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Case Studies

Qualitative and Mixed Methods Research Case Studies

Dedoose and its predecessor EthnoNotes have been in use for almost 15 years now! Along the way some very important research has been conducted and many publications have been generated from this work. Here are just a few of the projects where the Dedoose family of tools has proved invaluable to our users.

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A study in Hotel Branding and Naming

The Problem:

Hotel developers were looking to introduce a new concept “luxutique” hotel into the highly competitive Las Vegas area. The core mission was to create a new experience for high-income, well-traveled, and discriminating patrons.

But what is a luxutique hotel and what name captures a luxutique hotel essence?

The Approach/Methods:

Using a truly mixed methods design, the responsible research team gathered a sample of target-segment research participants. Respondents provided both open-ended responses on the “meaning” of luxutique and quantitative ratings on pre-screened name candidates and on the range of characteristics along which hotel types vary. Analysis included both the implementation of EthnoNotes (Dedoose’s predecessor) to identify and develop key hotel-type dimensions and a principle-components factor analysis to evaluate the name candidates in terms of how each captured the essence of a luxutique hotel.

Results and Findings:

What is a “Luxutique” hotel?

Open-ended responses converged on a set of key characteristics including: sophisticated, intimate, high-end services, detail-oriented, and nurturing:

“I think it is time for Vegas hotels to stop being so "Vegas"... a more intimate or sophisticated layout would be a nice change of pace and key differentiator… “

“Every customer should feel like a VIP. Also there should be several night life options ranging from casual sports bar to Hollywood style over the top clubbing and an opulent pool and spa”

“Concierge needs to be top notch. Connections to get the best seats in the best restaurants, any shows, golf, spa etc. Transportation to these events and/or airport should be top notch too - Bentley, Maserati, style”

“[Clientele] who live and move with confidence and comfort and who display experience in high-end hotels and show proper respect to other guests”

Having gathered information on the characteristics considered by the target market to best describe the essence of luxutique, ratings for these characteristics for each of a set of hotel name candidates were subjected to a principle components factor analysis in order to discern key dimensions and how well each name captured the characteristics of these dimension. A three-dimension solution emerged with dimensions representing:

• Dimension ‘A’ (46.6% of solution variance): discriminating, exotic, European, exciting, cosmopolitan, intriguing, and contemporary

• Dimension ‘B’ (30.4% of variance): luxurious, sexy, flirtatious, indulgent, intimate, and stylish

• Dimension ‘C’ (18.3% of variance): warm and sensuous

In the end, the developers got all that they bargained for in terms of hotel characteristic and name guidance AND the confidence that only comes from a rigorous evidence-based decision process.

Emergent Literacy—A Study on the Home Literacy Environments of Families with Children in Head Start Programs

Funded by the National Science Foundation, this project sought to understand the emergent literacy (EL) skill development of Head Start students and the home literacy environments (HLEs) in which they develop.

The Problem:

Knowing that English Language Learners (ELLs) are often challenged when entering kindergarten, this project was designed to provide a more comprehensive understanding of the family’s HLEs, discover important variation across these environments and discover how literacy promoting activities and routines can be supported and enhanced. SCRC co-founders, Weisner and Lieber, lead the UCLA team responsible for designing and conducting a qualitative study of the HLEs and carry-out a mixed methods analysis of the project data. EthnoNotes, the precursor to Dedoose, was central in all data management and analysis.

The Approach/Methods:

Implementing a mixed methods approach, the research team conducted over 200 open-ended interviews based on the Ecocultural Family Interview and focused on home literacy activities and emergent literacy skill development. The qualitative data from these interviews was integrated with descriptor data related to parent education, reading and language proficiency, ethnicity, and other family characteristics.

Findings:

Relative Sub-group Adjusted Tag Application by Primary Home Language

The data visualization reports easily available in EthnoNotes immediately exposed primary home language variation across a set of key themes—ANOVA results confirmed these differences to be statistically significant. Drilling deeper into these data via the click-through charts, the research team began to appreciate not only the wide variation across families living in similar circumstances, but in how these various HLE activities and routines combined together to further distinguish the families and point to key areas for intervention.

Drilling in, it was apparent that, unique within their language group, Spanish speaking families that combine HLE support also report at least a HS education, express appreciation of the demands of school success, and the importance of preparing their children. Many of these families’ activities take place in Spanish and, despite possible language obstacles, these families report regular communication with their children’s school. For example in one family, “Mother and other family members prepare the child for kindergarten by helping her to learn numbers and the alphabet. Mother explains, ‘this is a good gateway for other learning because these are the ‘basics’ and her daughter will have confidence once she is older.’” This determination and commitment to supporting EL development is illustrated by another family which reported that, “Mother and father sought outside assistance and suggestions for how to help their child be prepared for school. The Head Start teacher suggested several activities—teaching the alphabet and shapes. In response, these parents then devoted time each day to working on these skills with their child.”

In contrast, bilingual families that combine HLE supports report relatively less formal education, use both English and Spanish in guiding their children’s home activities, and describe their support of these activities at high levels from a more straightforward and practical school-skills oriented perspective. Additionally, like all families that combine high levels of HLE supports, these parents report regular communication with their children’s school. For example, “When describing home writing activities, mother said, ‘it gives joy to know that by coloring [her child] is also learning things like getting to know colors.” Another mother shared that she “… reads to her child like her father did with her so that her son can develop well.” Finally in another family, “Both parents spend time at home teaching their child things he will be learning in school (e.g., numbers, alphabet, how to behave). They do this so he will ‘understand what is expected from him once in school.’”

Overall, results indicate that families reporting high levels of activity across all three HLE supports have similar beliefs about preparing their children for regular school and describe their beliefs and understandings of how these activities will benefit their children in relatively complete and cohesive ways. Further, despite a variety of characteristic differences across home language groups, all recognize the importance of providing all core EL support experiences and find ways to assure they are consistently present in the daily routines of their homes. Finally, these parents all report actively communicating with their children’s teachers and steadily monitor their children’s progress in the Head Start program.

A key finding here is that, despite the perspective encouraged by deficit models, these low-income immigrant families show a wealth of EL development supports in their daily activities and routines. At the same time, it is important to recognize the variation across these home language groups in terms of education experience, language skills, and immigration background as these represent the context in which any intervention must be integrated. We find that the supportive activities reported by these families are not exhibited in the same ways by each language group. Recognizing and adapting to these variations will enhance the successful adoption and sustainability of education and intervention provisions. Particular group strengths should be identified, encouraged, and capitalized upon as culturally consistent and familiar practices that support EL development within a particular group.

A Study in Branding and Organizational Culture

The Academy of Motion Picture Arts and Sciences (AMPAS) sought to rebrand, re-identify, and re-capture their audience.

The Problem:

The AMPAS leadership had increasing concerns about declining award’s show audience and fragmentation in their marketing messaging and outreach. They hired a branding firm (Scarcliff | Salvador) and associated research consultants from SocioCulutural Research Consultants (SCRC—the company that brings you Dedoose) to conduct research that would expose brand weaknesses and inform marketing direction.

The Approach/Methods:

Implementing a mixed methods approach, the researchers conducted a series of intensive interviews with members of AMPAS members, board members, creative partners, and staff to tap into their perspectives on organizational culture, meaning, goals, assets, challenges, and potential solutions. Interviewees were also distinguished by the amount of time they were associated with the academy, their age, and gender. Needless to say, EthnoNotes (Dedoose’s predecessor) was the research team’s choice for managing and analyzing their data systematically and with the scientific rigor that encourages great confidence in study findings and the decisions that follow.

Findings:

The data visualization reports that are automatically generated allow the team to quickly see patterns in the complexity of the AMPAS culture, clear distinctions between the various constituents, and insight into the key themes that would lead to productive actionable decisions. From the data we were able to produce a “picture” of the overall culture, current perceived ‘brand,’ and the pressures and solutions that would lead to a successful consolidation and re-identification. Among the useful directions identified and explored were issues related to:

• Clarification of the AMPAS identity, personality, and public perceptions “You’re coming to these incredible programs where some of the greatest film-makers are holding court, talking about their film. We charge $5.00 for that. That’s definitely the mission. The mission drives everything we do, educating the public about film, honoring film, and then of course, preserving history of film, but it costs money” “… an image in my mind of the Oscar with two arms out, with the show in one hand and everything else that people are relatively unaware of in the other… and I think the general public would appreciate it. You know, they wouldn’t say, ‘Oh, they’re just a show. They do more than that.’ I think it’s a great opportunity to make it accessible to a much larger audience” “Though, with the Oscar I think is a huge, huge thing and maybe bigger than it needs to be in the sense that it's really just us kids taking a vote, but it has this huge importance. It is the big award in show business, and so that, right now, I think, is the image. I think when you say to the people the Academy, they picture an Oscar… and that's fine, but I think it needs to be more than that” “I think it’s a beautiful image, it’s the best-looking award around and that’s not just because I’m from here. In terms of aesthetics, we fortunately glommed on at a really good time, you know, that sort of deco, beautiful design. But it does, it’s sort of taken off as a life of its own, and I don’t know that you can get around that” “I totally understand where they’re coming from on the one hand because they have such a heritage and a history behind them that is something to be proud of and something to be held on high. But on the other hand, you know, entertainment should be entertaining and fun. It’s absolutely about finding some sort of harmony where they feel they can achieve both of those things. I don’t think it’s impossible. I think it’s just a matter of not feeling like anything that leans more towards the entertainment side and the fun side and the more lighthearted or more commercial, to use a word I know they don’t like, it doesn’t mean it has to be a bad thing”

• The tremendous AMPAS assets and how they can be better capitalized upon “I think again the strength is in the fact that we have got a membership that’s second to none. This is the only membership of its kind. The Oscar is the most coveted award in filmmaking. If we can’t do something with that it’s kind of sad” “If you become an academy member it’s not easy, it’s a huge, huge accomplishment. These are famous people who care and when we ask them to come to our public events, they show up. And we have unbelievable footage of hugely famous people in our theater and in our galleries from events that take place all year round” “Yeah, so it would be really neat to see Oscar not as the old white male in a stuffy suit, but to see him as Richard Edlund and to see him as the 12- year-old actress that was just, became a member of the Academy. To see him as this cinematographer or this person and that person” “At the end this woman -- and she was just a housewife in Hanoi -- just came to the screening, and she said, ‘I never knew that Americans cared for their families the way Vietnamese people do, and this has changed my whole opinion of America.’ And I thought, ‘Well, that's exactly why we're here.’ It's like the perfect moment for why we need to take not just our films but our people around the world” “I don’t think they speak from a unified voice… figuratively and literally. I think, like I was saying there, so many different passionate people that are guarded about their own work that there’s a real opportunity to unify their passion.”

• A variety of key challenges as understood by the membership, board, and staff and the range of solutions to be considered:

o Disappearing television audience—Solution: Welcome new audiences while staying true to our purpose; Bring in new talent—professionalize certain aspects of the organization where possible and appropriate; Update the show format and rethink the announcement

o The Academy is “off the radar”—Solution: Increased membership involvement; Extend reach to better highlight the many other Academy assets

o Concern about commercialization being a double-edged sword that threatens the core Academy purpose and identity—Solution: Choose partnerships wisely.

o Our traditions and reason for being include barriers to change—Solution: Evolve, don’t ‘change;’ Discover new ways to express organization identity and value in a modernizing world All these findings were provided at a fraction of the cost of the traditional market research that, often, provides such shallow information. Some terrific people within the organization digested and learned from the findings. And, indeed, the awards show has evolved, viewership increased in all target segments, and AMPAS is showing a more consistent persona in all aspects of their internal and external brand.

A study in Health Care - Pfizer Working to Bring Evidence to the Clinic

“If we can put the right information, at the right time, into physicians’ hands, we can change two things. [We can] lower costs and improve the quality of care by enabling physicians to make the right decisions with the right information.” —Dan Michelson, CMO, Allscripts-Misys Health-Care Solutions Inc.

The Problem

Many health care providers and economist are chasing after the dream described by Michelson (above) and Pfizer decided to investigate ways to make this happen by investing in efforts to help enhance the quality of health care services by bringing cutting-edge research into the clinic. They awarded funding to a team of researchers to learn more about how physicians can use the latest evidence-based research in the clinic in real time.

The Approach/Methods

Implementing a mixed methods approach, the researchers conducted a series of focus groups and intensive interviews with a range of practicing physicians to better understand their perspective on the value o evidence-based research results and what potential benefits and obstacles exist in creating such a system. EthnoNotes (Dedoose’s predecessor) was the research team’s choice for managing and analyzing their data. The fact that Weisner got the grant had nothing to do with it. Project resources included transcripts of focus groups which were then coded. Resource descriptors included physician age, gender, specialty, # of years in practice, type of practice setting and size, comfort with computers, online medical resources, and PDAs, and resources consulted in and out of the clinic.

Preliminary Findings

The research team used the code-by-code matrix—a feature that filters the qualitative data codes to search for pairs of codes used in an excerpt—and the code-by-descriptor charting engine—which runs codes by each descriptor variable (e.g., by gender, specialty, …). A number of important findings were quickly identified.


• Clinicians in particular areas of specialty see a greater need for evidence farming “Since most of the random controlled trials are done with adult, in pediatrics you have to make a judgment call…so that’s bad”

• Desire for up-to-date information on patient compliance with prescribed medication “Compliance is a big issue with hypertension…we’ve actually ordered the drug [but] we don’t capture whether the person has actually picked it up and certainly we don’t know if they’re taking it”

• Obstacles to system adoption include issues of the confidentiality of the data, patient-doctor relation management—discomfort in searching for information in front of a patient or leaving exam room to do search, trust in system accuracy, and time-consuming interface. “Now, we get the abstract data out of systems into a data warehouse that have the same model…and by that we mean the diagnosis of discharge. That’s the only one we store. And if everybody is doing that, regionally, then we can collect our diagnosis regionally and be reasonably certain that we’re all talking about the same thing. Now, if [X] gave us the admitting ones and UC Davis, you know, sent in discharge ones, and then Kaiser did something different, then it wouldn’t make any sense” “I mean if it’s more than a couple of clicks or keystrokes, it’s not going to get used...and sensitivity to the workflow is going to be a real key…in the right place at the right time for the right patient”

• Great value in quickly being able to diagnose and prescribe medication for ‘tricky’ ailments “Particularly, yeah, for people with chronic pain I think that’s very useful simply because your medication management becomes so tricky with issues with dependence and whatnot. Also insomnia would be another one where it’s very confusing as to what to do, what the first line should be, and how to really select amongst the medications available out there, you know, what the rationale is. There just doesn’t seem to be much guiding evidence at all. And then it would be most I guess in cases where I feel like my clinical experience is less than any data whatsoever”

Phase 2—Video Scenarios:

Findings from Phase 1 were used to shape the content and production of brief videos depicting scenarios of an electronic evidence-farming system being used within a clinical setting. A number of physicians and medical students viewed these videos and then participated in intensive interviews and/or focus groups. Phase 2 Findings:


Overall, the participants envisioned a great value if having detailed and scientific information available in the clinic. Yet they also astutely pointed out a number of issues that demanded consideration in the development and implementation of a viable system. Among the most illuminating issues raised:

• “Buy-in”—many physicians, particularly those with more extensive clinical experience, may be reluctant to use evidence based findings in the clinic. “I mean as much as we want to go evidence based on everything, you gotta be a little bit careful. Sometimes our instinct and what we go by is very simple and it might be the best option”

• Potential Limits on usefulness of Randomized Control Trial (RCTs) Findings “You don’t know how controlled it is, you don’t know how many people are actually making it in or not…[the clinic is] like a study. That’s why these studies are done, because it’s hard to get the patients. But now you’re just making up your own little study and extrapolating data and it just doesn’t seem… very safe”

• Tremendous value in reducing costs and patient discomfort if possible to share and explore diagnostic data in real-time—particularly for uncommon or poorly understood conditions and medication effectiveness “Or like the one with the leg pains, the weird viral thing? Oh that was wild. It was a viral thing. My son, literally, could not walk for 2 days because his legs hurt so much, and we had like 3 or 4 [cases], and it was like, just, you know, some poor kid went through a whole workup with a lumbar puncture and everything, and by the time it got to my side, it was like, ‘Oh, it’ll be over in a day and that’s it.’… If we put it in [to an evidence farming system] and then other people started seeing that…[it’s] something that’s not just isolated to one person…It makes the physician feel a little more comfortable… and then you see it resolve, and what works” “I’ll say, in 2 days if you’re not better, then you can go ahead and get it filled… and they’ll say, ‘Okay, that’s fair’ and then they’ll try it. And most of the time people get better with time, whether the antibiotics whether they’re taking it or not, but it’s nice to have a backup. To say, ‘Here, look, only 10 people out of 50 or 80 used it’ I think that could be helpful” “I think even something like adhesive medicines like say Aderol, say, and compare complications you’ve had and complications which you can’t understand, is there a theme and why and so forth? Something like that, something we could say is why we use this medicine a lot more. Why is this used a lot more, why is the price more, why is it used for osteoporosis or whatever it is, then you can have some idea of what education for the community is needed” “For me I’d really look for something to really track my outcomes as well, whether it’s having people come in and have a reexamination in a year or at three years or even just sending a questionnaire that they can fill out on-line and let you know how it’s going. It would be easy to track that data”

• The characteristics of patient populations must be considered “I think with our patient population it probably would work because our patient population is very computer savvy and generally well-educated, and isn’t overwhelmed by charts and graphs, and doesn’t feel intimidated by it, and I think perhaps with some patient populations that might get in the way, like it would be too information when they’re not feeling well. It’s easier with Pediatrics because you have the parent whose not, well hopefully not ill, as opposed to, I guess with you guys, because the patient who’s coming in is also the person you’re explaining to, and if they’re feeling miserable they may or may not hear all you have to say”

• And so many more benefits:

o Teaching“ I think it would be very useful in a teaching environment for a medical student. I could definitely foresee the attending kind of serving what’s going on in the clinic, the residency and everybody and then the medical student for in addition to everything that they’ve done there. The medical student pulling up data to further convince the patient if the patient argues with them. I mean I see that very much in a teaching setting”

o Added confidence“a lot of time there’s obvious surgical cases, obvious non-surgical cases, but there’s a fair amount that fall in the grey area where you have to really weigh the risks and benefits of the procedure and I think it would come into play quite often in those cases. Either in convincing yourself or convincing your patient…yes or no”

o Direction“90% have osteoporosis, then I’d say, ‘Maybe we should all start screening everybody, or maybe we should cut down the age group, or, you know, or are they all Japanese? Or are they all, are they white? Are they…?’ You know, it just, it would be very helpful, on screening people, I mean, to figure out what you should be looking at”

o Access to information“Once you step back from that training environment, you just don’t have that much access as much anymore because, you know, you’re in private practice or even the county, like being in a satellite clinic… So something like this you could actually plug into the data and know what’s going on right away”


EthnoNotes helped bring this study’s findings to light—quickly, systematically, and with results that were clear and to-point.

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