Strengthening Qualitative Research Through Methodological Innovation and Integration: An Integration of Conversation Analysis and Ethnography

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SES-0751032Stefan TimmermansJohn HeritageUniversity of California, Los AngelesThe aim of this project is to develop a set of methodological guidelines for integrating conversation analysis and ethnography. Conversation analysis is a widely used methodology focused on verbal communication for the investigation of social interaction. Ethnography is a methodology in which researchers participate in people's daily lives for an extended period of time to gather close observational data. In spite of their shared interests, few studies have successfully integrated both approaches. Conversation analysts have closely examined verbal exchanges but paid little attention to how these conversations contribute to the broader social picture. Ethnographers, in contrast, have been more sensitive to the social framing of interactions but tend to gloss over key details of interactions. In this mixed-methods project the investigators use ethnographic methods to provide access to salient social contexts, while using conversation analysis to trace detailed mechanisms of social change. They develop this mixed method approach to investigate the effects of newborn screening results on families. Newborn screening is a recently developed technique for determining rare metabolic and genetic disorders in infants. In the U.S. a 'heelprick' blood test is applied to all newborns for this purpose. Possible abnormalities are reported to pediatricians and referred to geneticists for further exploration. This study uses conversation analysis to study the details of communication between geneticists and parents immediately following test results, and uses ethnographic methods to follow the families' reactions and adjustments to the diagnosis over a two-year period. An integrated conversation analysis-ethnography research agenda will study social interaction as a sequence of processes that constitute the course of individual lives, formation of families, and working of social institutions. The goal is identify how clinician-parent communications influence family understandings of the diagnosis and its consequences, together with their adoption of coping strategies. In terms of broader impact, study findings contribute methodological to combining conversation analysis and ethnography and substantively to scholarship on communication and its consequences in newborn screening. In addition, while researchers are developing technologies to include more rare genetic conditions in newborn screening, little is known about the communication of these test results with their context of diagnostic and prognostic uncertainty. The study will yield policy relevant data about the social consequences of newborn screening and the effects of various communication styles, disease, and patient characteristics.