Critical incident technique: an innovative participatory approach to examine and document racial disparities in breast cancer healthcare services

Abstract

Disproportionate and persistent inequities in quality of healthcare have been observed among persons of color in the United States. To understand and ultimately eliminate such inequities, several public health institutions have issued calls for innovative methods and approaches that examine determinants from the social, organizational and public policy contexts to inform the design of systems change interventions. The authors, including academic and community research partners in a community-based participatory research (CBPR) study, reflected together on the use and value of the critical incident technique (CIT) for exploring racial disparities in healthcare for women with breast cancer. Academic and community partners used initial large group discussion involving a large partnership of 35 academic and community researchers guided by principles of CBPR, followed by the efforts of a smaller interdisciplinary manuscript team of academic and community researchers to reflect, document summarize and translate this participatory research process, lessons learned and value added from using the CIT with principles of CBPR and Undoing Racism. The finding of this article is a discussion of the process, strengths and challenges of utilizing CIT with CBPR. The participation of community members at all levels of the research process including development, collection of the data and analysis of the data was enhanced by the CIT process. As the field of CBPR continues to mature, innovative processes which combine the expertise of community and academic partners can enhance the success of such partnerships. This report contributes to existing literature by illustrating a unique and participatory research application of CIT with principles of CBPR and Undoing Racism. Findings highlight the collaborative process used to identify and implement this novel method and the adaptability of this technique in the interdisciplinary exploration of system-level changes to understand and address disparities in breast cancer and cancer care.

Cultural Brokering with Syrian Refugee Families with Young Children: An Exploration of Challenges and Best Practices in Psychosocial Adaptation

“…An adaptation of Flanagan's Critical incident method (Flanagan, 1954;Yohani, 2013) was used to generate detailed descriptions of the psychosocial needs and challenges of families during their first year of resettlement, and the activities cultural brokers engage in to support the adaptation and integration of families. When paired with principles of CBPR, this method can facilitate the generation of applied and actionable knowledge that can inform future programs and interventions (Yonas et al, 2013). As pointed out by Yohani (2013) who used critical incidents successfully in similar research examining the role of cultural brokers facilitating the adaptation of refugee children and families in schools, this method allows participants to share descriptive accounts of subjective experiences of situations that facilitate or hinder a particular goal.…”

“I keep hearing reports on the news that it's a real problem at the moment”: Public health nurses’ understandings of sexting practices among young people

“…This was a qualitative study that integrated the critical incident technique (CIT). CIT focuses on “real” events, rather than abstract concepts (Bradbury‐Jones & Tranter, ; Yonas et al., ). It involves asking respondents to recount actual incidents.…”

Community-Guided Focus Group Analysis to Examine Cancer Disparities

“…9 GHDC’s first CBPR project was Cancer Care and Racial Equity Study (CCARES), which used a novel data collection procedure, called Critical Incident Technique interviewing, to explore whether Black and White women with breast cancer received the same cancer treatment and, if not, determine the differences and possible reasons. 10 Our second study, ACCURE, is informed by the findings from CCARES through: Extending GHDC membership to include the healthcare institutions involved as partners in ACCURE.Applying Undoing Racism™ concepts to design components of the ACCURE intervention.Developing and implementing a community-guided focus group data analysis procedure. …”