Data analysis

5.6.1 Thematic analysis

Thematic analysis is a broad term used to describe analytic methods which seek to identify and classify the content of qualitative data, to explore patterns and differences across accounts in order to describe the relationships between different parts of the data, with the aim of providing explanatory conclusions clustered around themes.(406) Thematic analysis was used in this study to explore themes across participants’ accounts relevant to the research questions. Braun and Clarke’s (2006) method of conducting thematic analysis was followed, as will now be described.(407)

The first step in the analytic process was that the student read and re-read each transcript, when they were available, to familiarise herself with the data and to note concepts of interest within the data. This familiarisation stage particularly focused on topics of importance raised by the participants, and deviations from the pre-conceived question schedule; within the data. Completion of this stage of analysis supported iterative interviewing, where the information noted during data familiarisation, was used to guide further data collection by modification of the interview schedule. Field notes were examined alongside the reading of the interview to which the notes applied, to help explain the context of the transcript, for example where interruptions had impacted on the flow of the dialogue. This stage of analysis continued throughout data collection, to allow the student to develop a detailed knowledge of the data.

After data familiarisation, initial codes were assigned; that is, to apply a descriptive or conceptual label to selected data excerpts to define the content. The coding procedure outlined that all data were to be covered by a code to retain all data in the analysis, that more than one code could be assigned to a data excerpt, and, that the questioning needed to be retained in the selected data. For this stage of analysis, the student and research supervisor, LBH, discussed the first two interview transcripts together and manually applied initial codes generated during this discussion. Moving forward, and using Nvivo 11,(405) the student collated these initial codes according to conceptual similarity, to look for repeated patterns across the data. This stage of analysis continued throughout data collection.

The student started to think about how the conceptually grouped codes fitted together into overarching themes and sub-themes, and electronic memos were recorded to account any

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thoughts or initial observations she had about the data. A thematic map was drawn to assist in this process, to visually map out how the grouped codes may link together, to aid the progression of the analysis. When initial themes and sub-themes had been conceived, a coding frame was produced which provided a hierarchical structure of these themes and sub-themes, along with their content descriptions. This coding frame was used to support the coding of new interview data. It continued to be refined as further coding and re-mapping of the themes occurred, through further analysis or following discussions and reflections with the researcher supervisors. The coding frame was continuously reviewed to check that the coded data matched the code definitions, and were, in turn, a good fit within the overarching theme. Where required, the coding of extracts was changed or sub-themes merged into existing themes. Amended versions of the coding frame were retained throughout the analysis, to allow reflection on the progression of the analysis and to check that the correct meaning was retained while refining themes. When all data had been coded and allocated into themes, a review of the entire dataset was conducted to assess whether the final themes accurately reflected the dataset as a whole, and to check that themes were coherent, distinct and internally consistent.

When the resulting concepts were accepted by the student and research supervisors as accurately fitting together and incorporating the essence of the dataset, the themes were named to reflect the meaning of the content. The final coding frame was produced and a final thematic map was developed to summarise the results, providing a tool to visualise how the identified themes may fit together to inform the research questions.

The resulting themes and sub-themes, coding frame and thematic map are outlined in Chapter 6. The interpretation of women’s experiences is presented alongside direct participant quotes, so that the reader may have a lens through which they may view the participants’ worlds and be able to verify the resulting themes. Women were given pseudonyms which were used to attribute quotes.

5.6.2 Ensuring an ‘inductive’ approach in the thematic analysis

It was clearly acknowledged that the student entered into the research process with knowledge of the phenomenon. This knowledge influenced the interviews in that the question schedule was developed based on the literature review and previous research within this population. Furthermore, analysis of the initial interviews identified themes which closely followed this interview schedule, with sub-themes coded under these topics. However, during the analysis process the student remained cognisant of these pre- conceptions and employed techniques to allow a more emergent investigation to inductively

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develop a pattern of meaning in the data.(331) As introduced in section 5.5.3, an emergent ‘open coding’ process was applied to the data, allowing for the discovery of unexpected concepts in participants’ accounts so that the resulting themes were data driven rather than informed by theoretical assumptions.(403) Furthermore, by completing analysis alongside data collection, the identification of topics not fitting with the pre-conceived schedule allowed these topics to be added in subsequent interviews in an attempt to understand them in relation to the research questions. This ensured that further data was driven by the perspectives of the participants.(331) As the analysis progressed, and an inductive approach was applied, themes started to fit together under overarching themes related to women’s attitudes and beliefs. Data were recoded under these overarching themes and new sub- themes were identified.

5.6.3 Using the HELP intervention theory as an analytical lens

After initial coding of the interview transcripts had been completed, it was determined that using the HELP intervention theory, based on Control Theory and Social Cognitive Theory, would be useful as an analytical lens to organise some of the women’s accounts. Relevant concepts were mapped on to the theoretical mediators of change, namely social support, motivation, self-regulation and self-efficacy, and associated BCTs of monitoring and goal setting. Although this specifically evaluated the usefulness of the applied theory from the women’s perspectives, these concepts often overlapped with main themes interpreted from the data but did not emerge as strong sub-themes. Furthermore, the analysis used existing theory to organise the data, rather than the inductive approach taken to arrange themes. Therefore, this was conducted as a separate analysis and was not presented with the main themes. It was determined that this analysis would be best merged with the HELP trial process evaluation interview data. A matrix incorporating examples of women’s accounts mapped to theoretical concepts is presented in Appendix Q but will not be discussed within the scope of this thesis.

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