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Using Ethnographic Methods in Implementation Research

Qualitative methods are central to implementation research, which focuses on integrating evidence-based practices into “real-world” settings and contexts. Historically, implementation scientists have relied primarily on semi-structured interviews to characterize knowledge, attitudes, beliefs, and behaviors of various stakeholders involved in implementation. However, as the field has evolved, ethnographic methods are increasingly called upon to study complex implementation phenomena such as adaptations to interventions and strategies, contextual shifts, relationships and power dynamics, change over time, stakeholder engagement, and sustainability. In this new course, we will review principles of ethnographic research, and then discuss:

  • the rationale for and growth of this approach in implementation research (Gertner et al., 2021)
  • differing applications of ethnographic methods in implementation research (e.g., targeted, focused, rapid ethnography)
  • methodologic considerations in the context of team-based data collection (e.g., fieldnotes and other forms of documentation)
  • integration of ethnography in mixed methods implementation evaluations
  • innovations in and applications of ethnographically informed methods (e.g., Finley et al., 2018)

Methodological concepts will be illustrated via examples from implementation research in the context of varied settings such as healthcare organizations, educational institutions, and communities. 

Course content assumes working knowledge of implementation science. Participants will be provided with materials and bibliographies to support the use of ethnographic methods in implementation research. The course will draw on material from four resources:

  1. Finley, E. P., Huynh, A. K., Farmer, M. M., Bean-Mayberry, B., Moin, T., Oishi, S. M., ... & Hamilton, A. B. (2018). Periodic reflections: a method of guided discussions for documenting implementation phenomena. BMC medical research methodology, 18(1), 1-15. https://doi.org/10.1186/s12874-018-0610-y; https://rdcu.be/cEWG4 
  2. Gertner, A.K., Franklin, J., Roth, I., Cruden, G.H., Haley, A.D., Finley, E.P., Hamilton, A.B., Palinkas, L.A., Powell, B.J. (2021). A scoping review of the use of ethnographic approaches in implementation research and recommendations for reporting. Implementation Research and Practice. Jan-Dec;2:10.1177/2633489521992743. doi: 10.1177/2633489521992743 
  3. Hamilton, A., Finley, E. (2019). Qualitative methods in implementation research: an introduction. Psychiatry Research, Oct; 280:112516. https://doi.org/10.1016/j.psychres.2019.112516

Snell-Rood, C., Jaramillo, E., Hamilton, A., Raskin, S., Nicosia, F., Willging, C. (2021). Advancing health equity through a theoretically critical implementation science. Translational Behavioral Medicine, Apr 27:ibab008. doi: 10.1093/tbm/ibab008

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