QUALITATIVE DATA ANALYSIS 175

the researchers began to read and code the data. They noted a number of
barriers to breastfeeding. Returning to the study objectives, they focused the
analysis on these factors and were able eventually to prioritize strategies for the
media campaign. Internal barriers such as mothers’ concerns about sufficient
breast milk led to their recommendation for more effective counseling.
External barriers, such as lack of prenatal and perinatal counseling, clearly
pointed to certain policy changes.

Basic Steps in Qualitative Data Analysis

Qualitative analysis emphasizes how data fit together as a whole, bringing
together context and meaning. There are many analytic approaches, and
one way is simply to group data by each research question or theme within
the topic guide and then look for similarities and differences. This approach
may be particularly appropriate when time and resources are limited or when
the research is a smaller component of a larger quantitative study and is
conducted to provide further depth in predefined areas of interest.
In this book, we have chosen to describe a more in-depth, inductive analy-
sis. We have organized analysis in five interrelated steps. Step 1 includes careful
reading of the raw data, noting quality and identifying patterns. Step 2 moves
on to coding, with details on what to code, how to create a codebook, and how
to apply codes to the data. We also discuss coding as a team with implications
for consistency and reliability. In Step 3, we offer advice on how to examine
the data for finer distinctions within and among the themes, using data display
memos and notes to track discoveries and begin to develop hypotheses. Step 4
we call “getting the big picture.” It discusses how to reduce a large data-set to a
manageable size, using matrices and other summary devices to arrive at central
themes. Step 5 covers interpretation of the data, how to find essential mean-
ings, ensure trustworthiness, and interpret data from mixed-method studies.
The diagram in Box 6.1 shows the five steps and their relationships.
To illustrate the classic qualitative analysis procedure, we use a
mixed-method study that was conducted among young women in India
and Tanzania, also presented in Case Study 5 (Tolley, Kaaya, and others,
2014). The goal of the study was to assess the feasibility of recruiting ado-
lescent women younger than age 18 into HIV prevention clinical trials. The
qualitative component explored sexual and reproductive health (SRH) risk
among adolescent and young adult women in two countries in different socio-
cultural and epidemiologic contexts. We take the reader step by step through
our analysis to illustrate how to turn raw data into credible, publishable
results.
176 QUALITATIVE METHODS IN PUBLIC HEALTH: A FIELD GUIDE FOR APPLIED RESEARCH

BOX 6.1 QUALITATIVE DATA ANALYSIS: STEP BY STEP

Reading Coding
1. In the Field

Questioning Interpreting Verifying

2. At Your Desk
Reducing Displaying

Source:Adapted from Huberman and Miles (1994, p. 429).

Step 1. Reading: Developing an Intimate

Relationship with the Data

Most qualitative researchers would agree that qualitative analysis begins with
data immersion. This means reading and rereading each set of notes or tran-
scripts until you are intimately familiar with the content, noting content and
quality and identifying patterns. As we have emphasized, the researcher does
not wait for all the data to be collected, but starts a gradual immersion in a pro-
gressive review even as data are collected. The process is analogous to wading
into a lake instead of diving in head first.

Reading for Content

What do you look for as you read? First, content. Are you obtaining the kinds of
information that you intended to collect? Are responses full and detailed, or
superficial? Perhaps the questions are not adequately framed or sequenced.
Maybe the interviewers are not following up important leads with appropri-
ate probes (see Chapter 4 for discussion of common errors in moderation of
focus group discussions). Other aspects of the interview process may be inhibit-
ing data collection, such as setting, composition of groups, or interviewer style
or characteristics. As indicated in Chapter 5, it is helpful to note on transcripts
where discussion might have been more thoroughly explored. Further ques-
tions can then be incorporated into future interviews.
In the study to examine adolescent barriers to participation in HIV pre-
vention clinical trials, we wanted to understand the circumstances in which