that clinicians' abilities to draw on their personal experiences of living with a disability have on their interactions with clients. The analysis of semistructured interviews with 55 students and clinicians with disabilities from different fields contributes to the development of a theory of epistemic connection. The theory is informed by the following three themes: (a) building rapport through understanding, (b) from understanding to advocacy and creative approaches, and (c) between professionalism and disability. The findings emphasize not only the importance of diversifying the health care workforce but also incorporating disability epistemology into the health care culture.

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Health and social science researchers are increasingly interested in the range of new possibilities and benefits associated with diary methods, particularly using digital devices. In this article, we explore how a flexible diary method, which enables participants to choose the device (i.e., paper notebook, tablet, or computer) and medium (i.e., text, photographs, sketches) through which they narrate their experiences, can be used to promote sensitive and rigorous research engagement with family carers to people with dementia. We used a diary interview method with 10 carers over the course of 6 weeks to explore how they experience and interpret the changing behaviors of their cognitively impaired kin. We reflect on how the quality of diary data can be enhanced alongside the ethical dimensions of research with carer populations, through different forms of diary keeping, regular interaction with participants, reflexive practice, and follow-up interviews.

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Although medical interpreters are guided by a clear set of medical interpreting standards that are designed to ensure an accurate, clear line of communication between patient and provider, limited research has focused on interpreters' actual experiences: how they integrate the medical interpreting standards into practice, challenges they might face, how they address those challenges, and with what consequences. To address these gaps, we explored experiences of 15 interpreters working in health care settings. As this is a relatively unexplored area and we are exploring social processes, we used grounded theory. Data were analyzed through open, axial, and selective coding. We found all interpreters intended to practice "within" the encounter and valued the medical interpreting standards. However, patient and provider expectations, requests, and a desire to protect patient-provider relationships led to significant deviations from specific elements of the medical interpreting standards. Findings highlight the need to revise medical interpreting standards.

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We discuss strategies to promote the inclusion of people with developmental disabilities (DDs) in qualitative community-based research studies. Strategies were applied in three projects conducted between 2012 and 2017 that addressed issues of socioeconomic challenges, discrimination, and exclusion of children and young adults with developmental disabilities (YADD). Strategies included partnership with community organizations; inclusion of YADD, family caregivers (FCs), and service providers in advisory committees (ACs); and strategies to accommodate YADD. As part of our contribution, we discuss issues of invisibility and exclusion of individuals with DDs who have "low" functioning capacities. There is a need to review studies sampling inclusion criteria as they may constitute a barrier for participation. Preference for sampling "high" functioning individuals may reinforce exclusion in research, and replicate broader patterns of socioeconomic exclusion of individuals with disabilities. Our discussion of inclusive research is informed by critical disability studies and the underlying principle "nothing about us without us."

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Patrick O'Byrne criticizes the use of ethnography in public health research focused on cultural groups. His main argument is that ethnography disciplines marginalized populations that do not respect the imperative of health. In this article, I argue that O'Byrne has an erroneous understanding of ethnography and the politics of scientific research. My main argument is that a methodology itself cannot discipline individuals. I argue that if data are used as a basis to develop problematic public health policies, the issue is the policies themselves and not the methodology used to collect the data. While O'Byrne discourages researchers from conducting health research like ethnography focused on cultural groups, I argue the exact opposite. This has to do with justice and equity for marginalized communities and the obligation to tailor health services for their specific needs, which may not be the same as those of the general population.

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Recent increases in childhood vaccine exemption rates are a source of concern within the public health community. Drawing from the health belief model and in-depth interviews with 50 mothers ( n = 50) who refused one or more vaccine, the aim of this study was to identify the specific reasons and the broader decision context(s) that underscored participants' vaccine refusal. Results indicate that the vast majority of participants supported vaccination until a particular cue motivated them to consider otherwise, and qualitative analysis identified three main categories into which these cues fell: perceived adverse reactions, endorsements from health care professionals, and perceived contradiction among expert-endorsed messages. These categories point to the central role of health communication in motivating vaccine refusal. Better understanding these cues can inform vaccine communication scholarship and practice, and also lend theoretical insight into the intertextual nature of controversial health messages and decisions.

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In this article, I examine group medical visits, a clinic-based intervention that aims to improve patient health by combining clinical care, health education and peer support. Research shows that health care inequalities are reproduced through the interplay of interpersonal, institutional, and structural factors. I examine changing social relations made possible by group visits, including peer support and an expanded role for patient knowledge. The qualitative data presented here are part of a mixed-methods study of how group medical visits and integrative medicine are combined and implemented for low-income people with chronic conditions. I find that patients take active roles in each other's care, supporting, challenging, and advocating in ways that shift patient-provider relationships. Such shifts demand reflection about what kinds of knowledge matter for health. Health care encounters can reproduce inequality for marginalized patients; this study suggests group visits can restructure patient-provider encounters to interrupt healthcare inequalities.

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The overarching aim of qualitative research is to gain an understanding of certain social phenomena. Qualitative research involves the studied use and collection of empirical materials, all to describe moments and meanings in individuals' lives. Data derived from these various materials require a form of analysis of the content, focusing on written or spoken language as communication, to provide context and understanding of the message. Qualitative research often involves the collection of data through extensive interviews, note taking, and tape recording. These methods are time- and labor-intensive. With the advances in computerized text analysis software, the practice of combining methods to analyze qualitative data can assist the researcher in making large data sets more manageable and enhance the trustworthiness of the results. This article will describe a novel process of combining two methods of qualitative data analysis, or Intramethod triangulation, as a means to provide a deeper analysis of text.

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Syndemic theory seeks to understand the interactions and clustering of disease and social conditions and explain racial disparities in HIV. Traditionally applied to HIV risk, this study characterizes the syndemic challenges of engagement in care among Black men living with HIV and provides insight into potential HIV treatment interventions to retain vulnerable individuals in care. Interviews were conducted with 23 HIV-positive men who were either out-of-care or nonadherent to antiretroviral therapy (ART). Interviews were audio recorded, transcribed verbatim, and coded using MAXQDA qualitative software. Researchers analyzed data using thematic content analysis to identify syndemic factors associated with disengagement in care or suboptimal ART adherence among Black men. Analyses revealed the syndemic nature of four themes: intersectional stigma, depression, substance use, and poverty. Findings from this study offer numerous opportunities for intervention including social and structural-level interventions to address syndemic processes and the influence of stigma and poverty on engagement in care.

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To systematically improve the appropriateness of antibiotic prescribing, antimicrobial stewardship programs have been developed. There is a paucity of literature examining how pharmacists perform antimicrobial stewardship using a clinical decision support system in a hospital setting. The purpose of this qualitative study was to develop a model exploring how pharmacists perform antimicrobial stewardship to identify areas for programmatic improvement. Semistructured interviews were conducted across a health care system until saturation of themes was reached. Pharmacists identified that self-efficacy and time were vital for antimicrobial stewardship to be performed, while culture of the hospital and attitude facilitated the process of stewardship. Antimicrobial stewardship programs using clinical decision support tools should ensure pharmacists have adequate time to address rules, provide easy-to-use resources and training to support self-efficacy, and engage influential physicians to support a culture of collaboration.

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As photovoice continues to grow as a method for researching health and illness, there is a need for rigorous discussions about ethical considerations. In this article, we discuss three key ethical issues arising from a recent photovoice study investigating men's depression and suicide. The first issue, indelible images, details the complexity of consent and copyright when participant-produced photographs are shown at exhibitions and online where they can be copied and disseminated beyond the original scope of the research. The second issue, representation, explores the ethical implications that can arise when participants and others have discordant views about the deceased. The third, vicarious trauma, offers insights into the potenial for triggering mental health issues among researchers and viewers of the participant-produced photographs. Through a discussion of these ethical issues, we offer suggestions to guide the work of health researchers who use, or are considering the use of, photovoice.

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We reflect on the experiences of a researcher conducting a pilot exercise project with marginalized research participants within the substance use disorder treatment field, in a language that was nonnative to her. While the project collected and analyzed quantitative data, the researcher was motivated by qualitative inquiry's commitment to reducing participant-researcher distance and power differences. Despite multiple sources of power imbalances favoring the researcher, the ability of participants to speak their native language to a nonnative researcher, and the researcher's active recognition of her linguistic vulnerability, appeared to afford them an unexpected source of power within the context of the project. We discuss the researcher's observations of these power dynamics and their implications for cross-cultural research and when working with marginalized research participants.

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The purpose of this article is to explain how to improve intervention designs, such as randomized controlled trials (RCTs), in health science research using a process philosophy and theory known as dialectical pluralism (DP). DP views reality as plural and uses dialectical, dialogical, and hermeneutical approaches to knowledge construction. Using DP and its "both/and" logic, and its attempt to produce new creative syntheses, researchers on heterogeneous teams can better dialogue with qualitative and mixed methods approaches, concepts, paradigms, methodologies, and methods to improve their intervention research studies. The concept of reflexivity is utilized but is expanded when it is a component of DP. Examples of strategies for identifying, inviting, and creating divergence and integrative strategies for producing strong mixed methods intervention studies are provided and illustrated using real-life examples.

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Past research showed that East Asians' belief in holism was expressed as their tendencies to include background facial emotions into the evaluation of target faces more than North Americans. However, this pattern can be interpreted as North Americans' tendency to downplay background facial emotions due to their conceptualization of facial emotion as volitional expression of internal states. Examining this alternative explanation, we investigated whether different types of contextual information produce varying degrees of effect on one's face evaluation across cultures. In three studies, European Canadians and East Asians rated the intensity of target facial emotions surrounded with either affectively salient landscape sceneries or background facial emotions. The results showed that, although affectively salient landscapes influenced the judgment of both cultural groups, only European Canadians downplayed the background facial emotions. The role of agency as differently conceptualized across cultures and multilayered systems of cultural meanings are discussed.

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