Qualitative Research Methodology in Health

The report evaluates three research papers that investigated breastfeeding experience of Australian mothers. The report critically evaluates the research methodology used in each paper and identifies the quality of the findings presented. The report concludes that two of the three papers are of good quality research evidence.

Running head: QUALITATIVE RESEARCH METHODOLOGY IN HEALTH
Qualitative research methodology in health
Name of the student:
Name of the University:
Author’s note

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Introduction:
Breast feeding is a practice widely encouraged by the World Health Organization (WHO)
because of its benefits in providing ideal food and promoting healthy growth and development in
infants. WHO recommends exclusive breastfeeding for the first six months followed by addition
of complementary food till the age of two years or beyond. However, despite WHO’s
recommendation, only 35% of infants are breastfed globally (Akinyinka, Olatona & Oluwole,
2016). In case of Australia, 90% children initiated breastfeeding, however only 15.4% were
exclusively breastfed till 5 months (The Department of Health, 2018). To resolve the issue and
promote breastfeeding practice among mothers, it is essential to identify the factors that act as
barriers in breastfeeding and find the reason behind reduction in breastfeeding rates. Hence, the
report will critically evaluate research papers that have investigated about breastfeeding
experience of Australian mothers and identify the quality of the findings presented in terms
research rigour, suitability of data collection method and research design.
Article 1:
Gallegos, D., Vicca, N., & Streiner, S. (2015). Breastfeeding beliefs and practices of African
women living in Brisbane and Perth, Australia. Maternal & child nutrition, 11(4), 727-736.
Gallegos, Vicca and Streiner (2015) aimed to investigate about breastfeeding experience
among refugee women living in two major capital cities in Australia. Qualitative descriptive
research method using thematic content analysis method was employed to gain understanding
regarding breastfeeding experience in the target group. Data was collected from two sites of
Australia (Perth and Brisbane) and women from Africa living in Perth and Brisbane were
recruited through women’s community group. Informed consent and ethical approval

2QUALITATIVE RESEARCH METHODOLOGY IN HEALTH
requirement was maintained. Participants from all age group were taken who had children either
in Australia or in their own country. Interview was used as the main method to collect research
data and comprehensive data was collected regarding cultural beliefs, facilitators, barriers and
personal experiences of participants regarding breast feeding. The interview data was transcribed
verbatim and group-based discussion was audio-taped and recorded. Use of inductive approach
helped in developing themes from the research data. The findings of the research gave idea about
the complexity of breastfeeding behaviour among women. Stigma and shame was identified as a
barrier to breastfeeding as many African women avoided breastfeeding in public according to
Australian culture. Loss of family support was also identified as a barrier to breast feeding within
the Australian context.
Gallegos, Vicca and Streiner (2015) used descriptive qualitative research approach to
explore about breastfeeding experience among African mothers living in Australia. Qualitative
research design is appropriate according to the purpose of research as qualitative inquiry favours
gaining detail insight regarding the experience of individual regarding a phenomenon of interest
(Creswell & Creswell, 2017). Furthermore, use of thematic content analysis enhanced the quality
of research data as it helped in identifying patterns across dataset as well as critically evaluate the
research content in terms of richness of information and relevance to the research question.
Content analysis favoured transformation of data from being just descriptive data to an
interpretive data (Vaismoradi, Turunen & Bondas, 2013). During the stage of sample
recruitment, all ethical considerations related to informed consent and approval from Human
Research Ethics Committee was done. This promoted the reliability of research. The rigor in data
collection is understood by the use of both interview and group based discussion to collect data.
Both the method helped to understand cultural perspective of research participants regarding

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breast feeding. Thematic analysis was done using the inductive approach and the main advantage
of inductive reasoning during data analysis is that it helps to deduce various data to provide a
conclusion regarding research outcomes. The credibility of the research is also understood by the
use of two researchers to review and another researcher to verify the information. Such steps
helped to minimize biases during interpretation of research data (Vaismoradi et al., 2013).
Article 2:
McKellar, L., Fleet, J., & Dove, S. (2017). It’s more than just luck: A qualitative exploration of
breastfeeding in rural Australia. Women and Birth.
McKellar, Fleet and Dovez (2017) gave insight into breastfeeding experience of
Australian mothers by conducting a qualitative study to explore breastfeeding in rural Australia.
Focus group study design was used to collect research data. Although the study was a mixed
method study which used both quantitative and qualitative data to determine breastfeeding rate
and explore breastfeeding experience respectively, however McKellar, Fleet and Dovez (2017)
reported mainly about qualitative aspects of the results. For collection of qualitative research
data, a focus group was developed by distribution of information to target group. Women got the
option to nominate them in the focus group session and they were informed regarding the
purpose of the session too. Convenience sampling strategy was taken to recruit nine participants
and questionnaire was used to explore participant’s experience related to breastfeeding. Another
focus group session was also done with health care professionals. Thematic approach was used
to critically evaluate transcribed interview data and effectively present participants experience
related to breastfeeding. The main findings from the research was that women regarded

4QUALITATIVE RESEARCH METHODOLOGY IN HEALTH
continuing with breastfeeding as luck and the study also gave indication regarding differences in
the breastfeeding practices based on the kind support they got from home and community.
Focus group is a type of research methodology where small number of participants is
targeted to explore their feelings or thoughts related to a phenonmenon. As McKellar, Fleet and
Dovez (2017) mainly aimed to evaluate breastfeeding experience among rural Australian
women, the choice of research design is appropriate. In accordance with the research design, the
sample size for the study is also appropriate. Conducting interview with nine participants helped
to promote extensive discussion related to breastfeeding practices. For focus group study, it is
essential that participants be selected in a very careful manner so that they represent the target of
population of interest. In accordance with the research design, use of convenience sampling
strategy was appropriate because random sampling is not used in focus group studies.
Convenience sampling is a non-probability sampling where sample is collected based on ease of
contact (Emerson, 2015). The option of providing women the chance to self-select themselves as
per the information distributed eliminated selection bias in research. Informed consent
requirement and ethical approval was fulfilled too. Thematic approach and presentation of
research data using themes was also suitable according to the purpose of investigation. Thematic
approach provided the advantage of representing research outcomes as per common themes
identified and it enhances the quality of the work too (Vaismoradi et al., 2016).
Article 3:
Forster, D. A., & McLachlan, H. L. (2010). Women's views and experiences of breast feeding:
positive, negative or just good for the baby?. Midwifery, 26(1), 116-125.

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The main objective of the study by Forster and McLachlan (2010) was to explore
women’s view and experiences if breastfeeding. The qualitative study was done by collecting
data from a randomized controlled trial where a education intervention did not increased
breastfeeding among women. Hence, this data was pooled and analyzed as a cohort. The sample
for the study included Australian primiparous women residing in a tertiary women’s hospital in
Melbourne, Australia. The inclusion criteria for selection of participants included having a first
child, between 16 and 24 week pregnant and ability to speak and write in English. Data related to
women’s breastfeeding intention were collected before randomization process. Primary and
secondary data from participants were collected by interview during the time of delivery at
hospital and by telephone interview using structured questionnaires. The overall question that
was asked by the use of questionnaire include how women feel about breastfeeding. Data was
analyzed using thematic analysis. Ethical approval for research was also taken. The research
findings mainly gave rise to theme of positive views, negative views and agreement on
breastfeeding as good for the baby.
The study used a specific cohort from a randomized control to evaluate experience
related to breastfeeding. The advantage of using prospective cohort research design was that it
helped to get a clear insight regarding relation between exposure and outcome. For the study by
Forster and McLachlan (2010), the main exposure was breastfeeding and outcome was
experiences of women. The research design helped to examine multiple effects of the exposure
to breastfeeding practices (Hartas, 2015). Sample recruitment is an important element of
qualitative research and quality of research data is enhanced by taking a recruitment strategy that
ensures that whole population of interest is analysed. However, the limitation found in sample
recruitment is that women from single hospital were analyzed and research participants were

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limited to only those who speak in English. This reduced the possibility to evaluate breastfeeding
experience of cultural groups who lives in Australia following migration. Inclusion of
participants speaking other language was important because evidence has revealed that migrant
women leaving in Australia experience tension in their breastfeeding and knowing the reason
behind such experience was important (Schmied et al., 2012). However, thematic analysis to
present research data is a strength of the research as it enables adopting flexible approach to
present complex account of data. Findings from thematic analysis are quickly interpreted too
(Nowell et al., 2017).
Conclusion:
The critical evaluation of the above two studies gave an idea about the breast feeding
experience of mothers living in Australia. The strength of the research methodology was
identified by appropriateness of research design, use of rigour in research and use of strong
method for sample recruitment. Taking extra steps to enhance the quality and reliability of data
was also judged. Among the three articles, the article by Gallegos, Vicca and Streiner (2015) and
McKellar, Fleet and Dovez (2017) are considered good quality of research evidence as the study
had appropriate sample size, little scope of bias and rich data to understand women’s
breastfeeding experience in Australia. For example use of convenience sampling and provide the
option to self-invite in research as per research information distributed served the purpose of
focus group research design. On the whole, all the three research articles highlighted about
positive or negative views related to breastfeeding.

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References:
Akinyinka, M. R., Olatona, F. A., & Oluwole, E. O. (2016). Breastfeeding Knowledge and
Practices among Mothers of Children under 2 Years of Age Living in a Military Barrack
in Southwest Nigeria. International journal of MCH and AIDS, 5(1), 1.
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed
methods approaches. Sage publications.
Emerson, R. W. (2015). Convenience sampling, random sampling, and snowball sampling: How
does sampling affect the validity of research?. Journal of Visual Impairment & Blindness
(Online), 109(2), 164.
Forster, D. A., & McLachlan, H. L. (2010). Women's views and experiences of breast feeding:
positive, negative or just good for the baby?. Midwifery, 26(1), 116-125.
Gallegos, D., Vicca, N., & Streiner, S. (2015). Breastfeeding beliefs and practices of African
women living in Brisbane and Perth, Australia. Maternal & child nutrition, 11(4), 727-
736.
Hartas, D. (Ed.). (2015). Educational research and inquiry: Qualitative and quantitative
approaches. Bloomsbury Publishing.
McKellar, L., Fleet, J., & Dove, S. (2017). It’s more than just luck: A qualitative exploration of
breastfeeding in rural Australia. Women and Birth.
Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to
meet the trustworthiness criteria. International Journal of Qualitative Methods, 16(1),
1609406917733847.

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Schmied, V., Olley, H., Burns, E., Duff, M., Dennis, C. L., & Dahlen, H. G. (2012).
Contradictions and conflict: A meta-ethnographic study of migrant women’s experiences
of breastfeeding in a new country. BMC pregnancy and childbirth, 12(1), 163.
The Department of Health (2018). Breastfeeding. Retrieved from:
http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/
Vaismoradi, M., Jones, J., Turunen, H., & Snelgrove, S. (2016). Theme development in
qualitative content analysis and thematic analysis. Journal of Nursing Education and
Practice, 6(5), 100.
Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis:
Implications for conducting a qualitative descriptive study. Nursing & health
sciences, 15(3), 398-405.