Chapter 11: Survey DataOverview: Identify the different types of questions used in survey researchBe aware of the many threats to validity inherent to the survey research processIdentify how the sampling strategy should be represented in the resulting dataIdentify factors to reduce sample attritionList benefits and weakness of each type of survey medium
Why SurveySurvey research is primarily used to gather data From either participants in a systemOr consumers of a program / policy (citizens) Could be consumers of a productThat either do not exist or are available in another form
General Surveying RulesAvoid Value-Laden Questions“How should the City of Ventura best control & monitor lawn watering”? Answers are three various policiesNo Double-Barreled Questions“Do you agree with the following statement: The Thousand Oaks Police Department Officers are both well trained and well equipped”. Yes/NO Watch Out for Loaded Language“How often in one week do you use illegal drugs”? Avoid Jargon“Given existing legislation which fish and invertebrate barrier mechanisms do you believe is most useful to reduce the spread of Dreissena polymorpha in existing finfish onshore aquaculture sites”?
Types of Data Typically Collected by SurveyIndicator VariablesDemographic, geographic, organizational affiliation Open-ended QuestionsNo structure on the answer “Why does…”Likert-type QuestionsProvide a statementAsk for their agreement or disagreement on scale 1-51 = strongly agree2 = agree3 = neutral4 = disagree5 = strongly disagree
More Types of Data Typically Collected by SurveyGrouped Data Questions (categories are provided)Example, when asking income or age$15,000 – 30,000 / 18-25 years old$30,000 – 45,000 / 26 - 40Single and Multiple Response Questions“Check a box”“Mark all that apply” Continuous Data QuestionsBest, most versatile, kind of data to haveUsually hard to collect with a survey (age is easy example)
Techniques for Data Collection Using SurveysEmbedded experimentsEmbedding “tests” within your surveyValidity and Bias Tests You can increase validity by:Using established questions Use multiple measure of your “construct” (internal validity)Beta-test the question
Important Issues to Consider When Employing SurveysQuestion Location“Hard” questions later in the surveySurvey MediumsIn-person: very time consuming Telephone: once the standard, still done, less so Mail: expensive Electronic: becoming more and more common IncentivesGift cards “bribes”
Strengths of Survey DataSpeed of data captureCapturing data otherwise not availableGenerating “bridging” data to enhance the value of existing data
Weaknesses of Survey Data CollectionResponse Rates25% still ok for validityItem NonresponseRespondents “skip” a question AttritionIf you are collecting surveys overtime (longitudinal data), sometimes people move, die, etc. Test Effect
Chapter 12:
Coding and Data DisplayOverview: Basics of Data AnalysisCodingApproaches to D ...
Chapter 11 Survey DataOverview Identify the different ty.docx
1. Chapter 11: Survey DataOverview: Identify the different types
of questions used in survey researchBe aware of the many
threats to validity inherent to the survey research
processIdentify how the sampling strategy should be
represented in the resulting dataIdentify factors to reduce
sample attritionList benefits and weakness of each type of
survey medium
Why SurveySurvey research is primarily used to gather data
From either participants in a systemOr consumers of a program /
policy (citizens) Could be consumers of a productThat either do
not exist or are available in another form
General Surveying RulesAvoid Value-Laden Questions“How
should the City of Ventura best control & monitor lawn
watering”? Answers are three various policiesNo Double-
Barreled Questions“Do you agree with the following statement:
The Thousand Oaks Police Department Officers are both well
trained and well equipped”. Yes/NO Watch Out for Loaded
Language“How often in one week do you use illegal drugs”?
Avoid Jargon“Given existing legislation which fish and
invertebrate barrier mechanisms do you believe is most useful
to reduce the spread of Dreissena polymorpha in existing finfish
onshore aquaculture sites”?
2. Types of Data Typically Collected by SurveyIndicator
VariablesDemographic, geographic, organizational affiliation
Open-ended QuestionsNo structure on the answer “Why
does…”Likert-type QuestionsProvide a statementAsk for their
agreement or disagreement on scale 1-51 = strongly agree2 =
agree3 = neutral4 = disagree5 = strongly disagree
More Types of Data Typically Collected by SurveyGrouped
Data Questions (categories are provided)Example, when asking
income or age$15,000 – 30,000 / 18-25 years old$30,000 –
45,000 / 26 - 40Single and Multiple Response Questions“Check
a box”“Mark all that apply” Continuous Data QuestionsBest,
most versatile, kind of data to haveUsually hard to collect with
a survey (age is easy example)
Techniques for Data Collection Using SurveysEmbedded
experimentsEmbedding “tests” within your surveyValidity and
Bias Tests You can increase validity by:Using established
questions Use multiple measure of your “construct” (internal
validity)Beta-test the question
Important Issues to Consider When Employing SurveysQuestion
Location“Hard” questions later in the surveySurvey MediumsIn-
person: very time consuming Telephone: once the standard, still
done, less so Mail: expensive Electronic: becoming more and
more common IncentivesGift cards “bribes”
3. Strengths of Survey DataSpeed of data captureCapturing data
otherwise not availableGenerating “bridging” data to enhance
the value of existing data
Weaknesses of Survey Data CollectionResponse Rates25% still
ok for validityItem NonresponseRespondents “skip” a question
AttritionIf you are collecting surveys overtime (longitudinal
data), sometimes people move, die, etc. Test Effect
Chapter 12:
Coding and Data DisplayOverview: Basics of Data
AnalysisCodingApproaches to Data Display
Basics of Data AnalysisReducing the complexity of the real
worldLooking for patterns Help answer public management
questions & inform decisions that public managers have to make
CodingCoding is a technique used to reduce the complexity of
dataCodes serve to summarize dataCodes serve to make data
comparable Types of data that require codesCoding existing text
(very common)
Coding existing legislation or testimony for example
Interviews (see Exhibit 12.1, p. 223 for an example) Field
notesOpen-ended survey responsesPhotos
4. Chunks and CodesThe unit of analysis and “chunks”Example:
You are coding all the laws made by the 110, 111, 112 & 113th
Congress to determine which Congress was the most
“environmental” across a few categories Each law is a “chunks”
Types of codesDescriptive codes: each category of
“environmental” (water, air, etc.) Attribute codes: identify
who sponsored each bill, any other identification Valence /
magnitude codes: ranking the bills based on a predetermined
order of “how environmental” each law is (1 – 5 for example)
Purposes of codingDescriptionPattern identification
Individual CodingDeveloping your set of codesStart with: What
is your RQ and your HypothesesWhat are the key concepts you
need to measureWhat are the best metrics for you to use
Clarity
Consistency A split-page approach
Using margins or matching pages
Again, see Exhibit 12.1, p. 223 for an example
Group CodingAllows you to code a larger amount of
dataBecause there are more peopleComplications of
groupsInter-coder reliabilityStrategies for maximizing
reliabilityClear codesTrainingMultiple people coding some
percentage of the “chunks”
This helps you test inter-coder reliability
Improves your argument for internal validity
5. Data DisplayVisualization of dataAnother strategy for reducing
complexityTypes of displaysSummary displaysSite
displaysTime displaysTheoretical displays
Software for Coding and Data DisplayComputer Assisted
Qualitative Data Analysis Software (CAQDAS)
WeftQDA
Nvivo
Atlas.tiAdvantages of CAQDAS
Code management
Team coordination
Ease of coding
Ease of summaries
Use it
It is near impossible not to, certainly it makes your life WAY
Easier
Table 3: Chapter Three Hypotheses, Key Variables / Concepts,
and
Measures
RQ3: What role do coalition membership and organizational
affiliation have in shaping
policy actor and coalition members’ belief change and
reinforcement in a local and state
level energy and climate policy subsystem?
Hypotheses! Key
Variable / Concept
6. & Definition!
Measures:
Survey Questions
(Typically agree / disagree likert
scale 1-5)!
H1. Policy actors
within a coalition
will show substantial
consensus on deep
core and policy core
beliefs, less so on
secondary aspects.
1. Advocacy coalitions &
Coalition affiliation
“A group of legislators,
agency officials, interest group
leaders, and researchers with
similar policy core beliefs who
share resources and “engage in
a nontrivial degree of
coordination” (Sabatier and
Weible 2007 p.196)
!
2: Deep core beliefs
“General normative and
ontological assumptions about
human nature…the proper role
of government vs. markets in
general…” (Sabatier and
Weible 2007).
7. 1: Responses to survey
questions, which are already
collected, pertaining to deep
core, policy core, and secondary
beliefs will determine which
advocacy coalition respondents
are categorized into. Questions,
which will measure each of
those concepts, are listed below.
!
2a: “How liberal or
conservative do you consider
yourself to be on fiscal policy?”
(likert scale 1-5)
2b. “How liberal or conservative
do you consider yourself to be
on social policy?” (likert scale 1-
5)
H2: Policy actors will
report belief change,
as opposed to belief
reinforcement, more
so in secondary belief
levels and less so in
policy core beliefs.!
3. Policy core beliefs
“…moderate in scope and
span the substantive and
geographic breadth of a policy
subsystem” (Weible et al
2009: 122)
8. 3a: Responses to questions such
as “Human behavior is the
principal cause of climate
change”
3b. “The severity of predicted
impacts on society from climate
change are vastly overstated ”
3c. “Decisions about energy and
its effect on climate are best left
to the economic market, and not
to the government”
4. Secondary beliefs / policy
preferences
“…for example, detailed rules
and budgetary applications…”
(Sabatier and Weible 2007)
4a. “A cap and trade system of
permits for the emission of
greenhouse gases is required to
9. combat climate change”
4b. “An energy and/or carbon
tax is required to combat climate
change”
4c. “Government policies to
promote renewable energy
generation are required to
combat climate change”
(agree / disagree likert 1-5!
H3: Policy actors
from ideological /
purposive groups will
report more extreme
beliefs than policy
actors from material
groups
!
H4: Policy actors from
ideological / purposive
groups, and policy
actors from material
groups, will report
more extreme beliefs
than policy actors
from administrative /
government agencies.
5. Organizational affiliation
“Policy actors from material
groups (economic self-interest
groups such as private
industry) will have more
extreme beliefs than policy
actors from purposive groups
10. (ideological position groups
such as non-governmental
organizations)…Policy actors
from interest groups will have
more extreme beliefs than
policy actors from
administrative / government
agencies (Sabatier & Weible
2007: 220)
!
5. “Which of the following best
describes your organization?”
(Academic/Researcher, Private
Sector, Government, Non-profit)!
H5. Individuals with
more extreme beliefs
will report more belief
reinforcement than
individuals with less
extreme beliefs. !
6. Extreme beliefs
!
6. Those who answer 1 and 5 on
the likert scale to the Policy
Core & Second Belief questions.!
!
!
!
11. Table 4: Chapter Four Hypotheses, Key Variables / Concepts,
and
Measures
RQ4: What role does acquired information and information
sources have in shaping
policy and coalition belief change and reinforcement in a local
and state level energy and
climate policy subsystem
Hypotheses! Key
Variable / Concept
& Definition!
Measures:
Survey Questions
(Typically agree / disagree
likert scale 1-5)!
H6. Higher diversity of
information sources utilized for
an individual will led to higher
levels of reported belief change,
as opposed to belief
reinforcement
7. Diversity of information
sources
12. !
7. “How often do you use the
following types of information
in your climate and energy-
related policy work?”
(12 sources are offered across
a five point scale from daily to
never)!
H7. Individuals with similar
views will be more reported as
the source of reinforced beliefs,
as opposed to individuals with
dissimilar views or neutral
parties.
H8. Neutral parties will be
reported more as the source of
changed beliefs, as opposed to
individuals with similar or
dissimilar views.
8. Primary source of belief
change or reinforcement
!
8. “If your views have been
changed or reinforced, who
was the primary source
(4 Point Scale):
Someone I agree with
Someone I disagree with
Neutral Party
My views have neither
13. changed nor been reinforced
!
Table 5: Chapter Five Hypotheses, Key Variables / Concepts,
and
Measures
RQ5: What role do policy activities have in shaping policy actor
and coalition belief
change and reinforcement in a local and state level energy and
climate policy subsystem?
Hypotheses! Key
Variable / Concept
& Definition!
Measures:
Survey Questions
(Typically agree / disagree likert scale 1-
5)!
H9. Individuals that
report more
collaboration with those
with similar beliefs,
rather than those with
dissimilar beliefs, will
14. report more belief
reinforcement.
H10. Individuals that
have participated in
more collaboration
within coalitions only (as
opposed to cross-
coalitions) will report
more belief
reinforcement (and vice
versa).
9. Coordinating &
collaborating with those
with similar and dissimilar
beliefs
“…seek allies, share
resources, and develop
complimentary strategies”
(Sabatier & Weible: 196)!
9a. “In the past year, have you
participated in…coalition building (e.g.
networking, information sharing)?”
(Yes/No question)
9b. “How often do you use advice from
people you agree with?” (also disagree
with)
9c. “How often have you used the
following tools and techniques as part of
your work in the past year?”
5 Point Scale): Daily, Weekly, Monthly,
Yearly, Never Options include:
“Collaboration with those who share my
15. views on energy and climate goals?”
(also those who do not share my views)
H11. Individuals that
have participated more
in consensus-based
processes will report
more belief change, as
opposed to belief
reinforcement.
10. Participation in multi-
stakeholder consensus
based processes
“…a forum that is
prestigious enough to
force professionals from
different coalitions to
participate and; dominated
by professional norms”
(Sabatier & Weible 2007:
220)!
10a. “In the past year, have you
participated in…Negotiated in a multi-
stakeholder consensus based process”
(Yes/No question)
10b. “How often have you used the
following tools and techniques as part of
your work in the past year?”
5 Point Scale): Daily, Weekly, Monthly,
Yearly, Never Options include:
Options include:
“Facilitation/consensus building (e.g.
focus groups, roundtables)”
16. H12: Individuals that
have participated more
in consensus-based
processes will report
more belief change, as
opposed to belief
reinforcement, regarding
advocacy strategies.
11. Advocacy strategies
!
11. “To what extent have your strategies
changed or been reinforced regarding the
way you advocate for climate- related
issues and/or energy policy?”
(Same 6 point scale as Belief Change /
reinforcement above). Also asked the
“Primary source of belief change or
reinforcement” above
!
1
ALTERNATIVE BIRTHING PRACTICES IN VENTURA
COUNTY, CA
17. An Analysis of Home Birth Practices in Ventura County:
DraftComment by Pattison, Andrew: This is a HUGE
improvement and great work.
There are a few places where I think you could tighten things up
(see my comments) but overall, most of my comments are about
pushing you to develop your study a bit more for the next draft.
Overall 98/100
XXXXXXXXXXX
California Lutheran University
Fall 2013
PA 550
Pattison
18. Literature Review
Female-bodied individuals have been giving birth since the
beginning of time, and the methods and conditions under which
childbirth happens have been changing for just as long.
Considering childbirth from a worldly perspective, one would
experience drastically different birthing centers (from home to
hospital), birthing with an abundance of medical interventions
and those with none, births that include the whole community
and intimate spaces including only mothers and their caregivers,
and births that are preceded by pregnancies full of allopathic
intervention and those without any preconception, maternal, or
postpartum care at all. The common western experience of
childbirth today is far different from what has historically
happened all over the world, including the United States.
Obstetrics was not a part of the medical curriculum until the
19th century and even then there was little to no consideration
for the wishes of the mother, seeking only to shift the birthing
experience to one in which pain (physical, emotional) and time
spent were all drastically decreased (History of Women’s Health
in the United States, 2004).
Childbirth in the United States has long been considered
19. through the lens of gender roles and maleness. The study of
sexuality has a long history of being associated with male
sexuality, resulting in female sexuality merely being a
byproduct or branch of male sexuality (Tiefer, 1994). Before
obstetrics was incorporated into medical curriculum, the
business of caring for pregnant and birthing women was left to
midwives. Even as doctors began tending to pregnant women,
women who were attended by physicians had a drastically
higher infection rate than those tended to by midwives (History,
2004). Midwifery experienced increasing levels in
professionalism and regulation in the 20th century, but the
number of home births (90% in 1900 to 10% in 1950) and births
attended by midwives (40% in 1915 to 0.72% in 2009)
dramatically decreased (MacDorman, 2012). Today, very few
women choose to use midwives and, instead, choose what
Cheyney (2008) touts as “the dominant obstetric care
paradigm.” Although the movement toward institutionalized
obstetric care can be considered advancement, the United States
and Canada are the only two high-income nations in the world
in which highly trained surgical specialists (obstetricians) still
regularly attend normal, healthy, low-risk mothers in delivery
(Wagner, 2006). Today, maternal healthcare in the United States
denies women equity of treatment. From pre-conception to
postpartum care, physicians have monopolized the system (De
Vries, Benoit, van Teijlingen, and Wrede, 2001) and assumed
the power of decision-making for mothers, despite evidence that
midwifery care is “a safe and viable option, both in and out of
hospital” (Cheyney 2008). Comment by Pattison, Andrew: This
is all very good so far
Childbirth, the cornerstone of the maternal healthcare
experience, is a highly personal experience. For women who are
fortunate enough to have a choice in their maternal healthcare,
there are a multitude of factors that influence her choice,
including cultural and religious sensitivity, respect for
autonomy, and attention to patient comfort (Becker, 2009).
According to MacDorman (2012), the availability of these
20. resources to women is severely dependent on their
socioeconomic status and insured status. The percentage of
women choosing alternative birthing methods varies greatly by
maternal race and ethnicity, and these differences have widened
over time with non-Hispanic white women more likely to
partake in alternative methods than women of other ethnicities
(MacDorman, 2012). “Low-income and minority women are
[also] disproportionally at risk for experiencing more
intervention at delivery and are more likely to experience poor
birth outcomes overall” (Kistka, 2007). The decision to pursue
an alternative birthing method is also often directly linked to
the use of a midwife, 62% of home births are attended by
midwives while only 7% of hospital births are.
According to Cheyney (2008), women make the decision to have
a home birth (specifically that attended by a midwife) for a
multitude of reasons, including: the “refutation of a public
narrative and a challenge to obstetricians as indisputable
experts” (p. 257); the reinvestment of power and decision-
making abilities in the woman and her body; the utilization of
“knowledge as power, empowerment as embedded in the
intensity of labor and delivery, and power as healing” (p. 260);
the “often overwhelming personal power many experience as a
result of the intensity of their birthing experience” (p. 261); and
“a deep desire to create intimacy and a sense of personal
connection in the birthplace” (p. 262). Singer (1995) refers to
homebirth as “not only as a minority social movement, but also
as a form of systems-challenging praxis” (Cheyney 2008).
Comment by Pattison, Andrew: Good fixComment by Pattison,
Andrew: Same comment
The system of midwifery is shrouded in misconceptions. Many
insurance companies refuse to pay for maternal care if a woman
chooses a midwife instead of an allopathic medical doctor. And
many women experience negativity or refusal of service if they
try to talk to their medical doctor about using a midwife
(McKenzie, 2010). Despite this, when certified nurse-midwives
attended 11,788 planned home births from 1987-1991, the
21. resulting mortality rate for both mother and baby were lower
than for births that happen in the hospital (Anderson, 1995).
Although a very small amount of women are choosing to have
home births and/or utilize midwives today, the trend is rising in
small ways. In response to a more widespread understanding of
alternative birthing methods and a shift toward a mother-
friendly birthing experience, Cheyney (2008) suggests that some
hospitals offer midwifery services to supplement a woman’s
time with her physician. Others are rethinking birthing rooms,
including “floral wall paper, wooden beds, lovely cabinets that
hide medical equipment until the time of delivery, and
champagne and lobster dinners for postpartum celebration”
(Cheyney, 2008). But this is missing the point. A woman’s
decision to have a birth that is not medically mainstream is a
result of her being educated on all of the options that would
ensure her a safe pregnancy and delivery, and her being given
the autonomy and right of being able to make a decision that is
right for her. Conversations between women and their
caregivers are crucial opportunities to discuss all viable
methods, but such conversations often provide cookie-cutter
guidance, not that which has been formulated specifically for
the distinctive mother. “A recognition of clinical
communication as interactionally situated and socially
constructed allows both practitioners and researchers to be alert
to the complex discursive environment within which
practitioners and clients negotiate informed choice (McKenzie,
2009). The urgency now is a connection between science and
society, in hopes of creating a patient-caregiver dynamic in
which honest conversations can be had and which prioritize the
wellbeing, comfort, and needs of women.
The purpose of this study is to evaluate the decisions that
healthy women with low-risk pregnancies in Ventura County
make when planning for their birth. The purpose is not to raise
any form of childbirth above another, but instead to advocate
for a system in which a woman is offered all available options
and is given the autonomy to choose the one that is right for
22. her. This study will consider the differences between alternative
and traditional birthing methods. For the purpose of this study,
an alternative birthing method is defined as a family-centered,
home-like, low-technology birthing experience. Traditional
birthing method is defined as a high-technology, high-
intervention birth in a hospital setting. Alternative birth
methods do not include women who are expected to have a
complicated pregnancy or delivery. This study will not include
women who have had high-risk pregnancies or unplanned births
outside of the hospital. Regardless of the birthing method
ultimately chosen, it is paramount that women are fully
empowered by information and can make the decision that is
right for them, not just the one that her physician finds most
timely and simple. This research project will analyze the
reasons women choose alternative birthing methods, and
consider ways to make these options available to all women. If
there are, in fact, links between education and insured-status
and birthing choice, then a segment of the childbearing
population is being denied access to all of their options. And if,
as I hypothesize, women who make a well-informed birthing
choice are generally pleased with their birthing experience, then
informing women about their options will lead to more pleasing
birth outcomes. Comment by Pattison, Andrew: This is all very
good and I especially like the way you transition to the purpose
– a good length as well
Research Question
This research asks what factors affect a woman’s decision to
pursue an alternative birthing method.Comment by Pattison,
Andrew: Good, though if you are going to narrow down your
analysis on some of the factors such as socio-economic status
and not examine others (which is not only ok but expected),
then you might want to be more specific here)…your decision
Data Sources
The data used to inform this study will be the previously
published, precedent-setting research that has helped to
understand and analyze current and changing norms. The
23. Centers for Disease Control collates information relating to
United States fertility and childbirth, and produces an annual
report that discusses such factors as age, live-birth order, race
and Hispanic origin, marital status, attendant at birth, method of
delivery, and infant characteristics (Martin 2010). This
information will provide a statistical trail of historical
challenges and patterns of maternal choice in healthcare. While
such research will provide an important base of knowledge, this
research seeks to answer questions that remain unanswered.
I will incorporate prior research into my work, but I am going
beyond what has already been done to explore the reasons
behind choosing alternative birth methods in Ventura County.
Interviews with Ventura County women will also be used to
inform this research, in hopes that these conversations will help
to explain the needs of the maternal population and expose any
voids that may exist in the care currently provided. These
interviews will be approximately one hour long, and a mix of
structured, semi-structured, and unstructured questions. This
will give the women the time and space to share their own
stories and feelings and provide a human component to the data
I collect.Comment by Pattison, Andrew: You can say “will also
be used” if you want, but since this is the major thrust of your
study – and you already mentioned the preexisting research –
you can just say that these interview WILL INFORMComment
by Pattison, Andrew: Excellent section besides my above
comment
Hypotheses
I anticipate this evaluation will serve to further solidify the
understanding that the maternal healthcare system does not
provide equal access and opportunity to all women, and that
maternal healthcare options are a privilege given to those with
more education and health insurance. I also anticipate that this
evaluation will conclude that alternative birth methods
generally result in a positive birth experience. My potential
hypotheses are:Comment by Pattison, Andrew: This is important
24. point, see my comment on your RQ
H1: Women with more years of formal education are more
likely to use alternative birthing methods. Comment by
Pattison, Andrew: Good. One question I might have, and maybe
you will get into in in your questions is: are there gradations to
your I.V in Hypotheses 2? In other words, is it just a Y/N
question (you have heath insurance or not), or is there variation
you can measure? Such as “how happy / pleased / satisfied
women are with their health insurance means they are more
likely to use alternative birthing methods” - maybe that is not
something you are interested in…I am just throwing it out here.
You could ask them a question that give you more variety in
your I.V. here.
H2: Women with health insurance are more likely to use
alternative birthing methods than uninsured women.
H3: Women who use alternative birthing methods are generally
pleased with their birthing experience.
Variables
Hypotheses
Variables
Definitions
Sources
Anticipated Correlation
Metric
H1 –Comment by Pattison, Andrew: Good, one suggested
change might be to give One example here – in other words, list
these, but provide one question as a “sample”, not necessary,
25. just might be helpful.
Women with more years of formal education are more likely to
use alternative birthing methods
IV
Formal education
DV
Alternative birthing methods
Education provided in the system of schools, colleges,
Universities and other formal educational institutions, and that
normally constitutes a continuous ladder of full-time education
for children and young people, generally beginning at age 5 to 7
and continuing up to 20 or 25 years old or above
Family-centered, home-like, low technology birthing
experience; Alternative birth methods do not include women
who are expected to have a complicated pregnancy or delivery
OECD (2012)
26. Mathews and Zadak (2010)
+
+
Interview Question #1, Interview Question #3, Interview
Question #4, Interview Question #6, Interview Question #11
H2 –Comment by Pattison, Andrew: Same question as above,
plus see my question related to your hypotheses 2 above.
Women with health insurance are more likely to use alternative
birthing methods than uninsured women
IV
Health Insurance
DV
Alternative birthing methods
An individual or group disability insurance policy that provides
coverage for hospital, medical, or surgical benefits
Please see prior definition
California Insurance Code §106
27. Mathews and Zadak (2010)
+
+
Interview Question #2, Interview Question #6
H3 –Comment by Pattison, Andrew: Good, same comment as
comment # 10 related to providing one sample question – not
necessary but maybe a good idea.
Women who use alternative birthing methods are generally
pleased with their birthing experience
IV
Alternative birthing methods
DV
Happiness
Please see prior definition
Feeling pleasant emotions most of the time and infrequently
experiencing unpleasant emotions
Mathews and Zadak (2010)
28. Diener and Seligman (2002)
+
+
Interview Question #8, Interview Question #9, Interview
Question #10, Interview Question #12, Interview Question #14,
Interview Question #15
Data Analysis Technique
In analyzing the information received through interviews, I will
code the transcriptions, allowing me to “quickly locate excerpts
from all interviews... that refer to the same concept, theme,
event, or topical marker and then examine them together”
(Rubin, 2005, p. 219). Through utilizing NVivo Software, I will
be able to sort through the abundance of qualitative data I
receive to identify patterns. I will prepare the software by
coding with each hypothesis in mind.
H1
H2
H3
Potential + coded words
Smart, capable, knowledge, ability, learned, know, research,
education, care, knowledgeable, choice, understanding, aware,
awareness, class, seminar, books, internet, research, college,
degree, university, graduate, alternative
Insurance, money, doula, co-pay, deductible, midwife, home
birth, private insurance, employed, working, employer, job,
research, options, self-insured, alternative
Happy, happiness, ecstasy, pleasure, family, relief, support,
29. content, beautiful, trust, trusting, partner, safe, kind, gentle,
breath, breathing, midwife, doula, home birth, alternative
Potential - coded wordsComment by Pattison, Andrew: This
table is fantastic
Believe, money, unplanned, high school, GED, TV shows,
internet, traditional
Medicare, Medicaid, MediCal, expensive, unemployed, welfare,
single, poor, poverty, self-employed, traditional, cash
Regret, pain, blood, sadness, tears, sad, long time, anxiety, fear,
interventions, unsafe, dangerous, terrified, worried, hours, too
long
After coding my transcribed interviews, I will be able to utilize
statistical analyses to organize my data. The independent
variable in my first hypothesis is formal education. Because I
have organized this into a structured interview question
utilizing five ordinal categories, I will be able to utilize a chi-
square test in analysis. Once I have collected information on my
second hypothesis concerning insured-status, I will be able to
run a t-test on the data. Data analysis for my final hypothesis
concerning happiness will also utilize a t-test because happiness
will be measured as scale data. Comment by Pattison, Andrew:
True.
BUT, if you want to get more technical, to run a proper T-test
you’ll have to code in such a way that gives you a “mean” for
the positive and negatively coded variables. Otherwise you’ll
have to do a test that designed for dichotomous variables (you’ll
already have to do this for H2 as written) but I am just trying to
push you here. Try to see if you can identify a test for that.
There are good internet resources you can access, or I can
provide some books.
Sampling Design
30. This research will use stratified random sampling as means by
which to garner potential interviewees. Ventura County,
California is comprised of 20 school districts. For the purpose
of this study, I will be sampling from elementary schools in
seven of these school districts. Each school district has a
different number of elementary schools. The districts to be
sampled are: Comment by Pattison, Andrew: Good but say a bit
more.
I THINK the reason you will stratify is because you want to
insure you have a representative distribution of socio-economic
status in the county - and as such may need to sample more
people from certain schools to make sure you capture the SES
diversity you are interested in studying.
Conejo Valley School District – 18 elementary schools
Hueneme School District – 5 elementary schools
Oak Park School District – 3 elementary schools
Ocean View School District – 3 elementary schools
Santa Paula School District – 6 elementary schools
Simi Valley Unified School District – 21 elementary schools
Ventura Unified School District – 19 elementary schools
Thus, 75 elementary schools were chosen asare the environment
through which sampling will ould take place because K-12
education is mandated for all children. This sample was chosen
because it is representative of Ventura County geographically,
economically, and by population. These school districts vary in
size, in location, and in community. Because it is not feasible to
include every elementary school in Ventura County in the
sample size, this representative population serves as the sample
size. I will coordinate specifically with kindergarten teachers in
these elementary schools. Pending their permission, I will
create a flyer that will be distributed to all parents of
kindergarten students asking them to be a part of this research
project, detailing time and interview specifications as well as
potential incentives to participating. The parents will then be
31. able to contact me with their interest. I will also arrange to be
on campus certain days to ensure ease in research participation
for the parents. Comment by Pattison, Andrew: Good stuff
Instruments
The data collection tool that will be used in this research is an
interview. Because the topic is one of a personal nature, I feel
that an interview is the best instrument to use. A large benefit
to using interviews to collect my information is the rapport I
can build with a woman who is telling me her story. While I
anticipate that I will speak to many who are pleased with their
birthing experiences, I also will speak with women for whom
childbirth was traumatic. It is important for me to be able to
build rapport with the women so I can create a safe space in
which women can share their truths with me. There is also an
abundance of intersectionality that occurs in conversations
regarding healthcare. “The conceptual framework that motivates
[this] analysis draws on a behavioral model of service use and
quality. Individual predisposing, enabling, and need (risk)
factors, as well as system and environmental factors, drive
health practices, use of services, and subsequent outcomes”
(Benatar 2013). Because of this, interviews will be the best way
for me to communicate about the many factors that play into
one’s birthing decisions, while also enabling me to personally
witness a woman telling her own story. The interview guide
contains a mix of structured, semi-structured and unstructured
questions. The structured questions enable me to ensure that I
have answers that are measurable and that relate to the variables
as I have defined them (regarding formal education,
specifically). The semi-structured and unstructured questions
create space for women to tell their own stories and define their
birthing experience(s) as they understand it. The preliminary
interview guide and informed consent form for this research are
attached (please see Appendix A and B). Comment by Pattison,
Andrew: Ok to keep in but maybe define what you mean by
32. “personal” a bit more then.
In other words, true, but I think you could flesh this out a bit
more.
Now that I have finished reading this section I think you did
“flesh it out” but I do think you could boil this down a bit
through some edits. Comment by Pattison, Andrew: Great stuff
Limitations
The main limitation of this research is resultant of the sampling
technique. It is problematic that the sample size does not
include private schools or parents who home school. The
immensity of Ventura County suggests that incorporation of all
potential locations for a child to attend kindergarten is
unrealistic. In an attempt to remedy the exclusion of private
kindergartens and homeschooled children, I purposefully
included a wide array of public schools that represent an
economic and geographic variety of Ventura County. Another
limitation of this study is the fact that I am talking to parents of
kindergarteners about their birthing experiences, of which their
most recent may be 4-5 years ago. All of these limitations aside,
sampling through elementary schools remains a effective way to
ensure external validity of the study as it is inclusive of the
general population and can therefore be representative of the
general population. Comment by Pattison, Andrew: Excellent
Comment by Pattison, Andrew: And they may not remember the
details….
33. ReferencesComment by Pattison, Andrew: Good set of
references
Anderson, R.E., Murphy, P.A. (1995). Outcomes of 11,788
planned home births attended by certified nurse-midwives. A
retrospective descriptive study. Journal of Nurse Midwifery,
40(6), 483-492. doi: http://dx.doi.org/10.1016/0091-
2182(95)00051-8
Becker, David. (2009). Women’s Perspectives on Family
Planning Service Quality: An Exploration of Differences by
Race, Ethnicity and Language. Perspectives on Sexual and
Reproductive Health. 4(3) 158-165
Benatar, S., Garrett, A. B., Howell, E., & Palmer, A. (January
01, 2013). Midwifery Care at a Freestanding Birth Center: A
34. Safe and Effective Alternative to Conventional Maternity Care.
Health Services Research Chicago-, 48, 5, 1750-1768.
California Insurance Code §106
Diener, E., & Seligman, M. E. P. (January 01, 2002). Very
Happy People. Psychological Science, 13, 1, 81-84.
DeVries, R., Benoit, C., van Teijlingen, E., & Wrede, S. (Eds.).
(2001). Birth by design: Pregnancy, maternity care and mid-
wifery in North America and Europe. New York: Routledge.
History of Women's Health in the United States. (2004). In
Encyclopedia of Women's Health. Retrieved from
https://ezproxy.callutheran.edu/login?qurl=http%3A%2F%2Flite
rati.credoreference.com.ezproxy.callutheran.edu%2Fcontent%2F
entry%2Fsprwh%2Fhistory_of_women_s_health_in_the_united_
states%2F0
Kistka, Z.A.F., Palomar, L., Lee, K.A., Boslaugh, S.E.,
Wangler, M.F., Cole, F.S., et al. (2007) Racial Disparity in the
Frequency of Recurrence of Preterm Birth. American Journal of
Obstetrics and Gynecology, 196(2)
MacDorman, M. F., Mathews, T. J., Declercq, E., (2012) Home
Births in the United States, 1990-2009. CDC NCHS Data Brief
84(1)
Martin, Joyce A., Hamilton, Brady E., Ventura, Stephanie J.,
(2010) Births: Final Data for 2010. National Vital Statistics
Report 61(1)
Mathews, J.J., Zadak, K. (1991). The alternative birth
movement in the United States: history and current status,
Women Health, 17(1), 39-56.
McKenzie, P.J., Oliphant, T. (2009). Informing Evidence:
Claimsmaking in Midwives’ and Clients’ Talk About
Interventions. Qualitative Health Research, 20(29) 29-41. doi:
10.1177/1049732309355591
McKenzie, P. J. (2009). Informing choice: The organization of
institutional interaction in clinical midwifery care. Library &
Information Science Research, 31(3), 163-173. doi:
10.1016/j.lisr.2009.03.006.
35. OECD (2012). What Are the Returns on Higher Education for
Individuals and Countries? OECD’s Education at a Glance:
Education Indicators in Focus, 6(1). doi: 10.1787/22267077
Rubin, Herbert J., Rubin, Irene S. (2005). Qualitative
Interviewing: The art of hearing data. Thousand Oaks: Sage.
Singer, M. (1995). Beyond the ivory tower: Critical praxis in
medical anthropology. Medical Anthropology Quarterly, 9(1),
80-106.
Tiefer, L. (1994). Sexuality: Not a matter of health. In Dan, A.
J. (Ed.). Reframing women's health: Multidisciplinary research
and practice (pp. 151-161). Sage Thousand Oaks, CA.
Wagner, M. (2006). Born in the USA: How a broken maternity
system must be fixed to put mothers and babies first. Berkeley:
University of California Press.
36. Appendix A
Interview Guide
1. What is the highest level of education you have received?
a. Some high school
b. High school diploma/GED
c. Some college/Associates Degree
d. Bachelors Degree
e. Graduate Degree
2. Did you have insurance at the time of your baby’s
birth?Comment by Pattison, Andrew: See my comment on your
hypothesis 2 on this
-If so, who provided the insurance? (your employer, yourself)
-How much did you have to pay out of pocket for your birthing
experience?
3. Do you recall ever learning about birthing option in any
aspect of your formal education?
-If so, what did you learn?
37. -Where did you learn it?
4. How were you informed about your birthing
options?Comment by Pattison, Andrew: These questions will
give you some rich data. One idea that is coming to me
now…you do not have to do it.
Is to create two factors that might influence birth choice:
Formal education & formal doctor advice
Informal / personal information sources (friends, faith
community, etc.)
Then you could test which factor was more important. Just be
clear to revise your hypotheses, and potentially expand these
questions 9or just label them accordingly) if you do this.
Maybe there is a relationship between which of these factors is
more important and SES on birth choice…
Low SES = greater dependence on 1 (for instance)
This could be another hypotheses you could test that might give
you richer results.
It is just an idea.
5. What birthing method did you choose to use?
6. Why did you decide to pursue the birthing method you did?
7. What medical professional did you have at your birth?
-Ob/Gyn
-Nurse
-Certified Nurse Midwife (CNM)
-Doula
38. 8. How did your medical professional/doctor influence your
birthing method choice?
9. How did your family influence your birthing method choice?
10. How did your faith/beliefs/morals influence your birthing
method choice?
11. How did your education influence your birthing method
choice?
12. Tell me about the birthing plan you had before your baby
was born.
13. Tell me about your birthing experience.
14. What differences existed between what you wanted and what
actually happened?
15. Do you have any regrets about your birthing experience?
Appendix B
Informed Consent FormComment by Pattison, Andrew: All good
stuff
Dear Participant-
My name is Nina Kuzniak and I am a Masters student at
California Lutheran University. I am doing a research project
analyzing factors that influence a woman’s decision to pursue
an alternative birthing method.
You were selected as a potential participant because you are a
parent who has had your own birthing experience.
Purpose of the Study
39. The purpose of this study is to investigate the reasons that
women decide to make the birthing decisions they do in hopes
of better understanding why they do so.
Procedure
I would like to interview you in English for a maximum of one
hour. During the interview, I will take hand-written notes and,
with your consent, record the interview on a digital recorder. I
will ask you to select or I will assign you a fake name that will
be used in my notes and writings to make sure your information
stays confidential and no information can be used to identify
you.
Potential Risks and Discomforts
The nature of this topic is emotional. Some women associate
positivity with recalling their birthing experience, while others
recall negativity. The interview questions were drafted
purposefully and carefully to ensure the conversation is
productive without being unbearably intrusive. I anticipate that
your responses will shed light on the decision-making of parents
when creating a birth plan and choosing a birthing method. You
are not expected to divulge any personal information that makes
you uncomfortable.
Potential Benefits to Subjects and Society
I believe that you, as a parent, will be benefited by the research
done in this study. Your perspectives may be challenged and
you may be introduced to thinking other than your own. The
data collected can be used to better understand the needs of the
childbearing community and the ways in which education and
insured-status affect expectant mothers.
40. Confidentiality
Any information that is obtained in connection with this study
and that might be used to identify you will remain confidential
and will be disclosed only with your permission or as required
by law. I will ask you to select a pseudonym that I will employ
in all field notes, transcriptions, or public references to our
interview, oral or written, that this research produces. I will
alter or omit from publications any descriptive material or
information that might reveal your identity. You have the right
to designate specific material as strictly confidential, and I
promise to exclude such material from any publications or
presentations that may result from this research. I will keep all
audiotapes of interviews in a locked case in an undisclosed
location to be destroyed after completion of this study.
Participation and Withdrawal
It is your decision to participate in this study. If you decide to
revoke your participation, all information gathered from you
will be destroyed and you will be removed from the study
completely. Additionally, please feel free to refuse to answer
certain questions you are uncomfortable answering.
If you have any questions before or after participating in the
interview, please feel free to contact me by email:
[email protected] or phone: 702.332.3606.
I understand the procedures described above. Any questions I
had have been answered. I agree to participate in this study.
Additionally, I have been given a copy of this form.
__________________________________________
41. Name of Participant (print please)
___________________________________________
_______________
Signature of Participant Date
I have explained the research to the subject or his/her legal
representative and answered all of his/her/their questions. I
believe that s/he understands the information described in this
document and freely consents to participate.
___________________________________________
_______________
Signature of Researcher Date
(Nina Kuzniak)
EXAMPLES OF BAD QUESTIONS
&
SUGGESTIONS OF HOW TO FIX THEM!
42. Double Barreled question:
Please indicate how much you agree or disagree with each of
the following statements
about the childcare program.
Incorrect:
I feel welcomed by staff and other youth at the center
Correction:
I feel welcomed by staff at the center
I feel welcomed by other youth at the center
Biased/leading question
Incorrect:
Community organizing is hard. Do leadership trainings help
you feel prepared for
community organizing?
Much more prepared Somewhat more prepared
Slightly more prepared Not more prepared
Correct:
The leadership trainings prepare me for community organizing.
Strongly agree Agree Disagree Strongly disagree
Double Negative
Incorrect
Does it seem possible or does it seem impossible to you that the
Nazi extermination of
43. the Jews never happened? (22%)
Very possible Possible
Impossible Very impossible
Correct
Do you doubt that the Holocaust actually happened or not? (9%)
Very possible Possible
Impossible Very impossible
The following are additional examples of bad survey questions.
As a group,
apply our class discussion, evaluating each question and its
response choices to identify
one error in each question (ie. double barreled). Explain the
problem that your group
identifies in each question and propose an alternative that
solves the problem.
1. More people have attended the movie, Gone with the Wind,
than any other motion
picture produced this century. Have you seen this movie?
Yes No
2. In your opinion, how would you rate the speed and accuracy
of your work?
44. Excellent Good Fair Poor
3. Did you first hear about the bombing:
______ from a friend or relative ______ from your spouse
______ from a newspaper ______ at work
______ from the television or radio or other electronic media
4. How do you feel about the following statement? We should
not reduce military
spending.
Strongly agree Agree Disagree Strongly disagree
5. People grow up in all different types of families. What type
of family did you grow up
in?
______Mom as single parent ______Dad as a single parent
______Both Mom and Dad
6. Where do you get most or all of your information about
current events in the nation
and the world?
__radio __Newspapers __Magazines __internet
7. Higher than single-family density is acceptable in order to
make housing affordable.
Strongly Undecided Disagree Strongly Disagree
Agree Agree
1 2 3 4 5
EVALUATING SURVEYS
45. The following are some suggestions of how to fix the problems
of the survey
questions found on the prior page.
1. Problem: Biased/Leading
Solution
:
Have you seen the movie Gone with the Wind?
Yes No
2. Problem: Double Barreled