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Where history meets qualitative health research Dr Claire Hooker Public Health Sciences.

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2 Where history meets qualitative health research Dr Claire Hooker Public Health Sciences

3 Aims To reflect on the differences (if any) between historical research in the history of health and medicine, and qualitative research in health and medicine To discuss the utility and consequences of formalising research procedures To identify what we could do better

4 Aims …purpose?? -Reinventing the wheel -Conversation and pleasure -Intuition, nuance, experience, perception

5 My ‘narrative’ Honours, PhD in history History and material culture of public health in Australia History and Philosophy (& a lot of sociology) of science Political history of tobacco control in Australia Public health sciences

6 Disciplinary Shock ‘obfuscate, confuse, elude, obscure, mislead, betray, lie …’ A ‘methods’ section ‘qualitative research’ … software, textbooks, a whole journal chronologies …. What would this have looked like if I’d done it in history/ HPS?

7 The historian approaches … Principles: (a)to make things strange (b)Symmetry (c)To scrutinise power/ knowledge relations, expertise, hegemonies (d)To understand: which means, to identify the wider context and its interaction at a local level, and especially to celebrate complexity, ambivalence, confoundings All of this is probably inimical to actually achieving tobacco control!

8 … and goes to work What did smoking mean to people? what discourses were used to support tobacco control? How did it feel to be a company executive or a premier? Why did company practices develop as they did? How was thinking about tobacco control shaped by thinking about concepts like ‘risk’ or ‘drugs’? What insights can the history of tobacco control offer into a late modern therapeutic consumer culture? NB - these are *not* the same questions that older generations of historians might have asked

9 How? Gathering material Oral history Listening to the material Versus: ‘document research’ ‘semi structured or open ended interviews’ Coded / thematic analysis

10 Outcomes For the tobacco control group: Chronologies A few criticisms of ‘magicked quotations’ recommendations to Senate committees For me: -Notion of deliberation -A discourse about drugs -A new moralism -relations between politicians were complicated by adherence to particular political cultures that had changed over the period of tobacco control

11 History v Qual Health Research 1.History looks at change - qual looks at the present 2.History has more of a focus on ‘meta’ issues – qual more focused on specifics 3.Qual health research is fundamentally instrumental – history is not 4.Qual health research is formalised – history is not Major implication: in comparison to history, qual makes claims on objectivity and predictability that history does not (indeed, is opposed to in some sense)

12 Evidence! ‘ theory and method’ 1992: Ranke; structuralism; Annales school; Marx and historical materialism; Gramsci and hegemony; (political history) social history; cultural history; feminist history; postmodern history 2003: ideas about evidence; history wars; audio; visual; material; memory; biography; movies; public What is not included: statistics, history of ideas, political history, military history, archiving, and paradigm shift, inter alia

13 But wait! Not so fast! History IS a form of qualitative research! I could start by telling you who uses them: philosophers, psychologists, sociologists, anthropologists, students of literature, historians, biologists...anyone, in fact, who finds the methods of the physical sciences somehow inappropriate for understanding human (and, occasionally, even animal) realities.’ C. George Boeree

14 Current Philosophical Similarities Both stand in critical relation to quantitative research: ‘qualitative research exchanges the tyranny of numbers for the enigma of words’ ‘… rooted in a non tangible domain, fundamentally experiential and intuitive’ ‘… polyvocal attempts at interfacing with cultural / linguistic/ relational accounts of the real. They are therefore interpretations, not truths in the positivist sense’

15 Hence, similarities in analytical methods Narrative Storytelling Identity Frames Reflexive Differences between history of public health and qualitative studies in public health would seem to lie in scope, focus, interest, language (best described qualitatively!)

16 Grappling with validity both feel that their accounts capture some aspect of ‘truth’ Both try to generalise from multiple instances Both try to explain river systems as well eddies: both generate macro and micro levels of theory Both make claims to influence future actions

17 Process similarities 1.oral history and interview are concerned with memory, context, how the interviewer’s relation with the subject alters things, how the subject constructs their narrative. 2.both grapple with issues of authenticity, reliability and truth 3.both require their practitioners to go through an informal process of trying to get themselves out of the picture 4.Coding turned out to be the same! I just didn’t count

18 …I’ll be better next time? The IMRD format can really help crystallise the purpose of your research, and whether the method is adequate for that purpose A ‘methods section’ can help ensure your research is sufficiently complete, and invites readers/reviewers to scrutinise whether your conclusions are justified To historians I should think this would help in the interpretive questions they claim to be interested in: what can we learn from each piece of evidence? ie formalising one’s methods in advance and at the conclusion of research, like peer review, can aid in ‘objectivity’, the strength of research

19 I’ll also always be an historian A narrative piece invites playfulness, new kinds of coherence, intuitive and experiential facets for the audience Making strange, attention to change, and attention to a variety of evidence are good ways of keeping macro and micro engaged with each other, and of being constructively critical and reflexive

20 Conclusions and Implications Method should be thought of as dynamic until the paper is published: it is a kind of grappling Private research audits are probably a good idea Dialogue and deliberation are even better ones Living in someone else’s discipline once every 15 years is really good for you

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