The Person-Based Approach to Qualitative process analyses

Qualitative process analyses can include data from interviews, focus groups, diary studies or observation of how people use an intervention in practice, or a combination of these. While real-time user studies provide feedback about immediate reactions to the intervention, qualitative process studies are needed to understand users’ experiences of engaging with the intervention and attempting behaviour change in a real life context and over a period of time.

Key steps when carrying out qualitative process analyses:

  1. Decide which method or combination of methods to use, based on the time and resources available. Repeated interviews/observations with the same people can be carried out if you want to see how intervention use may change over time.
  2. Consider how long to give users to use the intervention/elements before you ask for their feedback? If you give users too long, they may have forgotten what they did or how they felt initially. If not long enough, they might not have had time to use all aspects of the intervention.
  3. Start with open questions for interviews which give participants freedom to tell their own story. Including questions such as “Can you talk me through…..”, “What happened during…..” allows users to describe both the processes and their reactions to them. You can use follow-up prompts to focus on key elements or evidence gaps, e.g. “Can you say a bit more about …”. This structure means that the interview will focus on topics that are most important to intervention users, but also allows you to follow-up on specific points of interest. 
  4. Use copies or summaries of intervention elements as prompts during interviews, to remind participants of intervention elements.
  5. Discuss qualitative findings with your team (including PPI and stakeholders) as you go along, and adjust questions as necessary before doing further interviews. This helps to make sure you have enough feedback about all elements of the intervention and can further explore any issues that seem especially important.

Example of mixed-methods process evaluation using the PBA with recommendations for how to optimise intervention:

Morton, K., Dennison, L., Band, R. et al. (2021). Implementing a digital intervention for managing uncontrolled hypertension in Primary Care: a mixed methods process evaluation. Implementation Sci 16, 57.

Click here to find more papers that relate to the use process analysis in the Person-Based Approach.