Writing Qualitative Research Proposals Using the Pathway Project Mapping Tool

Introduction

Although there is a critical need to conduct evidence-based healthcare research, only some existing tools provide structured guidance for novice researchers. To address this gap, the Pathway Project Mapping Tool (PPMT) was developed in 2020 and has since been used to assist students and trainees with planning quantitative research proposals (Matthews et al., 2020). The original PPMT has been used in grant writing courses, seminars, and consultations.

The PPMT tool was initially developed by one of the co-authors, Dr. Matthews, who incorporated methodologies from established nursing research textbooks and aligned it with the National Institutes of Health (NIH) research proposal review criteria. In developing the PPMT, they first reviewed and integrated key design factors impacting scientific rigor from established nursing research methods textbooks and articles. The decision to use established nursing research textbooks was to capture well-vetted and recognized critical methodological considerations within the nursing field. Next, they incorporated NIH Research Proposal Review Criteria (https://www.niaid.nih.gov/grants-contracts/scoring-summary-statements#A1) to align with the standards set by a leading authority in health research funding. Addressing criteria such as significance, innovation, methodological rigor, and expertise from the NIH enhances consideration of factors determining the strength of research protocols. Finally, they included specific examples from their research on smoking cessation among high-risk populations (e.g., Matthews et al., 2014). Incorporating specific examples from actual research provided additional guidance for new investigators. However, as the original tool focused on quantitative research proposals, there was a need to adapt this tool specifically for qualitative research proposals.

Qualitative research methods are increasingly recognized for their importance in healthcare-related research, particularly in contextualizing social and cultural realities that impact human behavior (Al-Busaidi et al., 2008; Renjith et al., 2021). There is a growing interest in and acceptance of qualitative research approaches in the health sciences, both as stand-alone methodologies and integrated with quantitative designs in mixed methods approaches (Al-Busaidi et al., 2008). This paper provides knowledge and application of various methods, enabling readers to develop qualitative research skills and proposals. Very few qualitative mapping tools are available; those that currently exist are over 15 years old (for example, Klopper, 2008; Sandelowski & Barroso, 2003; Vivar et al., 2007). Therefore, we identified a need for an updated qualitative mapping tool for new investigators, students, and trainees.

Our revised Qualitative Pathway Project Mapping Tool (QL-PPMT) utilizes an interdisciplinary lens, including nursing, gender and women’s studies, psychology, public health, and anthropology. The tool was revised to incorporate the newly released National Institutes of Health (NIH) research proposal review criteria, which include significance, innovation, methodological rigor, and investigators’ expertise. Finally, we provide specific examples from our community-engaged health disparities research best practices to create the QL-PPMT (Table 1). We describe each of the 26 sections of the QL-PPMT in detail below and support them with illustrative qualitative examples of research conducted with sexual minority men of color using PrEP (Pre-Exposure Prophylaxis). The QL-PPMT aims to provide new investigators with guidance to strengthen the development of qualitative research proposals.

1. Project Title

The title introduces the research project to the reader. The title must be concise and informative of the research design, study population(s), and focus. For example, in studies examining PrEP use in sexual minority men of color, the following titles could be used depending on the study focus or design.

Exploratory or Descriptive Study: “Exploring the experiences of sexual minority men of color receiving PrEP.”

Intervention Development or Adaptation Study: “A qualitative study of PrEP use for sexual minority men of color: Implications for group-based intervention development.”

Intervention Evaluation Study: “A qualitative evaluation of a group-based PrEP use intervention for sexual minority men of color.”

2. Problem Statement

The first step in creating a research proposal is to develop the problem statement. The problem statement articulates what the researcher wants to change (intervene in) or better understand (describe) (Matthews et al., 2020). Novice researchers often need help with this, but multiple approaches exist. The first is having the researcher look at their everyday experiences. If they are in the health sciences or clinical setting, they can identify questions about assessment, prevention, treatment, and cost-effectiveness of care. For example, healthcare providers often observe poor adherence to PrEP use within the clinical setting. Therefore, more research is needed to address this problem, providing opportunities for novice researchers to explore. Novice researchers can also identify existing or established research areas that have not been fully explored from a qualitative perspective or have not centered on the diverse perspectives of people experiencing health-related problems and disparities. Another strategy for identifying a research area is to look at national and international health priorities, like those of the NIH, World Health Organization (WHO), and Centers for Disease Control (CDC). The NIH publishes its strategic plan that identifies the most pressing research priorities and calls for funding. The following is an example of a problem statement related to PrEP use among sexual minority men of color in the United States:

“Perpetuated by individual and structural barriers to health maintenance, human immunodeficiency virus (HIV) disproportionately impacts communities of color in the United States (US). In the US, the estimated lifetime risk for HIV infection among sexual minority men is one in six, compared with heterosexual men at one in 524. Improving access to and uptake of pre-exposure prophylaxis (PrEP) among sexual minority men is essential to ending the US HIV epidemic and reducing new infections by 90 % by 2030. Racial and gender inequities in sexually transmitted infections (STI) rates among sexual minority men drive HIV disparities. Additionally, sexual networks and behavioral factors (i.e., multiple sexual partners, condomless anal sex, or substance use) may increase the risk of HIV and STIs for sexual minority men. In 2019, men who have sex with men represented 65.6% of individuals living with HIV in the City of Chicago. Therefore, more research is needed to explore the barriers to PrEP uptake experienced by sexual minority men in Chicago.”

3. Significance of the Problem

As illustrated in the above example, the first sentence of the problem statement should explicitly identify the problem to be studied (barriers to HIV prevention). The subsequent sentences should introduce any specific population groups that are the focus of the study (sexual minority men) and then provide evidence for the significance of the problem. Evidence should then be stated to support the importance of the problem, including information about incidence/prevalence, morbidity/mortality, and healthcare costs. In the above example, the authors describe national data provided by the CDC and then present geographic-specific data from the City of Chicago, which is the location of the proposed study.

4. Epistemological Approach

Researchers must identify specific epistemological approaches as they develop proposals, i.e., how they view and frame their research question and approach. Our epistemology shapes what we know, think, and do not know (Bowleg et al., 2017), often guiding our interest in specific research areas. The most common traditional epistemological approaches utilized in qualitative research are interpretive (postmodern), poststructuralist, and post-postmodernist (beyond postmodernism) (Creswell & Poth, 2018). Modern worldviews, including intersectionality, critical social theory, and symbolic interactionism, are used when working with marginalized and underrepresented populations (Abrams et al., 2020; Atewologun & Mahalingam, 2018; Crooks et al., 2020; Kincheloe & McLaren, 2011).

Traditional approaches, such as an interpretative (postmodern) approach, assume knowledge is subjective and context-driven. Interpretive research questions are often open-ended and interpreted through various methods. One of those methods includes Community-Based Participatory Research (CBPR), in which researchers and community members collaborate as equals in the research process to explore the study focus (Holkup et al., 2004; Wallerstein et al., 2017). CBPR is particularly useful in including underserved or vulnerable populations (i.e., sexual minority men of color) in health disparities research (Singer et al., 2022). Poststructuralists assume that knowledge is intersubjective and critiqued as power. Poststructural research questions are often open-ended and interpreted through various methods. The difference between poststructuralist and interpretive approaches is that outcomes are usually related to “relativistic statements about power relationships and institutions” and provide a challenge to the status quo (Creswell & Poth, 2018, p.17). Post-postmodernists assume that knowledge is “ultra-relativistic” and highly subjective. Research questions often allow room for the difference to emphasize relative self-understandings. Outcomes of post-postmodernism make no universal truth claims, offer options for public debate, and are usually left open to constant questioning (Creswell & Poth, 2018). The epistemological approach must be clearly stated in proposals as it helps reviewers understand the researcher’s approach to the study topic.

Contemporary worldviews such as intersectionality, critical social theory, and symbolic interactionism are often utilized to guide qualitative health research. Intersectionality is a theory, paradigm, and research method that acknowledges how multiple dimensions of social relationships and categories of difference, including race, gender, class, and sex, confer oppression and discrimination or power and privilege (Crenshaw, 1989; Crooks et al., 2020). In critical social theory, researchers use society and culture to attempt to reveal, critique, and challenge power structures and to empower marginalized voices (Calhoun, 2003). Symbolic interactionism is ideally suited to gain an in-depth understanding of social processes, related influencing conditions, and consequences of actions taken (Blumer, 1986). These worldviews lend themselves well to using qualitative methods and techniques such as reflexivity, in-depth interviews, community advisory boards, and participant-led data collection and analysis (i.e., photovoice) (Atewologun & Mahalingam, 2018). These theories also give special attention to social context, highlight the unique experiences of people of color, and acknowledge them as content experts in their own lives (Hancock, 2007).

5. Reflexivity and Positionality

Reflexivity will help the researchers understand their approach to the study topic; it is commonly understood as the process of self-reflection practices, positionality, and acknowledgment of potential bias that may affect the research process and outcomes (Berger, 2015). Through reflexivity, researchers must acknowledge their positionality as insiders, outsiders, and somewhere in between regarding their working communities (Kerstetter, 2012). Positionality refers to the positioning or role of the researcher in the social, cultural, and political context of the study—the community, the organization, or the participant group. The way to ascertain this importance is to develop a positionality statement that acknowledges the power dynamics, race, gender, and education level and the value of participants’ contributions to the study (Muhammad et al., 2015). Even though the researchers may share similar identities to their population of interest, they may be seen as outsiders because of their roles as study researchers (Kerstetter, 2012).

Additionally, reflexivity and positionality must consider how historical mistrust with communities/populations of color has been a challenge among research practices. Historical mistrust stems from unethical research practices, persistent health disparities, and lack of access to effective treatments for communities of color. It has led to growing skepticism regarding the objectivity of scientific research and weakened trust in healthcare system institutions and higher education (Crooks et al., 2021). For example, a positionality statement such as this one may be included in research proposals or manuscripts:

“Our interpretative paradigm revolves around social constructivism, positing that meanings and realities are diverse. It acknowledges that meanings are collaboratively shaped within social, historical, and cultural contexts arising from interacting with others. Our research team consisted of individuals of Arab, Black, or African American backgrounds living in the United States (US), specializing in nursing, psychology, and public health, and some of whom identify as lesbian, gay, or bisexual. We acknowledge that our multiple identities and experiences in the US and abroad (all authors, except one, were born and raised in the US) inform and influence our research interests, including this study’s research aims and approach. To address our personal biases, we adopted a rigorous approach that involved constant reflexivity, peer debriefing, and ongoing discussions regarding our analytical techniques and findings throughout the study. This diligent process allowed us to maintain high rigor in our research.”

6. Theory Guiding the Project

Theory is critical as it helps create the research proposal’s foundation. The selection of theory is often based on or related to the researcher’s epistemological approach and helps identify early in the proposal development phase (Matthews et al., 2020). However, scholars have varied perspectives on using theory in qualitative research (Anfara & Mertz, 2015). The use of theories in quantitative research studies is crucial since the method of reasoning is a top-down, deductive, theoretical process; however, in qualitative research, the use of theory to guide a study is less common since qualitative research aims to explore an under-researched topic from an inductive, bottom-up, data-driven process.

There are at least three primary applications of theory in qualitative research: (1) theory of research paradigm and method (Green, 2014), (2) theory building based on collected data, such as in grounded theory (Birks & Mills, 2015), and (3) theory as a framework to guide the study (Anfara & Mertz, 2015). Whether implicit or explicit, all research has a theoretical framework.

Some theories commonly used in healthcare include the Health Belief Model (Strecher & Rosenstock, 1997), the Theory of Planned Behavior (Ajzen, 1991), and the Social Ecological Model (McLeroy et al., 1988). Social theories such as Intersectionality (Crenshaw, 1989, 1991), Minority Stress Theory (Meyer, 1995), and Health Disparities Research Framework (National Institute on Minority Health and Health Disparities, 2017) may be used to understand the lived experiences of people, particularly those who are underserved, marginalized, or vulnerable, within various contexts.

During the proposal development phase, the researcher must select and provide a clear rationale for the theory choice. However, novice researchers may need a deeper understanding of the relevance of theories, the criteria for choosing a theory, and limited knowledge about applying the theory throughout the research project (Grant & Osanloo, 2014). The theory must inform or align with all phases of the research study, including the research question, the literature review, the design, the interview guide, and the analysis plan. More specifically, in qualitative proposals, theories may help develop the questions asked to populations so that they can answer the research questions adequately. The selection of a theory is typically based on those traditionally used in that area of research or with specific populations (Matthews et al., 2020). For example, the Minority Stress Model or the Intersectionality Framework has been used for research conducted with underrepresented populations who endure structural violence, such as discrimination due to a stigmatized identity status (i.e., sexual minority men of color) (Jeremiah, RD et al., 2021; Jeremiah RD., et al., 2017, 2020; Sun et al., 2018). In some cases, such as in a grounded theory study, selecting a theoretical framework is unnecessary as the aim is to generate new theories and develop conceptual frameworks (Charmaz, 2014; Strauss & Corbin, 1994).

7. Knowledge Gap

Highlighting the “gap” in the literature refers to a content area requiring additional study to better understand or intervene in a problem (Robinson et al., 2011). There are many unanswered questions for most subject areas. Four types of research questions can be asked about a problem area using qualitative research. The first question, “Who is most likely to experience the specific health problem and how do they experience it?” is the most common one investigated using qualitative methods. Examining the characteristics of individuals who experience a specific health problem can help us understand them and how they are impacted. The second type of research question, “What conditions or factors cause or exacerbate the health problem?” aims to understand the mechanisms and pathways associated with the health problem. The third question, “How can the problem be fixed?” focuses on developing interventions or programming related to the problem. The final question, “Can a theory or framework be developed to understand the experience of the problem better?” is asked to aid in health programming and intervention development and serve as a foundation for research. Populations must see themselves in theory so researchers/healthcare providers can better address the health problem. Developing theory and conceptual frameworks may provide more cultural nuances, making it easier to tailor to specific populations. Below is an example of a gap statement related to young sexual minority men using PrEP:

“The need for evidence-based interventions to increase PrEP use among sexual minority men is compelling, yet little is known about the experience of sexual minority men of color taking PrEP. This study will address an important gap in the literature by examining the experiences of sexual minority men of color taking PrEP, specifically, the sociocultural conditions contributing to HIV risk (barriers to PrEP use). Study results will have important implications for clinical practice, PrEP education, uptake, and intervention development.”

8. Innovation

For many funding agencies, the level of innovation associated with a research study has emerged as an essential consideration. For example, grant application guidelines from the NIH indicates that researchers should clearly describe how their study is innovative. According to the NIH, innovation represents “a challenge or shift to current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions.” This includes the development of a theory to help address a specific health problem. However, it can be challenging to illustrate succinctly and convincingly what makes a study innovative, especially for students/novice researchers. One suggestion is to begin with an introductory statement when writing one’s innovation section, “The proposed study on [the experiences of sexual minority men] is innovative in the following ways…” Following this sentence, the investigator briefly describes the nature of the innovation and provides supporting evidence of that innovation. Below is a sample innovation section:

“The proposed study on the experiences of sexual minority men of color taking PrEP is innovative in the following ways. First, a grounded theory research design will be used to identify barriers and facilitators of PrEP use among this population. Prior research studies have most often adapted interventions based on socioeconomic factors only. Second, this study will lead to the development of a conceptual framework, which can help guide future program/intervention development. To our knowledge, this framework will be the first designed for and by sexual minority men of color using PrEP. Third, the effects of individual-level HIV programs for sexual minority men of color decay over time. Innovative approaches and frameworks are essential to sustain long-term health outcomes, such as an increase in PrEP uptake and addressing barriers of PrEP use.”

9. Impact

An impact statement is a summary of the anticipated outcomes and significance of the research if completed. This statement is used to convince funders, institutional review board reviewers, and stakeholders of the value of the proposed research. In most cases, an impact statement clearly describes the contributions of the research to a field of study (e.g., HIV prevention research). As part of the impact statement, describing who will benefit from the work and in what ways is essential. There are several levels of benefits, including individual, organizational, community, and research community. Below is a sample impact statement:

“Upon study completion, the results of this research will significantly advance knowledge and understanding in the general area of HIV prevention research and, more specifically, the experiences of sexual minority men of color. This understanding has implications for guiding clinical practice, and the methods and approaches used in this study have implications for developing and testing culturally targeted interventions for other high-risk populations (e.g., sexual minority men who also use drugs).”

10. Research Question

The research question identifies what specific question(s) will be answered by a study. The PICO approach is a specialized framework for forming health-related research questions (Schardt et al., 2007). In this framework, PICO stands for Patient problem or population, Intervention Comparison or control condition, and Outcome (Schardt et al., 2007). In non-intervention research, E is substituted for I and stands for Exposure or Experience. Utilization of the PICO framework can help students/novice researchers more clearly understand their proposal. This helps conceptualize the research statement. For example, returning to the problem of PrEP use among sexual minority men of color, here is an example of using the PICO approach to develop a research question:

P = Young sexual minority men using PrEP

E = To better understand the experiences of young sexual minority men using PrEP

C = Young sexual minority men not using PrEP

O = PrEP use rates

The following research question could be: “What are the experiences of sexual minority men of color using PrEP?”

11. Research Design

Multiple research designs must be considered for a research study proposal depending on the research aims and questions. The most used methods in healthcare research are phenomenology, grounded theory, ethnography, and qualitative description (Bradshaw et al., 2017; Creswell & Poth, 2018).

Briefly, a phenomenological design aims to describe a specific phenomenon’s ordinary meaning based on the lived experiences of several individuals (Moran, 2002). Phenomenology originated in several philosophical perspectives (e.g., Husserl, Heidegger, Merlau-Ponty) and types (e.g., descriptive, interpretive, transcendental). A grounded theory design aims beyond description to generate a theory for a process or action (Birks & Mills, 2015). Grounded theory originated in sociology’s symbolic interactionism (Blumer, 1986) and, like phenomenology, has evolved over the years into different types of approaches characterized by specific, grounded theorists (e.g., Glaser, Strauss, Charmaz, Clark). Ethnography design aims to describe and interpret a culture-sharing group’s shared and learned patterns of values, behaviors, beliefs, and languages (e.g., nurses, teachers, sexual minority men) (Ridley, 2015). This design originated in anthropology and has been described to have two types: realist ethnography, which is a traditional approach, and critical ethnography, which is a more recent approach that addresses pressing societal problems, including the impact of power, privilege, and authority on shared values, attitudes, and behaviors. Lastly, qualitative description aims to describe the phenomenon of interest as the starting point, then moves beyond the description to interpret the findings without moving too far from the data description (Bradshaw et al., 2017; Kim et al., 2017). Once the researcher’s design is chosen, the researchers must provide a rationale for their design choice. Researchers are also encouraged to cite primary sources to justify their design choices. Below are two examples of a research design statement:

“We propose a grounded theory qualitative research study informed by the social constructivist approach of Charmaz to explain the processes of PrEP initiation and maintenance in sexual minority men of color. We will conduct 20–30 individual interviews following a structured interview guide to generate an understanding of the behavioral processes that explain PrEP initiation and maintenance in sexual minority men of color.”

12. Phases of Research

Qualitative research designs could be used in different research project phases: (1) a stand-alone qualitative study aiming at exploring a phenomenon of interest (e.g. exploring the meanings of being on PrEP among sexual minority men of color); (2) a mixed-methods design study conducted before, after, or in parallel to a quantitative design phase (Creswell & Clark, 2017) (e.g., exploring the meanings of PrEP among sexual minority men of color in tandem with quantifying clinical access of PREP in the Bronzeville neighborhood of Chicago); (3) as part of a multi-phase study either leading to an intervention development/adaptation, or following a pilot testing of an intervention for evaluation (e.g. feasibility, acceptability) (e.g., exploring the meanings of PrEP among sexual minority men of color in tandem with quantifying clinical access of PrEP in the Bronzeville neighborhood of Chicago to inform the pilot testing of a culturally-tailored awareness campaign intervention); and (4) an initial phase of an instrument development and evaluation (Boateng et al., 2018) (e.g., developing an instrument that can measure the impact of PrEP among sexual minority men of color in Chicago).

13. Target Population

In all types of qualitative designs, the target population is determined based on individuals having had experience with the phenomenon of interest. As such, the most common sampling strategy is purposive sampling. For example, based on the research question, “What are the experiences of sexual minority men of color using PrEP?” the target population would be sexual minority men of color using PrEP. Purposeful sampling means your recruitment strategy will be intentionally seeking individuals that fit into the study sample criteria. Establishing inclusion and exclusion criteria in proposal development is fundamental. Inclusion criteria help to identify who will be included in the study based on demographic characteristics (e.g., age, race/ethnicity, immigration status, location) and clinical characteristics (e.g., HIV status, clinical diagnosis of depression). On the other hand, exclusion criteria describe the characteristics that make an individual ineligible to participate in the study (e.g., cognitive impairment). Researchers should provide an evidence-based justification for their inclusion and exclusion criteria.

Depending on the study aims and focus, the researchers would also decide if the study sample should be homogenous or heterogenous. For example, if the study aims to explore the experiences of young sexual minority men of color using PrEP, then the researchers would target a homogenous sample based on age (for example, age between 18–25 years old); however, if the focus is not specific about age group, then the researchers would diversify their sample to include multiple age groups. Maximum variation sampling is a typical sampling strategy that helps diversify the sample. In most instances, qualitative researchers aim to understand a phenomenon from diverse perspectives; therefore, this strategy is considered a common approach.

The sample size is a contentious issue in qualitative methods. In most quantitative studies, the sample size is calculated before the study is implemented. However, in qualitative research, the sample size is determined by two critical factors: (1) access to diverse participants aware of the research topic and (2) getting to a saturation point. Therefore, it is essential to consider all factors contributing to their experiences to ensure a holistic insight. Saturation occurs when the study team observes that no new information is generated during ongoing data collection activities.

14. Recruitment and Retention Plan

The ability to recruit participants to a study is fundamental. Qualitative research studies require a smaller sample size than quantitative research because they address complex health issues involving social, cultural, political, and historical perspectives. Recruitment can be challenging. Qualitative research with historically marginalized populations such as sexual minority men of color requires establishing trust with the target community before recruitment (Singer et al., 2022). Therefore, researchers must develop a comprehensive recruitment plan designed in collaboration with the communities of interest to maximize success. For example, based on CBPR principles, forming a community advisory board that provides feedback on recruitment materials (e.g., flyers and social media posts) and recruitment sites (e.g., clinical and community sites) is essential to ensure initial interest as well as ongoing participation (retention). When a qualitative study is designed with multiple data collection time points (see section 18), a retention plan (e.g., reminders with text messages or emails, remuneration after each data collection time point) is needed to ensure that the retention of participants is successful.

15. Research Setting

One of the characteristics of qualitative research is its naturalistic approach, which includes conducting research in a natural setting (the field) and being situated within the context of lived experiences (Creswell & Poth, 2018). Depending on the research aims and the topic’s sensitivity, these settings could be a community-based organization, a public space (e.g., a public library or coffee shop), the participant’s home, or a clinical setting such as a hospital or a clinic. Academic settings are also an option but are less commonly used as they require participants to be situated in an unfamiliar place that would create discomfort and a power imbalance between the participant and the researcher. Identifying multiple options for the data collection setting enhances participant comfort.

Furthermore, researchers must also describe how they ensure participants’ privacy, especially if the agreed-upon setting is open-- public library or the hospital. Conducting research in a naturalistic setting has many benefits, including allowing participants to choose a convenient and comfortable space. However, there are limitations, including acquiring a space that ensures privacy and a quiet environment. To address these limitations, establishing community partnerships in the early study phases when developing the research aims and purpose of the qualitative analysis is crucial (Singer et al., 2022).

16. Data Collection

Over the years, qualitative data types have continuously evolved in the literature but can be categorized in four ways. The first and most common type is interviews. These include individual or one-on-one interviews, dyadic interviews (interviews with two people), and focus groups, either in-person or web-based interactions. In qualitative research, web-based data collection using online platforms (e.g., Zoom, Webex) or applications (e.g., FaceTime, WhatsApp) have emerged as data collection strategies, especially during the COVID-19 pandemic (Lobe et al., 2022). Lobe et al. (2022) systematically compared in-person and video-based online interviewing and found that each modality has strengths, weaknesses, and ethical issues to consider in a qualitative research proposal. The second data collection type is observation, ranging from non-participant to participant observers. The third type of data collection includes documents, such as journal notes, letters, emails, blogs, reports, etc. These data can also be used with other data collection types, such as interviews. The fourth type is audiovisual materials; these include examining websites or social media pages or having participants take photographs or record videos (a method usually referred to as photovoice and considered a CBPR method) (Liebenberg, 2018).

Data collection methods are based on the research aims and study design. For example, individual interviews are more suitable for research studies that address sensitive topics and require an in-depth understanding of the phenomenon based on personal experience; on the other hand, focus groups are more suitable for research studies that address issues better understood through dialogue and interactions between participants. Focus groups are also helpful in evaluating evidence-based interventions for their feasibility and acceptability by participants. Researchers developing qualitative research proposals must also consider triangulating multiple data collection types; triangulation strengthens the data’s credibility and improves the study’s rigor (Morse, 2015). There are two approaches to triangulation. The first can be participant triangulation, which would entail collecting data from different types of people (i.e., individuals, groups, families, and communities) to gain multiple perspectives on a topic. The second approach is source triangulation, which is collecting multiple sources of data (i.e., interviews, observation, medical records) to gain a deeper understanding of a topic (Campbell et al., 2020).

17. Standard Measure Instruments

Using measure instruments ensures systematic and rigorous practices within qualitative research. Measure instruments are essential when numerous research team members are concurrently recruiting, collecting, analyzing, and interpreting data, guaranteeing that every team member executes the study uniformly.

As noted earlier, interviews are a qualitative method to solicit individual data. Interview guides can be structured or semi-structured based on the nature of your research topic, access to the population, and data collection timeframe. Structured interview guides consist of a standardized list and sequencing of and systematized ratings of the participant’s responses (e.g., for sexual minority men of color, where do they access PreP). They are usually implemented when time is limited. In contrast, semi-structured interviews are less rigid and offer more latitude to probe and ask follow-up questions if more time is available (e.g., for sexual minority men of color, what are their thoughts about PreP? Why do they think that way?).

Focus group sessions can also adopt measurement instruments such as focus group guides to engage with several individuals to find group consensus. The focus group facilitator uses a focus group guide as an instrument to initiate, conduct, and conclude 60–90-min discussions. Semi-structured focus group guides will foster more open dialogue among participants to respond to a question or a topic.

Participant observation can also use measurement instruments in a naturalistic environment when study teams immerse themselves into the environment where the social and cultural context of the research topic naturally occurs (i.e., a familiar venue where sexual minority men of color will socialize together). Data will be observation notes generated that can be used to analyze and answer the research questions.

18. Measurement Time Points

Using time point measures is helpful if there are layers to the research topic that can not be captured in one data collection session. The use of time points measures is contingent on many ways to understand the true nature of a phenomenon. This is particularly relevant for sexual minority populations when trust and rapport need to be established that goes beyond one initial meeting.

Follow-Up Interviews: Follow-up data collection is an example of measuring time points and is used for several reasons: (1) Unable to gather enough information in one interaction; (2) Additional points of inquiry after initial contact; (3) Allow time for participant reflection. This can only be considered if access to your study participants is relatively easy and they are willing to meet again to share their thoughts.

19. Qualitative Analysis Plan

A qualitative data plan ensures that the interpretation of collected data is well-ordered, that the data elicits meaning, and that the findings represent the target population (Harding & Whitehead, 2013). This plan should have five essential steps: (1) Organizing data (sorting the data in a way that can enable researchers to know who shared the data and what they were speaking to in the initial coding); (2) Interpreting data (perceiving themes based on initial coding that speak to the research objectives); (3) Identifying patterns (recognizing patterns from among those generated themes); (4) Forming the basis for informed and verifiable conclusions (answering the research questions using the identified patterns); and (5) Tying research objectives to data (using the answers to inform the justification of the research objectives) (Nowell et al., 2017).

The previously discussed study framework will inform the strategies of a data analysis plan. Thematic analysis is a flexible family of methods utilizing a codebook, coding reliability, and reflexivity (Clarke & Braun, 2014). It generates themes from interview data and is helpful in case studies and generic qualitative and narrative analysis. Interpretative Phenomenological Analysis (IPA) is used for a phenomenological research study to identify the core of the phenomenon under review with the aim and focus of generating meaningful results (Smith et al., 1999). Grounded Theory uses a specific data analysis plan that requires concurrently analyzing data and a constant comparison method for the theoretical saturation (Strauss & Corbin, 1994). Narrative Analysis focuses on different elements to make diverse but equally substantial and meaningful interpretations and conclusions within the context of research shared by all in daily life. Discourse Analysis (DA) focuses on how people use language, including written texts, spoken contexts, sign language, and significant semiotic events. Its objective is defined in terms of coherent sequences of sentences, propositions, speech, or turns at talk. Case Study (CS) is a detailed study of individuals or groups providing narrative descriptions of behavior or experience. It helps investigate trends and situations and test theoretical models using them in real-time conditions (Clarke & Braun, 2013).

Given the volume of data, the most practical and reliable way to conduct qualitative data analysis is as a team. The team must adopt some essential validity practices, including dependability (member checking)—asking the study participants to review the transcribed data and confirm if what was captured is what they mean to represent; credibility (working in teams, reflexivity, memo writing)—to ensure that the assessment of the data is credible and that it can be used to answer the research questions; confirmability (bracketing, quotes)—confirming that the coded data represents the participant’s thoughts and ideas and not of the research team; transferability (thick description of the research findings)—the degree to which the results answer the research questions and applicability to the topic beyond the context of the study environment. Thick description is a critical strategy to improve the transferability and generalization of the data to other contexts (Ponterotto, 2006). Thick description requires a thorough explanation of participants’ views, motives, meanings, and understandings while accurately describing the context (Younas et al., 2023).

Numerous qualitative data analysis programs (Dedoose, NVivo, MAXQDA, ATLAS. ti) can help organize data and track coding activities. Some applications include collaborative features, allowing several research team members to simultaneously be on the same platform.

20. Study Procedures

Based on our qualitative research experiences, we define these essential study procedures for any qualitative studies:

1. In-depth understanding of the health issue—explain the health issue in terms of the study participants’ biological, social, and cultural constructs. Then, explain how it impedes an individual’s or community’s health and well-being. Such practice can help identify your study’s knowledge gap, under-utilization of services, or stakeholders' concerns that a health issue is not being addressed.

21. Using Appraisal Tools to Increase Methodological Rigor

One of the most critical components of developing and refining a research proposal is the identification and reduction of potential sources of bias. Bias refers to sources of error in the research project that negatively impact the validity of the research findings. Systematic bias can occur at any point in the research process, including the study design, selection and recruitment of participants, the execution of the study protocol, and the analysis of research findings. Tools that can help improve the methodological rigor of qualitative search studies are available. Examples of helpful tools that can instruct researchers on how to evaluate the methodological quality of research and reduce bias include the Joanna Briggs Institute (JBI) appraisal tool for qualitative studies (https://jbi.global/sites/default/files/2020-08/Checklist_for_Qualitative_Research.pdf), Critical Appraisal Skills Program (CASP) qualitative studies checklist (https://casp-uk.net/casp-tools-checklists/), The Centre for Evidence-Based Medicine (CEBM) for qualitative studies (https://www.cebm.ox.ac.uk/resources/ebm-tools/critical-appraisal-tools), to name just a few. These tools are beneficial in understanding potential sources of bias as one is developing a research proposal and should be consulted during the project development process.

22. Study Collaborators and Co-Investigators

One of the core evaluation criteria of most research funders is the training and expertise of the primary investigator and the collaborating team members. Indeed, most grant reviewers evaluate the strength of the combined research team in deciding the likelihood of successful conduct and completion of a proposed research project. Guidelines for NIH grant reviewers include the following questions regarding the study investigator and team members, “Are the principal investigators (PIs), collaborators, and other researchers well suited to the project? If early-stage investigators, new investigators, or in the early stages of independent careers, do they have appropriate experience and training? If established, have they demonstrated an ongoing record of accomplishments that have advanced their field(s)?” (https://grants.nih.gov/grants/peer/guidelines_general/Review_Criteria_at_a_glance.pdf).

As such, it is essential to demonstrate that at least one person on the research team can either guide (serve as a consultant) or perform (function as a study collaborator or co-investigator) each aspect of the proposed research project. In general, team members should be selected based on their expertise in the following areas: content expertise (HIV prevention), population expertise (MSM), clinical expertise, methodological approaches (grounded theory), and analyses.

23. Study Timeline

Developing a realistic timeline for completing a research project is often challenging for students and other new investigators. Given the need for experience conducting research projects, many new investigators must pay more attention to the time necessary to complete project tasks. One significant area that requires careful planning and consideration is participant recruitment. In qualitative research, participant recruitment can take twice as long as initially proposed, depending on the nature of the study. As such, developing a detailed study timeline is beneficial for mapping out what tasks need to be accomplished and how much time will be allocated to completing each task. The specific phases of the study timeline that should be considered and allotted time to complete include: (1) obtaining IRB approval; (2) staff hiring and onboarding activities; (3) staff training; (4) participant recruitment and enrollment; (5) data collection activities; (6) data transcription; (7) data analysis; (8) member checking activities; and (9) dissemination and publication of results. After the initial draft of the over-arching activities and specific tasks to be completed, consultation with a study collaborator will be invaluable in refining the timeline and helping to ensure the project is completed in the required period.

24. Research Proposal Reviewers

The adage “two heads are better than one” is especially pertinent to developing competitive research proposals. Indeed, very few research proposals are successfully developed and executed without input and critical review from more experienced researchers. As such, new and more experienced researchers should consider obtaining feedback from mentorship teams across the entire proposal developmental process. At a minimum, two other researchers should be solicited to provide input on a proposal. Several rules of thumb can be considered when soliciting feedback on a proposal. The first is the involvement of a mentor or primary research advisor and other team members involved in the study. Beyond that, the novice researcher should seek the input of individuals with expertise in the proposed methodological approach and someone with a strong history of obtaining grant funding. Methodological rigor and knowledge of putting together robust research applications are essential. When seeking input, clearly communicate with reviewers about the type of feedback wanted and, when possible, request written feedback. If written feedback is not possible, ask permission to audio record discussions about the strengths and weaknesses to capture relevant ideas. The feedback received from external reviewers should be shared with the primary mentor to obtain consensus on critical revisions that should be made.

25. Budget and Potential Sources of Funding

A significant barrier to conducting research is the ability to obtain funding to cover the costs of staff, materials, and participant reimbursement. As such, all new researchers will need to gain knowledge and skills related to grant writing. A large variety of grant writing resources and training opportunities exist. For example, the NIH offers workbooks and workshop opportunities to increase understanding of the application form, review criteria, and expectations for submitting a high-quality application to the NIH (https://www.grantcentral.com/workbooks/national-institutes-of-health/). Beyond the NIH, various funding sources should be considered for new research projects, including university or departmental funds, foundations, professional societies, government and international agencies, and pharmaceutical companies. Regardless of the funding source, there are several issues to consider before applying. The first is to make sure there is a close alignment between the project and the mission of the funding agency, the training qualifications (e.g., students, PhDs, physicians), what types of projects they will fund (e.g., qualitative versus quantitative research), and how many projects they support each cycle. The most successful applicants will be those whose projects align very closely with the funding organization’s mission and match the objectives of the specific funding type.

After a funding source has been identified, several steps should be followed to help ensure the success of the proposals. First, prepare a single-page description of the project and review the work with a representative from the funding organization to confirm that it is a good fit for the organization. Additionally, obtain a copy of a successfully funded proposal as an example of formatting and types of information to include; it can also be beneficial to ask more experienced researchers to share their experiences with specific funding agencies. Next, and most importantly, always carefully review all details regarding the submission dates, instructions, and application components—applicants who adhere to only some grant instructions risk having their applications rejected.

26. Safety of Study Participants

Ensuring the rights and protections of human subjects is a primary obligation of all research projects. Most research projects require approval by the institutional review board (IRB) before they begin. According to the Belmont Report, the United States Department of Health and Human Services (HHS) provides guidelines for researching human subjects in biomedical and behavioral research (https://www.hhs.gov/ohrp/). The Belmont Report established the following standards for the ethical conduct of human subject research, including respect for persons, beneficence, and justice. Respect for persons advances the internationally mandated criteria that all people enter the study voluntarily, with adequate information and informed consent. Informed consent as a criterion for research participation is required for all participants but is especially relevant for protecting individuals with cognitive and intellectual disabilities; informed consent protects minors, pregnant women, and incarcerated individuals. The second principle is beneficence, which is that all research participants are treated ethically and respectfully. The research team aims to do no harm, maximize the benefit, and reduce associated damages related to research participation. The final principle is that of justice. Here, the Belmont Report aimed to ensure that no populations were exposed to the excess burden associated with research participants and that the research benefits were not reserved for those with economic or social privileges. Obtaining a consultation with members of the IRB at the university or hospital setting can help identify potential problem areas and the strategies to address them.

Beyond these standard human protection issues, there are additional considerations to ensure the safety of participants. Qualitative research often examines susceptible research subjects, including vulnerable populations or stigmatized behaviors. As such, the safety concept must be expanded in several essential ways. The first relates to ensuring both the physical and emotional safety of participants. Discussing experiences with a stigmatized health diagnosis can be highly distressing to participants. As such, establishing a protocol that provides immediate support for the participant offers additional resources that can be accessed after the interview and an agreement to follow up with the participant in the next 24 hours to determine if distress remains elevated and further assistance is needed. The second area of participant safety relates to the ethical consideration of qualitative research and researching vulnerable populations (Crooks et al., 2021). Finally, several authors have described the importance of training to increase the cultural appropriateness and knowledge of the entire research team (Matthews, Castillo, et al., 2018; Matthews, Newman, et al., 2018; Rak et al., 2020) (Table 1).

OPEN IN VIEWER

Table 1.

The Qualitative Pathway Project Mapping Tool (QL-PPMT).

Conclusions

Increasingly, graduate students and other new trainees are utilizing qualitative research approaches to address various nursing-related topics, including those focused on health inequalities. Increasing the methodological rigor of qualitative research is a significant priority of graduate educational programs and the National Institutes of Health. This paper’s qualitative research project mapping tool summarizes essential elements to consider in developing a rigorous research proposal. However, additional work is warranted to evaluate how this tool can be incorporated into educational programs to teach research proposal development.