Public health is the promotion of health at a community level by the government. It includes prevention of disease through supplying clean water, proper waste disposal, and legislation for clean air, health education programs, and medical care for the whole community through doctors, nurses, and hospitals. Government acceptance of responsibility for public health began in the UK with the Public Health Act in 1848. Now, the welfare state, National Health Service, and health education and protection measures are a government responsibility. The department’s approach is to create an environment where people are encouraged and supported to adopt healthy lifestyles. This may be done by providing clear information to enable people to make their own decisions about choices that impact on their health, offering tailored support, personalised services and equal access, and by partnership working across communities even the Prisoners Health in UK.
However, in order to determine the healthcare needs of the people in the prisoners in Britain, it is important to conduct studies which are reliable and credible and generate knowledge which are useful. In doing research, one of the most important things to consider is to determine which methodologies to use. Primarily, the main goal of this paper is to compare two different research approaches and determine the strengths and advantages of these methods for generating knowledge for public health practice, in this case, generating knowledge to identify the needs of the prisoners of Britain.
Public Health practice is the context of knowing, identifying, and providing the needs for helping people change their lifestyle to move toward a state of optimal health. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of efforts to enhance awareness, change behavior, and create environments that support good health practices of the general public. Furthermore, a public health practice consists of development of lifestyle habits which healthy individuals and communities can adopt to maintain and enhance the state of well- being.
After such definition and understanding what have been the purpose of public health practice, it is now time to analyse the development of public health practice theoretically. Researches indicates that public health practice can help to improve health, reduce disease risks, manage chronic illnesses, and improve the well-being and self-sufficiency of individuals, families, organisations, and communities such as the prisoners in Britain. But not all public health practice programs and initiatives are equally successful. The programs that are most likely to succeed are based on a clear understanding of the targeted health behaviors and their environmental context which can be achieved through the conduction of research studies and investigations.
In addition, public health practice will succeed most when problems are analysed and programs are planned, keeping in mind the various levels of influence the ecological perspective comprises. In public health practice, it is a major challenge to determine new prevention, early detection, and treatment methods and to increase the use of programs and curricula that have been found to be successful. Sometimes, purchase decisions, or "adoption" decisions, are made on behalf of large organisations or communities. This happens when a school system adopts a curriculum, a teacher adopts a course textbook, a worksite health manager contracts for screening services, and a city council decides to acquire recycling bins. The challenge of diffusion requires approaches that differ from those focused solely on individuals or small groups. It involves paying attention to the innovation (a new idea, product, practice, or technology) as well as to communication channels and social systems (networks with members, norms, and social structures).
This enters the use of research methods and approaches in generating knowledge for public health practice. Traditionally, research in the field of public health practice has generated knowledge in order to determine ways on how to solve healthcare issues. However, the reductionistic framework of the cause of specific diseases cannot sufficiently describe the complex mechanisms which impacts health behavior. Two of the commonly used research methods in generating knowledge are the qualitative and quantitative approach.
The Quantitative research utilises approaches which are adopted from the physical sciences which are usually designed to guarantee generalisability, objectivity, as well as reliability of the research conducted. These approaches include the manners in which the respondents are chosen randomly from the entire population of the study in an unbiased ways. Herein, the standardised interview questionnaire or intervention that the respondents receive and the statistical methods utilise to test predetermined hypotheses about the relationships between relevant variables. The one who conducts the research is considered an external entity to the actual research, and results of the research are noted to be replicable no matter who do the study (Morris, 1999).
Through the use of qualitative and quantitative approach to public health practice people will be able to be careful in defining what they want to achieve with whom, when and where. The activities may be oriented to individual and collective well-being as outlined by whose definition of health. In an ideal public health practice, healthcare sectors may use both qualitative and quantitative information to give more complete details of the public health issue being addressed, the people involved, and the efficacy of the public health practice itself.
Qualitative and quantitative approach encompasses many strength and weaknesses. The greatest weakness of the quantitative approach is that it de-contextualises human behavior in a way that removes the event from its real world setting and ignores the effects of variables that have not been included in the model. And the disadvantage of qualitative approach is that data collection and analysis may be labor intensive and time-consuming (Creswell, 1994; Saunders et al, 2003) In addition, these methods are not yet totally accepted by the mainstream public health community and qualitative researchers may find their results challenged as invalid by those outside the field of social marketing. Through proper use and by merging these two approaches, public health practice may be successful However, if the use of these two are not being utilise this may lead to the intervention of the success of public health practice which may affect not only the theories to be applied but also the practice that the professional health workers. And worse, this may hinder all authorities to have the chance to learn and apply what is really needed for the promotion of health.
In conclusion the literature portrays that a mixture of process and outcome information are used to evaluate all public health practice initiatives, and policy makers should support the use of multiple methods to evaluate public health practice activities. The application of qualitative method in evaluation of public health practice activities derives interactive knowledge from lived experience. Qualitative evaluation is constructionist, naturalistic and ethnographic which emerges meaning and interpretations of events provided by individuals. Its theoretical bases are phenomenology, symbolic interactions and grounded theory that evolve understanding the connections among human beings using truth criteria of credibility, dependability, conformability and transferability (Lincoln and Guba, 1985). Working in the field emerges the designs of qualitative evaluation: ethnography approach, Participant-Observation, Observations-non-participants, collecting data, Interviewing-conversational, Narratives-story-telling-transcripts, Constructivism orientation, documentation and analysing and interpreting data. The qualitative evaluator is to try to find meaning and understanding of the phenomena. Finding themes, patterns, concepts, Insights, and comparisons in the data collected (Patton, 1990).
Public health practice comprises a wide-range of health care activities such as community development, social phenomena, biomedical-epidemiological, cultural history, psychological, political and ideological issues and problems. According to Patton (1990) “clarifying the purpose of study will determine what evaluation approaches are appropriate to apply. Qualitative methods are compatible in many fields of disciplines in particular all areas mention above. It can be thought what these disciplines issues or problems all have in common. Key word is people. No representative for the people is contrary to common rights. The burden of the people especially in poverty means nothing they can call their own. A qualitative methods or approach may encourage new creative programs and gives the people the chances to voice their opinions or perspectives. Key concept is effective programs or services to meet the needs of the People. Public health practice interventions of activities should produce the happiest consequences (Polgar & Thomas, 1995).
In combining or integrating methodologies warn outcomes maybe different when using different methods. The qualitative methods from the field of ethnography have been criticised for having insufficient well-define designs and methods (Neuman, 2000). Milbun et. al. (1995) on the contrary, warns that the use of mixed methods may produce contradictory results. I notice in reading about the subject qualitative labels appear to attach different labels to what are essentially comparable evaluation methods and this lack of consensus can be confusing (Neuman, 2000).
Therefore, it is wise and good for stakeholders, promoters, and professionals to listen to the people and work together to eliminate maladministration, oppression, injustice, and inequality.
Also, public health practices are very important to each and every one of us. It muse be noted that the success of such promotions of public health practices, specifically in the Health of Prisoners in Britain lies on how it has been disseminated and how it has been implemented. Furthermore, it is better to give opportunity to authorities who promote health to learn many methods and approach in order to reach the ultimate goal of generating knowledge health to every individual. It is important to foster and develop evaluation designs which combine the advantages of different research methodologies, quantitative with qualitative, in ways which are relevant to the stage of development of a program. The use of a diverse range of data and information sources will generally provide more illuminating, relevant, and sensitive evidence of effects that will be helpful in public health practices.
In comparison to quantitative research, which measures frequency, quantity and distribution within the population, interpretative approaches like symbolic interactions, phenomenology and ethnography refers to the qualitative approach of research. This approach tries to comprehend the nature of social reality by means of the respondents’ narrated accounts of concepts and principles constructed subjectively. Strauss and Corbin (1990) noted that the qualitative research is an approach which generates findings by means rather than quantifiable statistical procedures.
This means that qualitative approach produces verbal data instead of numerical ones (Polgar and Thomas, 1995; Knafl and Howard, 1984) as well as reveals an epistemology where phenomena are made up of socially-defined and multiple realities (McMurray, 1994, p. 18). The concept of qualitative approach presumes that the complexity of a phenomenon needs the researcher’s utilising methods, which will bring them nearer to information sources, interrogating data, interacting with participants, checking out hunches and following-up leads. These data are commonly produced in naturalistic settings. The researcher on the other hand, should prevent the manipulation of the events, actions and situations that will be encountered during the process.
Qualitative method shares the theoretical suppositions of the interpretative paradigm. This is based on the notion that the creation and persistence of social reality are brought about by the people’s subjective experience (Morgan, 1980). Accordingly, qualitative approach basically aims to decode, explain, analyse and interpret the meaning of a certain occurrence in an accurate manner (Fryer, 1991). The researchers give emphasis on the use of the models of the interpretative model which lies on the complexity, authenticity as well as contextualisation and the mutual subjectivity of the conductor of the research and participants including illusion reduction.
Several researchers had stated that generally, qualitative research takes place within a natural setting (Marshall and Rossman, 1989; Lincoln and Guba, 1985; Densin, 1971). It is less likely for qualitative research to impose restriction on data collection. Furthermore, it is more focused on idiographic descriptions and emergent themes rather than on categorical frameworks and very specific hypothesis (Cassell & Symon, 1994).
Fundamentally, qualitative method has three distinct characteristics. One is that it applies symbolic discourse composed of discussion, conversations and texts. Secondly, qualitative method involves the study of interpretative principles, which people utilise to make their symbolic activities sensible. Lastly, qualitative method of research requires the knowledge of contextual principles, including the physical setting, roles of the respondents and the set of situational events which guide the interpretation of the discussion (Ting-Toomey, 1984).
The quantitative mode of research is based on the supposition that reality possesses an objective ontological structure, with the individuals as the responding agents of this objective surrounding (Morgan & Smircich, 1980). The assumption behind this paradigm is that an objective truth exists in the world, which can be explained and measured scientifically. The main intention of the quantitative approach is that the measurement used are valid, credible, pertinent, and reliable (Cassell and Symon, 1994).
The value of qualitative research can best be understood by examining its features. Qualitative research is advantageous as it is more open to adjustment and refinement of research ideas as an inquiry proceeds. Also, the researchers do not attempt to influence the research setting, as in an experimental study, but rather seeks to understand naturally happening phenomena in their naturally occurring states. Inductive reasoning, as opposed to deductive reasoning, is common in qualitative research, along with content or holistic analysis in place of statistical analysis (Tucker et al, 1995).
Miles and Huberman (1984) believe that the data of qualitative research are particularly attractive because they provide: well-grounded, rich descriptions and explanations; preservations of time flows, chronologies, causality; serendipitous findings for new theory construction; and a quality of "undeniability". The qualitative type of research is primarily inductive in logical reasoning (McMillan and Schumacher, 1997).
It can be noted that one of the most evident strengths of the qualitative method is that is suggests a more realistic feeling of the setting of the study which cannot be acquired solely from numerical data and statistical analysis in quantitative approach. This type of approach permits flexibility in accomplishing data gathering, data analysis, and interpretation of collated date information. According to various authors (Patton, 1980; Bogdan and Taylor, 1975), qualitative method permits the researcher to present and show the phenomenon being analysed in a more holistic manner. Also, this method enables the social interaction with the research participants using their own language and terms (Kirk and Miller, 1986). In addition, it enhanced descriptive capability using unstructured and primary data.
Alternatively, quantitative approach enables researcher to avoid biasness in collecting and presenting research information and details. In this regard, the quantitative approach generates epistemological assumption that reality is unitary and objective in nature, which can only be known through a manger of transcending the perspective or perception of each individual. This phenomenon in turn must be thoroughly explained or discusses through the analysis of the data collated through objective types of instruments and measurement. According to Leininger (1985), the quantitative strategy of generating knowledge is essential, when a study needs to measure the causation and effect relationships which are noticeable between pre-selected and discrete variables. Herein, the main goal of quantitative approach is to reveal subjectivity through the analysis of information which characterises the experience being studied (Munhall, 2001, p. 73).
Various researchers have noted the advantages of using the quantitative approach in research. According to Frankfort-Nachmias & Nachmias (1992), quantitative methods has the ability to establish very precise research problem and issues. The, mass surveys, controlled observations, laboratory experiments and other manners of manipulation of research in qualitative method makes collected data more reliable and credible(Balsey, 1970). Subjectivity of judgment, which is unnecessary, specifically in generating knowledge for public health practice, can be prevented through quantitative methods (Kealey and Protheroe, 1996). Hence, discussion, conclusion, and experimentation involved in the research are more objective. The dependent and independent variables which are essential are precisely and clearly considered in a quantitative study. Furthermore, quantitative approach enables longitudinal measures of successive performance of the participants.
The use of qualitative research, which produces data that are subjective and contextual in nature, may affect the researcher’s intention to generalise the findings. Hence, with qualitative methods, results may be applicable to one context or situation while it may not be for others. Overcoming this disadvantage requires data gathering from various contexts, which in turn takes substantial effort and time. Thus, researchers that are under pressure to accomplish a qualitative study may not be a feasible research paradigm (Tucker et al, 1995).
There are other reasons that make qualitative method disadvantageous. For instance, using qualitative method increases the tendency to depart from the original objectives of the study due to the changing nature of the context (Cassell and Symon, 1994). Although similar information were gathered, the conclusion and outcome of the research tends to be subjective based on the personal character of the researcher. This method renders the researcher unable to study causality between various research phenomena. Explaining the distinction between quality and quantity of the gathered information from various respondents is often difficult with qualitative method and has the tendency to arrive at non-consistent conclusions. The researcher must have substantial experience and background in applying the qualitative method so as to acquire the needed data from the respondent. Outcome of the research also lacks reliability and consistency as the researcher can use various probing techniques while the respondents may choose to be selective in giving out information (Matveev, 2002).
According to Matveev (2002), quantitative method may be disadvantageous when the researcher is unable to acquire information about the context of the situation where the phenomenon being studied took place. The quantitative method also reduces the control the researchers have over the environment, particularly in cases where respondents are to provide answers in response to the survey questions. The outline of the whole research restricts the findings or results of the study due to its structured format and closed-type questions. Moreover, quantitative method does not encourage continuous investigation and research evolution of the phenomenon.
According to Whipp (1998), the limitations of qualitative approach are partly attributable to the researcher’s standpoint, as the restrictions could just as easily be seen as the innate strong point of the method. For instance, if a study is conducted using quantitative research only, the study would not have identified the social processes evident in the relations being analysed. On the other hand, the nature of the qualitative approach makes it prohibitively expensive to include a large number of respondents. As the number of participants interviewed or questioned using qualitative approaches rarely goes beyond 30, the researcher cannot be confident the research findings are representative. Using the quantitative approach alone has limitations as well. Presenting numerical data may be objective; however, this may not be enough to support the research findings. In some cases, subjective data that can be obtained from qualitative approach is necessary to elaborate on the values gathered in the process.
The use of research methods have been applied in various fields of studies. Specifically, qualitative and quantitative research methods have been part of numerous studies that led to several theories, concepts and principles that people apply at present.. There is a plethora of methodologies available to researchers in order to conduct a particular study, in this case, generating knowledge for public health practices in the prisoners of Britain. The wide array of research approaches and design is beneficial to the researchers as these allow them to apply specific methods that are appropriate for their available resources and research objectives. In most cases, research approaches and designs are used individually when conducting the research. However, all designs and approaches have their own limitations, which could significantly affect the research findings. Hence, in order to resolve this problem, a combination of various research design and approaches may be necessary.
In addition to the reduction of their respective limitations, the combined research design enables the researcher to present the study containing both subjective and objective data. The combination of the qualitative and quantitative research approach will facilitate the identification of different knowledge regarding the healthcare needs of the prisoners in Britain based on numerical data and respondents’ claims. Thus, selecting the appropriate research methods for the study is significant. This is in order for the researcher to maximise the use and purpose of each method employed.
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