From intimate to political voice: A case for illustrating generalizability of qualitative data

Though some narratives have the power to reveal universal existential issues and inform theoretical development, each story remains unique and cannot be generalized. If the goal of qualitative researchers is to have narrative knowledge effect social change in public health, we are faced with a pervasive problem. This paper’s main objective is to argue and illustrate that a Sequential-Consensual Qualitative Design (SCQD) can yield external validity in order to influence clinicians and public health programming. The qualitative research design we developed in our study had two purposes: 1) to help understand the experience and meaning that economically disadvantaged French-Canadian mothers attribute to their infant feeding choices (bottle vs. breast); 2) to use this understanding to formulate, with the input of the mothers, recommendations for public health policy, programming and guidelines for the promotion of breastfeeding. It is not the qualitative data itself that must have a direct impact on decision makers, but the insights they foster in relation to the public health problem under study. We conceived a research design that we called a (SCQD),that involved three distinct stages. Stages 1 and 2 were meant to produce data with strong credibility or internal validity, whereas Stage 3 aimed at strengthening external validity. Results from the three different stages will be presented to illustrate the process and heuristic approaches we used to encourage mothers (some being illiterate) to formulate complex ideas relating to policy and programming affecting them. This paper seeks to provide a methodological template for this type of qualitative design so that researchers can apply it to future projects to produce, transfer and translate popular knowledge from populations living in poverty, in a way that takes into consideration cultural context and influence social change in the areas of health policy and public health programming.