Culture and Meaning in Health Services Research

Elisa J. Sobo is a Medical Anthropologist at San Diego State University. Paul S. Kurtin is Director of the Center for Child Health Outcomes at Children's Hospital and Health Center in San Diego, California.

"In this book, Sobo bridges the disciplinary divide between health and social science, demonstrating the distinct angle of thoughtful analysis that anthropological method and interpretative tradition bring to unraveling the complexities of health service systems. Recognizing that many holes within current evidentiary health knowledge pertain to interactions in which human agency plays a central role, she engages the reader in a delightful and opinionated dialogue that creatively deconstructs conventional assumptions and convincingly reveals what social theorizing contributes to understanding and solving the problems confronting health service researchers today." -Sally Thorne, Professor and Director, UBC School of Nursing "Sobo provides health professionals and social scientists with a lifetime of real-world lessons aptly illustrating the added value and challenges of employing anthropologically informed qualitative methods in health service research in clinical settings. This highly engaging and very readable how-to book makes a compelling case for why this type of research is necessary and what it takes to get it done in busy clinical environments where researchers must maneuver carefully and be attentive to a system undergoing constant change. Notably, Sobo addresses the contexts in which research results are released and speaks to the power of teaching stories and translational research in a field largely guided by audit culture. The book is timely and speaks to both health social science and health care audiences." -Mark Nichter, University of Arizona "To meet today's health care challenges we must bring the methods and analytic skills and passions of medical anthropology into health service settings. Elisa Sobo boldly shows the way. Writing in an engaging and direct style, she argues the importance of meaning in hospitals and health care, clarifies what anthropologists do in such settings, and offers straightforward and sensible guidance about methods and everyday practice. In doing so, Sobo provides compelling reasons for health care providers to want anthropologists, and will inspire anthropologists and their students to take up the opportunities." -Lenore Manderson, School of Psychology, Psychiatry and Psychological Medicine, Faculty of Medicine, Monash University "...Aimed as a practical guide for health services researchers, this book goes beyond providing a how to' text to address the context and value of anthropologically informed qualitative health services research. It is aimed not only at other medical anthropologists working in healthcare research, such as the author herself, but also those engaged in health services research from other disciplines and backgrounds. The book achieves this by giving equal attention to the contexts of both health services research and anthropologically informed qualitative methods, inviting the reader to reflect on their own areas of familiarity as well as reflecting on the professional domains of others. Sobo makes extensive use of case studies and examples from her own experi- ence, setting out issues using illustrative anecdotes in a way that makes the subject matter accessible to readers less familiar with the field. This style of a sequentially written narrative may not suit readers who are seeking a more compartmentalized research methods text which can be dipped into'. The broad scope of the book and the interweaving of key concepts, personal experience and case studies, makes the whole book journey worthwhile and rewarding to orientate the reader to the subject matter."...- Kathryn Roulston, Qualitative Research

• I: The Value of Meaning; 1: The Journey Ahead: Aims and Means; 2: Why Focus on Stories?; II: The Lay of the Land; 3: Medical Anthropology: An Agenda; 4: Anthropology in and of Health Services; 5: Health Services: An Insider's Guide; 6: The Culture Concept, Cultural Competence, and the Dangers of “Anthro Lite”; III: Methodological Theory and Practice; 7: Doing Science—And Other Systematic Things; 8: Epistemology and Evidence: How Do We Know What We Know?; 9: The Realities of Research: Where and How to Begin; IV: Specific Methods; 10: Refocusing Focus Group Data Collection and Analysis; 11: Making the Most of One-Time Interviews; 12: Collecting Data as; 13: Making Rapid Improvements; V: Power Dynamics: The Politics of Research; 14: Institutional and Other; 15: Framing Our Message: Telling Stories, Making Action