hw.2

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Applied Research

journal homepage: www.elsevier.com/locate/apnr

Original article

“It’s just more personal”: Using multiple methods of qualitative data
collection to facilitate participation in research focusing on sensitive
subjects☆

Jennifer Heatha,⁎, Heidi Williamsona, Lisa Williamsb, Diana Harcourta

a Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK
b Chelsea and Westminster Burns Service, Chelsea and Westminster Hospital, London SW10 9NH, UK

A R T I C L E I N F O

Keywords:
Interview
Data collection
Participant choice
Response preference
Engagement
Sensitive research

A B S T R A C T

Background: Often researchers use only one interview method within a single study. However, it is increasingly
common for a variety of interview methods to be employed within a project. Providing choice to participants
may facilitate recruitment, particularly when research focuses on a sensitive subject.
Aim: This paper aims to explore participants’ reasons for their choice of interview method in qualitative research
focusing on a sensitive subject.
Methods: Qualitative data was collected from 12 participants regarding their choice of interview method (face-
to-face, Skype, telephone or email) in a wider study investigating parents’ experiences following their child’s
burn-injury. Interview data was transcribed verbatim and thematic analysis was used to analyse responses.
Results: Participants most frequently chose to take part in an interview by telephone (n = 5), followed by email
(n = 4), then Skype (n = 2), and face-to-face (n = 1). Four themes emerged suggesting that participants’ deci-
sions to participate via a particular method were determined by personal convenience, their belief in their ability
to be open with the researcher despite potential upset caused by the topic, their ability to get a “feel” for the
researcher, and concern about giving adequate depth in responses.
Conclusions: Flexibility regarding the ways in which participants can take part in qualitative research may
improve participant access to research, recruitment, and response-rate. Although, the depth and quantity of data
gathered using different methods can vary. It is important that researchers consider the procedures and ap-
propriateness of using different methods of interviewing and what impact such methods might have upon
themselves and their participants.

1. Introduction

When research focuses on a sensitive topic – topics which poten-
tially pose a threat to those who are, or have been, involved in them
(Lee, 1993) – the method through which information is collected can be
particularly important to participants. Personal data is most likely to be
disclosed when assurances of privacy, confidentiality and a non-con-
demnatory attitude are provided (Wellings, Branigan, & Mitchell,
2000). Issues of privacy and personal choice regarding how to disclose
information may be particularly relevant when the focus of research is
considered private, stressful, or sacred, where disclosure might cause
stigmatisation or fear, or where there is the presence of a political
threat (Lee, 1993). Such issues might be particularly relevant to nurse
researchers and other healthcare professionals who play vital roles in

recruiting people into studies (Bartlett, Milne, & Croucher, 2018).
A key underpinning of qualitative research into sensitive topics is

the establishment of rapport (Dickson-Swift, James, Kippen, &
Liamputtong, 2009), requiring researchers to take steps to make par-
ticipants feel relaxed and comfortable enough to share their experiences
(Liamputtong, 2007). Clark (2008) suggested that a lack of under-
standing about the research methods used might promote indifference
or resistance in participants. Therefore, transparency throughout the
research process is important, ensuring that participants can appreciate
the true purpose of the research and understand why the research is
being conducted in the way that it is (McQuaid, Barton, & Campbell,
2003).

Qualitative research typically utilises one interview method in iso-
lation. However, there are growing numbers of options available for

https://doi.org/10.1016/j.apnr.2018.06.015
Received 4 April 2018; Received in revised form 18 June 2018; Accepted 23 June 2018

☆ Funding source: This research was part of a program of PhD studies funded by the University of the West of England, Bristol, UK.
⁎ Corresponding author at: Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Frenchay Campus, Bristol BS16 1QY, UK.
E-mail address: [email protected] (J. Heath).

Applied Research 43 (2018) 30–35

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researchers wishing to conduct interviews. Face-to-face interviews are
seen as the gold standard (Deakin & Wakefield, 2014). They have
several key strengths; flexibility, spontaneous personal and observable
interaction, and more control over the interview environment than
would be possible during remote methods of interviewing. There are
also disadvantages with face-to-face interviews, such as the high cost
per participant, geographical and time constraints associated with tra-
velling.

Online interviews, such as those conducted over Skype, are often
presented as a second choice or alternative when face-to-face inter-
viewing is not possible (Deakin & Wakefield, 2014). They allow face-to-
face communication with the opportunity to appreciate some body
language and other non-verbal communication, which telephone in-
terviews cannot. However, they also rely on the participants having
good internet access and some participants might not be comfortable
“on-camera”, not presenting as they would in a person-to-person si-
tuation (Bertrand & Bourdeau, 2010).

Another alternative, email interviews, are being increasingly used
by nurse researchers (Hershberger & Kavanaugh, 2017). Email inter-
views have a number of strengths. They offer low cost interaction
without the need to travel, do not require researcher or participant
presence at the same pre-specified time, and are potentially more ac-
ceptable to those who might decline or be unable to participate in
spoken interviews but willing to answer questions posted on their
computer screens (Duffy, Smith, Terhanian, & Bremer, 2005). Online
data collection has been found to improve access to hard-to-reach
groups and participation from ethnic minorities (Joseph et al., 2013),
particularly those who are geographically diverse (Wilkerson, Iantaffi,
Grey, Bockting, & Rosser, 2014). Duffy et al. (2005) also found that
online respondents might be less susceptible to social desirability bias
because of the lack of researcher presence.

Knapp and Kirk (2003) argue that different modes of data collection
will result in equivalent results among technologically savvy groups,
although this assumes no connectivity problems or transmission delays
that can hinder online data collection, whether it be via Skype or email
(Fox, Morris, & Rumsey, 2007). Couper (2011) also noted that relying
on online data collection methods risks selective sampling, leading to
nonresponse bias from those without access to the internet, for example
those of low socioeconomic status or older participants.

The telephone interview is another option, but this is often viewed
as a less attractive alternative to the face-to-face interview (Novick,
2008). Notable strengths include good geographical coverage, personal
interaction, and low cost compared to face-to-face interviewing. How-
ever, disadvantages include a lower response rate compared to face-to-
face communication, and the inability to observe the participant
(Groves, 1990). Groves (1979) found that respondents expressed more
discomfort about discussing sensitive topics over the telephone than
face-to-face, with most reporting that they would have preferred to be
interviewed face-to-face rather than by telephone. More recent studies
have disagreed with Groves’ claim, finding that interviewees feel
comfortable with telephone interviews when discussing intimate, sen-
sitive, and personal issues in an open and honest manner, and are less
concerned about humiliation than when speaking face-to-face, perhaps
due to increased familiarity with telephones (Chapple, 1999).

With multiple options for interviewing available to researchers,
when planning a study, it is important that public involvement (PI) is
utilised. PI can help to inform researchers how best to engage potential
participants, advising on factors such as the appropriateness of research
questions, study information, and the data collection format (Brett
et al., 2014). Clark (2008) highlighted the importance of this, de-
scribing how research engagement is not necessarily interesting for
everyone, and that different methodological techniques will appeal
differently to those who do engage. Therefore, researchers themselves
have an important role in ensuring that participants have an optimal
research experience (Bartlett et al., 2018).

As different techniques of data collection with appeal to different

people, it is increasingly likely that more than one type of interview will
be employed in a single study; such as Skype and face-to-face (Deakin &
Wakefield, 2014), or a combination of face-to-face, telephone, and
email interviews (Dures, Morris, Gleeson, & Rumsey, 2011). This flex-
ibility may improve participant access to research and is discussed in
this paper in relation to research on a sensitive topic: parents’ experi-
ences of having a child suffer a burn-injury.

Burns research in general can be sensitive, focusing on an event that
is often very stressful. When parents are the focus of research following
their child’s injury, participation might be perceived as threatening due
to feelings of guilt, perceptions of failure, and the upset caused by re-
calling events (Heath, Williamson, Williams, & Harcourt, 2018). There
may also be fear of judgment or stigmatisation from the researcher,
and/or concerns about the anonymity of data (Braun & Clarke, 2013;
Pyer & Campbell, 2012). This issue is particularly pertinent in this
population; McQuaid et al. (2003) found that parents of burn-injured
children can be wary of research of their or their child’s experiences,
sometimes suspecting an alliance between researchers and social ser-
vices. As such, this is an under-researched area despite the fact that
58,000 children attend Accident and Emergency departments due to
burn-injuries every year in the UK (National Burn Care Review, 2001).

Centralisation of healthcare means that patients can live long dis-
tances from hospitals and some may find it difficult to travel (Jo, 2007).
For this reason, multiple methods of interviewing are increasingly re-
quired to access the necessary participant group, as important data may
be gleaned from those based in a range of geographical locations, with
diverse socioeconomic statuses, ages, and/or backgrounds (Deakin &
Wakefield, 2014). Recruitment can also be difficult for other reasons.
For example, burn injuries can have a significant impact on appearance
(rence, Mason, Schomer, & Klein, 2012) and the experience of
living with an unusual appearance is another sensitive area of research.
When studies focus on appearance or disability, some options for par-
ticipation may be more practical than others. The option to participate
without having to physically meet strangers or attend an unfamiliar
location may be particularly appealing to those with a visible difference
(Fox et al., 2007). Therefore, researchers need to be mindful not to
exclude certain groups, for example, by only including those with in-
ternet access or within reasonable travelling distance.

PI was utilised in the study described within this paper, aiming to
ensure the appropriateness of all aspects of the research, including the
interview schedule and data collection methods, to allow parents to
discuss fully their experiences of their child’s injury and subsequent
support. As a result, potential participants were given a choice about
how they took part in a semi-structured interview (either face-to-face,
by Skype, email, or by telephone). This paper describes reasons parti-
cipants gave for their chosen method of participation in a qualitative
study focusing on their experiences of having a child suffer a burn-
injury (Heath et al., 2018). The aim of this being to explore the reasons
behind participants’ preference for particular interview methods to help
future researchers consider how offering choice might facilitate greater
participation in research, particularly in that which focuses on a sen-
sitive subject.

2. Methods

2.1. Ethical approval

Ethical approval was granted by the Research Ethics Committee of
the Faculty of Health and Applied Sciences at the University of the West
of England. For inclusion in the study, parents had to be English
speaking, aged at least 18 years, with a child who suffered but survived
a burn injury before the age of 18 years requiring hospital treatment.
Exclusion criteria were non-accidental injury and when the child had
died because of their injury.

J. Heath et al. Applied Research 43 (2018) 30–35

31

2.2. Recruitment

Participants were recruited via advertisements on burn charity
websites, social media, a radio broadcast, university press release, and
emails to eligible parents who had opted into a university research
mailing list. These avenues were utilised as relationships with relevant,
known, organizations is thought to improve participants’ perceptions of
the research as credible and acceptable (Altpeter, Houenou, Martin,
Schoster, & Callahan, 2011). The advertisements directed parents to a
website hosting the study information, consent form, and space to add
their contact details should they wish to take part. The first author used
these details to arrange an interview with consenting parents.

2.3. Participants

A purposive sample of 13 parents/carers (11 mothers, 1 father and 1
grandfather) whose child had experienced an accidental burn-injury
was recruited. Informed consent was obtained from all participants via
the online survey, and where audio recording was used, verbal consent
was also obtained. Twelve parents/carers (10 mothers, 1 father and 1
grandfather) answered a question about why they had chosen their
interview method.

2.4. Interviews

Interviews were carried out over the telephone, using Skype, in
person or via email by the first author (a Clinical Psychologist and PhD
Researcher) using the same semi-structured interview schedule for each
method. Interviews covered: parents’ experience of the injury and
treatment, which models of support were available to them, and whe-
ther they thought peer support would have been valuable (Heath et al.,
2018). Interview mode was participant-led. During the post-interview
debrief, participants were asked, “Can you tell me why you chose this
method of participation?” Recorded interviews were transcribed ver-
batim and email interviews were stored as word documents for analysis.
All data files were anonymised and stored securely.

2.5. Analysis

The data was organised and analysed using a semantic inductive
thematic analysis, following the six steps described by Braun and Clarke
(2006). Direct quotations have been used from participants to ensure
that interpretation of the data directly links to their words. The first
author, with input from the supervisory team, conducted all data ana-
lysis. Member checking then validated the interpretation and adequacy
of the data.

3. Results

The mean age of the 12 participants whose data contributed to this
paper was 42.7 years (range = 29.0–63.0 years). Nine identified as
‘White British’, two as ‘British’ and one as ‘British Indian’. At the time of
interview, seven participants were employed, two were homemakers,
one was a carer and another a student. The grandfather was retired.
Nine participants were married, one was single, one was separated, and
one chose not to disclose this information. The mean age of their child
at the time of injury was 3.7 years (range = 0.6–13.0 years), and the
mean time since the injury event was 3.1 years
(range = 0.6–15.3 years). Nine children had experienced scalds, one
from bath water and eight from hot drinks, two had flame burns, and
one had injuries from flash flames. Interview characteristics are shown
in Table 1.

Following thematic analysis of the responses to the question re-
garding participation method, four themes emerged: convenience,
openness despite upset, getting a “feel” for the researcher, and depth of
response (Table 2). These themes are described below and illustrated

with quotations. Participants have been given a pseudonym to protect
their anonymity.

3.1. Convenience

Participants’ choice of method was often “purely for convenience”,
giving them the opportunity to take part without putting additional
demands on their time.

“I’m a very busy mum of three; I study as well, so it was just con-
venience for me.” [Sue: Email].

For some, it was key that participation was via a method that was
familiar or habitual to them, not requiring access to something that was
not already in routine use.

“By the time it’s taken me to write out all the answers I can’t be
bothered [with email]…[Skype is] just easier. I guess I’m used to
Skyping a lot for work… so it was just the most convenient form for me,
for us to talk. [Mary: Skype].

Nevertheless, there was perhaps a preference for face-to-face in-
teraction where possible, although this could be sacrificed in favour of
convenience.

“If we’d had a Skype account and I’d sorted it all out, then I might
have done Skype but I think the phone call’s just as quick personally.”
[Carol: Telephone].

3.2. Openness despite upset

It was crucial for participants to feel that they could communicate
openly with the researcher despite any upset they felt recalling the
events and their experiences of their child’s injury. For some, it was
easier to do this in writing.

“I would find it hard to talk openly over the phone or Skype, and
also struggle even when typing this, I feel a swell of emotion. Last night
when I was typing my responses, I cried plus experienced the noises
associated with the accident so I think doing it this way, for me anyway,
has been better.” [Colin: Email].

Remote methods of communication, in which neither the partici-
pant nor the researcher are actually visible, might be preferable for
some participants. This may be the case for those concerned that the
presence of a researcher, who might in some way implicitly judge their
situation, could hamper their answers to potentially challenging or
sensitive questions.

3.3. Getting a “feel” for the researcher

A sense of rapport, and sometimes a preference to see the re-
searcher, was important to participants in order for them to experience
a “more personal” connection during their participation in the research.

“I think email’s impersonal. If I hadn’t have spoken to you on the
phone I wouldn’t have got the feel I’ve got, I think you get a feel for a
person on the phone don’t you?” [Jim: Telephone].

Enabling the researcher to connect more personally with the parti-
cipant, ensuring that the researcher was getting the information that
they needed, particularly as the focus was on such an important and
emotive issue, was also significant for participants.

“By talking to someone you can build a better picture up… I feel it’s
important about research like this and I feel that if you’re typing the
questions that you might not get everything you need… I thought this
was the best way to get a feeling for, I suppose you, as well you get a
feeling for the family.” [Beth: Telephone].

In addition to this, it was vital that the researcher used appropriate
interpersonal skills to provide the participants with a safe, non-judge-
mental space to communicate their experience.

“I’ve felt more emotional at times, and still able to say the right
answer, because I can see your face as opposed to it feeling like there’s
someone judging the way you behaved, or behave. I would have
probably been more cagey [on the phone] and more like yeah

J. Heath et al. Applied Research 43 (2018) 30–35

32

everything was fine in a lot of answers.” [Trish: Skype].
Due to the significance of the topic for these parents, it was also

important that data collection did not feel like a “normal anonymous
survey”.

3.4. Depth of response

Participants were keen to support the research and wanted to take
part in a way they thought would best ensure their responses provided
in-depth data.

“With email, I don’t feel you can give full enough answers, you could
ask a question and I could give a three line answer whereas, when we’re
talking about it on the phone, I think you get more depth of informa-
tion.” [Fran: Telephone].

Some participants felt that full interpersonal interaction was sig-
nificant to the research process, valuing the verbal and nonverbal
communication achieved during a face-to-face interview, and re-
cognising the potential relevance of such information to the researcher.

“When there’s a silence, on the phone you don’t know what I’m
thinking but you can see my face now, whether I’m recalling stuff… I
think if I was on the phone or Skype I’d feel much more pressured to
come up with an answer straightaway, whereas I feel face-to-face I can
think about it and you can understand why I’m thinking about it… and
with email it’s too easy to just say something, whereas I think you’ll
know by my voice whether it’s genuine or not, whereas I don’t think you
can do that on email.” [Theresa: Face-to-face].

4. Discussion

This paper has presented the preferences of 12 participants re-
garding their choice of interview method when participating in re-
search that focused on their experiences of having a child suffer a burn
injury (Heath et al., 2018). Results indicated that their preferences were
determined by personal convenience, their belief in their ability to be
open with the researcher despite potential upset caused by the topic,
their ability to get a “feel” for the researcher, and concern about giving
adequate depth in their responses.

It is worth noting that, due to the preventable nature of burn in-
juries in young children and the inherent probability of parent/carer

guilt and self-blame, this population is particularly sensitive to judg-
ment from others. Therefore, although some participants benefit from
seeing or hearing a researcher who demonstrates a non-judgemental
attitude, it might be preferable for others to participate remotely to
facilitate their openness during research so that fear of judgment does
not hamper communication. It can also be the case that participants’
self-disclosure is facilitated when the research is conducted outside of
the clinical setting due to the informal nature of alternative environ-
ments (Borbasi, Chapman, Gassner, Dunn, & Read, 2002). In cases
where the clinical setting may restrict disclosure (for example, when a
participant is concerned that a hospital-based interview might arouse
painful memories) then remote methods of participation, or researcher
flexibility, may be preferable. Such issues are likely to be relevant to
patients within a number of other areas of healthcare.

Despite references to telephone interviews not being well suited to
qualitative interviewing due to the lack of face-to-face contact re-
stricting the development of rapport (Irvine, 2011), telephone inter-
views were the most frequently chosen option for participation in the
study (Heath et al., 2018). Hershberger and Kavanaugh (2017) also
found telephone interviews more frequently chosen when offering a
choice between email and telephone interviews in research within an-
other sensitive area. According to participants in this study, a telephone
interview offered a convenient method of participation whilst also al-
lowing them to get a “feel” for the researcher. The interaction with the
researcher over the telephone could also provide participants with a
sense that the depth of their response was appropriate.

The theme ‘getting a “feel” for the researcher’ reflects the estab-
lishment of rapport. As described earlier, this requires researchers to
manage emotions expressed within researcher-participant interactions
and make participants feel comfortable (Liamputtong, 2007), providing
a safe opportunity or environment for them to speak openly with the
researcher (Farooq, 2015; Pyer & Campbell, 2012). The method of in-
terviewing used is likely to influence participants’ responses, affecting
the extent to which they feel comfortable enough to answer openly and
honestly about a sensitive or personal topic (Dures et al., 2011). A more
informal or relaxed interviewing style is likely to facilitate the dis-
closure of material that might be withheld in more formal settings (Hart
& Crawford-Wright, 1999).

When reasons for choosing Skype were explored, convenience and
the ability to get a “feel” for the researcher emerged as themes.
Participants’ decisions to choose a method of participation that posi-
tioned them remotely from the researcher was perhaps a strategy em-
ployed by them to manage an emotional situation at a safe distance
(Groves, 1979), whilst also being ‘face-to-face’ with the researcher.
Reasons why telephone interviews might be preferable to participants,
particularly when discussing sensitive topics, have been proposed pre-
viously; comparatively, telephone encounters afford greater anonymity
and reduced intensity (Chapple, 1999).

Indeed, the sharing of experiences via telephone and email may
have been facilitated for some participants by the greater ‘social dis-
tance’ between them and the researcher than is afforded in a face-to-

Table 1
Interview frequency, characteristics and emerging themes.

Method N Participants Mean (range) length of interview (minutes) Emerging themes

Telephone 5 4 mothers
1 grandfather

58 (50–75) Convenience
Depth of response
Getting a “feel” for the
researcher

Email 4 3 mothers
1 father

2 emails: First email contained all questions. Second email contained individualised questions to clarify and
expand on answers provided.

Convenience
Openness despite upset

Skype 2 2 mothers 67 (61–73) Convenience
Getting a “feel” for the
researcher

Face-to-face 1 1 mother 57 Depth of response
Openness despite upset

Table 2
Themes and sub-themes.

Themes Sub-themes

Convenience a. Demands on time
b. Familiarity

Openness despite upset
Getting a “feel” for the researcher a. Personal connection

b. (Non)Judgment
Depth of response a. Reassurance

b. Interpersonal communication

J. Heath et al. Applied Research 43 (2018) 30–35

33

face encounter (Cook, 2012). This has been related to hypotheses about
the role of social desirability, with the avoidance of revealing person-
ally-perceived negative characteristics being heightened in the physical
presence of another. This affect is reduced somewhat in telephone
communication compared to face-to-face interview (Groves, 1990).
Whilst participants might acknowledge the value of sharing their ex-
periences, communicating them can be challenging due to concerns
about how they might be perceived. Therefore, it could also be hy-
pothesised that those participants who are concerned that researcher
presence would cause them to shy away from particularly challenging
or sensitive questions might feel more comfortable or safer about self-
disclosure when using a method in which they are not physically
visible. This factor may well have influenced the choice of some to
participate via email (Cook, 2012; Hershberger & Kavanaugh, 2017;
Meho, 2006).

However, these theories were not consistently supported in this
study. One participant commented that not being face-to-face with the
researcher might make participants present as “braver”, which could
make the communication “very contrived”. In this case, seeing the re-
searcher, as opposed to being on the telephone, was reassuring as facial
expressions communicated a non-judgemental attitude that facilitated
communication that was more candid. This finding supports Groves
(1979), who reported that most respondents would have preferred to be
interviewed face-to-face rather than by telephone regarding sensitive
topics.

The third interview method also chosen for its convenience was
email. Telephone calls could be made easily to participants at home or
work; however, one could …