Arctic Passages study scope and parameters

This comparative system of analysis, coupled with the original research questions to guide formulation of theoretical output, set the parameters for the resulting Arctic

Passages study design. I used qualitative data collection and analytical techniques. I have described above how the findings from the field helped shape and refine the emerging propositions concerning these mothers' impression of the maternal transport policy as it operated in their respective situations. The unit of analysis changed from relationships branching from three case-study primigravida mothers to multiple birth cases from

mothers of MSA distinct villages. Moreover, the analysis moved from one of deductive hypothesis testing of preliminary work to a framework approach involving advance-set objectives, shaped by inductive comparative testing of results of fieldwork. I continue with a description of how I developed analytical categories and theoretical framework to explain the social phenomenon of birth as it occurs for these women in this area.

2. 4 Sampling and Data collection techniques

I derived the study population from opportunity sampling of mothers from the communities selected, as previously discussed. Besides the assistance of an additional field interviewer in Point Hope, I was the source for all other interviews. There were two Point Hope trips into the field for ethnographic interviewing: one with both the field assistant and myself, and one with just the field assistant. Phone calls and email contacts prior to travel facilitated these interviews. On the multiple Kotzebue sessions—partly because it is a regional hub and partly because there were regional contacts there—I was able to secure fewer interviews than any other location. The larger size of the

Village could account for this. There is a decrease the likelihood that one will know as much of a percentage of the other folks living there.

I used ethnographic unstructured interviewing, coupled with observation and field notes to obtain the information needed to conduct this study. A broader approach to the subject was addressed in the exploratory phase of the research, resulting in a basic line of questions (see Appendix A) used for the inductive content analysis toward formation of grounded theory described in Table 2.1.

Each field session was planned with presence of availability of key contacts arranged prior to travel. In Buckland, arrangements were made for home visits and aside from preliminary work there, notes were made, as recordings were impractical. Interviews were recorded in Point Hope, and then transcribed. No recordings occurred in Kotzebue and only preliminary film footage with audio recording during a group interview, occurred in Buckland. For primary interviews in Buckland, notes were taken and transcribed for analysis.

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Table 2.1 Preliminary Deductive Stages of Framework Approach as Applied in

Arctic Passages Fieldwork and Analysis

Stage of Research:

Process

Outcome 'Moving Hypothesis

Forward' Preliminary

(Exploratory)

Exploring:

If ANVMT policy had an effect on Iñupiat Culture?

Deductive:

 Comparative testing techniques

 Birth practices "old ways" verses birth practices "new ways," via maternal transport system.

 Tested original theory that the transport policy was in part responsible for changing birth practices

 Preliminary medical personal and administrative input

 Discussion generated among village leaders, midwives, and a few originally 'non- qualifying' (multiparous) mothers  Acquired preliminary data  Emphasis on testing hypothesis impact of policy itself changed

 Mothers' well-being (assumed by cultural continuity)  Proceeded to develop Version 1 of study design Original Proposed Research Design (Version 1): (Social Network Analysis) Exploring:

Does involvement with ANVMT policy impact level of biomedical and community influences on expectant Iñupiat mothers?

Deductive:

 Proposed to use identified personnel and mothers involved in the different transport situations

 Designed investigation to determine whether the criteria (ANVMT policy) for transport impacted the social and cultural experiences of mothers

 Abandoned this approach when lack of continued involvement of medical personnel was made apparent

 And, themes counter to initially-proposed hypothesis emerged

 Set to analyze types and strengths of differing influences surrounding use of ANVMT policy

 Led to development of new scope and strategy in study design, which  Involves transition (liminality) and social (embodiment) and cultural influence during these transitions Source: Compiled by author from Pope, et al. (2000).

All participants were given informed consent forms, approved by IRB (see Appendix B), and Wal-Mart gift cards for participation. One-time short interviews were

compensated with $50 gift cards. Those with more in-depth coverage and follow-ups were compensated with $100 gift cards. With village 'Bush' deliveries offered at the Wal- Mart in Anchorage, this was a way to compensate participants without having to fill out income tax information. They did sign a form (see Appendix C) to acknowledge that they had been informed of the parameters and purpose of the study with the possible risks and benefits spelled out.

2. 4.1. Arctic Passages framework approach

As mentioned, this research started out with more of a deductive approach and began to follow a more inductive tact as the scope of the study changed and I began to compare results of preliminary fieldwork. Pope, Ziebland, and Mays (2000) explain how this combination of procedures can be typical for "applied or policy relevant qualitative research." When the objectives of the investigation are set in advance and "shaped by the requirements of the funding body [or health authority]," although not the case for the Arctic Passages study, policy analysis of this sort is oftentimes "short and there is often a need to link the analysis with quantitative findings." Pope, Ziebland, and Mays

(2000:116) point out that while "...the framework approach reflects the original accounts and observations of the people studies (that is grounded, and inductive), it starts out deductively from pre-set aims and objectives."

This approach enabled the results to be "viewed and assessed by people other than the primary analyst." The framework approach can be used to 'move the hypothesis forward' with analytical induction.

2. 4.2. Arctic Passages grounded theory

After preliminary fieldwork and analysis, and devising and revising methodology, I ultimately gathered, prepared, and analyzed findings from the Arctic Passages study presented in this thesis (Table 2.2). I used collection and analysis strategies described in the following Methods section. This process allowed me to develop a theoretical-based proposition that evolved from careful analysis of my concentrated findings, observations and participant input. This part of the analysis, an anthropological-based process called grounded theory (Bernard 2006; Pope, et al. 2000) allows the findings from the field to guide the researcher toward the propositions, rather than the standard scientific method of testing a pre-existing hypothesis. As I was not certain what to expect concerning the relationships among pregnant mothers, their communities and their use of maternal health

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Table 2.2 Final Stages of Framework Approach as Applied in Arctic Passages Fieldwork and Analysis

Stage of Research: Process Outcome 'Moving

Hypothesis Forward' Final Methodology:

(Framework Approach)

Inductive:

 Take preliminary results, to

 Recursively develop grounded theory, with

 Emergent themes from content analysis  New Design, conceptually and logistically more appropriate for available population,

 Uses what had been done up to this point to inform rest of analysis

Grounded Theory Inductive:

 Identifying analytical categories as they emerge from data

 Developing hypotheses from the ground or research field upwards

 Identification of analytical categories  Discovery of emergent themes is based on responses to descriptions of NW Iñupiat mothers' birth experiences :

 By home community

 By generation

 By birth location Emergent Themes Inductive:

 Constant comparison, in which items are checked and compared to rest of data

 Centered on like phrases or incidents or types of behavior

 Sections of the data are placed together in matrices

 Categories are added to reflect as many of the nuances as possible

 Discrete incidents with many themes

 Available for cross- indexing

Source: Compiled by author from Pope, et al. (2000).

services in this area—the grounded theory process evolved with this thesis as layers of information were acquired throughout the data collection stages of analyses.

The resulting findings from this process, along with a look at publicly available statistics concerning birth and infant mortality in the area are presented in chapter 5. I continue at this point with a description of procedures followed to supply and analyze the required information.