{"id":30,"date":"2023-02-13T05:33:20","date_gmt":"2023-02-13T05:33:20","guid":{"rendered":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/chapter\/__unknown__-4\/"},"modified":"2025-06-14T13:54:38","modified_gmt":"2025-06-14T13:54:38","slug":"__unknown__-4","status":"publish","type":"chapter","link":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/chapter\/__unknown__-4\/","title":{"raw":"Chapter 4: Theoretical frameworks for qualitative research","rendered":"Chapter 4: Theoretical frameworks for qualitative research"},"content":{"raw":"<div class=\"__UNKNOWN__\">\n<div class=\"textbox shaded\">\n<h2 class=\"import-Normal\"><strong>Learning outcomes<\/strong><\/h2>\n<p class=\"import-Normal\">Upon completion of this chapter, you should be able to:<\/p>\n\n<ul>\n \t<li>Describe qualitative frameworks.<\/li>\n \t<li>Explain why frameworks are used in qualitative research.<\/li>\n \t<li>Identify various frameworks used in qualitative research.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<h2 class=\"import-Normal\" style=\"background-color: #ffffff\"><strong>What is a Framework?<\/strong><\/h2>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">A framework is a set of broad concepts or principles used to guide research.\u00a0\u00a0As described by Varpio and colleagues<sup>1<\/sup>, a framework is a\u00a0logically developed and connected set of concepts and premises \u2013 developed from one or more theories \u2013 that a researcher uses as a scaffold for their study. The researcher must define any concepts and theories that will provide the grounding for the research and link them through logical connections, and must relate these concepts to the study that is being carried out. In using a particular theory to guide their study, the researcher needs to ensure that the theoretical framework is reflected in the work in which they are engaged.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">It is important to acknowledge that the terms \u2018theories\u2019 (<a href=\"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/chapter\/__unknown__-3\/\">see Chapter 3<\/a>), \u2018frameworks\u2019 and \u2018paradigms\u2019 are sometimes used interchangeably. However, there are differences between these concepts. To complicate matters further, theoretical frameworks and conceptual frameworks are also used. In addition, quantitative and qualitative researchers usually start from different standpoints in terms of theories and frameworks.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">A <a class=\"rId8\" href=\"https:\/\/journals.lww.com\/academicmedicine\/Fulltext\/2020\/07000\/The_Distinctions_Between_Theory,_Theoretical.21.aspx\" rel=\"noopener\"><span class=\"import-Hyperlink\">diagram<\/span><\/a> by Varpio and colleagues demonstrates the similarities and differences between theories and frameworks, and how they influence research approaches.<sup>1(p991)<\/sup> The diagram displays the objectivist or deductive approach to research on the left-hand side. Note how the conceptual framework is first finalised before any research is commenced, and it involves the articulation of hypotheses that are to be tested using the data collected. This is often referred to as a <em>top-down approach<\/em> and\/or a general (theory or framework) to a specific (data) approach.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">The diagram displays the subjectivist or inductive approach to research on the right-hand side. Note how data is collected first, and through data analysis, a tentative framework is proposed. The framework is then firmed up as new insights are gained from the data analysis. This is referred to as a <em>specific (data) to general (theory and framework) approach<\/em>.<\/p>\n\n<h2 class=\"import-Normal\" style=\"background-color: #ffffff\"><strong>Why <\/strong><strong>d<\/strong><strong>o <\/strong><strong>w<\/strong><strong>e <\/strong><strong>u<\/strong><strong>se <\/strong><strong>f<\/strong><strong>rameworks?<\/strong><\/h2>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">A framework helps guide the questions used to elicit your data collection. A framework is not prescriptive, but it needs to be suitable for the research question(s), setting and participants. Therefore, the researcher might use different frameworks to guide different research studies.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">A framework informs the study\u2019s recruitment and sampling, and informs, guides or structures how data is collected and analysed. For example, a framework concerned with health systems will assist the researcher to analyse the data in a certain way, while a framework concerned with psychological development will have very different ways of approaching the analysis of data. This is due to the differences underpinning the concepts and premises concerned with investigating health systems, compared to the study of psychological development. The framework adopted also guides emerging interpretations of the data and helps in comparing and contrasting data across participants, cases and studies.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">Some examples of foundational frameworks used to guide qualitative research in health services and public health:<\/p>\n\n<ul>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/doi.org\/10.1186\/1748-5908-6-42\" rel=\"noopener\">The\u00a0Behaviour Change Wheel<\/a><sup>2<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/cfirguide.org\/\">Consolidated Framework for Implementation Research (CFIR)<\/a><sup>3<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/doi.org\/10.1186\/s12913-017-2031-8\" rel=\"noopener\">Theoretical framework of acceptability<\/a><sup>4<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/doi.org\/10.1186\/1741-7015-8-63\" rel=\"noopener\">Normalization Process Theory<\/a><sup>5<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/doi.org\/10.1186\/s12913-018-3730-5\" rel=\"noopener\">Candidacy Framework<\/a><sup>6<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/nacchocommunique.com\/wp-content\/uploads\/2017\/09\/cphc-congress-final-report.pdf\">Aboriginal social determinants of health<\/a><sup>7(p8)<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241500852\" rel=\"noopener\">Social determinants of health<\/a><sup>8<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\">Social model of health<sup>9,10<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\">Systems theory<sup>11<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\">Biopsychosocial model<sup>12<\/sup><\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\">Discipline-specific models<\/li>\n \t<li class=\"import-Normal\" style=\"background-color: #ffffff\">Disease-specific frameworks<\/li>\n<\/ul>\n<h2 class=\"import-Normal\"><strong>E<\/strong><strong>xamples of <\/strong><strong>f<\/strong><strong>rameworks<\/strong><\/h2>\n<p class=\"import-Normal\">In Table 4.1, citations of published papers are included to demonstrate how the particular framework helps to 'frame' the research question and the interpretation of results.<\/p>\n[table id=9 \/]\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">As discussed in Chapter 3, qualitative research is not an absolute science. While not all research may need a framework or theory (particularly descriptive studies, outlined in Chapter 5), the use of a framework or theory can help to position the research questions, research processes and conclusions and implications within the relevant research paradigm. Theories and frameworks also help to bring to focus areas of the research problem that may not have been considered.<\/p>\n\n<h2 class=\"import-Normal\"><strong>References<\/strong><\/h2>\n<ol>\n \t<li class=\"import-EndNoteBibliography\">Varpio L, Paradis E, Uijtdehaage S, Young M. The distinctions between theory, theoretical framework, and conceptual framework. <em>Acad Med<\/em>. 2020;95(7):989-994. doi:10.1097\/ACM.0000000000003075<\/li>\n \t<li><span style=\"text-align: initial;font-size: 1em\">Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. <\/span><em style=\"text-align: initial;font-size: 1em\">Implement Sci<\/em><span style=\"text-align: initial;font-size: 1em\">.\u00a0 2011;6:42. doi:10.1186\/1748-5908-6-42<\/span><\/li>\n \t<li>CFIR Research Team. Consolidated Framework for Implementation Research (CFIR). Center for Clinical Management Research. 2023. Accessed February 15, 2023. <a href=\"https:\/\/cfirguide.org\/\" target=\"_blank\" rel=\"noopener\">https:\/\/cfirguide.org\/<\/a><\/li>\n \t<li>Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. <em style=\"text-align: initial;font-size: 1em\">BMC Health Serv Res<\/em><span style=\"text-align: initial;font-size: 1em\">. 2017;17:88. doi:10.1186\/s12913-017-2031-8<\/span><\/li>\n \t<li>Murray E, Treweek S, Pope C, et al. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. <em style=\"text-align: initial;font-size: 1em\">BMC Med<\/em><span style=\"text-align: initial;font-size: 1em\">.\u00a0 2010;8:63. doi:10.1186\/1741-7015-8-63<\/span><\/li>\n \t<li>Tookey S, Renzi C, Waller J, von Wagner C, Whitaker KL. Using the candidacy framework to understand how doctor-patient interactions influence perceived eligibility to seek help for cancer alarm symptoms: a qualitative interview study. <em style=\"text-align: initial;font-size: 1em\">BMC Health Serv Res<\/em><span style=\"text-align: initial;font-size: 1em\">. 2018;18(1):937. doi:10.1186\/s12913-018-3730-5<\/span><\/li>\n \t<li>Lyon P. <em style=\"text-align: initial;font-size: 1em\">Aboriginal Health in Aboriginal Hands: Community-Controlled Comprehensive Primary Health Care @ Central Australian Aboriginal Congress;<\/em><span style=\"text-align: initial;font-size: 1em\"><span style=\"text-align: initial;font-size: 1em\"> 2016. <\/span><\/span>Accessed February 15, 2023. <a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/nacchocommunique.com\/wp-content\/uploads\/2017\/09\/cphc-congress-final-report.pdf\" target=\"_blank\" rel=\"noopener\">https:\/\/nacchocommunique.com\/wp-content\/uploads\/2017\/09\/cphc-congress-final-report.pdf<\/a><\/li>\n \t<li>Solar O., Irwin A. <em style=\"text-align: initial;font-size: 1em\">A Conceptual Framework for Action on the Social Determinants of Health:<\/em><span style=\"text-align: initial;font-size: 1em\">\u00a0<\/span><em style=\"text-align: initial;font-size: 1em\">Social Determinants of Health Discussion Paper 2 (Policy and Practice); <\/em><span style=\"text-align: initial;font-size: 1em\">2010. Accessed February 22, 2023. <\/span><a class=\"rId68\" style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241500852\" target=\"_blank\" rel=\"noopener\"><span class=\"import-Hyperlink\">https:\/\/www.who.int\/publications\/i\/item\/9789241500852<\/span><\/a><\/li>\n \t<li>Yuill C, Crinson I, Duncan E. <em style=\"text-align: initial;font-size: 1em\">Key Concepts in Health Studies<\/em><span style=\"text-align: initial;font-size: 1em\">. SAGE Publications; 2010.<\/span><\/li>\n \t<li>Germov J. Imagining health problems as social issues. In: Germov J, ed. <em style=\"text-align: initial;font-size: 1em\">Second Opinion: An Introduction to Health Sociology<\/em><span style=\"text-align: initial;font-size: 1em\">. Oxford University Press; 2014.<\/span><\/li>\n \t<li>Laszlo A, Krippner S. Systems theories: their origins, foundations, and development. In: Jordan JS, ed. <em style=\"text-align: initial;font-size: 1em\">Advances in Psychology<\/em><span style=\"text-align: initial;font-size: 1em\">. Science Direct; 1998:47-74.<\/span><\/li>\n \t<li>Engel GL. From biomedical to biopsychosocial: being scientific in the human domain. <em style=\"text-align: initial;font-size: 1em\">Psychosomatics<\/em><span style=\"text-align: initial;font-size: 1em\">. 1997;38(6):521-528. doi:10.1016\/S0033-3182(97)71396-3<\/span><\/li>\n \t<li>Schmidtke KA, Drinkwater KG. A cross-sectional survey assessing the influence of theoretically informed behavioural factors on hand hygiene across seven countries during the COVID-19 pandemic. <em>BMC Public Health<\/em>. 2021;21:1432. doi:10.1186\/s12889-021-11491-4<\/li>\n \t<li>\n<div>Graham-Wisener L, Nelson A, Byrne A, et al. Understanding public attitudes to death talk and advance care planning in Northern Ireland using health behaviour change theory: a qualitative study. <em>BMC Public Health<\/em>. 2022;22:906. doi:10.1186\/s12889-022-13319-1<\/div><\/li>\n \t<li>Walker R, Quong S, Olivier P, Wu L, Xie J, Boyle J. Empowerment for behaviour change through social connections: a qualitative exploration of women\u2019s preferences in preconception health promotion in the state of Victoria, Australia. <em>BMC Public Health<\/em>. 2022;22:1642. doi:10.1186\/s12889-022-14028-5<\/li>\n \t<li>Ayton DR, Barker AL, Morello RT, et al. Barriers and enablers to the implementation of the 6-PACK falls prevention program: a pre-implementation study in hospitals participating in a cluster randomised controlled trial. <em>PLOS ONE<\/em>. 2017;12(2):e0171932. doi:10.1371\/journal.pone.0171932<\/li>\n \t<li>Pratt R, Xiong S, Kmiecik A, et al. The implementation of a smoking cessation and alcohol abstinence intervention for people experiencing homelessness. <em>BMC Public Health<\/em>. 2022;22:1260. doi:10.1186\/s12889-022-13563-5<\/li>\n \t<li>Bossert J, Mahler C, Boltenhagen U, et al. Protocol for the process evaluation of a counselling intervention designed to educate cancer patients on complementary and integrative health care and promote interprofessional collaboration in this area (the CCC-Integrativ study). <em>PLOS ONE<\/em>. 2022;17(5):e0268091. doi:10.1371\/journal.pone.0268091<\/li>\n \t<li>Lwin KS, Bhandari AKC, Nguyen PT, et al. Factors influencing implementation of health-promoting interventions at workplaces: protocol for a scoping review. <em>PLOS ONE<\/em>. 2022;17(10):e0275887. doi:10.1371\/journal.pone.0275887<\/li>\n \t<li>Wilhelm AK, Schwedhelm M, Bigelow M, et al. Evaluation of a school-based participatory intervention to improve school environments using the Consolidated Framework for Implementation Research. <em>BMC Public Health<\/em>. 2021;21:1615. doi:10.1186\/s12889-021-11644-5<\/li>\n \t<li>Timm L, Annerstedt KS, Ahlgren J\u00c1, et al. Application of the Theoretical Framework of Acceptability to assess a telephone-facilitated health coaching intervention for the prevention and management of type 2 diabetes.<em> PLOS ONE<\/em>. 2022;17(10):e0275576. doi:10.1371\/journal.pone.0275576<\/li>\n \t<li>Laing L, Salema N-E, Jeffries M, et al. Understanding factors that could influence patient acceptability of the use of the PINCER intervention in primary care: a qualitative exploration using the Theoretical Framework of Acceptability. <em>PLOS ONE<\/em>. 2022;17(10):e0275633. doi:10.1371\/journal.pone.0275633<\/li>\n \t<li>Renko E, Knittle K, Palsola M, Lintunen T, Hankonen N. Acceptability, reach and implementation of a training to enhance teachers\u2019 skills in physical activity promotion. <em>BMC Public Health<\/em>. 2020;20:1568. doi:10.1186\/s12889-020-09653-x<\/li>\n \t<li>Alexander SM, Agaba A, Campbell JI, et al. A qualitative study of the acceptability of remote electronic bednet use monitoring in Uganda. <em>BMC Public Health<\/em>. 2022;22:1010. doi:10.1186\/s12889-022-13393<\/li>\n \t<li>May C, Rapley T, Mair FS, et al. Normalization Process Theory On-line Users\u2019 Manual, Toolkit and NoMAD instrument. 2015. Accessed February 15, 2023. <a href=\"http:\/\/www.normalizationprocess.org\" target=\"_blank\" rel=\"noopener\">https:\/\/normalization-process-theory.northumbria.ac.uk\/<\/a><\/li>\n \t<li>Davis S. Ready for prime time? Using Normalization Process Theory to evaluate implementation success of personal health records designed for decision making. <em>Front Digit\u00a0<span class=\"highlight\">Health<\/span><\/em>. 2020;2:575951. doi:10.3389\/fdgth.2020.575951<\/li>\n \t<li>Durand M-A, Lamouroux A, Redmond NM, et al. Impact of a health literacy intervention combining general practitioner training and a consumer facing intervention to improve colorectal cancer screening in underserved areas: protocol for a multicentric cluster randomized controlled trial. <em>BMC Public Health<\/em>. 2021;21:1684. doi:10.1186\/s12889-021-11565<\/li>\n \t<li>Jones SE, Hamilton S, Bell R, Ara\u00fajo-Soares V, White M. Acceptability of a cessation intervention for pregnant smokers: a qualitative study guided by Normalization Process Theory. <em>BMC Public Health<\/em>. 2020;20:1512. doi:10.1186\/s12889-020-09608-2<\/li>\n \t<li>Ziegler E, Valaitis R, Yost J, Carter N, Risdon C. \u201cPrimary care is primary care\u201d: use of Normalization Process Theory to explore the implementation of primary care services for transgender individuals in Ontario. <em>PLOS ONE<\/em>. 2019;14(4):e0215873. doi:10.1371\/journal.pone.0215873<\/li>\n \t<li>\n<div>Mackenzie M, Conway E, Hastings A, Munro M, O'Donnell C. Is \u2018candidacy\u2019 a useful concept for understanding journeys through public services? A critical interpretive literature synthesis. <em>Soc\u00a0Policy\u00a0Adm<\/em>. 2013;47(7):806-825. doi:10.1111\/j.1467-9515.2012.00864.x<\/div><\/li>\n \t<li>Adeagbo O, Herbst C, Blandford A, et al. Exploring people\u2019s candidacy for mobile health\u2013supported HIV testing and care services in rural KwaZulu-Natal, South Africa: qualitative study.<em> J Med Internet Res<\/em>. 2019;21(11):e15681. doi:10.2196\/15681<\/li>\n \t<li>Mackenzie M, Turner F, Platt S, et al. What is the 'problem' that outreach work seeks to address and how might it be tackled? Seeking theory in a primary health prevention programme. <em>BMC Health Serv Res<\/em>. 2011;11:350. doi:10.1186\/1472-6963-11-350<\/li>\n \t<li>\n<div>Liberati E, Richards N, Parker J, et al. Qualitative study of candidacy and access to secondary mental health services during the COVID-19 pandemic. <em>Soc Sci Med.<\/em> 2022;296:114711. doi:10.1016\/j.socscimed.2022.114711<\/div><\/li>\n \t<li>Pearson O, Schwartzkopff K, Dawson A, et al. Aboriginal community controlled health organisations address health equity through action on the social determinants of health of Aboriginal and Torres Strait Islander peoples in Australia. <em>BMC Public Health<\/em>. 2020;20:1859. doi:10.1186\/s12889-020-09943-4<\/li>\n \t<li>\n<div>Freeman T, Baum F, Lawless A, et al. Revisiting the ability of Australian primary healthcare services to respond to health inequity. <em>Aust J Prim\u00a0<span class=\"highlight\">Health<\/span><\/em>. 2016;22(4):332-338. doi:10.1071\/PY14180<\/div><\/li>\n \t<li>Couzos S. <em>Towards a National Primary Health Care Strategy: Fulfilling Aboriginal Peoples Aspirations to Close the Gap<\/em>. National Aboriginal Community Controlled Health Organisation. 2009. Accessed February 15, 2023. <a href=\"https:\/\/researchonline.jcu.edu.au\/35080\/\" target=\"_blank\" rel=\"noopener\">https:\/\/researchonline.jcu.edu.au\/35080\/<\/a><\/li>\n \t<li>Napier AD, Ancarno C, Butler B, et al. Culture and health. <em>Lancet<\/em>. 2014;384(9954):1607-1639. doi:10.1016\/S0140-6736(14)61603-2<\/li>\n \t<li>WHO. <em>COVID-19 and the Social Determinants of Health and Health Equity: Evidence Brief<\/em>. 2021. Accessed February 15, 2023. <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789240038387\" target=\"_blank\" rel=\"noopener\">https:\/\/www.who.int\/publications\/i\/item\/9789240038387<\/a><\/li>\n \t<li>WHO.<em> Social Determinants of Health<\/em>. 2023. Accessed February 15, 2023. <a href=\"https:\/\/www.who.int\/health-topics\/social-determinants-of-health#tab=tab_1\" target=\"_blank\" rel=\"noopener\">https:\/\/www.who.int\/health-topics\/social-determinants-of-health#tab=tab_1<\/a><\/li>\n \t<li>McCrae JS, Robinson JAL, Spain AK, Byers K, Axelrod JL. The Mitigating Toxic Stress study design: approaches to developmental evaluation of pediatric health care innovations addressing social determinants of health and toxic stress. <em>BMC Health Serv Res<\/em>. 2021;21:71. doi:10.1186\/s12913-021-06057-4<\/li>\n \t<li>Hosseinpoor AR, Stewart Williams J, Jann B, et al. Social determinants of sex differences in disability among older adults: a multi-country decomposition analysis using the World Health Survey. <em>Int J\u00a0<span class=\"highlight\">Equity<\/span>\u00a0<span class=\"highlight\">Health<\/span>.<\/em> 2012;11:52. doi:10.1186\/1475-9276-11-52<\/li>\n \t<li>Kabore A, Afriyie-Gyawu E, Awua J, et al. Social ecological factors affecting substance abuse in Ghana (West Africa) using photovoice. <em>Pan Afr Med J<\/em>. 2019;34:214. doi:10.11604\/pamj.2019.34.214.12851<\/li>\n \t<li>B\u00edr\u00f3 \u00c9, Vincze F, M\u00e1ty\u00e1s G, K\u00f3sa K. Recursive path model for health literacy: the effect of social support and geographical residence. <em>Front Public Health<\/em>. 2021;9. doi:10.3389\/fpubh.2021.724995<\/li>\n \t<li>Yuan B, Zhang T, Li J. Family support and transport cost: understanding health service among older people from the perspective of social-ecological model. <em>Arch Public Health<\/em>. 2022;80:173. doi:10.1186\/s13690-022-00923-1<\/li>\n \t<li>Mahmoodi Z, Karimlou M, Sajjadi H, Dejman M, Vameghi M, Dolatian M. A communicative model of mothers\u2019 lifestyles during pregnancy with low birth weight based on social determinants of health: a path analysis. <em>Oman Med J<\/em>. 2017 ;32(4):306-314. doi:10.5001\/omj.2017.59<\/li>\n \t<li>Vella SA, Schweickle MJ, Sutcliffe J, Liddelow C, Swann C. A systems theory of mental health in recreational sport. <em>Int J Environ Res\u00a0Public Health<\/em>. 2022;19(21):14244. doi:10.3390\/ijerph192114244<\/li>\n \t<li>Henning S. The wellness of airline cabin attendants: A systems theory perspective. <em>African Journal of Hospitality, Tourism and Leisure<\/em>. 2015;4(1):1-11. Accessed February 15, 2023. <a href=\"http:\/\/www.ajhtl.com\/archive.html\" target=\"_blank\" rel=\"noopener\">http:\/\/www.ajhtl.com\/archive.html<\/a><\/li>\n \t<li>Sutphin ST, McDonough S, Schrenkel A. The role of formal theory in social work research: formalizing family systems theory. <em>Adv Soc Work<\/em>. 2013;14(2):501-517. doi:10.18060\/7942<\/li>\n \t<li>Colla R, Williams P, Oades LG, Camacho-Morles J. \u201cA new hope\u201d for positive psychology: a dynamic systems reconceptualization of hope theory. <em>Front Psychol<\/em>.\u00a0 2022;13. doi:10.3389\/fpsyg.2022.809053<\/li>\n \t<li>Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129\u2013136. doi:10.1126\/science.847460<\/li>\n \t<li>Wade DT, HalliganPW. The biopsychosocial model of illness: a model whose time has come. <em>Clin Rehabi<\/em>l. 2017;31(8):995\u20131004. doi:10.1177\/0269215517709890<\/li>\n \t<li>Ip L, Smith A, Papachristou I, Tolani E. 3 Dimensions for Long Term Conditions - creating a sustainable bio-psycho-social approach to healthcare.\u00a0 <em>J Integr Care<\/em>. 2019;19(4):5. doi:10.5334\/ijic.s3005<\/li>\n \t<li>FrameWorks Institute. <em>A Matter of Life and Death: Explaining the Wider Determinants <\/em><em>of Health in the UK<\/em>. FrameWorks Institute; 2022. Accessed February 15, 2023. <a href=\"https:\/\/www.frameworksinstitute.org\/wp-content\/uploads\/2022\/03\/FWI-30-uk-health-brief-v3a.pdf\" target=\"_blank\" rel=\"noopener\">https:\/\/www.frameworksinstitute.org\/wp-content\/uploads\/2022\/03\/FWI-30-uk-health-brief-v3a.pdf<\/a><\/li>\n \t<li>Zemed A, Nigussie Chala K, Azeze Eriku G, Yalew Aschalew A. Health-related quality of life and associated factors among patients with stroke at tertiary level hospitals in Ethiopia. <em>PLOS ONE<\/em>. 2021;16(3):e0248481. doi:10.1371\/journal.pone.0248481<\/li>\n \t<li>Finch E, Foster M, Cruwys T, et al. Meeting unmet needs following minor stroke: the SUN randomised controlled trial protocol.<em> BMC Health Serv Res<\/em>. 2019;19:894. doi:10.1186\/s12913-019-4746-1<\/li>\n<\/ol>","rendered":"<div class=\"__UNKNOWN__\">\n<div class=\"textbox shaded\">\n<h2 class=\"import-Normal\"><strong>Learning outcomes<\/strong><\/h2>\n<p class=\"import-Normal\">Upon completion of this chapter, you should be able to:<\/p>\n<ul>\n<li>Describe qualitative frameworks.<\/li>\n<li>Explain why frameworks are used in qualitative research.<\/li>\n<li>Identify various frameworks used in qualitative research.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<h2 class=\"import-Normal\" style=\"background-color: #ffffff\"><strong>What is a Framework?<\/strong><\/h2>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">A framework is a set of broad concepts or principles used to guide research.\u00a0\u00a0As described by Varpio and colleagues<sup>1<\/sup>, a framework is a\u00a0logically developed and connected set of concepts and premises \u2013 developed from one or more theories \u2013 that a researcher uses as a scaffold for their study. The researcher must define any concepts and theories that will provide the grounding for the research and link them through logical connections, and must relate these concepts to the study that is being carried out. In using a particular theory to guide their study, the researcher needs to ensure that the theoretical framework is reflected in the work in which they are engaged.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">It is important to acknowledge that the terms \u2018theories\u2019 (<a href=\"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/chapter\/__unknown__-3\/\">see Chapter 3<\/a>), \u2018frameworks\u2019 and \u2018paradigms\u2019 are sometimes used interchangeably. However, there are differences between these concepts. To complicate matters further, theoretical frameworks and conceptual frameworks are also used. In addition, quantitative and qualitative researchers usually start from different standpoints in terms of theories and frameworks.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">A <a class=\"rId8\" href=\"https:\/\/journals.lww.com\/academicmedicine\/Fulltext\/2020\/07000\/The_Distinctions_Between_Theory,_Theoretical.21.aspx\" rel=\"noopener\"><span class=\"import-Hyperlink\">diagram<\/span><\/a> by Varpio and colleagues demonstrates the similarities and differences between theories and frameworks, and how they influence research approaches.<sup>1(p991)<\/sup> The diagram displays the objectivist or deductive approach to research on the left-hand side. Note how the conceptual framework is first finalised before any research is commenced, and it involves the articulation of hypotheses that are to be tested using the data collected. This is often referred to as a <em>top-down approach<\/em> and\/or a general (theory or framework) to a specific (data) approach.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">The diagram displays the subjectivist or inductive approach to research on the right-hand side. Note how data is collected first, and through data analysis, a tentative framework is proposed. The framework is then firmed up as new insights are gained from the data analysis. This is referred to as a <em>specific (data) to general (theory and framework) approach<\/em>.<\/p>\n<h2 class=\"import-Normal\" style=\"background-color: #ffffff\"><strong>Why <\/strong><strong>d<\/strong><strong>o <\/strong><strong>w<\/strong><strong>e <\/strong><strong>u<\/strong><strong>se <\/strong><strong>f<\/strong><strong>rameworks?<\/strong><\/h2>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">A framework helps guide the questions used to elicit your data collection. A framework is not prescriptive, but it needs to be suitable for the research question(s), setting and participants. Therefore, the researcher might use different frameworks to guide different research studies.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">A framework informs the study\u2019s recruitment and sampling, and informs, guides or structures how data is collected and analysed. For example, a framework concerned with health systems will assist the researcher to analyse the data in a certain way, while a framework concerned with psychological development will have very different ways of approaching the analysis of data. This is due to the differences underpinning the concepts and premises concerned with investigating health systems, compared to the study of psychological development. The framework adopted also guides emerging interpretations of the data and helps in comparing and contrasting data across participants, cases and studies.<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">Some examples of foundational frameworks used to guide qualitative research in health services and public health:<\/p>\n<ul>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/doi.org\/10.1186\/1748-5908-6-42\" rel=\"noopener\">The\u00a0Behaviour Change Wheel<\/a><sup>2<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/cfirguide.org\/\">Consolidated Framework for Implementation Research (CFIR)<\/a><sup>3<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/doi.org\/10.1186\/s12913-017-2031-8\" rel=\"noopener\">Theoretical framework of acceptability<\/a><sup>4<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/doi.org\/10.1186\/1741-7015-8-63\" rel=\"noopener\">Normalization Process Theory<\/a><sup>5<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/doi.org\/10.1186\/s12913-018-3730-5\" rel=\"noopener\">Candidacy Framework<\/a><sup>6<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/nacchocommunique.com\/wp-content\/uploads\/2017\/09\/cphc-congress-final-report.pdf\">Aboriginal social determinants of health<\/a><sup>7(p8)<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\"><a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241500852\" rel=\"noopener\">Social determinants of health<\/a><sup>8<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\">Social model of health<sup>9,10<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\">Systems theory<sup>11<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\">Biopsychosocial model<sup>12<\/sup><\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\">Discipline-specific models<\/li>\n<li class=\"import-Normal\" style=\"background-color: #ffffff\">Disease-specific frameworks<\/li>\n<\/ul>\n<h2 class=\"import-Normal\"><strong>E<\/strong><strong>xamples of <\/strong><strong>f<\/strong><strong>rameworks<\/strong><\/h2>\n<p class=\"import-Normal\">In Table 4.1, citations of published papers are included to demonstrate how the particular framework helps to &#8216;frame&#8217; the research question and the interpretation of results.<\/p>\n<p>[table id=9 \/]<\/p>\n<p class=\"import-Normal\" style=\"background-color: #ffffff\">As discussed in Chapter 3, qualitative research is not an absolute science. While not all research may need a framework or theory (particularly descriptive studies, outlined in Chapter 5), the use of a framework or theory can help to position the research questions, research processes and conclusions and implications within the relevant research paradigm. Theories and frameworks also help to bring to focus areas of the research problem that may not have been considered.<\/p>\n<h2 class=\"import-Normal\"><strong>References<\/strong><\/h2>\n<ol>\n<li class=\"import-EndNoteBibliography\">Varpio L, Paradis E, Uijtdehaage S, Young M. The distinctions between theory, theoretical framework, and conceptual framework. <em>Acad Med<\/em>. 2020;95(7):989-994. doi:10.1097\/ACM.0000000000003075<\/li>\n<li><span style=\"text-align: initial;font-size: 1em\">Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. <\/span><em style=\"text-align: initial;font-size: 1em\">Implement Sci<\/em><span style=\"text-align: initial;font-size: 1em\">.\u00a0 2011;6:42. doi:10.1186\/1748-5908-6-42<\/span><\/li>\n<li>CFIR Research Team. Consolidated Framework for Implementation Research (CFIR). Center for Clinical Management Research. 2023. Accessed February 15, 2023. <a href=\"https:\/\/cfirguide.org\/\" target=\"_blank\" rel=\"noopener\">https:\/\/cfirguide.org\/<\/a><\/li>\n<li>Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. <em style=\"text-align: initial;font-size: 1em\">BMC Health Serv Res<\/em><span style=\"text-align: initial;font-size: 1em\">. 2017;17:88. doi:10.1186\/s12913-017-2031-8<\/span><\/li>\n<li>Murray E, Treweek S, Pope C, et al. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. <em style=\"text-align: initial;font-size: 1em\">BMC Med<\/em><span style=\"text-align: initial;font-size: 1em\">.\u00a0 2010;8:63. doi:10.1186\/1741-7015-8-63<\/span><\/li>\n<li>Tookey S, Renzi C, Waller J, von Wagner C, Whitaker KL. Using the candidacy framework to understand how doctor-patient interactions influence perceived eligibility to seek help for cancer alarm symptoms: a qualitative interview study. <em style=\"text-align: initial;font-size: 1em\">BMC Health Serv Res<\/em><span style=\"text-align: initial;font-size: 1em\">. 2018;18(1):937. doi:10.1186\/s12913-018-3730-5<\/span><\/li>\n<li>Lyon P. <em style=\"text-align: initial;font-size: 1em\">Aboriginal Health in Aboriginal Hands: Community-Controlled Comprehensive Primary Health Care @ Central Australian Aboriginal Congress;<\/em><span style=\"text-align: initial;font-size: 1em\"><span style=\"text-align: initial;font-size: 1em\"> 2016. <\/span><\/span>Accessed February 15, 2023. <a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/nacchocommunique.com\/wp-content\/uploads\/2017\/09\/cphc-congress-final-report.pdf\" target=\"_blank\" rel=\"noopener\">https:\/\/nacchocommunique.com\/wp-content\/uploads\/2017\/09\/cphc-congress-final-report.pdf<\/a><\/li>\n<li>Solar O., Irwin A. <em style=\"text-align: initial;font-size: 1em\">A Conceptual Framework for Action on the Social Determinants of Health:<\/em><span style=\"text-align: initial;font-size: 1em\">\u00a0<\/span><em style=\"text-align: initial;font-size: 1em\">Social Determinants of Health Discussion Paper 2 (Policy and Practice); <\/em><span style=\"text-align: initial;font-size: 1em\">2010. 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In: Jordan JS, ed. <em style=\"text-align: initial;font-size: 1em\">Advances in Psychology<\/em><span style=\"text-align: initial;font-size: 1em\">. Science Direct; 1998:47-74.<\/span><\/li>\n<li>Engel GL. From biomedical to biopsychosocial: being scientific in the human domain. <em style=\"text-align: initial;font-size: 1em\">Psychosomatics<\/em><span style=\"text-align: initial;font-size: 1em\">. 1997;38(6):521-528. doi:10.1016\/S0033-3182(97)71396-3<\/span><\/li>\n<li>Schmidtke KA, Drinkwater KG. A cross-sectional survey assessing the influence of theoretically informed behavioural factors on hand hygiene across seven countries during the COVID-19 pandemic. <em>BMC Public Health<\/em>. 2021;21:1432. doi:10.1186\/s12889-021-11491-4<\/li>\n<li>\n<div>Graham-Wisener L, Nelson A, Byrne A, et al. Understanding public attitudes to death talk and advance care planning in Northern Ireland using health behaviour change theory: a qualitative study. <em>BMC Public Health<\/em>. 2022;22:906. doi:10.1186\/s12889-022-13319-1<\/div>\n<\/li>\n<li>Walker R, Quong S, Olivier P, Wu L, Xie J, Boyle J. Empowerment for behaviour change through social connections: a qualitative exploration of women\u2019s preferences in preconception health promotion in the state of Victoria, Australia. <em>BMC Public Health<\/em>. 2022;22:1642. doi:10.1186\/s12889-022-14028-5<\/li>\n<li>Ayton DR, Barker AL, Morello RT, et al. Barriers and enablers to the implementation of the 6-PACK falls prevention program: a pre-implementation study in hospitals participating in a cluster randomised controlled trial. <em>PLOS ONE<\/em>. 2017;12(2):e0171932. doi:10.1371\/journal.pone.0171932<\/li>\n<li>Pratt R, Xiong S, Kmiecik A, et al. The implementation of a smoking cessation and alcohol abstinence intervention for people experiencing homelessness. <em>BMC Public Health<\/em>. 2022;22:1260. doi:10.1186\/s12889-022-13563-5<\/li>\n<li>Bossert J, Mahler C, Boltenhagen U, et al. Protocol for the process evaluation of a counselling intervention designed to educate cancer patients on complementary and integrative health care and promote interprofessional collaboration in this area (the CCC-Integrativ study). <em>PLOS ONE<\/em>. 2022;17(5):e0268091. doi:10.1371\/journal.pone.0268091<\/li>\n<li>Lwin KS, Bhandari AKC, Nguyen PT, et al. Factors influencing implementation of health-promoting interventions at workplaces: protocol for a scoping review. <em>PLOS ONE<\/em>. 2022;17(10):e0275887. doi:10.1371\/journal.pone.0275887<\/li>\n<li>Wilhelm AK, Schwedhelm M, Bigelow M, et al. Evaluation of a school-based participatory intervention to improve school environments using the Consolidated Framework for Implementation Research. <em>BMC Public Health<\/em>. 2021;21:1615. doi:10.1186\/s12889-021-11644-5<\/li>\n<li>Timm L, Annerstedt KS, Ahlgren J\u00c1, et al. Application of the Theoretical Framework of Acceptability to assess a telephone-facilitated health coaching intervention for the prevention and management of type 2 diabetes.<em> PLOS ONE<\/em>. 2022;17(10):e0275576. doi:10.1371\/journal.pone.0275576<\/li>\n<li>Laing L, Salema N-E, Jeffries M, et al. Understanding factors that could influence patient acceptability of the use of the PINCER intervention in primary care: a qualitative exploration using the Theoretical Framework of Acceptability. <em>PLOS ONE<\/em>. 2022;17(10):e0275633. doi:10.1371\/journal.pone.0275633<\/li>\n<li>Renko E, Knittle K, Palsola M, Lintunen T, Hankonen N. Acceptability, reach and implementation of a training to enhance teachers\u2019 skills in physical activity promotion. <em>BMC Public Health<\/em>. 2020;20:1568. doi:10.1186\/s12889-020-09653-x<\/li>\n<li>Alexander SM, Agaba A, Campbell JI, et al. A qualitative study of the acceptability of remote electronic bednet use monitoring in Uganda. <em>BMC Public Health<\/em>. 2022;22:1010. doi:10.1186\/s12889-022-13393<\/li>\n<li>May C, Rapley T, Mair FS, et al. Normalization Process Theory On-line Users\u2019 Manual, Toolkit and NoMAD instrument. 2015. Accessed February 15, 2023. <a href=\"http:\/\/www.normalizationprocess.org\" target=\"_blank\" rel=\"noopener\">https:\/\/normalization-process-theory.northumbria.ac.uk\/<\/a><\/li>\n<li>Davis S. Ready for prime time? Using Normalization Process Theory to evaluate implementation success of personal health records designed for decision making. <em>Front Digit\u00a0<span class=\"highlight\">Health<\/span><\/em>. 2020;2:575951. doi:10.3389\/fdgth.2020.575951<\/li>\n<li>Durand M-A, Lamouroux A, Redmond NM, et al. Impact of a health literacy intervention combining general practitioner training and a consumer facing intervention to improve colorectal cancer screening in underserved areas: protocol for a multicentric cluster randomized controlled trial. <em>BMC Public Health<\/em>. 2021;21:1684. doi:10.1186\/s12889-021-11565<\/li>\n<li>Jones SE, Hamilton S, Bell R, Ara\u00fajo-Soares V, White M. Acceptability of a cessation intervention for pregnant smokers: a qualitative study guided by Normalization Process Theory. <em>BMC Public Health<\/em>. 2020;20:1512. doi:10.1186\/s12889-020-09608-2<\/li>\n<li>Ziegler E, Valaitis R, Yost J, Carter N, Risdon C. \u201cPrimary care is primary care\u201d: use of Normalization Process Theory to explore the implementation of primary care services for transgender individuals in Ontario. <em>PLOS ONE<\/em>. 2019;14(4):e0215873. doi:10.1371\/journal.pone.0215873<\/li>\n<li>\n<div>Mackenzie M, Conway E, Hastings A, Munro M, O&#8217;Donnell C. Is \u2018candidacy\u2019 a useful concept for understanding journeys through public services? A critical interpretive literature synthesis. <em>Soc\u00a0Policy\u00a0Adm<\/em>. 2013;47(7):806-825. doi:10.1111\/j.1467-9515.2012.00864.x<\/div>\n<\/li>\n<li>Adeagbo O, Herbst C, Blandford A, et al. Exploring people\u2019s candidacy for mobile health\u2013supported HIV testing and care services in rural KwaZulu-Natal, South Africa: qualitative study.<em> J Med Internet Res<\/em>. 2019;21(11):e15681. doi:10.2196\/15681<\/li>\n<li>Mackenzie M, Turner F, Platt S, et al. What is the &#8216;problem&#8217; that outreach work seeks to address and how might it be tackled? Seeking theory in a primary health prevention programme. <em>BMC Health Serv Res<\/em>. 2011;11:350. doi:10.1186\/1472-6963-11-350<\/li>\n<li>\n<div>Liberati E, Richards N, Parker J, et al. Qualitative study of candidacy and access to secondary mental health services during the COVID-19 pandemic. <em>Soc Sci Med.<\/em> 2022;296:114711. doi:10.1016\/j.socscimed.2022.114711<\/div>\n<\/li>\n<li>Pearson O, Schwartzkopff K, Dawson A, et al. 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Health-related quality of life and associated factors among patients with stroke at tertiary level hospitals in Ethiopia. <em>PLOS ONE<\/em>. 2021;16(3):e0248481. doi:10.1371\/journal.pone.0248481<\/li>\n<li>Finch E, Foster M, Cruwys T, et al. Meeting unmet needs following minor stroke: the SUN randomised controlled trial protocol.<em> BMC Health Serv Res<\/em>. 2019;19:894. doi:10.1186\/s12913-019-4746-1<\/li>\n<\/ol>\n","protected":false},"author":35,"menu_order":4,"template":"","meta":{"pb_show_title":"","pb_short_title":"","pb_subtitle":"","pb_authors":["tess-tsindos"],"pb_section_license":""},"chapter-type":[],"contributor":[62],"license":[],"class_list":["post-30","chapter","type-chapter","status-publish","hentry","contributor-tess-tsindos"],"part":23,"_links":{"self":[{"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/pressbooks\/v2\/chapters\/30","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/wp\/v2\/users\/35"}],"version-history":[{"count":1,"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/pressbooks\/v2\/chapters\/30\/revisions"}],"predecessor-version":[{"id":31,"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/pressbooks\/v2\/chapters\/30\/revisions\/31"}],"part":[{"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/pressbooks\/v2\/parts\/23"}],"metadata":[{"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/pressbooks\/v2\/chapters\/30\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/wp\/v2\/media?parent=30"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/pressbooks\/v2\/chapter-type?post=30"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/wp\/v2\/contributor?post=30"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/openpub.libraries.rutgers.edu\/qualgo2\/wp-json\/wp\/v2\/license?post=30"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}