Next stop: Analysis.

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The very confusing process of analysis

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Analysis of qualitative data is a process. A very… very… long process. Luckily I am taking a course through my masters program which will structure that process and keep me on track to produce a report or paper or whatever I end up deciding on. I had my first class today and I am very excited. Most of the other people in the class have much larger data sets that are much more grounded in the perspectives and beliefs of the participants. Or it is part of a larger project with tons of funding and actual faculty PIs backing it. There is no one else with quite the same type of formative research. However, I do feel like I am a bit ahead of the game in some respects. Many of the people in the class are doing secondary analysis of a preexisting dataset. That means that they did not participate in the data collection and are not entirely familiar with the dataset. I conducted all my own interviews and although I did not do the transcription (clearly the best way to get to know your data), I did review the transcripts and have done preliminary data analysis for the dissemination phase of my project. All in all I feel in good shape to begin this phase of my research.

Dissemination continues

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After a two week hiatus in which I did nothing but study for my comprehensive masters exams, I got right back in the swing of things working on dissemination. I presented my research findings to the NC Agromedicine Institute this week and it went very well. I was a little nervous since this was a different crowd than my presentation to NC Farmworker Heath Program. The staff there are advocates and were very interested in the working conditions and possible legal violations on the part of the owners.

The NC Agromedicine Institute’s meeting, however, was full of people from the Farm Bureau, epidemiologists, and logging industry representatives. They were much more interested in the long term trends of the seafood processing industry, which I didn’t have that much information on. However, there were lots of great questions and I got a ton of feedback.

I also finally scheduled my meeting with the NCFHP bosses to discuss recommendations and how to use my results to advocate on behalf of seafood workers. One of the staff members mentioned that perhaps I could travel out to Greene county to give a presentation to clinic staff out there so they could be more aware of this population. I’m excited to meet on the 29th to discuss this possibility further! In the mean time, school starts next week and I will begin data analysis.

Dissemination

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I am now in the process of making the rounds, trying to raise awareness about aquaculture workers’ issues in North Carolina (I’m switching to refer to them as aquaculture rather than crab workers because I had the pleasure of interviewing a couple oyster workers in Elizabeth City).

Creating a presentation on my work really forced me to think through my main findings. Of course I’m not going to be able to really do any analysis on the text of the transcripts until next semester when I take an advanced qualitative methods course. But I think it’s been good to try to start wrapping my head around my findings already.

My results fall in to a couple different categories:

- Participant demographics: One of the main questions North Carolina Farmworker Health Program (NCFHP) wanted me to answer was Who are these people? Since so little information existed out there on NC aquaculture workers, step one was getting a kind of demographic sketch up.

- Living and working conditions: Another question NCFHP wanted answered was Where do these people live and what does their life in the US look like? In my project I really didn’t want to approach the interviews with the idea already in my mind that these workers were being mistreated. These workers come to NC year after year and spend long periods of time away from their families because it’s worth it to them. I was more interested in getting their perspective on their lives in the US rather than checking off possible housing violations.

- Health concerns: In order to begin thinking about extending medical services to this population, we have to first know What are the major health problems? I looked at conditions both related and unrelated to their work in the processing plants and I explored with them how they cured and solved their different health problems.

- Barriers to clinical care: Participants walked me through all of their experiences with the NC healthcare system, including times when they had wanted to attempted to get care and could not. From these stories, I was able to tease out the answer to the question What are workers’ main obstacles to accessing clinical care?

I presented to the staff of NCFHP last week and I was overwhelmed with how well it went. The staff members were very interested in engaged, asking tons of questions and we began brainstorming possible reasons why workers didn’t seek care in some situations and solutions. I ended up presenting for more than an hour and got some great feedback on my initial results. Moving forward, I will be presenting to an NC legal aid group and NC Agromedicine Institute in the next couple weeks. I also wrote an article about my work for the NC Agromedicine newsletter and will be meeting with NCFHP staff to speak more in depth about recommendations for their organization based on my results.

Data Collection: DONE!

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The day has come. Data collection is done. No more driving 6 hours in one day to the coast and back.

In the past two weeks I went to the coast twice to two different camps, the one in Aurora that I have been visiting and a new one in Elizabeth City, NC. That’s over 700 miles of driving in just a couple days! It was great to visit a new camp and I was surprised by how different the social and work life was.  The Elizabeth City camp was located much closer to a town, they had the chance to go to church, participate in soccer teams and there was a Latino Center close to them that could help them through any problem.  Their employer also provided them much more transportation since the distances were not huge. In contrast, workers in a plant like Aurora, which is much more isolated, have little to no access. I’m excited to start working through the analysis of these themes next semester.

On the other hand, visiting a new plant in Elizabeth City reminded me of how far I’ve come in creating a relationship with the workers in Aurora. In my last trip to Aurora, workers greeted me with hugs, invited me in to their rooms to catch me up on the latest work they’ve been doing and gave me bags of cucumbers to take home. I visited the plant in Elizabeth City with a Latino Outreach worker that is well known in the community, but I did not have the time to introduce myself and sit chatting with them like I could in Aurora. I could tell the difference in the interviews. Participants were not as open with me, they tended to give closed or short responses rather than a narration of their lives and experiences. It showed me how important laying the ground work of relationships is for conducting qualitative interviews.

Stranger in a strange land

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The long road to Aurora, NC

Today I realized the importance of a bridge person in conducting the interviews. I’m pretty disappointed to drive three hours out to the coast and three hours back and only get one interview done. The first problem is that I arrived too early. Now that the women have regular work they have less time to hang out and speak with me. I arrived and no one was there. I waited at the Dollar General for an hour and came back at 5pm just when they first women were walking back from the plant.

I tried to introduce the project and myself but they were obviously really tired and not very interested. I got let in to the dorm by one woman then sat in the comodor and introduced myself to a couple women. It was awkward because I felt like I was intruding in their space and everyone who passed was clearly confused to see a strange white girl hanging out in their home. Finally I saw two women who had I met when visiting the camp with the doctor, one that I had interviewed before and one I had not. The older women who I had not interviewed yet greeted me warmly and although I’m sure she was just as tired and hungry as the rest after waking up at 5am to work all day, she agreed to do the interview and we wernt outside. After I turned off the tape we continued chatting and she mentioned that she was there with her two daughters. She agreed that maybe she was less depressed or lonely than some of the other women because she has them with her but she said many of them had come so often and they come from the same place in Mexico that they are like a family. I believe that she feels this way but I think there are some women that do not feel as if they are part of a family, possibly the newer ones or ones without may friends.

So far this had been my most interesting finding and it is definitely something I am looking to explore in the next interviews. How is life different for the workers who don’t have friends or family in the area and who don’t know any of the other workers from years past? How is their mental state different? How does it change their access to health services? How to the workers without this social capital navigate the complex and confusing US healthcare system? Can they turn to the more experienced workers for help? The challenge will be identifying those women with less social capital so I can speak with them as well. From what I have heard from others, they are more withdrawn, less likely to be hanging out and chatting in common areas and therefore it’s less likely that I will meet them in order to be able to introduce myself and the project. I will also work harder to come on the weekends when the women are not as exhausted from working and arrive with bridge contacts, such as the church outreach worker, the doctor who runs the mobile clinic, or the ECU professor I have been in contact with.

Diving in

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Sign at crab worker housing in Grantsboro warning that visitors are not allowed

In the past couple weeks I finally got to visit the coast. After so much preparation it felt monumental to finally get out and meet the workers that I had been writing and talk about for months. I went out with a doctor who runs a mobile clinic for workers in the Pamlico/Jones County area. He has a previous relationship with them and I felt that it would give me more credibility with the community if he introduced me.

The visit was very productive, especially since I had no idea what to expect. My first visit I wanted to introduce myself and my project and just chat with the workers rather than trying to jump in and start the interviews. I felt that if they knew me a little first, then they would be more willing to speak with me and open up. So while the doctor saw patients inside the mobile clinic van, I helped workers fill out forms and just chatted with them about their lives and their work on the coast.

 

It’s been almost a year since I have spoken Spanish on a daily basis, and at first I was concerned that I would be a bit rusty. But that was not the case at all. All the workers are Mexican and their accent is easy to understand. I laughed and joked with them and in general had a great time hanging out for a couple hours. At the moment there is not much crab and so they are not working much. Many seem bored and antsy. I think this could help my project since they will be looking for anything to pass the time with.

I made some good contacts as well. While I was there I met a woman from the Health Department who is also a church outreach worker. I spoke to her about my project and she said she would make an announcement during the church services she performs at the camp. I also spoke at great length with the man “in charge” of the workers. While he could not be considered a “foreman,” he a Latino man who serves as the workers’ connection to the boss. Both of these people will be critical in recruiting participants for interviews.

 

Navigating the IRB process

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Navigating the IRB approval process is a notoriously challenging process. Months ago my academic advisor suggested that I start early and submit my application in March. She told me that, although it is difficult, the process would really help me think through the nitty gritty logistics of my project. However, I was a bit overwhelmed with the thought of writing a submitting an IRB application on my own for the first time. I have been involved in the IRB process with other, larger projects I have worked on and they seemed gargantuan undertakings. So I put it off, put it on the back burner, anything to try not to think about it.

In the end though, there was no avoiding it. Although the Bryan Fellowship does not specifically require that you get IRB approval, one of my other grants did. So I did what I always do when I’m unsure of myself. I ended emailing anyone and everyone who would talk to me and asking for their advice. I met with my advisor, a professor from the Epi department, and Duke professor, a lawyer on the coast, and had very long phone conversations with a delightful woman from the IRB office. I was amazed by how professors and professionals who were not in my department and did not know me were willing to take time out of their day to speak with me and take an interest in my project.

In the end I completed my IRB application and my advisor was right, it really did help me think through exactly what my plan was. But in the end I also did not submit a regular IRB application. Although the woman in the IRB office assured me that my project would probably fall under expedited review, I was terrified that they would have some issue with the interview guide or the recruitment script and that I would need to revise and resubmit. I was worried that this would push back my project timeline, which is already pretty tight. Another one of my professors let me know that, as a student, I could apply for an IRB waiver. Since the project I am working on is for educational purposes (I’m getting credit for my practicum) and it is for internal use only (NCFHP is going to use it for program development), I could get exempted from IRB approval. I went this route because I was afraid of timing issues, but it presents other complications. Since I was exempted from IRB approval, what I’m working on technically is not “research” and I have to be very careful not to portray it that way. As part of my fellowship, I would like to meet with North Carolina farmworker organizations and raise awareness about farmworkers, however I’m not going to have “findings” per say. I’m still happy with the route I went, but all the different options have pros and cons. I would suggest that anyone facing this decision in the future weigh these pros and cons carefully.

 

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