A Companion to Medical Anthropology. Группа авторов

in the domain –|––––– (Dengah et al. 2021; Dressler 2018; Ryan et al. 2000; Weller and Free lists Identify contents and boundaries of a Romney 1988) Pile sorts, triad tests triad tests Understand how participants perceive relationships among items in a cultural domain; examine semantic structure; describe inter- and intracultural variation Ask informants to sort stimuli into piles that belong together; stimuli could be index cards with names of concepts or physical objects (e.g., photos, artifacts) ––|–––– Successive free lists Explore relations between items in two domains (e.g., illnesses and symptoms); explore boundaries between categories and level of agreement among informants Elicit free lists for initial domain (e.g., illnesses); for each item in first domain, elicit free list for other domains (e.g., symptoms, treatments) –|––––– Frame substitution, yes-no Test hypotheses about relations between items in two domains (e.g., illnesses and causes); describe inter- and intracultural variation Construct frames of the form, “Can _____ come from ______?” Substitute items from related domains (e.g., illness and causes); record answers as yes-no ––––|– Rankings, ratings, paired comparisons Evaluate participants’ perception of items along one or more dimensions; test hypotheses about semantic structure; describe inter- and intracultural variation Ask informants to rank or rate items along some dimension; for paired comparisons, present informants with pairs of items and ask, “Which one is more ______?” ––––|– Focus groups Use group interaction to elicit data that would be harder to collect in individual interviews; explore perceptions of a topic or steps in a process; interpret results of survey or other more structured methods Recruit participants (usually 6–12); decide on group composition; prepare interview guide; train moderator and note-taker; decide on level of transcription required; sample size is equal to number of groups –|––––– –|––––– (Schensul and LeCompte 2013; Morgan and Krueger 1998; Sobo 2009:Ch. 10) Visual ethnography Document behavior and cultural practices; elicit participants’ perspectives; encourage collaboration and co-learning Construct visual record (photographs or video) using degree of structure suitable for research objectives –|––––– (El Guindi 2004; Wang and Burris 1997) Social network analysis Explore or test the pattern of social relations in a predefined group (sociocentric or whole network analysis) or in the web of social relations around focal individual (ego-centric or personal network analysis) Reconstruct social ties through archival materials, record with direct observation, or elicit through interview methods –|––––|– (Bernard 2018, Ch. 10; Borgatti et al. 2018 Spatial mapping Explore or test the spatial distribution of phenomena; study nested relations at multiple levels of analysis; elicit participants’ understanding of space and place Construct geographic information system using administrative (e.g., census) data or collect primary data; ask participants to make and interpret maps –|––––|– (Brondizio and Van Holt 2015; Steinberg and Steinberg 2006) Note: E–––––––C refers to continuum of exploratory to confirmatory research questions (see Figure 4.2). Hash marks suggest approximately where along this continuum each method of data collection would be appropriate. Some methods (e.g., social network analysis) are well suited to questions along the exploratory–confirmatory continuum; these methods are marked with two hash marks.

      DATA COLLECTION

      Methods of data collection in medical anthropology fall into three broad categories: participant observation, systematic observation, and interview methods. Participant observation is the bedrock of data collection in medical anthropology, as it is in the parent discipline. DeWalt and DeWalt (2011, p. 2) define participant observation as “a way to collect data in naturalistic settings by ethnographers who observe and/or take part in the common and uncommon activities of the people being studied.” The key task of participant observation is to create a systematic record of everyday life by writing field notes about informal observations, interactions, and conversations.

      There is variation in how researchers balance the roles of participant and observer in ethnographic research (Spradley 1980). For his work on immigration, social hierarchy, and health, Holmes (2013) immersed himself in the lives of migrant farmworkers. Over 18 months of participant observation, he lived in the village of San Miguel in Oaxaca State, earned the trust of Triqui people planning to cross the U.S.–Mexico border, was apprehended with but separated from his Triqui companions by U.S. border patrols, and eventually lived and worked in a labor camp, picking strawberries in Central California. Holmes placed high value on participation, drawing attention to his own bodily experiences as a field worker (in both senses) as a source of insight into social suffering (p. 34).

In health services research, Sobo (2009, p. 211) is more often a participating observer than an observing participant, but she emphasizes a sentiment all participant observers would embrace: “There is no substitute for being there.” Barrett (2008) distinguishes between two major kinds of participant observation in his ethnography of Aghor medicine. The first is “the classic form of ‘active participation’ in which the ethnographer increasingly engages in the distinctive behaviors of his or her informants in order to better understand those behaviors in their appropriate cultural context” (p. 14). The second drew on Barrett’s previous clinical experience as a registered nurse and volunteer at clinics in his field site. Barrett wasn’t engaged in these roles during his research, as is typical in active participant observation; rather he used participation in relevant contexts as a framework for making sense of ethnographic observations. Strong (2020), by contrast, “participated in nearly all aspects of the life of the hospital” in the Rukwa region of Tanzania where she studied maternal mortality and the ethics of care (p. 17).

      Systematic observation differs from participant observation because it imposes more structure on sampling and measurement (Johnson and Sackett 1998). For that reason, methods of systematic observation – including continuous monitoring, spot sampling, and time allocation – are best suited to confirmatory research questions. Systematic observation deserves wider use in medical anthropology, because many research questions concern what people do, not just what they say. And there is ample evidence that what people say is seldom a good proxy for what they do (Bernard et al. 1984).

      Vitzthum (1994) studied concordance between maternal recall and systematic observation of breastfeeding in the Peruvian Andes. She interviewed 30 Nuñoa women with children under three years of age and asked each woman to estimate how often and how long her child breastfed each