Reaching hidden or hard-to-reach populations

This is the third Qualitative Methods Journal Club from Drexel University (Philadelphia, United States). This time, four members of the Department of Community Health and Prevention at Drexel University’s Dornsife School of Public Health discussed ethnography, entrée and access to hidden spaces. 

Article summary

This article focused on the practice of using ethnographic methods to gain access to hidden or hard-to-reach populations in the context of studying drug use and drug treatment. The authors used fieldwork experiences from a project studying recovery houses created for Latino immigrants in Northern California to unpack the challenges and issues surrounding the study of hidden populations, including legality, public vs. private settings, and insider/outside status.

Group

Four members of the Department of Community Health and Prevention at Drexel University’s Dornsife School of Public Health – a mixture of faculty and doctoral students with backgrounds in substance use research and/or qualitative methods – discussed the article for one hour via zoom on July 28, 2022.

Discussion

The group observed that the ethnographic approaches employed in this article – particularly as they related to drug research – were less common in traditional public health circles and spent time discussing three core themes. First, the issue of legality is relevant in ethnographic drug research in ways not found in most other public health research because the researcher may be witnessing illicit activities in spaces where they take place. Second, studying hidden populations entails engaging both public and private spheres which provides different challenges.  For instance, when studying people in public spaces people may not realize you’re a researcher, but there can still be some obligation to disclose your position when gathering data. Whereas in a privately-owned space, such as a club, a researcher may need permission from management to conduct research. Third, it is difficult for a researcher to ever become a true insider or member of the group being studied given the different life experiences and goals separating the researcher from the participants. However, the researcher’s positionality (e.g., gender, race) can influence levels of rapport and ability gain greater entrée or acceptance. On this point, the group raised the point that insider/outsider status can be fluid depending on the audience and the setting.

The group observed that the authors mostly focused on the methodology of gaining access to hidden spaces, i.e., the three issues discussed above, rather than an exploration of the recovery house spaces themselves.  Most agreed that focus of the study – undocumented Latino men in Northern California living in unofficial drug treatment settings – presented a very marginalized group and difficult space to study, but a good context for learning techniques for access to hidden populations. For instance, a key rapport building

technique in the recovery house context was one that could be uncomfortable to some researchers. A common pathway to recovery was through sharing stories with fellow group members around one’s own substance use experiences, which compelled the researchers to share their own or family history to reciprocate. This practice subverted the typical one-way exchange of information found in traditional qualitative interviews.  However, this approach raised questions of objectivity among the group: could this type of self-disclosure influence or redirect conversations and data gathering towards more limited ends? Also, when deploying this more in-depth approach to rapport and relationships building, how does one not get overly involved in participants’ lives and avoid burnout, particularly when trauma may be a key focus on the research?

The group noted that since the lead investigator was a woman, gender was a key dynamic to be navigated in the all-male Latino recovery house context – both as an opportunity for access but also necessary to manoeuvre around unwanted romantic/sexual attention or stereotypes associated with women who misuse drugs or alcohol. In this case, it was necessary to involve other male researchers to ensure both access and safety.

The group concluded that this article gave voice to the experience of researchers doing a challenging type of ethnography, provided a useful perspective on a lesser known aspect of the research process, and would be good resource for anyone learning or teaching ethnographic research methods.

by Professor Stephen Lankenau

Editor’s note: The title and link for this website entry was changed on 6 January 2023

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