Quantitative-Positivist and Qualitative-Interpretivist Methodological Approaches - Essay Example

Quantitative/Positivist and Qualitative/Interpretivist methodological approaches, Design, and Causation Introduction Positivist/quantitative and qualitative/interpretivist methodological approaches, design, and causation offer health practitioners in general, and epidemiologists in particular, an opportunity to look into disease causes, prevalence, determination, and distribution. An epidemiologist should be aware of each these factors as a source of knowledge, as it is important to investigate all four to produce effective health policies (Aschengarau & Seage 2008, p. 21). This paper has two major parts, each divided into two subsections. Part 1a) is an identification, description, and exploration of qualitative and quantitative approaches, including my methods of data collection. Part 1b) constitutes an analysis of these two approaches, and examines the possibility of epidemiologists using a combination thereof. Part 2a) focuses on the differences between observational and experimental epidemiology, using information from books such as Bonita, Beaglehole and Kjellström (2006). Finally, Part 2b) addresses causation, its importance, its implications, and how the epidemiologist can use it effectively. Part 1 a) Quantitative/positivist and qualitative/interpretivist methodological approaches while including examples of their research methods of data collection Quantitative/positivist and qualitative/interpretivist perspectives are rich sources of information on how each methodological approach can impact research, especially on health issues (Kleczkowsk & Piblouleau 1976, p. 9). They are different in a number of ways; the following seeks to distinguish them by thorough description. Positivist Perspective The positivist perspective is the subject of much debate, as its definition is not clear, as it lends more weight to philosophical enquiry (Baum 2008, p20). In addition, it receives much praise for its beneficial effect on modern health research. The model of positivism is founded on the assumption that reality is absolute and therefore constant, and it seeks to demonstrate the achievable nature of objectivity. This shows a relationship between science and philosophy (Saks &Allsop 2007, p. 19). As a result, the natural science concerned with the methods, concepts pertaining to an individual can form a basis of knowing, and establishing the physical man and his health attributes. The development of methodological approach has had great influence on the social sciences Philosophers such as Auguste Comte and Herbert Spencer saw positivism as a crucial factor in understanding the hierarchy of humans, even during the evolution of humans and other organisms. It is therefore clear that positivism establishes itself by relying on embedded truths. Under this approach, experimentation is common, and usually tests specific theories. Positivism plays a vital role in health research, building a framework of controlling trials in order to obtain concrete research results, and using a system of pegging research data to numbers. Today, positivist research uses social science methodology to randomize and control trials to procure medical research conclusions. These include the establishment of disease origins, traits, course, and spread, among other crucial factors that concern health and its outcomes (Blobel 2002, p. 47). Positivism establishes this research by forming hypotheses that can quantify the behaviour of humans (Saks &Allsop 2007, p. 20). This methodology proves its worth by creating concrete and consistent outcomes while establishing the effectiveness of health care systems. The methods used in this approach can be controlled to achieve desired results although Saks &Allsop say that the results will ultimately conform to the general paradigm of positivist methodology. Examples of these positivist methodology methods include surveys, structured interviews, systematic reviews, content analysis, and questionnaires that require self-completion. Baum (2008) points out that the issue of generalisation leads to a great deal of opposition to positivist methodology as objective categorisation during analysis of a society is not achievable. Interpretivist Perspective The interpretivist perspective differs from its positivist counterpart in that it seeks to form a deeper understanding of the lives and experiences of individuals in an attempt to realise the reasons behind their decision paths and their eventual reactions. Creswell mentions that the qualitative approach is essential and differs from the positivist paradigm in its consideration of the nature of individuals engaged in research. The researcher can deduce a pattern, and can observe regularities or irregularities from the respondents (Baum 2008, p. 190). The approach is not experimental in nature; however, it does seek to include various aspects pertaining to an individual’s situation, and in the process form a hypothesis or theory. This approach is essential to health research, as its process employs qualitative methods and adopts a naturalistic view. Interpretivism often presents its findings verbally, whereas positivism advocates a numerical presentation of information (Saks & Allsop 2007, p. 22). It is important since it looks at the respondents in their daily life settings, and aims to form subjective conclusions. This renders it a specialised or partial approach. It helps determine procedures used for the categorisation and prioritisation of medical provisions. Its complex nature allows opportunity to make effective analyses, and it generally concludes with the presentation of a valid research report. The methods used include intense observation, participations, descriptions of individual preferences, interviews that are not structured (Baum 2008, p. 188), use of focus groups, and employment of secondary analysis. Brannen holds the view that this approach is effective, and receives appreciation because it reduces use of the old research methods. On the other hand, it holds some disadvantages in that it allows the researcher to draw subjective conclusions. This potential for bias forms a basis for discrediting interpretivist methodology. b) Traditionally, epidemiology has focused on quantitative research for the types of research designs that are associated with Part 2 (a). Can social epidemiology include both quantitative and qualitative methodological approaches? - Critically discuss Epidemiology as a public health science focuses on distribution, determinants, and prevalence of diseases, but the key function of epidemiology is to identify and map diseases as they emerge. It has made improvements in the establishment of public health services. During attempts to identify diseases, careful research must be undertaken before a policy on health receives implementation (Büttner & Muller 2011, p. 29), and there is usually a delay between these two steps. This needs an appropriate methodology. Traditionally, the use of the positivist approach was common; however, the possibility of the use of both positivism and interpretivism in epidemiology is subject to discussion, of which the following is part. Descriptive epidemiological studies use such methods as studies on the larger population as concerns the disease (ecology method), and regular collection of data (Johnson & Christensen 2008, p.24). Regular data collection does not link exposure to a particular causative agent, focusing rather on either morbidity or mortality. Individuals usually carry out this exercise, and it cannot be undertaken in areas of economic deprivation (Huberman & Miles 2002, p.58). In contrast, ecology epidemiological study uses groups of persons to carry out research, increasing the possibility of linking the exposure to the disease. More data is gathered when this strategy is used (Pope & Mays 2000, p.29). Of the two methods, the qualitative approach is the more useful in carrying out regular data collection, as the individual can seek to understand the individual. The ecology method better suits a quantitative paradigm, as its cost-effectiveness allows groups to carry out conventional test methods, using figures to ascertain certain qualities of the disease. From this, it is clear that the two approaches can co-exist. Another study method is that of analysis. The analytical study employs models such as cohort studies (either prospective or longitudinal), studies of case control, and cross-sectional surveys. The cross-sectional survey focuses on testing hypotheses, and, crucially, uses geographically randomised surveys. In cohort studies, individuals who are likely to have been exposed to a certain disease are studied over a long period of observation. This method is expensive and usually involves the establishment of a rare disease (Baum 2008, p. 161). A study of case control is a retrospective study, including one active research case that involves people with a particular disease, and looking also at individuals who do not have the infection (Baum 2008, p. 161). Of the three methods, the cross-sectional one can most actively employ a positivist approach. The other two(namely, the cohort study and the control study) employ a qualitative approach in researching. However, the control study may at times employ both approaches. A further method of study is that of experimentation. Experimentation studies can use Randomized Control Trials (RCTs), or community trials. RCTs are designed to test new or improved therapy or preventative measures. Treatment groups in this case are chose from a population sample. The combination of the treatment group and the rest of the population establishes a control group; this practice has a strong emphasis on collected evidence (Denzin & Lincoln 1998, p. 52), made particularly effective by randomisation in picking the test subjects. In community trials, individuals receive samples of new preventative drugs while in their societal groups. However, these methods take a quantitative approach, a qualitative approach will be essential in determining viable respondents and in interpreting results. Quantitative approach methodology is essential, as it is the backbone of epidemiological studies. Using statistical analysis and predetermined research methods, the researcher is able to establish important and relevant factors pertaining to the disease. One also needs to consider the issue of individual relationships and attitudes to the disease, as factors that can relate specifically to certain individuals are important; for example, disease spread may be due to individual interactions or participations (Alderson 2007, p. 49). A qualitative approach is essential in this case, and combinational approaches such as socio-anthropology improve effectiveness. From the above, positivist and interpretivist approaches can co-exist. The three areas of epidemiological studies, present opportunities for the methodologies’ use together as part of the same study. In addition, Alderson maintains that researches analysing the two methods show that their combined use improves service delivery and efficiency. The consideration of environmental aspects combines the values of qualitative and quantitative paradigms. Part 2 a) Based on your reading of books such as Beaglehole (1993) describe what you know about observational epidemiology as a research approach and compare it to experimental studies. Describe some of the designs within each An observational study concerning epidemiology occurs when the investigator or observer measures activities but does not interfere with processes. Observational studies can be either analytical or descriptive in nature. Experimental studies constitute attempts that can lead to a change in an agent that determines a disease in terms of behaviour, exposure, or the progress in terms of treatment. These two research approaches have a significant impact on epidemiology, and as such, they are comparable. This segment will seek to look at each approach and in the process establish a comparison. Observational Epidemiology Ecology is an observational epidemiology, focusing on the nature of groups of individuals. A group of observers normally does this observation, which is particularly useful in hypothesis generation. Cross-sectional studies focus on a certain group of people that share specific traits. They are easy, cost-effective observations to undertake. The data obtained from these studies provides essential insight into the needs of the people in terms of health care. Case control studies, which seek retrospectively to ascertain the origin of a disease, are essential in studying rare disease cases. Groups are divided based on those who have the disease and those who do not, where the latter acts as a control group for the former. Cohort studies examine the probability of an individual to contact a certain disease. Groups with an exposure to a particular disease are compared to those who have not been exposed. This study has drawn interest for its provision of reliable information in establishing causation of a disease (Baum 2008, p. 161). This is necessarily a lengthy study, since the establishment of disease prevalence often requires long exposure; for example, in 1991, a cohort study established the prevalence of gastric cancer in the USA (Bonita, Beaglehole & Kjellström 2006, p. 44). Experimental Epidemiological Studies These studies tend to alter a particular variable within a population, incorporating steps towards the eradication of a causative agent of a disease through scientific interventions (Baum 2008, p. 162). One of these study designs is the Randomized Control Trial, which studies the effect of an intervention on a population. A treatment is administered to a section of the population selected at random, and the results are compared are against those without treatment. Monitoring of the two groups begins at the initial stages, even before administration of the drugs (Baum 2008, p. 162). In field trials, people who are within the general population but perceived to be at risk are the subject of data collection. This is mostly a preventive measure carried out by measuring an occurrence of a disease or health problems among healthy individuals. In community trials, the respondents are members of a community as opposed to individuals. This is essential since some diseases have prevalence in terms of the social setting of the people (Bonita, Beaglehole & Kjellström 2006, p. 51). b) Discuss why ‘causation’ is important in the field of epidemiology. Why must researchers be cautious to say that Variable A causes Variable B? What can epidemiologists do in terms of providing evidence that a certain risk factor is the cause of a particular disease? Causation in epidemiology is extremely important, as it aids the researcher to establish the data and to make associations and correlations. It involves the assessment and understanding of the risks, determinants, causes, and factors concerning mortality, disabilities, and morbidity within a population set. Causation is important in determining diagnosis, disease treatment, or prevention, all of which form part of the public health provisions and policies. The cause of a disease or a health concern cannot often be determined immediately (Bonita, Beaglehole & Kjellström 2006, p. 83) because causes are numerous and diverse. The cause could involve the physiology of the human body, social factors, environmental determinants, cognition, or behaviour. In some cases, associations or correlations are present in the analysis of health issues. However, the general approach is that correlation might not imply causation. It would therefore be wrong for an observer or a researcher generally to imply that two distinct indications point towards causation. For example, correlation of drug abuse and depression cannot form a concrete basis for a researcher to conclude that one causes the other variable; there may be another variable connecting the two. Another reason for disregarding this notion is that one might not know the variable that depends on the other (Bonita, Beaglehole & Kjellström 2006, p. 85). From the above, we cannot ascertain whether drug abuse leads to depression or whether the reverse is true. However, the ‘attributable fraction’ enables the epidemiologist to single out a factor that is likely to have an impact on the prevalence of a disease or preventive measure if it undergoes elimination. In light of these facts, an epidemiologist needs to have a suitable method by which to conduct a causation analysis. The requirement is to have an approach that is systematic and that can be effective. In normal cases, the researcher begins with the disease before concentrating on finding the cause. However, in some cases the researcher starts with the cause and later focus on the sustained effects (Aickin 2002, p.39). Researchers in this case have come under strong criticism for not taking into account the possibility of multiple causes of a disease. As such, these factors should be considered: predisposing attributes, which are individual traits affecting immune system; precipitating factors, including exposure to a disease-causing agent; enabling factors, which favour the disease development; and reinforcing attributes, which increase exposure risks (Bonita, Beaglehole & Kjellström 2006, p. 87). In establishing disease causes, the epidemiologist must examine crucial aspects such as causation consideration. This employs systematic approaches based on tests and trials to establish causation. Temporal relationships, which state that causes have effects, may also be considered. The plausibility of an association provides the epidemiologist with knowledge of consistency of the causation to what he or she knows. Consistency allows the epidemiologist to know and to demonstrate analysis that tallies with previous studies and researches. A dose-relationship is suitable if there is change in a possible cause when there are changes in the incidence or prevalence of an effect (Bonita, Beaglehole & Kjellström 2006, p. 89). Conclusion The above discussions on qualitative and quantitative approaches, design and causation in epidemiological study are as engaging as they are wide. The two approaches analyse public health issues differently, but they can be used together to achieve better results. Effective combination of the two can see the realisation of better service provision and the tackling of health issues. The designs vary in terms of application and effect, and their use highlights the importance of epidemiological research. Causation, a major area of study, is a vital aspect of the two approaches. As demonstrated above, it should be a primary concern for all epidemiologists. The final, and most preferred, outcome takes place when the epidemiologist establishes the causation of a disease or health issue. References Aickin, M. 2002, Causal analysis in biomedicine and epidemiology: Based on minimal sufficient causation,Marcel Dekker, New York. Alderson, P. 2007, Governance and ethics in health research, Sage Publications, London. Aschengrau, A.&Seage, G.R. 2008, Essentials of epidemiology in public health, Jones and Bartlett Publishers, Sudbury, Massachusetts. Baum, F. 2008, The New Public Health, 3rd edn, Oxford University Press, South Melbourne. Blobel, B. 2002, Analysis, design and implementation of secure and interoperable distributed health information systems,IOS Press, Amsterdam. Bonita, R.,Beaglehole, R.&Kjellström, T. 2006, Basic epidemiology, 2ndEdn, World Health Organisation. Brannen, J. 1992, Mixing methods: Qualitative and quantitative research, Aldershot, Avebury. Büttner, P.& Muller, R. 2011, Epidemiology, Oxford University Press, South Melbourne. Creswell, J.W. 2003,Research design: Qualitative, quantitative, and mixed method approaches,Sage Publications,Thousand Oaks, California. Denzin, N.K.& Lincoln, Y.S. 1998, Collecting and interpreting qualitative materials,Sage Publications, Thousand Oaks, California. Huberman, A.M.& Miles, M.B. 2002, The qualitative researcher's companion,Sage Publications, Thousand Oaks, California. Johnson, B.& Christensen, L.B. 2008, Educational research: Quantitative, qualitative, and mixed approaches,Sage Publications, Los Angeles. Kleczkowski, B.M.&Pibouleau, R. 1976, Approaches to planning and design of health care facilities in developing areas, World Health Organization, Geneva. Pope, C.& Mays, N. 2000, Qualitative research in health care, BMJ Books, London. Saks, M.&Allsop, J. 2007, Researching health: Qualitative, quantitative and mixed methods,Sage Publications, Los Angeles. Read More