Rethinking Barriers and Enablers in Qualitative Health Research

Limitations, Alternatives, and Enhancements

Bibliographic Data

ID4714425
AuthorsAmanda Haynes (0000-0001-5703-5683, Institute for Musculoskeletal Health, Sydney Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia, corresponding author), Victoria Loblay (0000-0003-4094-9619, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia)
Year2024
Volume34
Issue14
Pages1371-1383
Publication date2024-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueQualitative Health Research (JOURNAL)
Journal identifiersISSN: 1049-7323 • E-ISSN: 1552-7557
PublisherSAGE Publications Inc (PUBLISHER)
DOI10.1177/10497323241230890
PMID38459909
OpenAlexW4392620665
LanguageEN
Citations received13
References cited81

Explorations of barriers and enablers (or barriers and facilitators) to a desired health practice, implementation process, or intervention outcome have become so prevalent that they seem to be a default in much health services and public health research. In this article, we argue that decisions to frame research questions or analyses using barriers and enablers (B&Es) should not be default. Contrary to the strengths of qualitative research, the B&Es approach often bypasses critical reflexivity and can lead to shallow research findings with poor understanding of the phenomena of interest. The B&Es approach is untheorised, relying on assumptions of linear, unidirectional processes, universally desirable outcomes, and binary thinking which are at odds with the rich understanding of context and complexity needed to respond to the challenges faced by health services and public health. We encourage researchers to develop research questions using informed deliberation that considers a range of approaches and their implications for producing meaningful knowledge. Alternatives and enhancements to the B&Es approach are explored, including using 'whole package' methodologies; theories, conceptual frameworks, and sensitising ideas; and participatory methods. We also consider ways of advancing existing research on B&Es rather than doing 'more of the same': researchers can usefully investigate how a barrier or enabler works in depth; develop and test implementation strategies for addressing B&Es or synthesise the B&Es literature to develop a new model or theory. Illustrative examples from the literature are provided. We invite further discussion on this topic

Conceptual framework · Deliberation · Enabling · Engineering ethics · Knowledge management · Management science · Political science · Reflexivity · Social science · Sociology · Computer Science · Engineering · Health Policy Implementation Science · Mental Health and Patient Involvement · Primary Care and Health Outcomes · Psychology

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