1. Using Conversation Analysis in Health-related Research Elizabeth Boyd, Ph.D. EPI 240: Qualitative Research Methods 5/4/2006

2. Outline of Topics What is Conversation Analysis (CA)? Methodology -- How to do CA Theoretical Background –Origins –Assumptions Applications and Empirical Findings Translating into Policy

3. What is CA? A qualitative method of sociological analysis based on: –Audio and/or video recordings of –Naturally-occurring interactions Methods: –Details transcription –Turn-by-turn analysis Purpose/Goal: –Specify recurrent features of interaction

4. Methods: How to do CA? Collect data Transcribe data Turn-by-turn analysis Collections or single case analysis

5. Methods: Collecting Data Sampling issues Equipment Informed Consent Confidentiality

6. Methods: Transcription System to render oral as written: special notation Faithful to the actual interaction –Not normalized –Production features: silences, hitches, breaths, laughter –Body movement and gaze –Inherently analytic and incomplete

7. Methods: Analysis Turn-by-Turn: Language as social action Attention to: –Overall organization –Sequences and activities –Turn design –Lexical choice –Asymmetries Single case analysis Collections

8. Assumptions about social interaction Organized patterns of stable, recurrent structural features Meaning through context –The Giants are playing today. No detail a priori insignificant Sequences of action Normative Deviant case analysis Competence of the analyst Demonstrable relevance/orientations of the participants themselves

9. A:Is there something bothering you or not? (1.0) A:Yes or no? (1.5) A:Eh? B:No. (Drew and Heritage, 1979:52)

10. (1) A:Why don't you come up and see me some[times? B: [I'm sorry, I've been so busy. (2) A: Why don't you come up and see me some[times? B: [Sure, when?

11. Applications and Empirical Findings Single case analysis: –Dallas 911 Collections: –Utilization review –Antibiotic prescribing behavior –Survey research

12. Translating into Policy As a methodology, CA is useful for some research questions; less useful for others: –Relevant areas of research: Directly observable behavior Quality of care Delivery of services Implementation of policies Explaining particular outcomes Accounting for the failure of a system, process, program

13. Translating into Policy Less relevant areas of research: –Many macro-level concerns –Non-interactional or non-behavioral issues –Psychological motivations of the actors Additional concerns: –Labor intensive –Human subjects issues

14. Doing Conversation Analysis Select a sequence or segment Characterize the actions in the sequence Consider how form of the action provides for certain understandings and options for response Consider how timing and taking of turns provides for certain understandings of actions Consider how the ways actions are accomplished implicate identities, roles, and/or relationships –Pomerantz and Fehr (1997)

15. Doing Conversation Analysis Initial analysis/coding -line by line Second, cumulative or abstracted -- more formal analytic observations Finally, building collections Always stay grounded in the data and the orientations of the participants themselves