Transforming Health Interviews
The first featured article in ANS Volume 41:4 discusses ways to move interviews to approaches that more clearly reflect the context and experience of health challenges. The article is titled “Creating Emancipatory Dialogues About Identity and Health by Modernizing Interviews,” authored by Doris M. Boutain, PhD, RN, PHNA-BC; Robin Evans-Agnew, PhD, RN; Fuqin Liu, PhD, RN; and Marie-Anne S. Rosemberg, PhD, RN. The article will be available to download at no cost while it is featured, and we invite you to read it and join a discussion in this blog! The authors sent this message about this work for ANS blog readers:
Imagine the following scenario: it is the afternoon of a school day and a health
researcher, the recruited youth, and parents meet for the first time. The place is a quiet corner of a public café selected by the parents who will give their consent for research participation. The researcher explains the study using consent forms previously distributed to the family to read. The parents ask a few questions and then sign the consent form. The youth also signs the assent form. Then the researcher conducts a short interview asking the youth some pre-selected, close-ended questions about demographics and establishes a follow-up meeting time. What is the value of the information collected in this encounter, and who owns this value? How does this
encounter set up the power-relations for the development of knowledge for the remainder of the research study? What did the researcher miss that might have been important concerning the identity and health of the youth.
We developed this article to share another way to design an interview. Dr. Boutain was first introduced to the need to transform the interview in her dissertation research on hypertension management with African Americans in rural South Louisiana in 1999. In her dissertation, she describes a story of how she developed her interview questions using the advice from two neighborhood groups who both instructed her to modify the interview question “How much money do you earn in a year?”, by phrasing it differently and having a different target
of inquiry. Namely, they suggested the two questions, “Are you doing okay making your ends meet?” together with “How does making ends meet affect your blood pressure?” The neighborhood groups’ suggestions led Dr. Boutain to consider a genesis of power in the interviewer-interviewee relationship. Namely, two questions became apropos: Who decides which questions to ask in the interview?, and Which interview questions are most meaningful for research participants?. The neighborhood groups taught Dr. Boutain to ask about the relationship between identity and health, and to care about the research participants’ way of relating their identity to their health in the process of the interview. The neighborhood groups provided a public service to Dr. Boutain and created the emergence of the Identity-Research-and Health
Dialogic-Open-ended interview (I-REH-DO).
As former graduate students and current colleagues working with Dr. Boutain we identified ourselves in a participatory scholarship group called “Scholars Ready”. Drs. Evans-Agnew, Liu, and Rosemberg, applied the I-ReH-DO interview in their own research beginning in 2010. Our article is an opportunity to provide new insights into the application of the I-ReH-DO interview across diverse, and critically situated, research interests. Our work involves community-based inquiry and health interview environments similar to the scenario above. Dr. Rosemberg’s interests lie in transnationalism and immigrant worker health, including people working in hotels and nail salons. Dr. Liu conducts inquiry about global maternal child health, especially in preconception and interconception care policy in China. Dr. Evans-Agnew focuses on childhood asthma inequities, citizen science, and environmental justice with Latina and African American groups. Dr. Boutain, as the John and Marguerite Walker Corbally Professor in Public Service at the University of Washington, has deepened her interests in systems research to promote knowledge about how to sustain health equity policies and practices with community-based organizations, faith-based organizations, and public health programs and services.
As scholars ready to advance emancipatory research methodologies, we are excited to publish the use of the I-ReH-DO interview. We regard the I-ReH-DO interview as an important visioning tool for new and experienced researchers to elicit novel ways of knowing about identity and health. The I-ReH-DO interview will facilitate research encounters which advance the power of participants to define their identity and health in a way that is significant and relevant for them. Thus, we as researchers will support the emergence of emancipatory research generation. We envision that the use of the I-ReH-DO will: (1) facilitate knowledge generation from participants who define themselves for themselves; (2) extend the close-ended facet of demographic surveys to result in rich contextual data; (3) inform sustainable programs/interventions that are applicable to individuals’ identity; and (4) foster changes in structural/systemic forces that participants identify as drivers of their health.
Doris M. Boutain
Marie-Anne S. Rosemberg
Lovely and so timely for me as I write my dissertation proposal to undertake interviews with an indigenous population and diabetes type 2. I’ve been thinking about the interview questions from a community based partipatory research perspective. Importantly the dialog of designing culturally relevant questions must include how researchers are situated between the research aims and congruency with the community values and norms. Thus, the creativity of the researcher comes into play by being reflexive in asking the right questions in context to the participants worldview. I will follow Dr. Boutain and colleagues with interest. Thank you!