Introduction and Overview

Every empirical study you have ever read began with a research question. Most introductory methods courses devote a single lecture to question formulation and then move on, as if the rest of the design followed mechanically once the question was set. Bernard, Wutich, and Ryan take the opposite view: the question is the single most consequential choice a researcher makes, and a defensible qualitative project is one in which every later decision — sampling, instrument, analytic method, write-up — can be traced back to a well-specified research question. This lesson is about doing that upstream work well.

In the prior epidemiology sequence you were given research questions to answer with established designs (case-control, cohort, regression). In HSCI 841 the question is yours to formulate, and the texture of your data — 20 loneliness transcripts collected with a semi-structured guide — both enables and constrains what you can defensibly ask.

1.1 Exploratory and Confirmatory Qualitative Research

The two terms describe the epistemic position of the researcher at the start of the study, not the analytic technique they use. An exploratory question is one for which the researcher does not yet have a candidate answer (or has only weak, ill-formed candidates). A confirmatory question is one for which the researcher has a specific candidate answer (a hypothesis, a model, a theory-derived prediction) and is testing it against data.

Qualitative work has historically been most associated with exploration. The reason is that qualitative methods are particularly good at discovering categories — what counts as a thing, what its dimensions are, how it differs across people — and discovery is the natural mode when you do not yet know what to measure. Bernard, Wutich, and Ryan are careful, however, not to collapse qualitative work into exploration. Grounded theory's later phases (Charmaz, 2006), analytic induction, and qualitative comparative analysis are confirmatory qualitative techniques (Module 11 will return to them). The point is that the same dataset can be analyzed exploratorily or confirmatorily, and you owe the reader an explicit statement of which posture your study is taking.

Notice that both questions can be answered from the same 20 transcripts. The first asks the data to teach you the categories; the second asks the data to evaluate a category already proposed in the literature.

1.2 The Four Screening Questions

Before you commit to a research question, Bernard, Wutich, and Ryan recommend running it through four screening questions. Each one is a different kind of feasibility check, and a question that fails any one of them is not yet a good question.

Many students arrive at this course with a topic, not a research question. The four screens are most useful as a movement from topic to question. “Loneliness” is a topic. “How do recently-bereaved older women in British Columbia describe the shape of their loneliness, and what social, material, and embodied features of their daily lives are they identifying as constitutive of it?” is a research question. Note how the second one specifies who, what, where, and what kind of answer it expects.

1.3 What Makes a Question Defensible for the Capstone Dataset

The capstone dataset constrains the questions you can defensibly ask. Some constraints are obvious and some are less so.

The dataset has 20 transcripts. Twenty in-depth transcripts is a defensible qualitative sample size for descriptive and interpretive work (Sandelowski, 1995). That means questions about prevalence (“how common is…?”) are off-limits. So are questions that require dense subgroup contrasts (a question that splits the dataset 15 ways will have one or two transcripts per cell, which is not enough to characterize anything). Questions about kinds (what kinds of loneliness exist? how is each kind structured?), processes (how do people come to recognize their loneliness? what do they do when it shows up?), and meanings (what does loneliness signify to them?) are well-supported.

The dataset was collected using a specific semi-structured guide. Topics the guide asked about (definitions of loneliness, triggers, coping, social world, stigma, policy preferences) will be richly represented across transcripts. Topics the guide did not directly ask about (clinical symptomatology, family-of-origin attachment styles, neurobiological correlates) will appear only sporadically. A defensible question concentrates on what the guide elicited.

The dataset is synthetic. This is unusual and your methods section must acknowledge it. The transcripts are pedagogically valuable and analytically coherent, but you cannot draw causal claims from them, and you should be cautious about claims that depend on real-world demographic representativeness (since the synthetic composites were designed for analytic variation, not for representative sampling).

Introduction and Overview

In the prior courses theory often appeared as background: the biological model of disease, the social-ecological model, the proportionate-universalism framing of inequity. You used theory to motivate a study and to interpret findings, but you rarely had to declare which theoretical tradition you were working within. Qualitative research is different. The methodological tradition expects you to name your paradigm and to align your method to it. This section walks through the four paradigms most commonly named in contemporary public-health qualitative research and shows how the same loneliness question would be approached differently in each.

2.1 What a Paradigm Is

A paradigm is a bundle of commitments about three things: ontology (what kind of thing is the social world?), epistemology (how can we know about it?), and axiology (what role do values play in research?). The bundles are not all internally consistent in every detail, but they cohere enough that researchers within a paradigm tend to agree on what counts as a good study.

You may find paradigm-talk uncomfortable if your training is quantitative. The discomfort is legitimate — quantitative epidemiology rarely makes you say out loud that you believe in an external reality knowable through measurement, because almost everyone in the room is already a postpositivist. Qualitative research, by contrast, draws practitioners from very different positions, so the convention is that you declare yours.

2.2 Positivism / Postpositivism

The view that an external reality exists and is, in principle, knowable. Strict positivism (rare today) treats social facts as fully observable; postpositivism — the dominant position in quantitative epidemiology — accepts that our access to reality is fallible and shaped by our instruments, while still treating reality as the target. A postpositivist qualitative study of loneliness would treat participants' accounts as imperfect windows onto an underlying phenomenon and would prioritize procedures (intercoder reliability, triangulation, transparency) that increase the credibility of the inference from accounts to phenomenon.

2.3 Interpretivism / Constructivism

The view that the social world is constituted through meaning-making, and that the researcher's job is to understand those meanings rather than to extract underlying facts behind them. An interpretivist qualitative study of loneliness would treat the accounts as the data — the loneliness of interest is the loneliness as constructed in talk, not a hypothetical thing behind the talk (Thorne, Kirkham, & MacDonald-Emes, 1997). Charmaz's constructivist grounded theory (Charmaz, 2006; Module 7) is the most widely cited contemporary interpretivist methodology in health research.

2.4 Critical and Critical-Realist Paradigms

Frameworks that explicitly attend to power, structural inequality, and the historical embeddedness of phenomena. Feminist, anti-racist, decolonial, Marxist, and critical-realist approaches share the commitment that research is not neutral and that part of the researcher's job is to make visible the structural conditions that produce the phenomenon. A critical loneliness study might foreground how policy choices (housing affordability, immigration restrictions, healthcare under-funding, long-term-care austerity) produce specific patterns of isolation, and would treat participants' accounts as evidence about structural conditions, not only about individual experience.

2.5 Pragmatism

A meta-stance that picks methods to fit the question rather than committing in advance to one paradigm. Pragmatist researchers will mix methods, draw on different paradigms in different parts of a project, and ground decisions in “what works for this question.” Pragmatism is common in applied health-services and implementation-science research. Its critics worry that it can become an excuse for non-disclosure; its defenders argue that strict paradigm-fidelity can produce studies that are philosophically clean but practically irrelevant.

Introduction and Overview

In HSCI 230 L2 you learned to conduct a systematic review for quantitative evidence: PRISMA, PICO, MeSH terms, risk-of-bias instruments. The literature search for qualitative evidence works on a similar logic but with important differences. The searchable concepts are different, the databases are partly different, the inclusion criteria are different, and the synthesis methods are very different. This section walks through what is the same, what is different, and how to conduct a defensible qualitative-evidence search for your capstone.

3.1 What Is the Same as a Quantitative Review

The basic discipline of a systematic search transfers directly. You still:

• Specify your search question in advance, using a structured frame (PICO can be adapted; SPIDER — Sample, Phenomenon of Interest, Design, Evaluation, Research type — is purpose-built for qualitative searches (Cooke, Smith, & Booth, 2012)).
• Search multiple databases.
• Document your search strings, dates, and result counts.
• Apply inclusion and exclusion criteria with audit trail.
• Screen titles/abstracts, then full text, with a second reviewer if possible.
• Extract data into a structured table.
• Appraise the quality of included studies.

The PRISMA flow diagram (or its qualitative variants — eMERGe for meta-ethnography, ENTREQ for transparency in reporting synthesis) is still the convention. For reporting your own primary qualitative study, the two dominant standards are COREQ (Tong, Sainsbury, & Craig, 2007) for interview and focus-group studies and SRQR (O'Brien, Harris, Beckman, Reed, & Cook, 2014) for qualitative research more broadly.

3.2 What Is Different

The differences are substantive enough that doing a qualitative search using a quantitative-review playbook will produce a worse search.

The search terms are different. Qualitative studies are not always indexed with reliable terms like “qualitative” or “interview” in their titles or abstracts. The Cochrane Qualitative and Implementation Methods Group has published validated search filters for several databases that you should use rather than improvising. Common useful terms include qualitative, interview, focus group, ethnography, grounded theory, phenomenology, lived experience, narrative, plus methodologically specific terms.

The databases are partly different. MEDLINE and Embase still matter, but CINAHL (nursing), PsycINFO (psychology), Sociological Abstracts, and ASSIA (Applied Social Sciences Index and Abstracts) are particularly important for qualitative health research. Several databases have dedicated qualitative-research filters built in. Grey literature (theses, reports, working papers) is more important in qualitative reviews because qualitative studies are over-represented in unpublished form.

The quality appraisal is different. The Cochrane risk-of-bias tool is not the right instrument. The Critical Appraisal Skills Programme (CASP) qualitative checklist, the Joanna Briggs Institute qualitative checklist, and the Walsh and Downe (2006) criteria are the most widely used.

The synthesis is profoundly different. You do not pool effect sizes. The next subsection turns to what you do instead.

3.3 The Major Qualitative-Evidence Synthesis Methods

Five approaches dominate the qualitative-evidence synthesis literature. They differ in epistemology and in how aggressively they reduce findings.

For your Week 2 capstone literature framing you are not being asked to conduct a synthesis. You are being asked to summarize what is known about loneliness from qualitative research, identify the gap your study would address, and locate your candidate research question in that landscape. A one-page framing with eight to twelve cited sources is the target.

Introduction and Overview

This section walks through the process of moving from a public-health topic to a defensible capstone research question, using a worked example. It then sets up the Week 2 capstone deliverable.

4.1 Worked Example: From “Loneliness in Older People” to a Capstone Question

A typical student arrives at the course with a topic like “loneliness in older people” or “immigrant loneliness.” Each of these is a starting point, not a research question. The work of question formulation is to narrow, specify, and ground the topic.

Step 1: From topic to question stub. What about loneliness in older people interests you? “How older people describe the experience of loneliness.” That is closer to a question, but still vague — “describe” could mean anything from clinical phenomenology to social-network mapping.

Step 2: Specify the kind of answer. What do you want to know that you do not now know? “What dimensions and triggers of loneliness do older participants name in their own accounts, and how do these compare to younger participants' accounts?” Now the question has a comparison built in and is asking for content that the dataset can provide.

Step 3: Ground the question in the dataset. Can the 20 transcripts answer this? Five of the 20 participants are over 65 (P05 Linda, P11 Helen, P14 Kenji, P17 Jacob, P20 Frank). Five is enough for descriptive characterization but not for fine-grained subgroup work. The question is dataset-feasible if you accept that “older” will be defined by those five and that comparison to younger participants will be at the level of patterns, not statistical contrasts.

Step 4: Locate in the literature. The qualitative literature on older-adult loneliness is well-developed (Cacioppo & Patrick, 2008; Hawkley & Cacioppo, 2010; the Cardona et al. 2025 review). What can your capstone add? A defensible answer: a comparison across life-stage from a single, methodologically consistent dataset, where most prior qualitative work has studied life-stages separately.

Step 5: Run the four screens. Personal interest (you do care). Empirical answerability (the dataset can support the question, with stated caveats about sample size). Resources (12 weeks is sufficient for a five-vs-fifteen-transcript comparative analysis). Ethics (the dataset is synthetic, so the question is REB-clean for instructional purposes).

Final question: “How do older British Columbian adults (age 65+) describe the dimensions and triggers of their loneliness, and in what ways do their accounts pattern differently from those of younger adults in the same dataset?”

4.2 Your Capstone Question

You are now ready to draft your own. Use the worked example as scaffolding, not as a template. The question you arrive at should be specific enough that another reader could predict, in broad terms, what your methods section will say.

4.3 Ethics of Qualitative Research — What Your Methods Section Will Address

Even with a synthetic dataset, your methods section is expected to address what the ethical considerations would be for a real-world study. The TCPS 2 framework asks you to address:

• Free and informed consent — what would participants be told? How would consent be obtained for sensitive topics? How would withdrawal work?
• Confidentiality — how would identifying details be removed from transcripts? What is your data-storage plan? How will quoted excerpts be presented?
• Risk of harm — what is the risk of re-traumatization from an interview about loneliness? What support resources would be provided?
• Justice in subject selection — who is included, who is excluded, and on what grounds?
• Researcher obligations of care — what does the researcher owe a participant who discloses something distressing during an interview?

Bernard, Wutich, and Ryan (Ch. 2, pp. 23–26) are good on the ethics framing. The Canadian-specific operationalization is in TCPS 2 (2022).

Bringing It All Together

Lesson 2 has done the upstream design work: you have moved from a topic to a defensible research question, named the paradigm you will work in, and located the question in the qualitative loneliness literature. This work feels disproportionate to its concrete output (a paragraph and a page), but it determines what every later step of the course can do for you. A vague question produces a vague methods section, a vague analysis, and a vague paper. A precise question makes everything that follows possible.

Lessons 3 and 4 turn to the design infrastructure your methods section will be written in: sampling logic (already partly fixed for the capstone, but you still must document it defensibly) and data collection (also partly fixed, but the methodological vocabulary is what makes the dataset legible to your reader). Lessons 5 onward begin analysis proper.

The final reflection below asks you to articulate the question that will anchor your capstone for the remaining ten weeks. Make it as good as you can — you will return to it every week.

This glossary collects the key concepts, methods, and people introduced in Lesson 2. Type in the search box to filter entries.