importance of quantitative research on communication

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Quantitative Research in Communication

• Mike Allen - University of Wisconsin - Milwaukee, USA
• Scott Titsworth - Ohio University, USA
• Stephen K. Hunt - Illinois State University, USA
• Description

Written for communication students, Quantitative Research in Communication provides practical, user-friendly coverage of how to use statistics, how to interpret SPSS printouts, how to write results, and how to assess whether the assumptions of various procedures have been met. Providing a strong conceptual orientation to techniques and procedures that range from the "moderately basic" to "highly advanced," the book provides practical tips and suggestions for quantitative communication scholars of all experience levels. In addition to important foundational information, each chapter that covers a specific statistical procedure includes suggestions for interpreting, explaining, and presenting results; realistic examples of how the procedure can be used to answer substantive questions in communication; sample SPSS printouts; and a detailed summary of a published communication journal article using that procedure.

· Engaged Research application boxes stimulate thought and discussion, illustrating how particular research methods can be used to answer very practical, civic-minded questions.

· Realistic examples at the beginning of each chapter show how the chapter's procedure could be used to answer a substantive research question.

· Examples and application activities geared toward the emerging trend of service learning encourage students to do projects oriented toward their community or campus.

· Summaries of journal articles demonstrate how to write statistical results in APA style and illustrate how real researchers use statistical procedures in a wide variety of contexts, such as tsunami warnings, date requests, and anti-drug public service announcements.

· How to Decipher Figures show students how to "read" the statistical shorthand presented in the quantitative results of an article and also, by implication, show them how to write up results .

Quantitative Research in Communication is ideal for courses in Quantitative Methods in Communication, Statistical Methods in Communication, Advanced Research Methods (undergraduate), and Introduction to Research Methods (Graduate) in departments of communication, educational psychology, psychology, and mass communication.

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This is an excellent book. My students love it.

I particularly like the chapter on meta-analysis as this is one topic that most of the books on survey that I have been using do not discuss.

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5.5: Quantitative Methods

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• Page ID 184632

• Scott T. Paynton & Laura K. Hahn with Humboldt State University Students
• Humboldt State University

Steps for Doing Quantitative Research

Rhetorical research methods have been being developed since the Classical Period. As the transition was made to seeing communication from a social scientific perspective, scholars began studying communication using the methods established from the physical sciences. Thus, quantitative methods represent the steps of using the Scientific Method of research.

• Decide on a focus of study based primarily on your interests. What do you want to discover or answer?
• Develop a research question(s) to keep your research focused.
• Develop a hypothesis(es). A hypothesis states how a researcher believes the subjects under study will or will not communicate based on certain variables. For example, you may have a research question that asks, “Does the gender of a student impact the number of times a college professor calls on his/her students?” From this, you might form two hypotheses: “Instructors call on female students less often then male students.” and “Instructors call on students of their same sex.”
• Collect data in order to test hypotheses. In our example, you might observe various college classrooms in order to count which students professors call on more frequently.
• Analyze the data by processing the numbers using statistical programs like SPSS that allow quantitative researchers to detect patterns in communication phenomena. Analyzing data in our example would help us determine if there are any significant differences in the ways in which college professors call on various students.
• Interpret the data to determine if patterns are significant enough to make broad claims about how humans communicate? Simply because professors call on certain students a few more times than other students may or may not indicate communicative patterns of significance.
• Share the results with others. Through the sharing of research we continue to learn more about the patterns and rules that guide the ways we communicate.

The term quantitative refers to research in which we can quantify, or count, communication phenomena . Quantitative methodologies draw heavily from research methods in the physical sciences explore human communication phenomena through the collection and analysis of numerical data. Let’s look at a simple example. What if we wanted to see how public speaking textbooks represent diversity in their photographs and examples. One thing we could do is quantify these to come to conclusions about these representations. For quantitative research, we must determine which communicative acts to count? How do we go about counting them? Is there any human communicative behavior that would return a 100% response rate like the effects of gravity in the physical sciences? What can we learn by counting acts of human communication?

Suppose you want to determine what communicative actions illicit negative responses from your professors. How would you go about researching this? What data would you count? In what ways would you count them? Who would you study? How would you know if you discovered anything of significance that would tell us something important about this? These are tough questions for researchers to answer, particularly in light of the fact that, unlike laws in the physical sciences, human communication is varied and unpredictable.

Nevertheless, there are several quantitative methods researchers use to study communication in order to reveal patterns that help us predict and control our communication. Think about polls that provide feedback for politicians. While people do not all think the same, this type of research provides patterns of thought to politicians who can use this information to make policy decisions that impact our lives. Let’s look at a few of the more frequent quantitative methods of communication research.

Types of Quantitative Methods

There are many ways researchers can quantify human communication. Not all communication is easily quantified, but much of what we know about human communication comes from quantitative research.

• Experimental Research is the most well-established quantitative methodology in both the physical and social sciences. This approach uses the principles of research in the physical sciences to conduct experiments that explore human behavior. Researchers choose whether they will conduct their experiments in lab settings or real-world settings. Experimental research generally includes a control group (the group where variables are not altered) and the experimental group(s) (the group in which variables are altered). The groups are then carefully monitored to see if they enact different reactions to different variables.

To determine if students were more motivated to learn by participating in a classroom game versus attending a classroom lecture, the researchers designed an experiment. They wanted to test the hypothesis that students would actually be more motivated to learn from the game. Their next question was, “do students actually learn more by participating in games?” In order to find out the answers to these questions they conducted the following experiment. In a number of classes instructors were asked to proceed with their normal lecture over certain content (control group), and in a number of other classes, instructors used a game that was developed to teach the same content (experimental group). The students were issued a test at the end of the semester to see which group did better in retaining information, and to find out which method most motivated students to want to learn the material. It was determined that students were more motivated to learn by participating in the game, which proved the hypothesis. The other thing that stood out was that students who participated in the game actually remembered more of the content at the end of the semester than those who listened to a lecture. You might have hypothesized these conclusions yourself, but until research is done, our assumptions are just that (Hunt, Lippert & Paynton).

Case In Point

Quantitative methods in action.

Wendy S. Zabada-Ford (2003) conducted survey research of 253 customers to determine their expectations and experiences with physicians, dentists, mechanics, and hairstylists. Her article, “Research Communication Practices of Professional Service Providers: Predicting Customer Satisfaction and Loyalty” researched the perceptions of customers’ personalized service as related to their expectations in order to predict their satisfaction with the actual service they received. In this study, the goal was to be able to predict the behavior of customers based on their expectations before entering a service-provider context.

Michael T. Stephenson’s (2003) article, “Examining Adolescents’ Responses to Anti-marijuana PSAs” examined how adolescents respond to anti-marijuana public service announcements in the U.S. On the surface, this study may fit into the “understanding” part of the continuum of intended outcomes. However, this research can be used to alter and change messages, such as PSAs, to produce behavioral change in the culture. In this case, the change would be to either keep adolescents from smoking marijuana, or to get them to stop this behavior if they are currently engaged in it.

• Survey Research is used to ask people a number of questions about particular topics. Surveys can be online, mailed, handed out, or conducted in interview format. After researchers have collected survey data, they represent participants’ responses in numerical form using tables, graphs, charts, and/or percentages. On our campus, anonymous survey research was done to determine the drinking and drug habits of our students. This research demonstrated that the percentage of students who frequently use alcohol or drugs is actually much lower than what most students think. The results of this research are now used to educate students that not everyone engages in heavy drinking or drug use, and to encourage students to more closely align their behaviors with what actually occurs on campus, not with what students perceive happens on campus. It is important to remember that there is a possibility that people do not always tell the truth when they answer survey questions. We won’t go into great detail here due to time, but there are sophisticated statistical analyses that can account for this to develop an accurate representation of survey responses.

• Content Analysis . Researchers use content analysis to count the number of occurrences of their particular focus of inquiry. Communication researchers often conduct content analyses of movies, commercials, television shows, magazines, etc., to count the number of occurrences of particular phenomena in these contexts to explore potential effects. Harmon, for example, used content analysis in order to demonstrate how the portrayal of blackness had changed within Black Entertainment Television (BET). She did this by observing the five most frequently played films from the time the cable network was being run by a black owner, to the five most frequently played films after being sold to white­-owned Viacom, Inc. She found that the portrayal, context and power of the black man changes when a white man versus a black man is defining it. Content analysis is extremely effective for demonstrating patterns and trends in various communication contexts. If you would like to do a simple content analysis, count the number of times different people are represented in photos in your textbooks. Are there more men than women? Are there more caucasians represented than other groups? What do the numbers tell you about how we represent different people?
• Meta-Analysis . Do you ever get frustrated when you hear about one research project that says a particular food is good for your health, and then some time later, you hear about another research project that says the opposite? Meta-analysis analyzes existing statistics found in a collection of quantitative research to demonstrate patterns in a particular line of research over time. Meta-analysis is research that seeks to combine the results of a series of past studies to see if their results are similar, or to determine if they show us any new information when they are looked at in totality. The article, Impact of Narratives on Persuasion in Health Communication: A Meta-Analysis examined past research regarding narratives and their persuasiveness in health care settings. The meta-analysis revealed that in-person and video narratives had the most persuasive impacts while written narratives had the least (Shen, Sheer, Li).

Outcomes of Quantitative Methodologies

Because it is unlikely that Communication research will yield 100% certainty regarding communicative behavior, why do Communication researchers use quantitative approaches? First, the broader U.S. culture values the ideals of quantitative science as a means of learning about and representing our world. To this end, many Communication researchers emulate research methodologies of the physical sciences to study human communication phenomena. Second, you’ll recall that researchers have certain theoretical and methodological preferences that motivate their research choices. Those who understand the world from an Empirical Laws and/or Human Rules Paradigm tend to favor research methods that test communicative laws and rules in quantitative ways.

Even though Communication research cannot produce results with 100% accuracy, quantitative research demonstrates patterns of human communication. In fact, many of your own interactions are based on a loose system of quantifying behavior. Think about how you and your classmates sit in your classrooms. Most students sit in the same seats every class meeting, even if there is not assigned seating. In this context, it would be easy for you to count how many students sit in the same seat, and what percentage of the time they do this. You probably already recognize this pattern without having to do a formal study. However, if you wanted to truly demonstrate that students communicatively manifest territoriality to their peers, it would be relatively simple to conduct a quantitative study of this phenomenon. After completing your research, you could report that X% of students sat in particular seats X% of times. This research would not only provide us with an understanding of a particular communicative pattern of students, it would also give us the ability to predict, to a certain degree, their future behaviors surrounding space issues in the classroom.

Quantitative research is also valuable for helping us determine similarities and/or differences among groups of people or communicative events. Representative examples of research in the areas of gender and communication (Berger; Slater), culture and communication (McCann, Ota, Giles, & Caraker; Hylmo & Buzzanell), as well as ethnicity and communication (Jiang Bresnahan, Ohashi, Nebashi, Wen Ying, Shearman; Murray-Johnson) use quantitative methodologies to determine trends and patterns of communicative behavior for various groups. While these trends and patterns cannot be applied to all people, in all contexts, at all times, they help us understand what variables play a role in influencing the ways we communicate.

While quantitative methods can show us numerical patterns, what about our personal lived experiences? How do we go about researching them, and what can they tell us about the ways we communicate? Qualitative methods have been established to get at the “essence” of our lived experiences, as we subjectively understand them.

Contributions and Affiliations

• Survey of Communication Study. Authored by : Scott T Paynton and Linda K Hahn. Provided by : Humboldt State University. Located at : en.wikibooks.org/wiki/Survey_of_Communication_Study/Preface. License : CC BY-SA: Attribution-ShareAlike

Guide to Communication Research Methodologies: Quantitative, Qualitative and Rhetorical Research

Overview of Communication

Communication research methods, quantitative research, qualitative research, rhetorical research, mixed methodology.

Students interested in earning a graduate degree in communication should have at least some interest in understanding communication theories and/or conducting communication research. As students advance from undergraduate to graduate programs, an interesting change takes place — the student is no longer just a repository for knowledge. Rather, the student is expected to learn while also creating knowledge. This new knowledge is largely generated through the development and completion of research in communication studies. Before exploring the different methodologies used to conduct communication research, it is important to have a foundational understanding of the field of communication.

Defining communication is much harder than it sounds. Indeed, scholars have argued about the topic for years, typically differing on the following topics:

• Breadth : How many behaviors and actions should or should not be considered communication.
• Intentionality : Whether the definition includes an intention to communicate.
• Success : Whether someone was able to effectively communicate a message, or merely attempted to without it being received or understood.

However, most definitions discuss five main components, which include: sender, receiver, context/environment, medium, and message. Broadly speaking, communication research examines these components, asking questions about each of them and seeking to answer those questions.

As students seek to answer their own questions, they follow an approach similar to most other researchers. This approach proceeds in five steps: conceptualize, plan and design, implement a methodology, analyze and interpret, reconceptualize.

• Conceptualize : In the conceptualization process, students develop their area of interest and determine if their specific questions and hypotheses are worth investigating. If the research has already been completed, or there is no practical reason to research the topic, students may need to find a different research topic.
• Plan and Design : During planning and design students will select their methods of evaluation and decide how they plan to define their variables in a measurable way.
• Implement a Methodology : When implementing a methodology, students collect the data and information they require. They may, for example, have decided to conduct a survey study. This is the step when they would use their survey to collect data. If students chose to conduct a rhetorical criticism, this is when they would analyze their text.
• Analyze and Interpret : As students analyze and interpret their data or evidence, they transform the raw findings into meaningful insights. If they chose to conduct interviews, this would be the point in the process where they would evaluate the results of the interviews to find meaning as it relates to the communication phenomena of interest.
• Reconceptualize : During reconceptualization, students ask how their findings speak to a larger body of research — studies related to theirs that have already been completed and research they should execute in the future to continue answering new questions.

This final step is crucial, and speaks to an important tenet of communication research: All research contributes to a better overall understanding of communication and moves the field forward by enabling the development of new theories.

In the field of communication, there are three main research methodologies: quantitative, qualitative, and rhetorical. As communication students progress in their careers, they will likely find themselves using one of these far more often than the others.

Quantitative research seeks to establish knowledge through the use of numbers and measurement. Within the overarching area of quantitative research, there are a variety of different methodologies. The most commonly used methodologies are experiments, surveys, content analysis, and meta-analysis. To better understand these research methods, you can explore the following examples:

Experiments : Experiments are an empirical form of research that enable the researcher to study communication in a controlled environment. For example, a researcher might know that there are typical responses people use when they are interrupted during a conversation. However, it might be unknown as to how frequency of interruption provokes those different responses (e.g., do communicators use different responses when interrupted once every 10 minutes versus once per minute?). An experiment would allow a researcher to create these two environments to test a hypothesis or answer a specific research question. As you can imagine, it would be very time consuming — and probably impossible — to view this and measure it in the real world. For that reason, an experiment would be perfect for this research inquiry.

Surveys : Surveys are often used to collect information from large groups of people using scales that have been tested for validity and reliability. A researcher might be curious about how a supervisor sharing personal information with his or her subordinate affects way the subordinate perceives his or her supervisor. The researcher could create a survey where respondents answer questions about a) the information their supervisors self-disclose and b) their perceptions of their supervisors. The data collected about these two variables could offer interesting insights about this communication. As you would guess, an experiment would not work in this case because the researcher needs to assess a real relationship and they need insight into the mind of the respondent.

Content Analysis : Content analysis is used to count the number of occurrences of a phenomenon within a source of media (e.g., books, magazines, commercials, movies, etc.). For example, a researcher might be interested in finding out if people of certain races are underrepresented on television. They might explore this area of research by counting the number of times people of different races appear in prime time television and comparing that to the actual proportions in society.

Meta-Analysis : In this technique, a researcher takes a collection of quantitative studies and analyzes the data as a whole to get a better understanding of a communication phenomenon. For example, a researcher might be curious about how video games affect aggression. This researcher might find that many studies have been done on the topic, sometimes with conflicting results. In their meta-analysis, they could analyze the existing statistics as a whole to get a better understanding of the relationship between the two variables.

Qualitative research is interested in exploring subjects’ perceptions and understandings as they relate to communication. Imagine two researchers who want to understand student perceptions of the basic communication course at a university. The first researcher, a quantitative researcher, might measure absences to understand student perception. The second researcher, a qualitative researcher, might interview students to find out what they like and dislike about a course. The former is based on hard numbers, while the latter is based on human experience and perception.

Qualitative researchers employ a variety of different methodologies. Some of the most popular are interviews, focus groups, and participant observation. To better understand these research methods, you can explore the following examples:

Interviews : This typically consists of a researcher having a discussion with a participant based on questions developed by the researcher. For example, a researcher might be interested in how parents exert power over the lives of their children while the children are away at college. The researcher could spend time having conversations with college students about this topic, transcribe the conversations and then seek to find themes across the different discussions.

Focus Groups : A researcher using this method gathers a group of people with intimate knowledge of a communication phenomenon. For example, if a researcher wanted to understand the experience of couples who are childless by choice, he or she might choose to run a series of focus groups. This format is helpful because it allows participants to build on one another’s experiences, remembering information they may otherwise have forgotten. Focus groups also tend to produce useful information at a higher rate than interviews. That said, some issues are too sensitive for focus groups and lend themselves better to interviews.

Participant Observation : As the name indicates, this method involves the researcher watching participants in their natural environment. In some cases, the participants may not know they are being studied, as the researcher fully immerses his or herself as a member of the environment. To illustrate participant observation, imagine a researcher curious about how humor is used in healthcare. This researcher might immerse his or herself in a long-term care facility to observe how humor is used by healthcare workers interacting with patients.

Rhetorical research (or rhetorical criticism) is a form of textual analysis wherein the researcher systematically analyzes, interprets, and critiques the persuasive power of messages within a text. This takes on many forms, but all of them involve similar steps: selecting a text, choosing a rhetorical method, analyzing the text, and writing the criticism.

To illustrate, a researcher could be interested in how mass media portrays “good degrees” to prospective college students. To understand this communication, a rhetorical researcher could take 30 articles on the topic from the last year and write a rhetorical essay about the criteria used and the core message argued by the media.

Likewise, a researcher could be interested in how women in management roles are portrayed in television. They could select a group of popular shows and analyze that as the text. This might result in a rhetorical essay about the behaviors displayed by these women and what the text says about women in management roles.

As a final example, one might be interested in how persuasion is used by the president during the White House Correspondent’s Dinner. A researcher could select several recent presidents and write a rhetorical essay about their speeches and how they employed persuasion during their delivery.

Taking a mixed methods approach results in a research study that uses two or more techniques discussed above. Often, researchers will pair two methods together in the same study examining the same phenomenon. Other times, researchers will use qualitative methods to develop quantitative research, such as a researcher who uses a focus group to discuss the validity of a survey before it is finalized.

The benefit of mixed methods is that it offers a richer picture of a communication phenomenon by gathering data and information in multiple ways. If we explore some of the earlier examples, we can see how mixed methods might result in a better understanding of the communication being studied.

Example 1 : In surveys, we discussed a researcher interested in understanding how a supervisor sharing personal information with his or her subordinate affects the way the subordinate perceives his or her supervisor. While a survey could give us some insight into this communication, we could also add interviews with subordinates. Exploring their experiences intimately could give us a better understanding of how they navigate self-disclosure in a relationship based on power differences.

Example 2 : In content analysis, we discussed measuring representation of different races during prime time television. While we can count the appearances of members of different races and compare that to the composition of the general population, that doesn’t tell us anything about their portrayal. Adding rhetorical criticism, we could talk about how underrepresented groups are portrayed in either a positive or negative light, supporting or defying commonly held stereotypes.

Example 3 : In interviews, we saw a researcher who explored how power could be exerted by parents over their college-age children who are away at school. After determining the tactics used by parents, this interview study could have a phase two. In this phase, the researcher could develop scales to measure each tactic and then use those scales to understand how the tactics affect other communication constructs. One could argue, for example, that student anxiety would increase as a parent exerts greater power over that student. A researcher could conduct a hierarchical regression to see how each power tactic effects the levels of stress experienced by a student.

As you can see, each methodology has its own merits, and they often work well together. As students advance in their study of communication, it is worthwhile to learn various research methods. This allows them to study their interests in greater depth and breadth. Ultimately, they will be able to assemble stronger research studies and answer their questions about communication more effectively.

Note : For more information about research in the field of communication, check out our Guide to Communication Research and Scholarship .

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Quantitative criticalism for social justice and equity-oriented communication research

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Youllee Kim, Quantitative criticalism for social justice and equity-oriented communication research, Human Communication Research , Volume 50, Issue 2, April 2024, Pages 162–172, https://doi.org/10.1093/hcr/hqad048

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An increasing number of communication researchers have noted the potential of quantitative criticalism (QuantCrit) or the use of quantitative approaches to pursue social justice and equity agenda. Nonetheless, how to achieve the goals and ideals of QuantCrit in communication studies still largely remains uncharted terrain. This article offers five concrete suggestions for how researchers can bring critical consciousness to quantitative communication research: (a) broadening and diversifying the scope of communication research, (b) (re)framing research questions with a social justice orientation, (c) critiquing dominant narratives and centering the counternarratives, (d) incorporating intersectionality to address marginalization, and (e) employing statistical methods that illuminate interdependence, systems, and power dynamics. This article seeks to enrich the discussion on ways to embrace QuantCrit in communication research to revitalize perspectives and means for identifying and addressing inequalities, and eventually to advance transformative scholarship.

A scholar’s research paradigm, or the lens through which researchers view the world, has implications for the research questions they propose, their ways of knowing, and the methodological choices they make ( Kuhn, 1962 ). Traditionally, the predominant research paradigms, such as postpositivist and critical paradigms, tended to claim their own ways of conducting research based on distinctive research goals and questions. However, the paradigmatic boundary has started to be challenged by scholars who seek greater possibilities of what their overlap can explore, explain, and achieve ( Curtis et al., 2022 ; Else-Quest & Hyde, 2016a ; Suter, 2018 ). The term quantitative criticalism (QuantCrit) describes research efforts that use quantitative approaches, which have generally been grounded in a postpositivist paradigm, to identify and challenge socially perpetuated injustices and inequalities ( Stage & Wells, 2014a ). Allowing researchers to reimagine the possibilities of quantitative approaches, QuantCrit has implications for social justice and equity research, which has been thought of as located within the critical paradigm ( Stage, 2007 ).

When properly employed, QuantCrit approaches provide communication researchers with the capacity to use scientific practices to investigate and challenge dominant ideologies, power dynamics, and systemic oppression that are at play in different levels (e.g., intrapersonal, interpersonal, societal, etc.) and contexts (e.g., family, health, political, etc.) of communication. Within the last few decades, communication scholars have shown a growing interest in employing quantitative methods to pursue social justice and equity agenda ( Scharrer & Ramasubramanian, 2021 ). Both across different disciplines and within the field of communication, there is a general consensus on what QuantCrit should strive for. Nevertheless, the question of how we should achieve the ideals and aims of QuantCrit still largely remains unanswered, leaving quantitative researchers with inadequate guidelines for critical reflection. In this article, I aim to elaborate on how communication researchers can employ quantitative methods to conduct critical research. This article contributes to theory development and the expansion of communication research by proposing QuantCrit as a way of inquiry through which communication scholars can reflect on the types of questions they ask, interrogate their decisions during the research process, and seek to transform our world.

To this end, I begin this article with an overview of different paradigms and an introduction to QuantCrit. I then make five suggestions on how communication researchers can bring critical consciousness to quantitative research: (a) broaden and diversify the scope of communication research, (b) (re)frame research questions with a social justice orientation, (c) critique the dominant narratives and center the counternarratives, (d) incorporate intersectionality to address marginalization, and (e) employ statistical methods that illuminate interdependence, systems, and power dynamics. For each suggestion, I critically review exemplary studies and/or tweak existing studies with a critical lens.

Research paradigms and quantitative criticalism (QuantCrit)

Multiple research paradigms exist, each of which involves four, interrelated philosophical components: ontology, epistemology, axiology, and methodology ( Crotty, 2003 ). At the highest level, ontological assumptions about the nature of reality lead to an epistemological stance or a way of knowing. Axiology refers to the assumptions regarding ethics and value systems, which shape the aim and process of research. Ontological, epistemological, and axiological choices and assumptions have tended to guide methodology or the way in which researchers collect and evaluate evidence ( Guba, 1990 ). Building on different philosophical components, research paradigms have traditionally claimed distinctive boundaries from one another.

To provide bases for QuantCrit, I first review aspects of postpositivist and critical paradigms as they have developed in communication studies. The philosophical root of postpositivism is positivism, which is grounded in the assumption that a single, objective reality exists. From positivists’ point of view, all scientific inquiries should be value-free to discover the Truth that is unbiased ( Crotty, 2003 ). More prevalent in communication studies are postpositivist views, which dismiss the notion of a single reality (one Truth), but maintain that truths about the world can be revealed through research ( Corman, 2005 ). Though acknowledging that researchers’ value systems might influence the questions they ask, postpositivists still try to reduce the subjectivity in data collection and analysis processes as much as possible. With the aim of explaining, predicting, and controlling the phenomena of interest, communication research that is situated within the postpositivist paradigm has conventionally employed quantitative approaches in which researchers test hypotheses with numerical data ( Miller, 2005 ).

Evolved from the German Frankfurt School, the critical paradigm has grown to embrace different perspectives under the critical canon such as race, feminist, queer, disability, and decolonial theories (e.g., Crenshaw, 1991 ; Goodley, 2013 ; Watson, 2005 ). Philosophical assumptions underlying the critical paradigm are not always unitary, but there are commonalities among the variants of critical theory. While some critical scholars favor more objective views of reality and see the social structures as relatively fixed, most critical scholars today hold an assumption that what can be known about the world is socially constructed (see Miller [2005] for further discussion of different positions held by critical theorists). The belief that we cannot separate ourselves from our knowledge inevitably influences critical scholar’s inquiry. Understanding reality within power relations, critical scholars are committed to using their work as a form of criticism that identifies, evaluates, and challenges systems of power, thereby stimulating social change and transformation ( Morrow & Brown, 1994 ). For critical scholars, research is a value-laden activity that should advocate for the oppressed and disadvantaged. Although critical research in many disciplines including communication has often been conducted with data that are qualitative and in-depth in nature, there is nothing about critical inquiry itself that is inherently opposed to quantitative approaches to research, which presents an opportunity for QuantCrit scholarship ( Stage & Wells, 2014a ).

In advocating for QuantCrit, I note Deetz’s (2001) perspective that emphasizes the fluid and integrative nature of knowledge production. Ontological, epistemological, and axiological assumptions of different paradigms provide meaningful distinctions that help us understand how and why research is conducted and interpreted. Yet, these higher-order philosophical assumptions should not impose limits on methodological assumptions about generating knowledge ( Morgan, 2007 ). Isolating knowledge production within a certain paradigm results in polarizing different types of knowledge and disconnecting our understanding of the phenomenon under study, rather than meaningfully advancing scholarship ( Droser, 2017 ). QuantCrit deconstructs assumptions that certain types of research inquiry are tied to particular methodologies and subsequent practical procedures at the level of data collection and analysis. I suggest that the value of identifying and addressing injustices and inequalities can be a place of common ground where researchers with different methodological approaches build a more inclusive and comprehensive base of knowledge for socially just purposes. Any research method can be used for socially just purposes, and QuantCrit maximizes the potential of quantitative research or the ‘power of numbers’ ( Scharrer & Ramasubramanian, 2021 , p. 2) to identify inequalities and raise awareness, to propose and test solutions, or to otherwise pursue social justice and equity agenda.

Along with increasing scholarly attention, QuantCrit scholarship has faced critiques and challenges. One critique is relevant to the history of ethical violations and perpetuation of existing prejudices by scientific research (see Cokley & Awad [2013] and Scharrer & Ramasubramanian [2021] for the discussion of specific examples). In a sense, QuantCrit is a call to prove the value of quantitative research in promoting social justice and equity notwithstanding the historical scientific misconduct. In addition to minimizing the potential risks of harm associated with research, QuantCrit researchers should foreground ethical considerations to ensure that the processes as well as products of research reduce social inequalities and improve the social contexts in which their research is grounded.

Another critique relates to epistemological tensions between the paradigms, such that certain elements of quantitative methodologies, including researcher objectivity and emphasis on generalizability, seem at odds with a critical paradigm ( McLaren, 2017 ). QuantCrit researchers have addressed these tensions by pointing out that quantitative approaches that claim to be objective are in fact value-laden and not free from researchers’ potential bias ( Stage, 2007 ). QuantCrit researchers are encouraged to reflect on their own positionality as researchers and the values they hold, which help them understand the power afforded and constrained in the assumptions and choices they make in research. Importantly, QuantCrit researchers should maintain methodological rigor and high levels of statistical expertise while maintaining a critical stance ( Stage & Wells, 2014b ). Researchers inexperienced with a critical scholarship may fail to appreciate the potential of research in transforming the current status quo, while researchers without a high level of statistical expertise may not know how to accurately analyze quantitative data to their fullest potential ( Curtis et al., 2022 ).

Concerns have also arisen regarding the meaning of critical inquiry ( Stage & Wells, 2014a ). Some critical scholars have argued that to be critical, the methods must be directly transformative or at least engage with the community of interest. Although there is value in action-oriented critical research, QuantCrit embraces a broader conceptualization of critical inquiry, one that, regardless of the method, reveals inequality and attends to the experiences of marginalized individuals ( Stage & Wells, 2014b ). By adopting this broader understanding of critical inquiry, QuantCrit allows for many different ways to utilize quantitative approaches for social change and transformation, ranging from raising awareness and offering critique based on quantitative evidence to examining the causal logic of interventions and assessing unintentional consequences of interventions for social justice.

With an aim of offering concrete guidelines for the integration of QuantCrit in communication studies, I next turn to articulate five suggestions for how researchers can infuse critical consciousness into quantitative communication research. Before proceeding further, I note two important points. First, for each suggestion, I introduce example studies that illustrate the main point of the suggestion while acknowledging that the discussed studies often entail features that may also relate to other suggestions. Second, a single QuantCrit study may not always incorporate all five suggestions. Instead, I ask QuantCrit researchers to strive for building a program of research involving multiple studies that incorporate different sets of suggestions that, together, support social justice and equity goals.

Broadening and diversifying the scope of communication research

One way to promote critical consciousness in quantitative research is to broaden and diversify the scope of research to be more inclusive of often marginalized populations and their communication practices. Although being inclusive of members from diverse backgrounds does not always guarantee social justice, diversity and inclusion are critical components of social justice ( Cokley & Awad, 2013 ). Putting conscious efforts in research toward examining diverse population groups and cultural contexts not only broadens our understanding of human communication but also helps avoid generalizing the findings from one group (e.g., WEIRD samples; “people from Western, Educated, Industrialized, Rich, and Democratic societies.” Henrich et al., 2010 , p. 61) to other humans with different lived experiences.

In broadening the scope of communication research, QuantCrit researchers should examine neglected communication phenomena in relation to systems of power and oppression. For instance, interpersonal communication research has mostly been conducted with WEIRD samples, which resulted in not only silencing discussions of race and power but also limiting our capability to draw transferable insights regarding people and topics that have been traditionally marginalized ( Afifi & Cornejo, 2020 ). In addition, research examining interpersonal communication of non-WEIRD populations has tended to locate them in relation to the WEIRD population by highlighting the differences in interracial communication encounters, and thus largely ignoring intracultural stories or interpersonal communication among romantic partners, families, and friends within the non-WEIRD population groups ( Houston, 2002 ).

Kam et al. (2017) is noteworthy in that researchers examined interpersonal communication among a marginalized population, but it also showcases why studying a marginalized population is not sufficient to make the research critical. One example of an understudied group in communication is Spanish-speaking families and especially child language brokers in these families who translate the English language and interpret cultural practices for their English-limited parents ( Kam et al., 2017 ). Based on the data from low-income, Spanish-speaking mother–child dyads, Kam et al. (2017) found that child language brokers in families in which mothers and children share communal coping views were less likely to experience depressive symptoms than in families where mothers deny the responsibility of stress ownership and coping behaviors. Furthermore, Kam et al. (2017) tested empirical constructs, such as close ties to family (i.e., familismo ) and respect for family (i.e., respeto ) rooted in the values and realities of Latino/a families, as predictors of different coping styles.

Despite the study’s many insights, the nature of Kam et al. (2017) is descriptive and predictive, and not critical. Critical research should attend to issues of power and critique the status quo to pursue social justice ( Suter, 2016 ). To propose and answer questions from a critical stance, future studies may examine how the unequal power dynamics and the systems of oppression faced by immigrants, such as exclusionary immigration policies, economic hardships, and racial discrimination, shape the experience of language brokering in immigrant families. In doing so, quantitative approaches can enable researchers to examine and compare multiple structural factors that contribute to negative (or positive) consequences of language brokering.

In media effects studies, for a different example, prior research on the impact of media representations of minorities mostly focused on the majority members while only a few studies examined the effects of exposure to stereotypical media content on minorities themselves ( Mastro, 2009 ; Riles et al., 2022 ). In Saleem et al. (2019) , for a notable exception, exposure to negative news coverage of Muslims decreased Muslim Americans’ strength of identification as Americans, but not as Muslims, which in turn, reduced their trust in the U.S. government. Similarly, Saleem and Ramasubramanian (2019) demonstrated that Muslim Americans who viewed negative media representations of Muslims, compared to a control video, were less likely to desire acceptance by other Americans and more likely to avoid interactions with non-Muslim Americans.

Although the above-mentioned studies did not explicitly adopt the critical lens to research, Saleem et al. (2019) interpreted their findings with a critical consciousness, highlighting that a broader social context like the hegemonic power of mainstream media that transcends individual, personal experiences (e.g., everyday experience of discrimination) should be accounted for in research on stigmatized minorities. In addition to calling for more balanced representations of minority groups in mainstream media, Saleem and Ramasubramanian (2019) emphasized that their findings can serve as a basis to develop minority group members’ critical media literacy skills that help challenge negative media images. As evidenced in these examples, the integration of QuantCrit approaches can begin as early as when choosing the communication phenomenon of interest and continue throughout the research process to expose and challenge inequity when interpreting the study findings.

(Re)framing research questions with a social justice and equity orientation

The second suggestion for communication researchers seeking to embrace QuantCrit in their work is to consider (re)framing research questions with more explicit intentionality toward social justice and equity. In rejecting the notion that quantitative research is value-free and politically neutral, QuantCrit researchers can take an ethical position and propose research questions with social justice goals. Without establishing social justice orientations in research questions, quantitative research that examines marginalized populations may as well perpetuate existing power dynamics by making individuals accountable for the inequalities.

To discuss examples of quantitative communication studies that adopt research questions with a social justice orientation, I first turn to the field of health communication. Many health interventions take the form of persuasive communication that targets individuals’ psychological processes to change personal health behaviors (e.g., Fishbein & Cappella, 2006 ). The success of health communication campaigns has thus generally been evaluated based on the extent to which interventions influence individuals’ cognitions, emotions, and engagement with the recommended behavior ( Dutta-Bergman, 2005 ). With critical inquiry, quantitative researchers can go beyond examining interventions’ effects on individual-level changes and explore interventions’ effects on reducing health disparities at a societal level.

Launched by the Centers for Disease Control and Prevention (CDC) in 2011, the Testing Makes Us Stronger (TMUS) campaign serves as a good example. To address disproportionate rates of HIV transmission in the Black/African American population in the United States, the TMUS campaign aimed to increase HIV testing among Black or African American men who have sex with men (BMSM). Prior studies that evaluated the campaign effectiveness mostly focused on the campaign’s influence on individual-level attitude and behavior change (e.g., Badal et al., 2019 ). When the research question centers on understanding individual-level outcomes, such findings can be the basis to document the success of the TMUS campaign.

Nevertheless, a question with a social justice orientation may illuminate a different side of the story. A QuantCrit researcher may ask, “Will the campaign aiming to increase HIV testing among BMSM reduce disproportionate rates of HIV transmission in the Black or African American population?” Even though the campaign increased BMSM’s HIV testing rates, there existed a continuous rise of HIV transmissions within the BMSM community, thus bringing into question the success of the TMUS campaign ( Hawkins, 2020 ). Importantly, socioeconomic issues associated with poverty including homelessness, lack of access to health care, and food insecurity, directly and indirectly, increase the risk of contracting HIV among BMSM ( Centers for Disease Control and Prevention [CDC], 2019 ). Additionally, culturally constructed barriers, such as homophobia and HIV-related stigma, may affect other stages of the HIV care continuum, challenging individuals to seek appropriate care after being tested positive for HIV ( Arnold et al., 2014 ). Critical inquiry can guide researchers to be more attentive to systemic inequities and cultural influences in which health problems are embedded. With the capability to examine macrolevel, large-scale patterns with numerical data, quantitative approaches are well-positioned to provide clear and convincing answers to critical questions asked at the societal level.

While the above example centers on health communication, QuantCrit researchers can ask questions that advocate for social transformation across any subdiscipline of communication. For instance, from Asch’s (1955) research on group conformity to Noelle-Neumann’s (1991) spiral of silence theory, robust literature indicates that people tend to remain silent when their opinions do not seem to match with that of the majority. Of course, this is not always true. Although fewer in number, some researchers have investigated why certain minorities still express their opinions in such contexts ( Morrison & Miller, 2008 ). Exploring the possibility that minorities can challenge the existing social norms entails reframing research questions, which can be an initial step toward social justice-oriented research.

By reframing research questions to examine the phenomenon of minority opinion expression, most (non-QuantCrit) prior research has examined self- (e.g., need for uniqueness; Blanton & Christie, 2003 ) and group- (e.g., motivation to improve the group with which they identify; Rios, 2012 ) oriented motivation, as well as personality traits (e.g., low trait communication apprehension; Neuwirth et al., 2007 ), as contributors for minority opinion expression. In these works, the term minority is usually defined as a vocal minority whose attitudes differ from those of most other group members. In comparison, a QuantCrit researcher may be more interested in individuals from historically marginalized groups who might or might not be vocal minorities in a given context. Research questions can then be framed to examine how and why marginalized individuals challenge systemic inequality factors to have their voices heard. Instead of examining individuals’ motivations or personality traits, a QuantCrit researcher can investigate how social exclusion measured at the group level (e.g., Chakravarty & D’Ambrosio, 2006 ) or network level (e.g., Parks, 1977 ) interfere with marginalized individuals’ willingness to express their opinion. A QuantCrit researcher can also test the dominant group members’ cultural privilege as a prominent contributor to systemic inequality. Considering how a research question shapes the decision-making in the subsequent research process, proposing a social justice-oriented question is an integral step for QuantCrit research.

Critiquing dominant narratives and centering the counternarratives

QuantCrit researchers can offer alternate perspectives to formulate narratives and provide tools to test narrative effects. Narratives shape reality because they have the power to either silence or give a voice to individuals, and thus legitimize (or delegitimize) the status quo ( Nelson, 2001 ). Because much scientific inquiry has been pursued through the voices of WEIRD cultures, the lived experiences of marginalized populations and their narratives have often been ignored ( Kanazawa, 2020 ). The concept of counternarratives, or narratives that reflect the perspectives of those who have been historically marginalized, emerged to resist dominant narratives ( Bamberg, 2014 ). Counternarratives empower marginalized populations to contest existing systematic oppression and create their own narratives ( Saldanha et al., 2022 ).

In the mainstream media, majority groups occupy dominant narratives and are assumed to be normative while those of minoritized groups are largely silenced or depicted as problematic ( Larson, 2006 ). Researchers studying media effects have noted that even the ostensibly positive portrayals of marginalized individuals can intensify marginalization and oppression. For example, media messages showing people with disabilities performing physically impressive or strenuous activities are often considered inspirational, but could be insulting to those with disabilities ( Ramasubramanian & Banjo, 2020 ). Such a message—termed a supercrip narrative —contributes to the dominant narrative that disability is something to overcome through individual efforts.

In this context, quantitative approaches can contribute to critiquing dominant narratives and centering the counternarratives in several ways. Even though not all alternative narratives serve to resist existing systemic oppression from a critical point of view, opening alternative ways to spur dialog can be a reasonable starting point. For instance, supercrip narratives may have other kinds of positive influences beyond inspiring the able-bodied audience. Bartsch et al. (2016) showed that empathic feelings evoked by supercrip narratives increased stronger positive attitudes and behavior intentions toward people with disabilities ( Bartsch et al., 2016 ). The task for QuantCrit researchers, then, is to investigate which message features within a particular supercrip narrative stereotype people with disabilities while other features facilitate positive intergroup outcomes. QuantCrit research can also assess the potential harm of supercrip narratives and create messages with careful consideration of possible impacts on all who might be influenced by the messages. Because counternarratives need to reflect the perspectives of marginalized populations and empower them for social transformation, it is imperative that QuantCrit researchers examine the impacts of messages on people with disabilities themselves, such as their sense of self-identity, social belonging, and empowerment.

To more actively interrogate dominant narratives, QuantCrit researchers may redefine success in the messages they create. In supercrip narratives, success is judged on the ability to conform to the norms of the able-bodied majority ( Silva & Howe, 2012 ). In the counternarrative, success could be defined as how well people live with a disability rather than defy it. Being successful could also be based on the extent to which people with disabilities self-advocate for accommodations, educate others about disability, and engage in disability activism ( Kimball et al., 2016 ). By capitalizing on quantitative analyses’ capacity to test the message effects, QuantCrit researchers are well-positioned to find answers for how narratives can be written in ways that avoid stigmatizing language and promote social identities preferred by the marginalized group.

For a different example of the dominant narrative, we can turn to health communication during the COVID-19 pandemic. With many health communication efforts advocating mask-wearing as an effective COVID-19 preventive behavior, those who do not wear masks were often regarded as noncompliant and disruptive (e.g., Lehmann & Lehmann, 2021 ). As a way to challenge this dominant narrative, QuantCrit research can examine structural influences that may limit individuals’ ability to wear masks. When there were shortages of masks during the pandemic, many laypersons used scarves and bandanas, which have long been associated with stereotypes regarding gang affiliation, violence, and criminality. Because these stereotypes are particularly relevant to certain racialized groups, the decision to wear face coverings can be dangerous and even deadly for some individuals ( MacLin & Herrera, 2006 ).

Although not explicitly employing the critical perspective, Webber et al. (2022) resisted the dominant narratives that largely ignore systematic influence by proposing experiences of racism as a critical determinant of mask-wearing behaviors for people of color. Through a cross-sectional survey data, Webber et al. (2022) showed that Black, Latinx, and Asian individuals who experienced more racism perceived more barriers to wearing masks. Furthermore, for Black and Asian participants, perceived barriers inhibited intentions to wear a mask in public. As in Webber et al. (2022) , acknowledging structural barriers faced by minoritized groups (e.g., race-based discrimination) can be a way to compose counternarratives. Quantitative research findings that reveal the influence of structural barriers on individuals’ health behaviors are invaluable because they can further inform health communication efforts to advocate structural approaches to health promotion, shifting from individual approaches. By constructing and disseminating counternarratives through research, QuantCrit researchers can contribute to addressing the historical inequities that are disproportionally experienced by marginalized populations.

Incorporating intersectionality to address marginalization

QuantCrit researchers are tasked to consider inequality and unfairness entrenched in everyday communication phenomena. A way of thinking about multiple identities and their relationships to power, intersectionality ( Crenshaw, 1991 ), can be a lens through which communication research assesses how social structures and inequitable systems of power characterize individuals’ everyday experiences. Even though intersectional approaches have often employed qualitative methods to illuminate sociohistorical forces of marginalization and to contextualize phenomena under study (e.g., Bowleg, 2008 ), several researchers have argued that intersectionality is not tied to a particular method ( Else-Quest & Hyde, 2016b ). While there are many ways of engaging in intersectionality scholarship, McCall’s (2005) conceptualization of three different intersectional approaches (i.e., anticategorical, intracategorical, and intercategorical) is particularly relevant in employing intersectionality in quantitative research. Conceptualized as existing on a continuum, the three approaches are distinguished based on how they understand and use analytical categories to explore the complexity of intersectionality.

On one end, there exists the anticategorical approach, which argues that any form of categorization essentializes and perpetuates differences and inequalities between groups. The anticategorical approach critiques and deconstructs social categories on the basis that they fail to appreciate the rich diversity and irreducible complexity of social life. While the anticategorical approach allows for assessing the specificity of discrimination as experienced at individual intersections, it poses a greater challenge to quantitative research by delegitimizing the provisional division of individuals into social categories, which serves as the basic premises to examine whether and why one social group is worse off than another ( Bauer et al., 2021 ). Falling in the middle of the continuum, the intracategorical approach acknowledges categories and focuses on a subpopulation at one or more marginalized intersectional locations. This approach analyzes complex social processes operating at a particular intersection by examining within-group differences. On the other end of the continuum lies the intercategorical approach, which adopts existing analytical categories to reveal inequalities that exist among social groups. The intercategorical approach investigates inequalities across different intersections (i.e., between-group differences). In the following section, I showcase how QuantCrit communication research can adopt intracategorical and intercateogrical intersectional approaches to address the influence of social structural factors on communication experience. 1

With its focus on Black women’s intersectional experience, Davis and Afifi (2019) present one example of the intracategorical approach. The study builds on the notion that the embodied representation of the oppression that Black women in the United States experience cannot be explained based on one social status location (e.g., either race or gender ). The Strong Black Woman Collective Theory claims that images of strong Black women, which have mostly been thought of as oppressive and detrimental to Black women’s well-being, can be functional as Black women collectively affirm strength in each other and promote solidarity to confront oppressive forces ( Davis, 2015 ). Drawn from prior research that identified strength as a defining aspect of Black women’s communication behavior, Davis and Afifi developed a new scale to measure strength regulation, or “the extent to which Black women reinforce the communication and overall embodiment of SBW [Strong Black Women] in themselves and others” (p. 3). They were then able to demonstrate the positive influence of Black women’s strength regulation on confronting hostile outsiders. The development of the strength regulation scale is enlightening, especially considering that existing measures would not accurately capture the unique lived intracategorical intersectional experiences of marginalized Black Women.

Regarding the intercategorical approach, Mora’s (2018) study provides a commendable example. The study attended to a media character Gloria Pritchett in the American Broadcasting Company’s family sitcom series Modern Family whose embodied Latinidad is simultaneously gendered and classed. Mora conceptualized intersected, social identity prototypes in Gloria Pritchett and demonstrated that her prototypical traits as a strong and confident Latina (i.e., ethnicity and gender) and American middle-classness (i.e., ethnicity and social class) predicted the character likability, whereas as the Latina spitfire trope (i.e., ethnicity and gender) predicted dislike toward the character. To test whether the audience-character likability depends on how the audience felt toward various social identities, the study recruited participants from multiple ethnicities, genders, and social classes. By testing a multiple regression model with a three-way interaction, Mora demonstrated that the likability toward Gloria Pritchett was higher when participants had strong gender, social class, and ethnic identities and when they had weaker ethnic and gender identities but a stronger social class identity. The findings that the likability of Gloria Pritchett depends on the various intersected social identities of the character and audience suggest that audiences do not understand the character exclusively in racial or ethnic terms even if the mainstream media primarily frames Gloria Pritchett in terms of race (i.e., Latinidad). Through the intercategorical approach, this study quantitatively demonstrated how the lived experience of the audience that is differentially racialized, gendered, and/or classed matters to understanding the media character.

In reviewing quantitative research that explicitly adopts or closely connects with the intersectional approach, I note a few concrete strategies for future intersectionality research. First, QuantCrit researchers should become familiar with critical scholarship that addresses socio-historical and structural inequality ( Few-Demo et al., 2014 ; Suter, 2018 ). In-depth, qualitative research findings can offer inspiration throughout the research process, but especially when determining the intersectional marginalization of focus. Second, QuantCrit researchers need to identify multiple disadvantages experienced by marginalized people. In employing the intersectional lens, it is critical to provide a rationale for the conceptualization and operationalization of social identities as they relate to various forms of inequality. Third, QuantCrit researchers may develop new scales or modify existing scales to capture intersectional experience. Marginalized populations often score worse on measures developed and normed on the majority (e.g., WEIRD Americans) because such assessments fail to capture the familial strengths and contextual resources of marginalized populations ( Curtis et al., 2022 ). Finally, intersectionality can be incorporated into any stage of research. Ideally, intersectional approaches could inform critical decision-makings at the beginning of a study, such as when proposing a research question; yet, QuantCrit researchers can also employ the intersectional lens when interpreting research findings.

Employing statistical methods that illuminate interdependence, systems, and power dynamics

Different statistical methods offer different capacities to embrace QuantCrit, due in large part to how social processes are captured (or not) by the assumptions and logic of each analysis technique (Scott & Siltanen, 2017). In this section, I discuss three techniques of quantitative analysis—multilevel modeling, social network analysis, and spatial analysis—that are easily compatible with QuantCrit given their capability to illuminate interdependence, systems, and power dynamics. For each analytical technique, I explain its logic and the assumptions on which the analysis is built, and I discuss how communication researchers can bring critical consciousness when employing the proposed analysis techniques. It should be noted that researchers’ goals of applying the techniques and ways of interpreting the analysis results make a study critically oriented, not a particular statistical method per se. I caution that without researchers’ critical consciousness, analysis techniques described here could inadvertently be used to undermine the goals of QuantCrit research. Moreover, I stress that many other statistical methods can be employed in QuantCrit research to pursue social justice and equity goals; more examples of statistical methods for QuantCrit research are available elsewhere (e.g., Else-Quest & Hyde, 2016b ; Evans et al., 2020 ; Scott & Siltanen, 2017 ).

Multilevel modeling could be used to reveal the interdependence of individuals’ experiences who are nested within groups (e.g., neighborhood, county, and state; Snijders & Bosker, 2012 ). My intention here is to highlight the implications of examining cross-level interactions in multilevel modeling for social justice and equity-oriented communication research. Examining interaction effects helps investigate multiplicative effects that may reveal inequalities and marginalization over and above additive effects of multiple explanatory variables ( Scott & Siltanen, 2017 ). Even though various statistical models can examine interaction effects (e.g., ANOVA, regression, etc.), multilevel models are especially promising for QuantCrit research because they take into account various higher-level contexts and thus allow for assessing cross-level interactions.

The call for creating cross-level theory and research in the communication field is not new ( Slater et al., 2006 ). Communication infrastructure theory (CIT; Kim & Ball-Rokeach, 2006a ) offers an example of communication theory that considers cross-level interaction effects. Grounded in the ecological perspective that emphasizes how organisms interact with their environment, the CIT theorizes that each community has a communication infrastructure comprised of a neighborhood storytelling network embedded in a communication action context ( Kim & Ball-Rokeach, 2006a ). Many quantitative studies on the CIT measured the extent to which individuals are integrated into a neighborhood storytelling network and predicted its impact on civic engagement in various contexts; however, the influence of a communication action context has rarely been considered. Notably, Kim and Ball-Rokeach (2006b ) referred to census data to examine two aspects of communication action context: ethnic heterogeneity and residential stability. In a multilevel model predicting civic engagement outcomes, Kim and Ball-Rokeach assessed the effects of individual-level variables (i.e., the extent to which participants are integrated into a neighborhood storytelling network), neighborhood-level effects (i.e., ethnic heterogeneity and residential stability of the census tract in which each participant resides), and cross-level interactions between the two. Study findings demonstrated the cross-level interaction effects such that the connectedness with a neighborhood storytelling network was particularly important in predicting civic engagement in heterogeneous and unstable areas. Kim and Ball-Rokeach discussed that ethnically fragmented and unstable neighborhoods make it challenging for residents to generate and accumulate neighborhood stories, which in turn, result in heavy reliance on a neighborhood storytelling network for civic engagement. Cross-level interaction effects in this study illuminate the need to address social systems and associated inequalities that shape individuals’ everyday experiences. QuantCrit researchers may capture multiple forms of structural discrimination by incorporating various types of contextual-level information, such as inequality indexes, social norms, and public policies.

In addition to multilevel modeling, statistical techniques like social network analysis and spatial analysis are particularly attentive to structural influences. Social network analysis includes the means by which to examine the pattern of relationships (i.e., ties) among a set of actors (i.e., nodes), actors’ positions within the system of relationships, and the characteristics of a system based on the relationships within it ( Wasserman & Faust, 1994 ). Drawing on the assumption that network structure has significant implications on the outcomes of interest, social network analysis adopts the interdependent view of social processes over an individualist view ( Smith, 2014 ). In comparison to a non-relational study design where the data typically capture individuals’ attributes, social network analysis requires the collection and analysis of relational data that capture dyadic ties between actors ( Wasserman & Faust, 1994 ).

With its focus on social interaction as a potential driver of individual- and aggregate-level outcomes, social network analysis can provide valuable insights into QuantCrit research, including understanding the structure of a network that influences actors’ capacity to (un)thrive, uncovering the influences of social interaction on population-level inequalities, and examining the diffusion (or centralization of) innovations like new ideas and technologies within the network. Importantly, social network analysis can be utilized to design and implement “network interventions” ( Valente, 2012 , p. 49). Based on social network analysis of the data collected from households ( N  =   3,763) in 10 different communities in Namibia, Smith (2009) recommended network interventions to address HIV for a majority of communities, with suggestions that varied based on each community’s characteristics. Because the higher network centrality score indicates that more community members participate in a particular social group, health campaigns in such communities should work with the centralized social group, such as a local church. In other cases, social network analysis identified individuals with centralized positions, who can act as opinion leaders or super diffusers to spread health information ( Smith, 2009 ). Some other strategies that can be implemented in network interventions include identifying and targeting vulnerable populations ( Pagkas-Bather et al., 2020 ) and promoting peer-to-peer education ( Hunter et al., 2019 ), which could all be means for QuantCrit researchers to drive social justice and equity-oriented change.

Whereas social network analysis understands the phenomena from a relational perspective, spatial analysis adopts a geographical perspective to examine data in a spatial context. The underlying assumption of spatial analysis is that the geographical area one lives in affects one’s access to resources and opportunities as well as exposure to risks. Spatial data refer to data for which locational attributes serve as critical sources of information, which can be collected from various sources such as geometric data that map the spatial information and geographic information that captures the latitude and longitude of a location ( Downey, 2006 ). In social science, spatial analysis has increasingly been utilized to understand spatial relationships and patterns, engaging with concepts like location, proximity, boundaries, and neighborhood effects ( Goodchild & Donald, 2004 ). Of particular relevance to QuantCrit research is the use of spatial analysis to reveal the importance of neighborhood effects and spatial patterns of inequality and marginalization.

Although only a small amount of communication research has employed spatial analysis, existing studies support the geographical perspective’s assumption that living in the same neighborhoods allows people to experience shared aspects of community life. For example, Matei et al. (2001) examined how residents’ fear is structurally constructed in ethnically diverse residential communities. In the study, participants were asked to draw mental maps by color-coding the areas based on the level of comfort and fear they feel. Using a spatial regression model that used the computerized color-coded mental maps as dependent variables and area-level sociodemographic and economic characteristics as independent variables, Matei et al. (2001) found that higher fear toward an area was associated not with an area’s higher crime rates, but with a higher presence of African American and Hispanic populations in the area. Further analyses also revealed that participants more strongly connected to television and having more interpersonal communication with neighbors were significantly more fearful of areas with high African American and Hispanic populations ( Matei et al., 2001 ). Findings regarding misrepresented fear toward the areas and roles of communication in shaping spatial perception have implications for urban policymaking that seeks to construct racial harmony as well as residential stability. As such, geographical perspectives and spatial analysis can enable QuantCrit communication researchers to ask and answer unique kinds of questions that have implications for social justice and equity-oriented work.

The goal of this article was to provide a guide for researchers interested in applying quantitative approaches to social justice and equity-oriented communication research. By proposing five concrete suggestions for QuantCrit research and discussing relevant examples, this article contributes to theoretical innovation in communication scholarship in several ways. In the following, I revisit five suggestions with a focus on their theoretical implications for advancing our field.

The first suggestion for QuantCrit research is broadening and diversifying the scope of communication research to enhance our understanding of marginalized communication phenomena in relation to systems of power and oppression. Prioritizing the opportunities to ensure that the voices of marginalized and minoritized populations are heard allows researchers to theorize often neglected aspects of human communication ( Afifi & Cornejo, 2020 ; Bates, 2021 ). QuantCrit encourages researchers to test existing communication theories across subpopulations and cultural contexts, thereby identifying boundary conditions and assessing generalizability. By paying closer attention to structural factors that contribute to the experiences of marginalized populations, QuantCrit also invites new theories that better attend to power relations and structural oppression in ways that promote social justice and equity-oriented change.

The second suggestion is to frame research questions with a social justice orientation. QuantCrit researchers should be attentive to the fact that individuals and their communication experience are embedded in what is often an unequal and unjust social context. Critical theorizing requires interrogating an unquestioned presumption of empowered, independent individuals in communication research ( Dutta-Bergman, 2005 ). When research begins with questions like “What is unequal about the social context?” “How do we raise awareness of unequal social contexts?” and “What are the means to address inequalities?,” communication researchers are better positioned to modify theoretical models in ways that more accurately capture the roles of power and oppression.

Third, QuantCrit researchers are encouraged to critique dominant narratives and center the counternarratives. Marginalized groups and their stories can and should be studied on their own without always having to compare them to the dominant group’s narratives ( Kanazawa, 2020 ; Smith & Osoro, 2023 ). By explicitly considering systemic inequality and power imbalance, QuantCrit researchers can use quantitative evidence to expose and challenge unfair assumptions toward marginalized and minoritized populations. I argue for a more critical approach to theorizing communication scholarship to better reflect the diverse perspectives and lived experiences in the changing sociopolitical landscape.

The fourth suggestion relates to incorporating intersectional approaches in quantitative communication research to address marginalization. Depending on the study objectives, main research questions, and ways of interrogating inequalities shaped by multiple axes, QuantCrit researchers may have different rationales and approaches for theorizing and analyzing social categories.

The final suggestion is employing statistical methods that illuminate interdependence, systems, and power dynamics. Different statistical methods enable QuantCrit researchers to theorize different aspects of social structural influences. Some methods are uniquely positioned to uncover macrolevel influences while other methods are more relevant to analyze individuals’ marginalized experiences. I introduced three analysis techniques, including multilevel modeling, social network analysis, and spatial analysis. QuantCrit researchers competent in these and other advanced statistical techniques would be better positioned to reveal and embrace the theoretical issues raised when examining power and oppression.

Admittedly, some of the suggestions discussed in this article may meet budgetary, time, and data constraints in practice. Building relationships with marginalized communities and engaging these communities throughout the research process require more time and funding than conducting research with readily available data from online panels or university student samples. Certain population groups may need additional accommodations to participate in a study for various reasons including a heightened risk for discrimination (e.g., LGBTQ individuals), unpredictable work hours (e.g., low-income individuals with unstable jobs), and cultural values (e.g., individuals from cultural and ethnic groups different than those of the researchers) in which cases require researchers’ flexibility and cultural competency. Moreover, to consider social contexts in their various forms in statistical analysis, additional information such as neighborhood-level data and spatial data needs to be acquired. Especially considering that certain scholars, such as those with contingent appointments at the institutions, might face greater challenges in conducting research that likely requires more time, funding, and training, it is also critical to be mindful of equity and accessibility issues within academia. Advancing QuantCrit scholarship, therefore, needs not only the conscious efforts of individual researchers but also disciplinary supports.

Of many institutional and disciplinary changes that could help promote QuantCrit scholarship, I note three here. First, editors and editorial boards must value non-traditional ways of engaging with critical scholarship. While editors should provide unbiased consideration to all manuscripts submitted to a journal, they can set a vision to support the publication of manuscripts that push the field into new directions. Second, reviewers should pay more careful attention to both the procedure and outcomes of QuantCrit research with social justice and equity standards. In doing so, reviewers could appreciate the value of historically marginalized samples and researchers’ efforts to engage with them. Third, at the institutional level, tenure and promotion systems should be altered to consider the efforts required to conduct QuantCrit research and other engaged scholarship. Instead of evaluating one’s research accomplishments solely based on published peer-reviewed academic articles, universities can support various research outcomes (e.g., policy reports, town hall meetings, and art-based works) produced for both academic and nonacademic audiences.

Despite the challenges and the long road ahead for the discipline to address the challenges, QuantCrit allows researchers to capitalize on the potential of quantitative research to pursue social justice and equity agenda. Thus, I believe there is value in interrogating traditional ways of conducting quantitative research because it presents communication researchers with revitalized perspectives and means for identifying and addressing injustice and inequalities, and eventually advancing transformative scholarship. As communication researchers gravitate toward embracing QuantCrit to pursue social justice and equity agenda, I hope this work will inspire new possibilities for future research.

I would like to thank Rachel A. Smith, Elizabeth A. Suter, and Haley Schneider for their feedback on an earlier version of this article.

Conflict of interest

None declared.

This is not to preclude the use of anticategorical intersectional approach in quantitative research. Researchers can integrate anticategorical approach in quantitative studies, for instance, by incorporating open-ended measures to investigate the way people see themselves (e.g., Riles et al., 2022 ). There has also been discussion on operationalizing anticategorical intersectionality by using the statistical concept of discriminatory accuracy, which assesses the power and validity of a category to discriminate between individuals who do and do not exhibit the outcomes of interest ( Mulinari et al., 2018 ; Wemrell et al., 2017 ). When discriminatory accuracy is low, it indicates that the category is not likely to be suitable for individual-level inference ( Merlo, 2014 ). Studies in the fields of epidemiology and public health have shown that while social categorizations can be used to discover driving forces for outcomes of interest, low discriminatory accuracy can point to the importance of not treating identity categories as static, thus offering a means for embracing anticategorical approaches within quantitative research (e.g., Wemrell et al., 2017 ).

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The Quintessence of Basic and Clinical Research and Scientific Publishing pp 733–754 Cite as

Communicating Results of Quantitative Research

• Jane E. Miller 4  
• First Online: 01 October 2023

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In this chapter, I show how to apply expository writing techniques and principles for writing about numbers to communicate effectively about the results of quantitative research. Using examples from the biomedical literature, I demonstrate how to write a clear narrative with numbers as evidence, introducing the question, describing individual facts and patterns, and maintaining a focus on the topic and context at hand. The chapter starts with basic principles for writing about numbers including specifying the context and several dimensions of units. It then discusses how to choose and design complementary tools (prose, tables, charts, and maps) to communicate results, with guidance about how to make exhibits self-contained and how to organize numbers in those exhibits to match the associated narrative description. Next, the chapter introduces principles for comparing two or more numbers, including specifying direction, magnitude, and statistical significance, and how to summarize complex patterns. Those principles are demonstrated for presenting results of both bivariate and multivariate analyses, with examples of how to coordinate tables or charts with prose. The chapter ends by emphasizing the importance of conveying both the substantive and statistical significance of numeric findings.

• Communication
• Effect Size
• Multivariate Regression
• Statistical Significance
• Substantive Importance

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Miller JE (2023) Beyond statistical significance: a holistic view of what makes a research finding ‘important’. Numeracy 16(1):Article 6. https://doi.org/10.5038/1936-4660.16.1.1428

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Miller, J.E. (2023). Communicating Results of Quantitative Research. In: Jagadeesh, G., Balakumar, P., Senatore, F. (eds) The Quintessence of Basic and Clinical Research and Scientific Publishing. Springer, Singapore. https://doi.org/10.1007/978-981-99-1284-1_45

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Quantitative and Qualitative Research

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Quantitative methodology is the dominant research framework in the social sciences. It refers to a set of strategies, techniques and assumptions used to study psychological, social and economic processes through the exploration of numeric patterns . Quantitative research gathers a range of numeric data. Some of the numeric data is intrinsically quantitative (e.g. personal income), while in other cases the numeric structure is  imposed (e.g. ‘On a scale from 1 to 10, how depressed did you feel last week?’). The collection of quantitative information allows researchers to conduct simple to extremely sophisticated statistical analyses that aggregate the data (e.g. averages, percentages), show relationships among the data (e.g. ‘Students with lower grade point averages tend to score lower on a depression scale’) or compare across aggregated data (e.g. the USA has a higher gross domestic product than Spain). Quantitative research includes methodologies such as questionnaires, structured observations or experiments and stands in contrast to qualitative research. Qualitative research involves the collection and analysis of narratives and/or open-ended observations through methodologies such as interviews, focus groups or ethnographies.

Coghlan, D., Brydon-Miller, M. (2014).  The SAGE encyclopedia of action research  (Vols. 1-2). London, : SAGE Publications Ltd doi: 10.4135/9781446294406

What is the purpose of quantitative research?

The purpose of quantitative research is to generate knowledge and create understanding about the social world. Quantitative research is used by social scientists, including communication researchers, to observe phenomena or occurrences affecting individuals. Social scientists are concerned with the study of people. Quantitative research is a way to learn about a particular group of people, known as a sample population. Using scientific inquiry, quantitative research relies on data that are observed or measured to examine questions about the sample population.

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Communicating and disseminating research findings to study participants: Formative assessment of participant and researcher expectations and preferences

Cathy l. melvin.

1 College of Medicine, Medical University of South Carolina, Charleston, SC, USA

Jillian Harvey

2 College of Health Professions/Healthcare Leadership & Management, Medical University of South Carolina, Charleston, SC, USA

Tara Pittman

3 South Carolina Clinical & Translational Research Institute (CTSA), Medical University of South Carolina, Charleston, SC, USA

Stephanie Gentilin

Dana burshell.

4 SOGI-SES Add Health Study Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Teresa Kelechi

5 College of Nursing, Medical University of South Carolina, Charleston, SC, USA

Introduction:

Translating research findings into practice requires understanding how to meet communication and dissemination needs and preferences of intended audiences including past research participants (PSPs) who want, but seldom receive, information on research findings during or after participating in research studies. Most researchers want to let others, including PSP, know about their findings but lack knowledge about how to effectively communicate findings to a lay audience.

We designed a two-phase, mixed methods pilot study to understand experiences, expectations, concerns, preferences, and capacities of researchers and PSP in two age groups (adolescents/young adults (AYA) or older adults) and to test communication prototypes for sharing, receiving, and using information on research study findings.

Principal Results:

PSP and researchers agreed that sharing study findings should happen and that doing so could improve participant recruitment and enrollment, use of research findings to improve health and health-care delivery, and build community support for research. Some differences and similarities in communication preferences and message format were identified between PSP groups, reinforcing the best practice of customizing communication channel and messaging. Researchers wanted specific training and/or time and resources to help them prepare messages in formats to meet PSP needs and preferences but were unaware of resources to help them do so.

Conclusions:

Our findings offer insight into how to engage both PSP and researchers in the design and use of strategies to share research findings and highlight the need to develop services and support for researchers as they aim to bridge this translational barrier.

Introduction

Since 2006, the National Institutes of Health Clinical and Translational Science Awards (CTSA) have aimed to advance science and translate knowledge into evidence that, if implemented, helps patients and providers make more informed decisions with the potential to improve health care and health outcomes [ 1 , 2 ]. This aim responded to calls by leaders in the fields of comparative effectiveness research, clinical trials, research ethics, and community engagement to assure that results of clinical trials were made available to participants and suggesting that providing participants with results both positive and negative should be the “ethical norm” [ 1 , 3 ]. Others noted that

on the surface, the concept of providing clinical trial results might seem straightforward but putting such a plan into action will be much more complicated. Communication with patients following participation in a clinical trial represents an important and often overlooked aspect of the patient-physician relationship. Careful exploration of this issue, both from the patient and clinician-researcher perspective, is warranted [ 4 ].

Authors also noted that no systematic approach to operationalizing this “ethical norm” existed and that evidence was lacking to describe either positive or negative outcomes of sharing clinical trial results with study participants and the community [ 4 ]. It was generally assumed, but not supported by research, that sharing would result in better patient–physician/researcher communication, improvement in patient care and satisfaction with care, better patient/participant understanding of clinical trials, and enhanced clinical trial accrual [ 4 ].

More recent literature informs these processes but also raises unresolved concerns about the communication and dissemination of research results. A 2008 narrative review of available data on the effects of communicating aggregate and individual research showed that

• research participants want aggregate and clinically significant individual study results made available to them despite the transient distress that communication of results sometimes elicits [ 3 , 5 ]. While differing in their preferences for specific channels of communication, they indicated that not sharing results fostered lack of participant trust in the health-care system, providers, and researchers [ 6 ] and an adverse impact on trial participation [ 5 ];
• investigators recognized their ethical obligation to at least offer to share research findings with recipients and the nonacademic community but differed on whether they should proactively re-contact participants, the type of results to be offered to participants, the need for clinical relevance before disclosure, and the stage at which research results should be offered [ 5 ]. They also reported not being well versed in communication and dissemination strategies known to be effective and not having funding sources to implement proven strategies for sharing with specific audiences [ 5 ];
• members of the research enterprise noted that while public opinion regarding participation in clinical trials is positive, clinical trial accrual remains low and that the failure to provide information about study results may be one of many factors negatively affecting accrual. They also called for better understanding of physician–researcher and patient attitudes and preferences and posit that development of effective mechanisms to share trial results with study participants should enhance patient–physician communication and improve clinical care and research processes [ 5 ].

A 2010 survey of CTSAs found that while professional and scientific audiences are currently the primary focus for communicating and disseminating research findings, it is equally vital to develop approaches for sharing research findings with other audiences, including individuals who participate in clinical trials [ 1 , 5 ]. Effective communication and dissemination strategies are documented in the literature [ 6 , 7 ], but most are designed to promote adoption of evidence-based interventions and lack of applicability to participants overall, especially to participants who are members of special populations and underrepresented minorities who have fewer opportunities to participate in research and whose preferences for receiving research findings are unknown [ 7 ].

Researchers often have limited exposure to methods that offer them guidance in communicating and disseminating study findings in ways likely to improve awareness, adoption, and use of their findings [ 7 ]. Researchers also lack expertise in using communication channels such as traditional journalism platforms, live or face-to-face events such as public festivals, lectures, and panels, and online interactions [ 8 ]. Few strategies provide guidance for researchers about how to develop communications that are patient-centered, contain plain language, create awareness of the influence of findings on participant or population health, and increase the likelihood of enrollment in future studies.

Consequently, researchers often rely on traditional methods (e.g., presentations at scientific meetings and publication of study findings in peer-reviewed journals) despite evidence suggesting their limited reach and/or impact among professional/scientific and/or lay audiences [ 9 , 10 ].

Input from stakeholders can enhance our understanding of how to assure that participants will receive understandable, useful information about research findings and, as appropriate, interpret and use this information to inform their decisions about changing health behaviors, interacting with their health-care providers, enrolling in future research studies, sharing their study experiences with others, or recommending to others that they participate in studies.

Purpose and Goal

This pilot project was undertaken to address issues cited above and in response to expressed concerns of community members in our area about not receiving information on research studies in which they participated. The project design, a two-phase, mixed methods pilot study, was informed by their subsequent participation in a committee of community-academic representatives to determine possible options for improving the communication and dissemination of study results to both study participants and the community at large.

Our goals were to understand the experiences, expectations, concerns, preferences, and capacities of researchers and past research participants (PSP) in two age groups (adolescents/young adults (AYA) aged 15–25 years and older adults aged 50 years or older) and to test communication prototypes for sharing, receiving, and using information on research study findings. Our long-term objectives are to stimulate new, interdisciplinary collaborative research and to develop resources to meet PSP and researcher needs.

This study was conducted in an academic medical center located in south-eastern South Carolina. Phase one consisted of surveying PSP and researchers. In phase two, in-person focus groups were conducted among PSP completing the survey and one-on-one interviews were conducted among researchers. Participants in either the interviews or focus groups responded to a set of questions from a discussion guide developed by the study team and reviewed three prototypes for communicating and disseminating study results developed by the study team in response to PSP and researcher survey responses: a study results letter, a study results email, and a web-based communication – Mail Chimp (Figs.  1 – 3 ).

Prototype 1: study results email prototype. MUSC, Medical University of South Carolina.

Prototype 3: study results MailChimp prototypes 1 and 2. MUSC, Medical University of South Carolina.

Prototype 2: study results letter prototype.

PSP and researcher surveys

A 42-item survey questionnaire representing seven domains was developed by a multidisciplinary team of clinicians, researchers, and PSP that evaluated the questions for content, ease of understanding, usefulness, and comprehensiveness [ 11 ]. Project principal investigators reviewed questions for content and clarity [ 11 ]. The PSP and researcher surveys contained screening and demographic questions to determine participant eligibility and participant characteristics. The PSP survey assessed prior experience with research, receipt of study information from the research team, intention to participate in future research, and preferences and opinions about receipt of information about study findings and next steps. Specific questions for PSP elicited their preferences for communication channels such as phone call, email, social or mass media, and public forum and included channels unique to South Carolina, such as billboards. PSP were asked to rank their preferences and experiences regarding receipt of study results using a Likert scale with the following measurements: “not at all interested” (0), “not very interested” (1), “neutral” (3), “somewhat interested” (3), and “very interested” (4).

The researcher survey contained questions about researcher decisions, plans, and actions regarding communication and dissemination of research results for a recently completed study. Items included knowledge and opinions about how to communicate and disseminate research findings, resources used and needed to develop communication strategies, and awareness and use of dissemination channels, message development, and presentation format.

A research team member administered the survey to PSP and researchers either in person or via phone. Researchers could also complete the survey online through Research Electronic Data Capture (REDCap©).

Focus groups and discussion guide content

The PSP focus group discussion guide contained questions to assess participants’ past experiences with receiving information about research findings; identify participant preferences for receiving research findings whether negative, positive, or equivocal; gather information to improve communication of research results back to participants; assess participant intention to enroll in future research studies, to share their study experiences with others, and to refer others to our institution for study participation; and provide comments and suggestions on prototypes developed for communication and dissemination of study results. Five AYA participated in one focus group, and 11 older adults participated in one focus group. Focus groups were conducted in an off-campus location with convenient parking and at times convenient for participants. Snacks and beverages were provided.

The researcher interview guide was designed to understand researchers’ perspectives on communicating and disseminating research findings to participants; explore past experiences, if any, of researchers with communication and dissemination of research findings to study participants; document any approaches researchers may have used or intend to use to communicate and disseminate research findings to study participants; assess researcher expectations of benefits associated with sharing findings with participants, as well as, perceived and actual barriers to sharing findings; and provide comments and suggestions on prototypes developed for communication and dissemination of study results.

Prototype materials

Three prototypes were presented to focus group participants and included (1) a formal letter on hospital letterhead designed to be delivered by standard mail, describing the purpose and findings of a fictional study and thanking the individual for his/her participation, (2) a text-only email including a brief thank you and a summary of major findings with a link to a study website for more information, and (3) an email formatted like a newsletter with detailed information on study purpose, method, and findings with graphics to help convey results. A mock study website was shown and included information about study background, purpose, methods, results, as well as, links to other research and health resources. Prototypes were presented either in paper or PowerPoint format during the focus groups and explained by a study team member who then elicited participant input using the focus group guide. Researchers also reviewed and commented on prototype content and format in one-on-one interviews with a study team member.

Protection of Human Subjects

The study protocol (No. Pro00067659) was submitted to and approved by the Institutional Review Board at the Medical University of South Carolina in 2017. PSP (or the caretakers for PSP under age 18), and researchers provided verbal informed consent prior to completing the survey or participating in either a focus group or interview. Participants received a verbal introduction prior to participating in each phase.

Recruitment and Interview Procedures

Past study participants.

A study team member reviewed study participant logs from five recently completed studies at our institution involving AYA or older adults to identify individuals who provided consent for contact regarding future studies. Subsequent PSP recruitment efforts based on these searches were consistent with previous contact preferences recorded in each study participant’s consent indicating desire to be re-contacted. The primary modes of contact were phone/SMS and email.

Efforts to recruit other PSP were made through placement of flyers in frequented public locations such as coffee shops, recreation complexes, and college campuses and through social media, Yammer, and newsletters. ResearchMatch, a web-based recruitment tool, was used to alert its subscribers about the study. Potential participants reached by these methods contacted our study team to learn more about the study, and if interested and pre-screened eligible, volunteered and were consented for the study. PSP completing the survey indicated willingness to share experiences with the study team in a focus group and were re-contacted to participate in focus groups.

Researcher recruitment

Researchers were identified through informal outreach by study investigators and staff, a flyer distributed on campus, use of Yammer and other institutional social media platforms, and internal electronic newsletters. Researchers responding to these recruitment efforts were invited to participate in the researcher survey and/or interview.

Incentives for participation

Researchers and PSP received a $25 gift card for completing the survey and $75 for completing the interview (researcher) or focus group (PSP) (up to $100 per researcher or PSP).

Data tables displaying demographic and other data from the PSP surveys (Table ​ (Table1) 1 ) were prepared from the REDCap© database and responses reported as number and percent of respondents choosing each response option.

Post study participant (PSP) characteristics by Adolescents/Young Adults (AYA), Older Adults, and ALL (All participants regardless of age)

Age mean (SD) = 49.7 (18.6).

Focus group and researcher interview data were recorded (either via audio recording and/or notes taken by research staff) and analyzed via a general inductive qualitative approach, a method appropriate for program evaluation studies and aimed at condensing large amounts of textual data into frameworks that describe the underlying process and experiences under study [ 12 ]. Data were analyzed by our team’s qualitative expert who read the textual data multiple times, developed a coding scheme to identify themes in the textual data, and used group consensus methods with other team members to identify unique, key themes.

Sixty-one of sixty-five PSP who volunteered to participate in the PSP survey were screened eligible, fifty were consented, and forty-eight completed the survey questionnaire. Of the 48 PSP completing the survey, 15 (32%) were AYA and 33 (68%) older adults. The mean age of survey respondents was 49.7 years, 23.5 for AYA, and 61.6 for older adults. Survey respondents were predominantly White, non-Hispanic/Latino, female, and with some college or a college degree (Table ​ (Table1). 1 ). The percentage of participants in each group never or rarely needing any help with reading/interpreting written materials was above 93% in both groups.

Over 90% of PSP responded that they would participate in another research study, and more than 75% of PSP indicated that study participants should know about study results. Most (68.8%) respondents indicated that they did not receive any communications from study staff after they finished a study .

PSP preferences for communication channel are summarized in Table ​ Table2 2 and based on responses to the question “How do you want to receive information?.” Both AYA and older adults agree or completely agree that they prefer email to other communication channels and that billboards did not apply to them. Older adult preferences for communication channels as indicated by agreeing or completely agreeing were in ranked order of highest to lowest: use of mailed letters/postcards, newsletter, and phone. A majority (over 50%) of older adults completely disagreed or disagreed on texting and social media as options and had only slight preference for mass media, public forum, and wellness fairs or expos.

Communication preference by group: AYA * , older adult ** , and ALL ( n = 48)

ALL, total per column.

While AYA preferred email over all other options, they completely disagreed/disagreed with mailed letters/postcards, social media, and mass media options.

When communication formats were ranked overall by each group and by both groups combined, the ranking from most to least preferred was written materials, opportunities to interact with study teams and ask questions, visual charts, graphs, pictures, and videos, audios, and podcasts.

PSP Focus Groups

PSP want to receive and share information on study findings for studies in which he/she participated. Furthermore, participants stated their desire to share study results across social networks and highlighted opportunities to share communicated study results with their health-care providers, family members, friends, and other acquaintances with similar medical conditions.

Because of the things I was in a study for, it’s a condition I knew three other people who had the same condition, so as soon as it worked for me, I put the word out, this is great stuff. I would forward the email with the link, this is where you can go to also get in on this study, or I’d also tell them, you know, for me, like the medication. Here’s the medication. Here’s the name of it. Tell your doctor. I would definitely share. I’d just tell everyone without a doubt. Right when I get home, as soon as I walk in the door, and say Renee-that’s my daughter-I’ve got to tell you this.

Communication of study information could happen through several channels including social media, verbal communication, sharing of written documents, and forwarding emails containing a range of content in a range of formats (e.g., reports and pamphlets).

Word of mouth and I have no shame in saying I had head to toe psoriasis, and I used the drug being studied, and so I would just go to people, hey, look. So, if you had it in paper form, like a pamphlet or something, yeah I’d pass it on to them.

PSP prefer clear, simple messaging and highlighted multiple, preferred communication modalities for receiving information on study findings including emails, letters, newsletters, social media, and websites.

The wording is really simple, which I like. It’s to the point and clear. I really like the bullet points, because it’s quick and to the point. I think the [long] paragraphs-you get lost, especially when you are reading on your phone.

They indicated a clear preference for colorful, simple, easy to read communication. PSP also expressed some concern about difficulty opening emails with pictures and dislike lengthy written text. “I don’t read long emails. I tend to delete them”

PSP indicated some confusion about common research language. For example, one participant indicated that using the word “estimate” indicates the research findings were an approximation, “When I hear those words, I just think you’re guessing, estimate, you know? It sounds like an estimate, not a definite answer.”

Researcher Survey

Twenty-three of thirty-two researchers volunteered to participate in the researcher survey, were screened eligible, and two declined to participate, resulting in 19 who provided consent to participate and completed the survey. The mean age of survey respondents was 51.8 years. Respondents were predominantly White, non-Hispanic/Latino, and female, and all were holders of either a professional school degree or a doctoral degree. When asked if it is important to inform study participants of study results, 94.8% of responding researchers agreed that it was extremely important or important. Most researchers have disseminated findings to study participants or plan to disseminate findings.

Researchers listed a variety of reasons for their rating of the importance of informing study participants of study results including “to promote feelings of inclusion by participants and other community members”, “maintaining participant interest and engagement in the subject study and in research generally”, “allowing participants to benefit somewhat from their participation in research and especially if personal health data are collected”, “increasing transparency and opportunities for learning”, and “helping in understanding the impact of the research on the health issue under study”.

Some researchers view sharing study findings as an “ethical responsibility and/or a tenet of volunteerism for a research study”. For example, “if we (researchers) are obligated to inform participants about anything that comes up during the conduct of the study, we should feel compelled to equally give the results at the end of the study”.

One researcher “thought it a good idea to ask participants if they would like an overview of findings at the end of the study that they could share with others who would like to see the information”.

Two researchers said that sharing research results “depends on the study” and that providing “general findings to the participants” might be “sufficient for a treatment outcome study”.

Researchers indicated that despite their willingness to share study results, they face resource challenges such as a lack of funding and/or staff to support communication and dissemination activities and need assistance in developing these materials. One researcher remarked “I would really like to learn what are (sic) the best ways to share research findings. I am truly ignorant about this other than what I have casually observed. I would enjoy attending a workshop on the topic with suggested templates and communication strategies that work best” and that this survey “reminds me how important this is and it is promising that our CTSA seems to plan to take this on and help researchers with this important study element.”

Another researcher commented on a list of potential types of assistance that could be made available to assist with communicating and disseminating results, that “Training on developing lay friendly messaging is especially critically important and would translate across so many different aspects of what we do, not just dissemination of findings. But I’ve noticed that it is a skill that very few people have, and some people never can seem to develop. For that reason, I find as a principal investigator that I am spending a lot of my time working on these types of materials when I’d really prefer research assistant level folks having the ability to get me 99% of the way there.”

Most researchers indicated that they provide participants with personal tests or assessments taken from the study (60% n = 6) and final study results (72.7%, n = 8) but no other information such as recruitment and retention updates, interim updates or results, information on the impact of the study on either the health topic of the study or the community, information on other studies or provide tips and resources related to the health topic and self-help. Sixty percent ( n = 6) of researcher respondents indicated sharing planned next steps for the study team and information on how the study results would be used.

When asked about how they communicated results, phone calls were mentioned most frequently followed by newsletters, email, webpages, public forums, journal article, mailed letter or postcard, mass media, wellness fairs/expos, texting, or social media.

Researchers used a variety of communication formats to communicate with study participants. Written descriptions of study findings were most frequently reported followed by visual depictions, opportunities to interact with study staff and ask questions or provide feedback, and videos/audio/podcasts.

Seventy-three percent of researchers reported that they made efforts to make study findings information available to those with low levels of literacy, health literacy, or other possible limitations such as non-English-speaking populations.

In open-ended responses, most researchers reported wanting to increase their awareness and use of on-campus training and other resources to support communication and dissemination of study results, including how to get resources and budgets to support their use.

Researcher Interviews

One-on-one interviews with researchers identified two themes.

Researchers may struggle to see the utility of communicating small findings

Some researchers indicated hesitancy in communicating preliminary findings, findings from small studies, or highly summarized information. In addition, in comparison to research participants, researchers seemed to place a higher value on specific details of the study.

“I probably wouldn’t put it up [on social media] until the actual manuscript was out with the graphs and the figures, because I think that’s what people ultimately would be interested in.”

Researchers face resource and time limitations in communication and dissemination of study findings

Researchers expressed interest in communicating research results to study participants. However, they highlighted several challenges including difficulties in tracking current email and physical addresses for participants; compliance with literacy and visual impairment regulations; and the number of products already required in research that consume a considerable amount of a research team’s time. Researchers expressed a desire to have additional resources and templates to facilitate sharing study findings. According to one respondent, “For every grant there is (sic) 4-10 papers and 3-5 presentations, already doing 10-20 products.” Researchers do not want to “reinvent the wheel” and would like to pull from existing papers and presentations on how to share with participants and have boilerplate, writing templates, and other logistical information available for their use.

Researchers would also like training in the form of lunch-n-learns, podcasts, or easily accessible online tools on how to develop materials and approaches. Researchers are interested in understanding the “do’s and don’ts” of communicating and disseminating study findings and any regulatory requirements that should be considered when communicating with research participants following a completed study. For example, one researcher asked, “From beginning to end – the do’s and don’ts – are stamps allowed as a direct cost? or can indirect costs include paper for printing newsletters, how about designing a website, a checklist for pulling together a newsletter?”

The purpose of this pilot study was to explore the current experiences, expectations, concerns, preferences, and capacities of PSP including youth/young adult and older adult populations and researchers for sharing, receiving, and using information on research study findings. PSP and researchers agreed, as shown in earlier work [ 3 , 5 ], that sharing information upon study completion with participants was something that should be done and that had value for both PSP and researchers. As in prior studies [ 3 , 5 ], both groups also agreed that sharing study findings could improve ancillary outcomes such as participant recruitment and enrollment, use of research findings to improve health and health-care delivery, and build overall community support for research. In addition, communicating results acknowledges study participants’ contributions to research, a principle firmly rooted in respect for treating participants as not merely a means to further scientific investigation [ 5 ].

The majority of PSP indicated that they did not receive research findings from studies they participated in, that they would like to receive such information, and that they preferred specific communication methods for receipt of this information such as email and phone calls. While our sample was small, we did identify preferences for communication channels and for message format. Some differences and similarities in preferences for communication channels and message format were identified between AYA and older adults, thus reinforcing the best practice of customizing communication channel and messaging to each specific group. However, the preference for email and the similar rank ordering of messaging formats suggest that there are some overall communication preferences that may apply to most populations of PSP. It remains unclear whether participants prefer individual or aggregate results of study findings and depends on the type of study, for example, individual results of genotypes versus aggregate results of epidemiological studies [ 13 ]. A study by Miller et al suggests that the impact of receiving aggregate results, whether clinically relevant or not, may equal that of receiving individual results [ 14 ]. Further investigation warrants evaluation of whether, when, and how researchers should communicate types of results to study participants, considering multiple demographics of the populations such as age and ethnicity on preferences.

While researchers acknowledged that PSP would like to hear from them regarding research results and that they wanted to meet this expectation, they indicated needing specific training and/or time and resources to provide this information to PSP in a way that meets PSP needs and preferences. Costs associated with producing reports of findings were a concern of researchers in our study, similar to findings from a study conducted by Di Blasi and colleagues in which 15% (8 of 53 investigators) indicated that they wanted to avoid extra costs associated with the conduct of their studies and extra administrative work [ 15 ]. In this same study, the major reason for not informing participants about study results was that forty percent of investigators never considered this option. Researchers were unaware of resources available on existing platforms at their home institution or elsewhere to help them with communication and dissemination efforts [ 10 ].

Addressing Barriers to Implementation

Information from academic and other organizations on how to best communicate research findings in plain language is available and could be shared with researchers and their teams. The Cochrane Collaborative [ 16 ], the Centers for Disease Control and Prevention [ 17 ], and the Patient-Centered Outcomes Research Institute [ 18 ] have resources to help researchers develop plain language summaries using proven approaches to overcome literacy and other issues that limit participant access to study findings. Some academic institutions have electronic systems in place to confidentially share templated laboratory and other personal study information with participants and, if appropriate, with their health-care providers.

Limitations

Findings from the study are limited by several study and respondent characteristics. The sample was drawn from research records at one university engaging in research in a relatively defined geographic area and among two special populations: AYA and older adults. As such, participants were not representative of either the general population in the area, the population of PSP or researchers available in the area, or the racial and ethnic diversity of potential and/or actual participants in the geographic area. The small number of researcher participants did not represent the pool of researchers at the university, and the research studies from which participants were drawn were not representative of the broad range of clinical and translational research undertaken by our institution or within the geographic community it serves. The number of survey and focus group participants was insufficient to allow robust analysis of findings specific to participants’ race, ethnicity, gender, or membership in the target age groups of AYA or older adult. However, these data will inform a future trial with adequate representations from underrepresented and special population groups.

Since all PSP had participated in research, they may have been biased in favor of wanting to know more about study results and/or supportive/nonsupportive of the method of communication/dissemination they were exposed to through their participation in these studies.

Conclusions

Our findings provide information from PSP and researchers on their expectations about sharing study findings, preferences for how to communicate and disseminate study findings, and need for greater assistance in removing roadblocks to using proven communication and dissemination approaches. This information illustrates the potential to engage both PSP and researchers in the design and use of communication and dissemination strategies and materials to share research findings, engage in efforts to more broadly disseminate research findings, and inform our understanding of how to interpret and communicate research findings for members of special population groups. While several initial prototypes were developed in response to this feedback and shared for review by participants in this study, future research will focus on finalizing and testing specific communication and dissemination prototypes aimed at these special population groups.

Findings from our study support a major goal of the National Center for Advancing Translational Science Recruitment Innovation Center to engage and collaborate with patients and their communities to advance translation science. In response to the increased awareness of the importance of sharing results with study participants or the general public, a template for dissemination of research results is available in the Recruitment and Retention Toolbox through the CTSA Trial Innovation Network (TIN: trialinnovationnetwork.org ). We believe that our findings will inform resources for use in special populations through collaborations within the TIN.

Acknowledgment

This pilot project was supported, in part, by the National Center for Advancing Translational Sciences of the NIH under Grant Number UL1 TR001450. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Disclosures

The authors have no conflicts of interest to declare.

Ethical Approval

This study was reviewed, approved, and continuously overseen by the IRB at the Medical University of South Carolina (ID: Pro00067659). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Chapter 16: Communication Research

Quantitative methods, steps for doing quantitative research.

Quantitative methods represent the steps of using the Scientific Method of research.

• Decide on a focus of study based primarily on your interests. What do you want to discover or answer?
• Develop a research question(s) to keep your research focused.
• Develop a hypothesis(es). A hypothesis states how a researcher believes the subjects under study will or will not communicate based on certain variables. For example, you may have a research question that asks, “Does the gender of a student impact the number of times a college professor calls on his/her students?” From this, you might form two hypotheses: “Instructors call on female students less often then male students.” and “Instructors call on students of their same sex.”
• Collect data in order to test hypotheses. In our example, you might observe various college classrooms in order to count which students professors call on more frequently.
• Analyze the data by processing the numbers using statistical programs like SPSS that allow quantitative researchers to detect patterns in communication phenomena. Analyzing data in our example would help us determine if there are any significant differences in the ways in which college professors call on various students.
• Interpret the data to determine if patterns are significant enough to make broad claims about how humans communicate? Simply because professors call on certain students a few more times than other students may or may not indicate communicative patterns of significance.
• Share the results with others. Through the sharing of research we continue to learn more about the patterns and rules that guide the ways we communicate.

The term quantitative refers to research in which we can quantify, or count, communication phenomena . Quantitative methodologies draw heavily from research methods in the physical sciences explore human communication phenomena through the collection and analysis of numerical data. Let’s look at a simple example. What if we wanted to see how public speaking textbooks represent diversity in their photographs and examples. One thing we could do is quantify these to come to conclusions about these representations. For quantitative research, we must determine which communicative acts to count? How do we go about counting them? Is there any human communicative behavior that would return a 100% response rate like the effects of gravity in the physical sciences? What can we learn by counting acts of human communication?

Suppose you want to determine what communicative actions illicit negative responses from your professors. How would you go about researching this? What data would you count? In what ways would you count them? Who would you study? How would you know if you discovered anything of significance that would tell us something important about this? These are tough questions for researchers to answer, particularly in light of the fact that, unlike laws in the physical sciences, human communication is varied and unpredictable.

Nevertheless, there are several quantitative methods researchers use to study communication in order to reveal patterns that help us predict and control our communication. Think about polls that provide feedback for politicians. While people do not all think the same, this type of research provides patterns of thought to politicians who can use this information to make policy decisions that impact our lives. Let’s look at a few of the more frequent quantitative methods of communication research.

Types of Quantitative Methods

There are many ways researchers can quantify human communication. Not all communication is easily quantified, but much of what we know about human communication comes from quantitative research.

• Experimental Research is the most well-established quantitative methodology in both the physical and social sciences. This approach uses the principles of research in the physical sciences to conduct experiments that explore human behavior. Researchers choose whether they will conduct their experiments in lab settings or real-world settings. Experimental research generally includes a control group (the group where variables are not altered) and the experimental group(s) (the group in which variables are altered). The groups are then carefully monitored to see if they enact different reactions to different variables.

To determine if students were more motivated to learn by participating in a classroom game versus attending a classroom lecture, the researchers designed an experiment. They wanted to test the hypothesis that students would actually be more motivated to learn from the game. Their next question was, “do students actually learn more by participating in games?” In order to find out the answers to these questions they conducted the following experiment. In a number of classes instructors were asked to proceed with their normal lecture over certain content (control group), and in a number of other classes, instructors used a game that was developed to teach the same content (experimental group). The students were issued a test at the end of the semester to see which group did better in retaining information, and to find out which method most motivated students to want to learn the material. It was determined that students were more motivated to learn by participating in the game, which proved the hypothesis. The other thing that stood out was that students who participated in the game actually remembered more of the content at the end of the semester than those who listened to a lecture. You might have hypothesized these conclusions yourself, but until research is done, our assumptions are just that (Hunt, Lippert & Paynton).

Case In Point

Quantitative methods in action.

Wendy S. Zabada-Ford (2003) conducted survey research of 253 customers to determine their expectations and experiences with physicians, dentists, mechanics, and hairstylists. Her article, “Research Communication Practices of Professional Service Providers: Predicting Customer Satisfaction and Loyalty” researched the perceptions of customers’ personalized service as related to their expectations in order to predict their satisfaction with the actual service they received. In this study, the goal was to be able to predict the behavior of customers based on their expectations before entering a service-provider context.

Michael T. Stephenson’s (2003) article, “Examining Adolescents’ Responses to Anti-marijuana PSAs” examined how adolescents respond to anti-marijuana public service announcements in the U.S. On the surface, this study may fit into the “understanding” part of the continuum of intended outcomes. However, this research can be used to alter and change messages, such as PSAs, to produce behavioral change in the culture. In this case, the change would be to either keep adolescents from smoking marijuana, or to get them to stop this behavior if they are currently engaged in it.

• Survey Research is used to ask people a number of questions about particular topics. Surveys can be online, mailed, handed out, or conducted in interview format. After researchers have collected survey data, they represent participants’ responses in numerical form using tables, graphs, charts, and/or percentages. On our campus, anonymous survey research was done to determine the drinking and drug habits of our students. This research demonstrated that the percentage of students who frequently use alcohol or drugs is actually much lower than what most students think. The results of this research are now used to educate students that not everyone engages in heavy drinking or drug use, and to encourage students to more closely align their behaviors with what actually occurs on campus, not with what students perceive happens on campus. It is important to remember that there is a possibility that people do not always tell the truth when they answer survey questions. We won’t go into great detail here due to time, but there are sophisticated statistical analyses that can account for this to develop an accurate representation of survey responses.

• Content Analysis . Researchers use content analysis to count the number of occurrences of their particular focus of inquiry. Communication researchers often conduct content analyses of movies, commercials, television shows, magazines, etc., to count the number of occurrences of particular phenomena in these contexts to explore potential effects. Harmon, for example, used content analysis in order to demonstrate how the portrayal of blackness had changed within Black Entertainment Television (BET). She did this by observing the five most frequently played films from the time the cable network was being run by a black owner, to the five most frequently played films after being sold to white­-owned Viacom, Inc. She found that the portrayal, context and power of the black man changes when a white man versus a black man is defining it. Content analysis is extremely effective for demonstrating patterns and trends in various communication contexts. If you would like to do a simple content analysis, count the number of times different people are represented in photos in your textbooks. Are there more men than women? Are there more caucasians represented than other groups? What do the numbers tell you about how we represent different people?
• Meta-Analysis . Do you ever get frustrated when you hear about one research project that says a particular food is good for your health, and then some time later, you hear about another research project that says the opposite? Meta-analysis analyzes existing statistics found in a collection of quantitative research to demonstrate patterns in a particular line of research over time. Meta-analysis is research that seeks to combine the results of a series of past studies to see if their results are similar, or to determine if they show us any new information when they are looked at in totality. The article, Impact of Narratives on Persuasion in Health Communication: A Meta-Analysis examined past research regarding narratives and their persuasiveness in health care settings. The meta-analysis revealed that in-person and video narratives had the most persuasive impacts while written narratives had the least (Shen, Sheer, Li).

Outcomes of Quantitative Methodologies

Because it is unlikely that Communication research will yield 100% certainty regarding communicative behavior, why do Communication researchers use quantitative approaches? First, the broader U.S. culture values the ideals of quantitative science as a means of learning about and representing our world. To this end, many Communication researchers emulate research methodologies of the physical sciences to study human communication phenomena. Second, you’ll recall that researchers have certain theoretical and methodological preferences that motivate their research choices. Those who understand the world from an Empirical Laws and/or Human Rules Paradigm tend to favor research methods that test communicative laws and rules in quantitative ways.

Even though Communication research cannot produce results with 100% accuracy, quantitative research demonstrates patterns of human communication. In fact, many of your own interactions are based on a loose system of quantifying behavior. Think about how you and your classmates sit in your classrooms. Most students sit in the same seats every class meeting, even if there is not assigned seating. In this context, it would be easy for you to count how many students sit in the same seat, and what percentage of the time they do this. You probably already recognize this pattern without having to do a formal study. However, if you wanted to truly demonstrate that students communicatively manifest territoriality to their peers, it would be relatively simple to conduct a quantitative study of this phenomenon. After completing your research, you could report that X% of students sat in particular seats X% of times. This research would not only provide us with an understanding of a particular communicative pattern of students, it would also give us the ability to predict, to a certain degree, their future behaviors surrounding space issues in the classroom.

Quantitative research is also valuable for helping us determine similarities and/or differences among groups of people or communicative events. Representative examples of research in the areas of gender and communication (Berger; Slater), culture and communication (McCann, Ota, Giles, & Caraker; Hylmo & Buzzanell), as well as ethnicity and communication (Jiang Bresnahan, Ohashi, Nebashi, Wen Ying, Shearman; Murray-Johnson) use quantitative methodologies to determine trends and patterns of communicative behavior for various groups. While these trends and patterns cannot be applied to all people, in all contexts, at all times, they help us understand what variables play a role in influencing the ways we communicate.

While quantitative methods can show us numerical patterns, what about our personal lived experiences? How do we go about researching them, and what can they tell us about the ways we communicate? Qualitative methods have been established to get at the “essence” of our lived experiences, as we subjectively understand them.

• Survey of Communication Study. Authored by : Scott T Paynton and Linda K Hahn. Provided by : Humboldt State University. Located at : https://en.wikibooks.org/wiki/Survey_of_Communication_Study/Preface . License : CC BY-SA: Attribution-ShareAlike

• Open access
• Published: 03 April 2024

Co-development of a training programme on disability for healthcare workers in Uganda

• Tracey Smythe 1 , 2 ,
• Andrew Sentoogo Ssemata 3 , 4 ,
• Sande Slivesteri 3 ,
• Femke Bannink Mbazzi 1 , 3 &
• Hannah Kuper 1  

BMC Health Services Research volume  24 , Article number:  418 ( 2024 ) Cite this article

Metrics details

Approximately 1.3 billion people worldwide face barriers in accessing inclusive healthcare due to disabilities, leading to worse health outcomes, particularly in low and middle-income countries (LMIC). However, there is a lack of training of healthcare workers about disability, both globally and in Uganda.

To use mixed research methods to develop a comprehensive training program with standardisedelements for healthcare workers in Uganda, focusing on improving their knowledge, attitudes, and skills inproviding care for people with disabilities.

The Medical Research Council (MRC) approach was employed to guide the development of the training intervention. We conducted an umbrella review to gather relevant literature on disability training for healthcare workers. Interviews were conducted with international experts to gain insights and perspectives on the topic. Additionally, interviews were undertaken with people with disabilities and healthcare workers in Uganda to understand their experiences and needs. A participatory workshop was organised involving key stakeholders, to collaboratively design the training material based on the findings from these data sources.

Eight review articles examined training programs for healthcare workers on disability. Training settings ranged from specialised clinical settings to non-clinical settings, and the duration and evaluation methods of the training varied widely. Lectures and didactic methods were commonly used, often combined with other approaches such as case studies and simulations. The impact of the training was assessed through healthcare worker reports on attitudes, knowledge, and self-efficacy. Interviews emphasised the importance of involving people with disabilities in the training and improving communication and understanding between healthcare providers and people with disabilities. Five themes for a training on disability for healthcare workers were generated through the workshop, including responsibilities and rights, communication, informed consent, accommodation, and referral and connection, which were used to guide the development of the curriculum, training materials and training approach.

This study presents a novel approach to develop a training program that aims to enhance healthcare services for people with disabilities in Uganda. The findings offer practical insights for the development of similar programs in LMICs. The effectiveness of the training program will be evaluated through a pilot test, and policy support is crucial for its successful implementation at scale.

Key messages

1. Healthcare workers require training to effectively address the health concerns of people with disabilities, yet this is rarely included in curricula worldwide.

2. Uganda recognises the importance of addressing this issue and is taking steps to improve training programs about disability for healthcare workers.

3. We used multiple research methods (umbrella review, semi-structured interviews, participatory research and collaborative design) to co-develop a comprehensive training program with standardised elements for healthcare workers in Uganda, focusing on improving their knowledge, attitudes, and skills in providing care for people with disabilities.

4. The developed training material could be adapted for healthcare workers in other resource-limited settings, and policy support is needed to ensure its implementation at scale.

Peer Review reports

Introduction

Approximately 16% of the world’s population, or 1.3 billion people, live with a disability, and the majority live in low and middle income countries (LMIC) [ 1 ]. Access to inclusive healthcare services is vital for promoting health equity and social inclusion for all [ 2 , 3 ]. However, healthcare workers’ lack of knowledge, skills, and attitudes towards disability remains a significant barrier to achieving this goal [ 4 ]. Efforts to integrate disability-related education and training into healthcare curricula and continuing education programs, as emphasized by the WHO report [ 1 ], are crucial in addressing this issue. Equipping healthcare workers with the necessary tools and resources to provide effective, respectful, and culturally sensitive care to people with disabilities is essential in meeting their needs and promoting positive health outcomes. People with disabilities want to be “expected, accepted and connected” by the health system [ 2 ]. This requires training to ensure that healthcare staff are aware of disabilities, possess relevant skills, and maintain positive attitudes, enabling them to make appropriate linkages to other necessary care. Efforts to integrate disability-related education and training into healthcare curricula and continuing education programs are crucial in addressing this issue [ 1 , 2 , 3 , 5 ].

Training on disability can lead to improvements in the knowledge and attitudes of healthcare workers towards people with disabilities throughout all stages of their careers. For example, two medical colleges in the US integrated disability across medical student training curricula, and medical students improved their knowledge, attitudes, and core competencies in treating patients with disabilities [ 6 ]. In Rwanda, continuing professional development training about childhood disability used case studies and clinic visits, and instructors gave participants’ immediate feedback on their practice. As a result, participants demonstrated improved clinical decision making skills in paediatric rehabilitation [ 7 ]. Similarly, programmes that invited people with disabilities as teachers found that participants believed the nonclinical interaction enhanced their comfort and attitudes towards people with disabilities [ 8 , 9 ].

Despite the global recognition that well-trained, fairly distributed and motivated healthcare workers are critical to improving population health and achieving universal health coverage (UHC) and Sustainable Development Goals (SDGs) [ 10 ], there are limited standardised training programs focusing on disability [ 11 ], especially in LMICs. Existing programs cover diverse content areas such as general disability awareness, condition-specific knowledge, rehabilitation skills, assistive technology, inclusive design, universal design for learning, mental health, and primary healthcare (Table  1 ). There has been little consideration to date on what is optimal in terms of content of disability training for healthcare workers.

There are various potential approaches to training, including face-to-face or remote, involvement of people with disabilities or not, and emphasis on knowledge, skills, or attitudes, as well as different underlying models, such as medical or rights-based [ 11 , 12 ]. Despite this range of possibility, there is limited collation or scrutiny of information, including input from people with disabilities and healthcare workers, to identify the most effective approach. Additionally, LMICs face unique challenges in healthcare provision, including resource constraints and limited access to education and training [ 13 ], which may contribute to the acute lack of training opportunities for healthcare workers. For instance, Uganda encounters significant challenges in training healthcare workers on disability due to limited resources, infrastructure, and cultural barriers that may stigmatise or exclude people with disabilities [ 14 , 15 , 16 ].

The objective of this study was therefore to use multiple research methods to develop a comprehensive training program with standardised elements for healthcare workers in Uganda, focusing on improving their knowledge, attitudes, and skills in providing care for people with disabilities. This paper describes the development of the disability training and presents the framework of the training material developed. We provide an in-depth examination of the training needs of healthcare workers in the area of disability and offer a practical solution in the form of the developed training material that can be used to improve the knowledge and skills of healthcare workers on disability. A future study will pilot test and evaluate the training material.

We used the Medical Research Council (MRC) approach, which involves a systematic and evidence-based framework to development of a programme [ 17 ]. It emphasises the importance of involving stakeholders throughout the process and ensures that interventions are evidence-based, feasible, and acceptable to those involved in their implementation. This approach aims to create effective and sustainable interventions that improve health outcomes and services.

Overview of methods

This study utilised data from an umbrella review, interviews with international experts on disability training for healthcare workers, and interviews with people with disabilities and healthcare workers in Uganda. The data informed the design of a workshop that involved key stakeholders, including healthcare workers and people with disabilities, in co-creating the training material. The training material was developed based on information gathered from the umbrella review, interviews, and design workshop.

Umbrella review

The umbrella review was conducted to identify systematic reviews and meta-analyses of studies that examined associations between training of healthcare workers on any disability and change in healthcare worker behaviour, attitude or treatment delivered. The protocol for this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO), reference number #CRD42023390881. We used the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement for conducting umbrella reviews. We searched PubMed for studies published in English between 1st January 2015 and 11th January 2023, using the terms (“train*” OR “educat*”) AND (“healthcare worker” OR “health professional” OR “medical professional”) AND (“disability” OR “impairment”) filtered for systematic reviews and meta-analyses for this rapid umbrella review. Inclusion criteria were established as: systematic reviews or meta-analyses that evaluated training on disability (intervention) for any health professional (population). Studies were excluded if published prior to 2015 to ensure the currency and relevance of information, and if in any other language than English. We searched reference lists of included studies for additional eligible papers.

Two reviewers (TS, ASS) independently assessed study eligibility and extracted the data. The risk of bias of the included studies was assessed using AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews) [ 18 ], designed to appraise systematic reviews that include randomised controlled trials. The instrument provides a broad assessment of quality, including flaws that may have arisen through poor conduct of the review with uncertain impact on findings. We developed and pilot-tested an extraction tool in Excel, to systematically record information from included studies. Extracted information included: (1) Publication characteristics: author, title, year of publication, setting/country; (2) Study design: study design, sample size; (3) Participant characteristics: cadre, and any other relevant descriptive data; (4) Outcomes: effect size of training. Data were extracted by TS and checked for accuracy by ASS. Where studies included information on training other professionals (e.g. police officers, teachers) only data on healthcare workers were extracted. Data were also only extracted on training when reviews included additional information (e.g. use of disability measurement tools). We narratively synthesised the results.

Semi-structured interviews

Interviews were conducted with international experts with experience of delivering training on disability in January 2022, in order to explore current practices and to identify gaps in practice and policy. Six experts were purposively sampled to represent people with and without disabilities, in low and high income settings. They were interviewed by TS, a physiotherapist and epidemiologist from Zimbabwe with mixed-methods expertise. Interviews were held online using Zoom. Verbal informed consent was given. A set of open-ended questions (Supplementary file 1) elicited detailed responses on the experiences, perspectives and practices of experts in the field of healthcare worker training on disability. The interviews were recorded and transcribed for analysis. Transcripts were coded and thematically analysed using NVIVO.

Interviews were then conducted in Uganda with people with disabilities and healthcare workers. Written consent was given. People with disabilities were asked what they wished healthcare workers would know about disability, and interviews with a range of healthcare workers were used to gather more detailed information on their specific training needs and to understand their perceptions of the current training available. Semi-structured interviews were conducted in-person with 17 healthcare workers and 27 people with disabilities in Luuka District, Uganda. ASS and SS, Ugandan social scientists with expertise in qualitative methodology undertook the interviews. Participants were recruited through existing networks, non-government organisations and health facilities. The healthcare workers were selected from the eight sub-counties that make up Luuka district based on cadre (clinical officers, midwives, nurses, village health trainers, laboratory technicians, health officers), and level of health facility (health centre, II, III or IV). The people with disabilities were purposively selected to ensure representation of age, gender and impairment. Interviews were undertaken with persons with visual impairment ( n  = 5), physical impairment ( n  = 5), multiple impairment ( n  = 5), cognitive/ intellectual impairment ( n  = 5) and albinism ( n  = 1). Interviews with people with hearing impairment ( n  = 6) were conducted by a member of the research team who is deaf (Supplementary file 2: Participant demographics). The semi-structured interviews explored experiences and perspectives of delivering and receiving health services (Supplementary file 3: Healthcare worker, Supplementary file 4: People with disability). The interviews were conducted in a private and comfortable setting and lasted 50–80 min. They were audio recorded and transcribed. Those conducted in Lusoga and Luganda were translated to English. The transcripts were coded and manually analysed using a deductive thematic analysis approach.

Design workshop

A design workshop was held to develop a framework for the disability training intervention in Entebbe Uganda in September 2022. The workshop brought together a group of people with diverse disabilities ( n  = 7) and healthcare workers and medical educationalist ( n  = 5) to actively participate in the design process over 2 days. The workshop was facilitated by TS and ASS. The workshop consisted of a series of participatory activities, including group discussions, brainstorming sessions, and small group exercises. These activities were designed to elicit the perspectives, experiences, and recommendations of participants. The workshop concluded with a consensus-building activity, where participants discussed and agreed on the key components of the training framework.

Development of training material

A theory of change was used to inform the content design and implementation of the training framework. The research team created the first theory of change model, led by TS, drawing on information gathered from the international experts. The theory of change approach involved identifying the desired outcomes of the training and the necessary steps and activities to be put in place to achieve those outcomes. The training material was then developed by the study team drawing on evidence from the umbrella review, interviews and design workshop on the most effective training strategies for healthcare workers on disability, and was refined based on feedback from five people with disabilities.

The literature search for the umbrella review yielded 377 studies, with 24 full-text articles selected for further review. Eight review articles were eligible for inclusion in the final analysis (Fig.  1 ). A total of 227 studies were included in the reviews, but only 4 studies were conducted in LMICs. The reviews related to training in intellectual and developmental disabilities, mental health, and all disabilities. Three systematic reviews were rated with high confidence on the AMSTAR2 tool, two rated with medium and three rated with low confidence (Supplementary file 5 ). The systematic reviews receiving a low confidence rating in their findings were evaluated as such because they failed to pre-register the review and did not include an appropriate evaluation of bias, including publication bias of the included studies.

PRISMA for umbrella review of systematic reviews and meta-analyses on training of healthcare workers on disability

The training settings included specialised clinical settings, non-specialised clinical settings (inpatient and outpatient), continuity-clinic based, non-clinical settings, medical schools, GP practices, primary care clinics, and various other settings such as clinics, camps, schools, residential settings, and universities. The timeline of training and training evaluation methods varied across the articles; Some articles reported single-session training, short-term training (< 1 month), and longer-term training (1–3 months or > 3 months).

Lectures and didactic (instructional) methods were the most commonly reported teaching methods in disability education, often combined with other approaches, such as case studies, simulations, and placements. Some training programmes leverage multimedia tools, such as video recording or simulations, to enhance the learning experience. The content of the education typically includes disability from a rights-based perspective, as well as particular skills, such as sign language for medical and pharmacology terms (Table  2 ). Many programmes involved people with disabilities as active participants in the education, such as simulating patients or serving as teachers to help run activities. Through these interactions, contact with people with disabilities was transformative, leading to significant changes in attitudes and perceptions of participants.

A broad variety of evaluation methods were used, such as pre- and post-test knowledge assessments, questionnaires at baseline up to 18 months, and immediate post-training evaluations. The impact of the education was typically measured by healthcare worker reports of comfort and attitudes towards people with disabilities, as well as communication skills, knowledge, and self-efficacy. Target outcomes for the training interventions varied, with some focusing on perspective/awareness/comfort, medical and clinical knowledge. Several had unclear outcomes. However, only a few studies considered the longer-term impact, specifically three months post-intervention. The training effect estimates are almost exclusively for high income countries.

Interviews with international experts

International experts reported that people with disabilities play an important role in improving the quality of care for themselves and others. Interviewees identified several ways that this role would occur, as people with disabilities can: offer unique insights into their experiences and perspectives, identify areas for improvement in their care, serve as advocates and role models, and help to promote a culture of inclusion and understanding in the healthcare system. They can also help to ensure that training programs are relevant, effective, and responsive to the needs of people with disabilities.

Experts reported that good practice examples of training methods included contextualized story-telling and activities adapted by the trainer to the local context. Participants believed that these methods were most effective in engaging learners and improving their knowledge, attitudes, and skills related to disability. However, the success of these methods depended on the quality of the training materials, the experience and skills of the trainers, and the level of buy-in and engagement from learners.

Interviewees identified challenges in providing disability education within healthcare training, citing issues such as lack of standardization in curricula and limited time and resources. They expressed concern that these factors may contribute to inadequate understanding of disability issues among healthcare providers, resulting in disparities in care and outcomes for people with disabilities. Additionally, participants discussed emerging trends in healthcare, such as the use of telemedicine and wearable devices, which they believed would require healthcare workers to develop an even deeper understanding of the needs of people with disabilities. They identified opportunities for scaling training, including integrating disability education into undergraduate degrees, continuing education programs, mentoring, and coaching. Overall, participants viewed the future of disability education for healthcare workers as an exciting opportunity for growth and advancement in the healthcare industry.

Interviews in Uganda

Overall, the importance of improving communication, understanding, and collaboration between healthcare providers and people with disabilities to promote equitable and high-quality healthcare services was emphasised in interviews with both people with disabilities and healthcare workers.

People with disabilities highlighted that they expected healthcare workers to recognise and be made aware of the challenges they face when trying to access healthcare services. Additionally, they emphasised that they desired to be treated with the same respect and dignity as any other patient, and they value a positive attitude from healthcare providers towards their care.

“We want healthcare workers to know that all people are equal, including those of us with disabilities, and they should treat each person with dignity.” (Male, visual impairment). “The doctors in the hospital should know that we too are humans, and have blood like them. The difference maybe is that one of my parts is weak, but it doesn’t stop us from getting sick like them.” (Female, physical impairment).

Many of the participants with disabilities acknowledged that better communication skills from healthcare providers, such as clear and concise explanations, are essential to building trust and rapport with people with disabilities.

“What I know is that for my life to continue being good, it is important for me to be able to visit a healthcare worker who understands my situation and I am not insulted…The care and respect you give me when you see me, and how you speak, is helpful.” (Male, Albinism).

Similarly, the healthcare workers expressed a need for more training and education on disability to provide high-quality care. The reported training needs ranged from basic training orientation on disability, including communication skills and knowledge on how to navigate the time needed for disability-inclusive care, to how to examine and treat people with disabilities during routine health visits.

“First of all, we need training because people with disabilities cannot be managed like other individuals. We need training on the forms of disabilities because the different types of disabilities call for different management. So, we can be empowered…and we can manage the expected and non-expected challenges.”(Male, Medical officer) . “We need to know, how do you assess, and how do you support and counsel them. If you do not have those skills sometimes you can mishandle them. For example, you may just look at the cough they have but behind the cough there could be other things.” (Female, Senior nursing officer).

Furthermore, healthcare providers pointed out the need for adequate information about specialised service needs, how to make referrals and contextual considerations (e.g. cultural, social, economic) to ensure that people with disabilities received appropriate care and were referred for further management.

“If I recognise the need for specialised care, I would simply write a referral note. However, many times I am unsure of where to refer them, so I am unable to follow up on whether they received the necessary assistance. Writing a referral is the best I can do.” (Male, Senior medical officer). “We can train healthcare workers within the facility on the best practices for interacting with people with disabilities. Even those of us who support them in the community can be trained on how to connect them with specialised services .” (Male, VHT coordinator). “It may be beneficial to collaborate with others who work with individuals with disabilities and provide holistic care. Since we operate at different levels and some hospitals have specialised clinics for individuals with disabilities, working together can help ensure they receive proper services”. (Female, Midwife)

Involving people with disabilities in training was regarded as a way of facilitating mutual understanding and enabling healthcare workers to better address the specific needs of persons with disabilities, while establishing a designated person for follow-up could enhance continuity of care.

“Sometimes we are left behind, but if we are invited to health workshops, we can share our experiences with healthcare workers, including how we feel and how we should be treated. We can discuss the specific disabilities we face and the challenges we encounter. This would provide an opportunity for healthcare workers to better understand and appreciate what individuals with disabilities go through. ” (Male, Person with disability councillor, Visual impairment).

The findings suggest that healthcare workers often feel uncertain about referring people with disabilities for specialised care, leading to challenges in ensuring necessary and appropriate healthcare. Training healthcare workers on best practices for interacting with people with disabilities, both within the facility and in the community was recommended to help improve their ability to connect patients with specialised services and provide holistic care.

Themes and recommendations from the participatory workshop

Five themes for healthcare worker training on disability were generated by consensus from discussions during the participatory workshop. These themes included the need for a focus on:

Responsibilities and rights: emphasising understanding of the rights of people with disabilities;

Communication: highlighting effective communication for building rapport;

Informed consent: focusing on respecting privacy during examinations;

Accommodation: advocating for disability-inclusive practices; and

Referral and connection: ensuring appropriate referrals and connections to other healthcare services.

The workshop also emphasised the importance of active participation, clear communication, and inclusivity in the design process.

It was recommended that the disability training program should adopt a modular approach, focusing on different aspects of providing healthcare to people with disabilities. It should also focus on increasing knowledge and understanding of disabilities, and improving the attitudes and practices of healthcare workers towards people with disabilities. Emphasis should be placed on adopting a disability-inclusive approach, training healthcare workers on the social model of disability, recognising the impact of societal barriers on the lives of people with disabilities, and addressing these barriers to promote greater inclusion and participation in society. Cultural sensitivity and the use of appropriate terminology are essential help to ensure that the training is inclusive and relevant to the diverse population of people with disabilities that healthcare workers may encounter.

Interaction with people with disabilities was recommended as a key component. This will involve inviting people with disabilities to participate in the training sessions to share their experiences and perspectives. The training should also adopt a learner-centred and participatory approach, based on the values of the healthcare worker, promoting reflection on their own values and beliefs and applying them in their practice, which may be effective in promoting a sense of ownership and commitment to working with people with disabilities.

Ongoing mentorship and peer learning should support the training, pairing healthcare workers with experienced mentors to provide guidance and support as they apply their new knowledge and skills in practice. Practical skills should be included in the training, such as techniques for measuring the weight of a person with a physical impairment, to ensure comprehensive and considerate examination and treatment of people with disabilities.

Training material structure

The theory of change provided a clear and logical structure for the development of the training framework and helped to ensure that the framework was comprehensive, evidence-based and responsive to the specific needs and experiences of people with disabilities in Uganda. The desired outcomes of the training included increasing the knowledge, skills and attitudes of healthcare workers on disability, to ensure that people with disabilities are expected, accepted and connected within health systems. The ceiling of responsibility is the distal outcome that healthcare workers provide disability inclusive care that is considerate and comprehensive. Key components and activities that would be necessary to achieve the proximal outcomes included interaction with people with disabilities, a learner centred participatory approach based on the values of healthcare workers, ongoing mentorship and peer learning (Fig.  2 ).

Theory of change *HCW = healthcare worker, PWD = people with disabilities

The developed training programme included a range of activities such as pre-training self-assessments, interactive workshops, case studies and mentoring. The training framework also included specific provisions for accessibility and inclusion, recognising the importance of addressing the specific needs and experiences of people with disabilities.

The training will be delivered by a healthcare worker and a person with a disability. They will facilitate the training in person over one day for various healthcare workers (nurses, technicians, community health workers, allied health professionals, doctors). The programme will focus on key areas such understanding disability, good practices in work, and personal motivations for providing disability-inclusive healthcare. Participants will learn about routine health needs, communication skills, assessing and treating persons with disabilities, appropriate referrals, and ensuring accessibility in healthcare settings.

The training program aims to achieve its goals through several strategies. It promotes a disability-inclusive approach by engaging people with disabilities and encouraging active participation and reflection. Ongoing mentorship and peer learning opportunities are provided for continuous support. Practical tools are shared to equip healthcare workers with necessary skills. Cultural sensitivity is fostered to ensure healthcare workers can provide care that is respectful and responsive to diverse cultural backgrounds and language preferences. By incorporating these strategies, the training program aims to empower healthcare workers with the expertise needed to provide inclusive and effective healthcare services for persons with disabilities.

Developing a comprehensive training programme for healthcare workers on disability is an important step in addressing barriers to healthcare access for people with disabilities [ 3 ]. We used the Medical Research Council approach to develop the training material [ 17 ], considering practical solutions to improve the knowledge and skills of healthcare workers on disability. Our umbrella literature search revealed that lectures and didactic methods were commonly used in disability education, often combined with other approaches such as case studies and simulations. The review also highlighted the importance of using various teaching methods and including people with disabilities in disability education. The impact of education was measured in various ways, including through healthcare worker reports on comfort, attitudes, communication skills, knowledge, and self-efficacy. There is need for a standardised approach to allow comparison between contexts and countries. Standardisation in curricula and limited time and resources were identified as challenges in providing disability education within healthcare training.

People with disabilities and healthcare workers in Uganda expressed the need for better communication skills from healthcare providers, training on disability, and recognition of challenges faced by people with disabilities. These findings are echoed in other studies globally [ 19 , 20 , 21 , 22 ]. The participatory workshop successfully generated a comprehensive and inclusive framework for a disability training programme, incorporating the diverse perspectives of people with disabilities and healthcare workers. Our findings are consistent with other studies that highlight the importance of disability education in healthcare training, utilising various teaching methods and incorporating the perspectives of people with disabilities [ 23 , 24 ]. The next step is to pilot-test the training programme with healthcare workers in Luuka District, Uganda. During pilot testing, the training program will also consider the cultural context in which it will be delivered, as previous research has shown that cultural competence is essential for providing effective and appropriate care to people with disabilities [ 25 , 26 ].

One of the strengths of our study was the use of the MRC approach to develop the training material, which enabled us to systematically examine training needs and develop practical solutions to improve the knowledge and skills of healthcare workers on disability. In addition, the study encompasses a diverse range of health worker cadres and people with varying types of disabilities, ensuring a comprehensive exploration of perspectives and experiences. Our study also has limitations to consider when interpreting the results. A systematic umbrella review was undertaken rather than a systematic review. Recruitment through existing networks, NGOs, and health facilities may not capture the perspectives of people with disabilities who are not affiliated with these organisations. We included the perspectives of people with disabilities and healthcare workers in Uganda, and thus the generalisability of the disability training to other contexts may be limited. While we did include the opinions of international experts and a global umbrella review, further research is needed to confirm the effectiveness and applicability of the training program in different settings, as the umbrella review noted important gaps in the literature.

Our findings have important implications for policy, programmes and research. Specifically, our study suggests that a disability training programme should be inclusive of diverse cultural backgrounds and adaptable to specific needs, and should incorporate the perspectives of both people with disabilities and healthcare workers. These findings could be used to inform the adaptation of future training programs for healthcare workers in Uganda and other resource-limited settings. Nevertheless, people with disabilities are a diverse group with varying needs and this has implications for training. While advocating for overall disability training, it is essential to also focus on different types of impairment. Additionally, the needs of different healthcare workers will vary due to their diverse roles, raising questions about the feasibility of a generic training programme. Policy support is vital to ensure implementation and support of disability training for healthcare workers (e.g. mandating inclusion in medical and nursing curricula). Future studies could use more objective measures of impact, such as patient outcomes or changes in healthcare service provision.

The proposed development of a disability training for healthcare workers aims to address the barriers and challenges faced by people with disabilities in accessing health care services in Africa. The training will adopt a modular approach. Components of the training include interaction with people with disabilities, a learner-centred and participatory approach, ongoing mentorship and peer learning, practical tools to deliver a comprehensive and considerate examination and treatment, and cultural sensitivity.

Data availability

The majority of the datasets supporting the conclusions of this article are included within the article and its additional files. However, underlying interview data associated with this study will not be made freely available, as the small number of healthcare worker and people with disabilities makes data potentially identifying. Applications for access to the raw qualitative data for this study should be made via email to the corresponding author [email protected], outlining the purpose of the proposed analyses and the data requested. These applications will be reviewed by the LSHTM’s data access committee, and if accepted, the requested data will be shared.

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TS and HK designed the work: TS, HK, TS, ASS and SS collected the data, TS, ASS and SS analysed and interpreted the data. TS drafted the article, TS, ASS, SS, FBM and HK provided critical revision of the article and all authors gave final approval of the version to be submitted.

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All protocols were approved by the Uganda Virus Research Institute research ethics committee (ref: GC/127/904) and the London School of Hygiene & Tropical Medicine (ref: 26715) and the Uganda National Council of Science and Technology (SS1348ES).This study was conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all participants. Written informed consent was obtained from participants (people with disabilities and healthcare workers) who undertook interviews that were conducted in Uganda. Verbal informed consent was obtained from stakeholders, whose interviews were online, and the ethics committee approved this procedure.

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Smythe, T., Ssemata, A.S., Slivesteri, S. et al. Co-development of a training programme on disability for healthcare workers in Uganda. BMC Health Serv Res 24 , 418 (2024). https://doi.org/10.1186/s12913-024-10918-z

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Received : 29 June 2023

Accepted : 27 March 2024

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DOI : https://doi.org/10.1186/s12913-024-10918-z

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