HEALTHY EATING
4.4 DATA COLLECTION
4.4.2 Individual interviews
4.4.2.1 Motivation for choice of individual interview methodology
An interview can be described as a series of pre-detennined questions to collect important infonnation about consumer behaviours, attitudes, beliefs and characteristics. This study therefore also made use of interviews (questionnaires) that were administered by an interviewer in an individual manner. Individual interviewing provided several advantages, namely, higher response rate, assurance that only the designated respondent answers the questions, and the ability to control question order, standardise and control the environment, observe non-verbal behaviour, record spontaneous answers, ensure all questions are answered, and reach respondents unable to complete the questionnaire themselves (illiterate, semi-literate, disability such as blindness) (Britten 1995; Perkin
1992).
4.4.2.2 Use of individual interview methodology in the study
Individual interviews were conducted using a selection of 128 colour food photographs (see Appendix 5), a pre-tested questionnaire (see Appendix 7) and coloured illustrations of food guides commonly used in South Africa (see Appendix 8).
The questionnaire was compiled in English and translated into Zulu by three independent sources. Both English and Zulu questionnaires were pilot tested and adjusted accordingly to produce the final versions. Adjustments due to pilot testing included rewording of some questions to reduce ambiguity and restructuring the record sheets to facilitate capturing of answers by field workers.
The selection of colour food photographs used was the same as those used for the focus group discussions. However, as an outcome of the focus group discussions, an additional nine food photographs were included based on commonly identified items for which there were no photographs, namely, "sev 'n nuts" (snack food of nuts), ginger, garlic, spices, stock cubes, soup powder, flour, bottled water, and traditional home-brewed Zulu beer.
Each interview took an average of 1 Y2 hours to conduct. Interviews were conducted in the home of the participant by a trained female interviewer, in the home language of the participant, namely, English or Zulu. During the interview, participants were asked to:
• identify common foods and drinks (known and frequently consumed by the family)
• provide reasons for non-consumption of known foods/drinks
• categorise their selection of common foods and drinks according to their own understanding of the word "similar"
• categorise their selection of common foods and drinks according to their own understanding of the food categories as implied by the FBDGs
• discuss their exposure to and usage of five food guides commonly used in South Africa, namely, 3 food groups, 5 food groups, food guide pyramid, food square, mixed meal guide
Interviewers were trained regarding the asking of questions and the completion of the questionnaire record sheets. Questions were read exactly as worded on the questionnaire, with inadequate answers indirectly probed in a non-judgemental manner. All individual interviews were coded onto record sheets and then captured onto computer by the researcher.
4.4.3 Intentional participant observation
4.4.3.1 Motivation for choice of intentional participant observation methodology
Intentional participant observation is an approach to data collection in which evidence is collected through ddiberate observation of participants. This approach was employed during focus group discussions and individual interviews, where study participants were observed performing different tasks using a selection of colour food photographs. This methodology provided a greater understanding of how study participants applied their knowledge regarding the dietary guidelines. This methodology also enhanced the validity of the study by providing a third form of data collection, that is "triangulation" (Mays &
Pope 1995; Pope & Mays 1995).
Food photographs used in the study consisted of foods/drinks commonly consumed by South Africans as identified from regional and ad hoc food and nutrient intake studies. All foods/drinks were photographed in a non-stylistic, uncooked/unprepared Africans, as identified through regional and ad hoc food and nutrient studies (see Appendix 5). The foods/drinks chosen for the study have purposely excluded "composite" (mixed) foods.
This is in keeping with findings from American and British food guide research, namely, that food guides are best used to describe single foods, and additional education needs to be done regarding mixed foods. All foods/drinks were photographed in a non-stylistic, uncooked/unprepared manner to enhance identification and to reduce bias regarding brand names and preparation methods. Where a food/drink was mentioned for which there was no photograph, the name of the food/drink was written on a separate index card and included in the discussion/interview.
Photographs of foods were chosen instead of line-drawn pictures and silhouettes as studies have shown that photographs (realistic representations) of objects are interpreted more accurately than line drawings (schematic representations) (Gummeson, Jonsson, Conner &
Svensson 1996; Fuglesang 1973).
4.4.3.2 Use of intentional participant observation methodology in the study Focus group participants were asked to provide verbal examples of commonly consumed foods/drinks for each of the food categories implied by the FBDGs, namely, starchy foods, fruits and vegetables, legumes, foods from animals, foods containing fat, foods containing salt, alcoholic beve:'ages and snacks. Coloured food photographs of the food/drink examples provided were given to the focus group participants who were divided into smaller groups and asked to plan a typical day's meals using the various food photographs.
Such participant observation provided greater understanding as to the ability of study participants to apply their knowledge regarding the dietary guidelines. Intentional participant observation was also used to provide feed back to participants to determine if participant responses had been recorded accurately.
4.4.4 Ensuring reliability and validity
In the health (and nutrition) field, with its strong attachment to traditional, conventional, quantitative research methodology, qualitative research is often criticised for lacking scientific rigour. Important criticisms are researcher bias, lack of reproducibility, lack of generalisability, and lack of validity (Mays & Pope 1995; Pope & Mays 1995; Sandelowski 1995).
Researcher bias
Qualitative research is regarded by some as a mere assembly of anecdotal and personal impressions, strongly subject to researcher bias. The problem with presenting qualitative analyses objectively is the sheer volume of data customarily produced and the relatively greater difficulty faced by the researcher in summarising this data. One solution offered is to present extensive sequences from the original data accompanied by a detailed explanation. Another solution is to combine a qualitative analysis with some quantitative summary of the results. To reduce researcher bias within this study, qualitative results are accompanied by a detailed explanation and are also verified with quantitative data.
Lacking reproducibility (reliability)
Qualitative research is regarded by some as so personal to the researcher that there is no guarantee that a different researcher would not come to radically different conclusions.
For the majority of qualitative research, data is collected in a relatively unstructured format - often audio recordings or transcripts of conversations. To enhance reliability, it is therefore recommended that qualitative researchers maintain meticulous notes of discussions and observations, and that they document the analysis process in detail. The reliability of the analysis of qualitative data can be enhanced further through the use of:
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a fairly structured interview (topic) guide, where questions/topics to be covered in the focus group discussions are logically organised so that data is collected in a more useable form;*
computer software and/or an independent assessor.To enhance reliability of this study, a standard pre-tested topic guide was used together with audio tape cassettes to record focus group discussions (providing greater opportunity for analysis), and data analysis was done by an independent consultant using a qualitative research software programme, namely Atlas.ti.
Lacking generalisability
Qualitative research is regarded as generating large amounts of detailed information about a small number of settings. To maximise generalisability, it is suggested that statistical sampling methods, such as random sampling, be used so as to provide raw data for a comparative analysis. In an attempt to maximise generalisability, this study has therefore used a stratified, random sampling procedure of magisterial districts and enumerator areas as supplied by Statistics South Africa (KwaZulu Natal Provincial Office). Comparative analysis has also been done within and across enumerator areas.
Lacking validity
Alongside the issue of reliability is the extent to which qualitative research truly reflects the phenomenon under scrutiny. Supporters of qualitative research propose that qualitative methods actually score higher on validity than quantitative methods "by getting at how pe?ple really behave and what people actually mean when they describe their experiences, attItudes and behaviours". To check the validity of qualitative research, it is recommended
that the study methodology include a "triangulation" approach, where three or more different data collection methods are used and the results compared for convergence. To enhance validity of this study, "triangulation" was used in the form of focus group discussions, individual interviews, and intentional participant observation and feedback to determine if participants regarded the findings as a reasonable account of their experiences.