Data analysis

The question is, “What facilitated the change in drinking behaviour in the Ceres study?” From the quantitative data analysis it is evident that there is a statistically significant difference between the post intervention alcohol use disorders identification test (AUDIT) scores of the control group and the intervention group. The intervention effect between the control group and the intervention group shows that the intervention definitely contributed to the change in drinking behaviour that was observed within the intervention group. By comparing quantitative data from the profiles of the intervention group and the control group, one would be able to establish who, in terms of various profile variables from the intervention group, changed more probably because of the intervention and who would most probably have changed after the brief first intervention that both groups received.

In the follow-up sessions with the intervention group, although perhaps quite infrequent and with too much time elapsed between interviews, I became aware of the complex nature of behaviour change and the influence of the therapeutic alliance, interactive relationships and interplay of personal, contextual and situational variables contained in the intervention process. The information, simple advice, brief counselling, and supportive interest were new and strange to the pregnant women. Most of them were from deprived circumstances, did not plan their pregnancies and received very little support from their partners and families. All these factors influencing behaviour change could not be captured by only comparing the quantitative results of the control group and the intervention group.

Additional data was collected during follow-up interviews. This data included field notes, programme notes and open-ended questions contained in the Alcohol Record

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Questionnaires (ARQ) used in the first follow-up interview (only done with the intervention group). I abstracted questions 9(a) and 9(b) of the first follow-up ARQ from the Excel database and created a new document containing answers from respondents on these questions: 9(a) “what were the main stumbling blocks to your self-help plan?” and 9(b) “what were the main factors that helped you?” Following this, I noticed that general comments written down on the first ARQ provided more qualitative information related to the research question. I then made another abstract from the Excel database on “general comments”. Once quantitative results became available, I realised that an analysis of the change that took place in the intervention group would provide better answers to the research question. I then decided to combine quantitative and qualitative data and to include question 2 of the ARQ “has your drinking pattern changed in any way since our last meeting?” and to compare this together with data derived from the Personal Assessment Questionnaire (PAQ) within the change and no-change groups in the intervention arm of the study. To be able to compare the two groups in the intervention group further, I derived “readiness for change” data from the AUDIT measured in the first and last interviews. These documents formed the basis of the data analysis on how pregnant women changed their drinking behaviour during the Ceres Intervention Study. I used the Atlas.ti qualitative data analysis computer programme to store, manage and present the qualitative data.

Miles and Huberman (cited in Ryan & Bernard, 2000:781) note that “coding is analysis” in qualitative research and often involves reading through a manuscript for „first impressions‟. In subsequent readings, the qualitative researcher attempts to develop concepts and codes on a higher level of abstraction. According to them it does not matter how the researcher actually does inductive coding, by the time the themes are identified and refined to the point where they can be applied to an entire section of text, a great deal of interpretative analysis has already been done Therefore, the process of coding is comparative to the process of analysis. By reading and re-reading the text, dominant themes started to emerge, based on the research question how pregnant women were able to change their drinking behaviour during the process of an intervention.

For the purpose of this study, I read the transcripts several times before manually coding the data with a pencil. I did this against the background of the literature study I have undertaken as part of this thesis. I started with some general themes derived from reading the literature, added more themes and sub-themes and merged some

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of the themes as suggested by Willms, et al, (1990) and Miles and Huberman (1994) (cited in Ryan & Bernard, 2000:783).

The following steps were followed to identify themes:

First, themes and quotations were selected by manually underlining the text in the hard copy. Then, on the computer, the manually selected quotes were colour coded according to themes (a different colour was used for each theme with the name of the theme in brackets). Following this, the different selected and colour-coded quotations were copied into a document for selected code categories. Again a printout was made and each selected quote was manually coded within the different themes trying to stay as close to the text as possible. This was again transferred to the computer where codes and comments were inserted using the “insert comment” function. I did this preliminary analysis to provide me with some clues as to what to look for in the data. By doing this, I discovered the relation between risk and protective factors and change mechanisms started to emerge from the data. I also realised that in order to clarify the question further, it was necessary to record the contents and implementation methods of the intervention programme as this was not done before.

The next step was to open a new hermeneutic unit in Atlas.ti and the four primary documents (field notes, programme notes, general comments and ARQ 9a and 9b, described above) captured in MS Word were loaded into Atlas.ti. Using the research questions as well as the marked hard copies as guidelines, the relevant pieces of text were then selected and coded while writing memos and comments that could be used later on in the data analysis process. The data was repeatedly scanned and quotations were altered as the process became more tailored. Categories were grouped into “families”, hypertext links were made and links between text/or codes were developed and displayed in “family networks”. The qualitative data analysis process was used to gain more insight into the complex nature of the process of behaviour change as quantitative data did not provide sufficient information on the process of change that took place.

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