Using a Mixed-Methods Approach to Identify Health Concerns in an African American Community

Abstract

Objectives We used qualitative and quantitative data collection methods to identify the health concerns of African American residents in an urban community and analyzed the extent to which there were consistencies across methods in the concerns identified. Methods We completed 9 focus groups with 51 residents, 27 key informant interviews, and 201 community health surveys with a random sample of community residents to identify the health issues participants considered of greatest importance. We then compared the issues identified through these methods. Results Focus group participants and key informants gave priority to cancer and cardiovascular diseases, but most respondents in the community health survey indicated that sexually transmitted diseases, substance abuse, and obesity were conditions in need of intervention. How respondents ranked their concerns varied in the qualitative versus the quantitative methods. Conclusions Using qualitative and quantitative approaches simultaneously is useful in determining community health concerns. Although quantitative approaches yield concrete evidence of community needs, qualitative approaches provide a context for how these issues can be addressed. Researchers should develop creative ways to address multiple issues that arise when using a mixed-methods approach.

A comparative effectiveness education trial for lifestyle health behavior change in African Americans

“…Socioeconomic factors (e.g. gender, age, marital status, education, employment and income) were also obtained during the baseline by self-report using items from our previous research [18]. We also used the CDC formula to calculate body mass index (BMI) using self-reported height and weight.…”

“…Consistent with this approach, we first conducted a multilevel needs assessment with African American residents in the Philadelphia, PA metropolitan area and found that community members were concerned about chronic health conditions such as cardiovascular disease (CVD) and cancer and wanted greater education about obesity reduction and prevention through lifestyle modification and health behavior change [18]. Next, we used developed an integrated approach for providing education about risk factors for chronic diseases to address the priorities identified by community residents as part of a pilot study [20].…”

“…An integrated approach is based on an ecological model of health that emphasizes multiple types of determinants that operate at individual and community levels [21]; in this study, we conceptualized integration in terms of the disease foci because of the priorities and concerns that were identified by community residents in our needs assessment [18]. Moreover, interventions that are integrated in terms of disease foci are consistent with a primary care model of health behavior in which health care providers deliver counseling or advice about multiple health behaviors to patients [22].…”

“…We chose to address CVD as part of the DSE because of the high rates of risk factors for this condition in the African American community. Further, greater education was identified as a priority among community residents [18]; we wanted to ensure that residents would have access to education about strategies for health promotion and disease prevention, regardless of their randomization to INT or DSE. We focused on changes in diet and PA rather than weight loss because these behaviors are important to obesity and community residents expressed a strong preference for educational interventions that C. H. Halbert et al…”

“…emphasized lifestyle behavior change [18]. We hypothesized that INT, which focused on shared risk factors for cancer and CVD, would lead to greater changes in meeting guidelines for PA and FV intake compared with DSE about CVD only.…”