Semi-Structured Interviews

King (2004, p. 11) identifies the goal of any qualitative research interview as seeing the research topic “…from the perspective of the interviewee, and to understand how and why they come to have this particular perspective.” Fontana and Frey (2000) propose that structured interviews capture precise data while semi-structured interviews place greater emphasis on understanding the complexities of behaviour and realities of members of society without imposing any categorisation.

Six semi-structured interviews were conducted at the conclusion of the nine-month observation period15. The purpose for conducting interviews was two-fold. Firstly, it provided opportunity to validate perceptions and understandings I had formed during the nine-month period when I attended meetings and observed the range of activities which contributed to the planning process. The second reason for conducting interviews was to gain increased understanding of the emerging determinants for community participation in this unique Horowhenua context. To obtain the best representative sample I interviewed

14 _{Refer to Appendix C for template used for this record.} 15 _{See Appendix D for details of personnel interviewed.}

three members of the Steering Committee; a community representative, an iwi representative and a GP representative. The three stakeholders’ groups external to the Steering Committee which were central to the planning process were the Community and Public Health Advisory Committee, the DHB Funding Division and the DHB Primary Health Care Reference Group. I therefore asked one representative from each of these groups. This made the total of six people interviewed.

At the time of the initial approach to prospective interview participants I provided a verbal overview of the research and an indication of the amount of time the interview would take. All interviews took place at a setting of the participant’s choice. Prior to commencing the interview sufficient time was given to the participant to read the Information Sheet and have any questions answered16. They received a copy of the prepared interview questions. However, they also understood that these were a guide only, and that there were likely to be further questions based on matters raised during the interview17_{. A Consent Form was} signed and all participants agreed to the interview being tape recorded. At the conclusion of the interview they understood that I would be transcribing the tape and that they would receive either an electronic or a hard copy of the transcript (their preference) to which they could make alterations before I used it for analysis.

4.9 ANALYSIS

For a nine-month period, from 22 August 2003 to 21 June 2004 primary and secondary data were gathered from a range of sources. The central unit for analysis was the Horowhenua PHO Steering Committee. Closely associated with this Committee’s activities were the Funding Division of the MidCentral DHB and the Reference Group. The Horowhenua District Council Health and Transport Subcommittee influenced process but more indirectly. In addition to obtaining data from minutes and/or observations from these committees, data were also sourced from public meetings, media reports, the Ministry of Health Web-site and publications and MidCentral DHB publications. It is acknowledged

16 _{See Appendix B for Consent Form and Information Sheet.} 17 _{See Appendix E for semi-structured interview questions.}

that the approach to this research was not to investigate or evaluate the extent to which the community was engaged in the planning of how best to prepare for PHO establishment. Members of the Health Services Review Committee determined that the process for PHO establishment be the formation of a Steering Committee to complete all preparations. This committee also determined the constituency representation of the Steering Committee – that is, the number of GP, Practice Nurse, pharmacy, iwi and community representatives to be appointed onto the committee. The community representatives on the Health Services Review Committee opted to select the community representatives and this was agreed by the Committee. This research did not include as one of its objectives evaluation of the merits of these community representatives’ decision. I did not approach the community-at- large or health professionals working in the region. I was assured – based on the perspectives provided by all the Steering Committee Members (community representatives included) and information received from the public during the information sharing day (February 2004) and from health professionals at their information evening (January 2004) – that the community had minimal knowledge of the primary health care strategy and its implementation and minimal interest in participation in the PHO establishment planning. The decision made by the community to manage the establishment process in this way was not influenced by external stakeholders – for example, the Funding Division.

Early in the data collection phase themes began to emerge. As a preliminary step in collation, the data were coded using this initial choice of themes. This process was not intended to set in place a firm approach to analysis but rather to begin to provide some structure upon which to establish an approach to the analysis. Over the data collection period the number of themes increased. At its conclusion seven themes were identified:

1. Nature of relationships 2. Volunteer role

3. Constituency representation 4. Resources

5. Knowledge and information 6. Autonomy versus control

It became apparent that several common elements were emerging which crossed a number of the seven themes. Ensuring I did not lose any of these elements, the final themes arrived at were:

¾ The origins of the Horowhenua PHO Steering Committee,

¾ Relationships Steering Committee members had with each other, their community and stakeholders,

¾ The Steering Committee members’ experience of participating in this PHO development, and,

¾ Steering Committee and stakeholder perceptions of community readiness to participate.

Table 4.4 Realignment of Themes

Refined theme Original Theme

The origins of the Horowhenua PHO Steering Committee

¾ Constituency representation Relationships Steering Committee members

had with each other, their community and stakeholders

¾ Nature of relationships

¾ Impact / influence of other supporting infrastructures in the community

The Steering Committee members’ experience of participating in this PHO development

¾ Volunteer role ¾ Resources

¾ Knowledge and information Steering Committee and stakeholder

perceptions of community readiness to participate

¾ Autonomy versus control

These refined themes provided the framework for in-depth analysis.