Session 5: Using Qualitative Methods to Adapt and Evaluate Evidence-based Interventions


Anna Napoles-Springer


To acquaint fellows with qualitative methods that can be used in conjunction with quantitative methods (mixed methods) to adapt and evaluate interventions.


After this session, fellows will be familiar with:
  1. The rationale for using qualitative methods in adapting evidence-based interventions
  2. Semi-structured interviews and how they can help in adapting and assessing interventions
  3. Cognitive pretests of self-reported structured process and outcomes measures
  4. How to develop a semi-structured interview guide

Key Terms

  • Qualitative research: involves collection of non-quantitative data and inductive approaches, which can answer certain types of questions more effectively than quantitative approaches.  Qualitative methods are important for understanding how and why certain outcomes of an intervention were achieved and any unintended consequences.  Qualitative research seeks to understand a research issue from the perspectives of the population it involves, making these approaches especially effective in obtaining culturally specific information about the beliefs, norms, behaviors, and social contexts affecting a particular health issue.  Qualitative research can also answer important questions about the relevance of interventions for specific populations.
  • Semi-structured interviews: use of open-ended questions and probing (follow-up questioning) to a respondent’s comments), which gives participants the opportunity to respond in their own words, rather than forcing, them to choose from structured response options. Open-ended questions can elicit responses that are meaningful and culturally salient to the participant, unanticipated by the researcher, and rich and explanatory in nature.  These interviews can be conducted individually or in a group (focus groups of 6-10 respondents).
  • Cognitive pretest interviews to assess intervention process and outcome measures: many process and outcomes measures consist of self-reported structured surveys of participants.  Cognitive interview methods utilize open-ended probes to test whether structured items are interpreted by respondents as intended by the survey developers.  They are useful for making decisions about items that may need to be dropped or revised for particular populations.


  • 09:00-09:15: Why and when are qualitative methods useful for informing adaptations of evidence-based (EB) interventions?
  • 09:15-09:30: What can qualitative studies tell us about how to adapt and assess EB interventions?
  • 09:30-10:15: Using semi-structured individual and focus group interviews to adapt, develop, and assess interventions.
  • 10:15-11:00: Exercise - applying qualitative methods to help adapt an EB intervention.
  • 11:00 -11:10: Break
  • 11:10-12:00: RSG


Teaching Materials

  • PowerPoint slides
  • Sample focus group interview guide
  • Sample demographic items for focus group participants
  • In-class exercises (2)

Supplemental Resources

  • Kruegar R.A., Casey M.A. (2002). Focus Groups: A Practical Guide for Applied Research, (3rd ed.). Thousand Oaks, CA: Sage Publications, Inc.


  • Fellows should review the Ward and Atkins guide to familiarize themselves with focus groups and pertinent issues in low-income populations.  Pay particularly close attention to tips for including community members and how to develop an introductory script and series of questions to be used by the facilitator during the focus group to describe the process, direct the conversation, and gather information from participants.

Summaries of Objectives

  1. Understand the rationale for using qualitative methods in adapting evidence-based interventions
    1. Using qualitative methods to refine the conceptual frameworks underlying interventions
    2. Advantages and disadvantages of using semi-structured interviews (individual and focus groups)
  2. Semi-structured interviews and how they can help in adapting and assessing interventions
    1. Using mixed methods to identify relevant themes and targeted constructs for an intervention
    2. Using mixed methods to identify logistical aspects of intervention delivery, e.g. mode, intensity, frequency
  3. Cognitive pretests of self-reported structured process and outcomes measures
    1. Purpose of cognitive interviews
    2. Steps involved in cognitive interview pretesting of self-reported survey measures
    3. Conducting cognitive probe interviews
  4. How to develop a semi-structured interview guide
    1. Developing appropriate research questions
    2. Identifying a sampling strategy
    3. Developing the interview guide

Assessment Data and Learner Feedback

  • We will conduct an in-class exercise in which fellows will develop research questions, a sampling strategy, and an interview guide to address a particular challenge in developing or adapting an intervention in a specific population. The instructor will provide specific feedback on the depth, content, and strategies employed.

Teaching Tips/FAQ

  • A particular challenge is convincing quantitative researchers of the merits and usefulness of qualitative research methods.  An effective solution is to present quantitative and qualitative methods as complementary and to present the advantages of mixed methods approaches. Conducting semi-structured individual and focus group interviews requires a certain level of expertise and resources. Reading the Ward and Atkins manual will provide fellows with a practical, detailed “how-to” manual that can be used to plan such a project including how to identify the necessary resources required.