Retaining nuance: Challenges with defensible transferability of qualitative theoretical perspectives and findings into development and implementation of health interventions

Health interventions, particularly those originally guided by the theoretical foundations of qualitative inquiry and/or developed from qualitative study findings, all too often undergo inappropriate or thoughtless application in contexts outside of the original study bounds. As naturalists, we provide thick descriptions of contextual and environmental factors in which our findings are applicable. The onus is placed upon those outside of the original research to defend any future transferability. As researchers how might we better ensure trustworthiness of our qualitative data throughout the life of its use; specifically, from theoretical conceptualization to findings informing quantitative confirmability studies, to subsequent intervention development and dissemination, and most importantly, for intervention implementation in ‘other’ contexts? What does an appropriate theory of change (TOC) health intervention developed from qualitative inquiry look like? How do we ensure sanctity of our guiding qualitative lenses, and subsequent findings, when they are likely to be applied in contexts that differ from those that guided development of the original intervention?

Using our program of research (POR), we address these questions, and broader implications of health intervention transferability challenges in an implementation science framework. Our POR includes four completed studies and two in-progress studies (3 qualitative and 2 quantitative); each collectively exploring relational dynamics between estheticians and clients seeking pubic hair removal, focusing on the role of estheticians in identifying, diagnosing, and providing health-related referrals. It is anticipated the POR findings will inform development/implementation of an esthetician-led health intervention, as estheticians appear to play a pivotal role in the overall health of their clientele.

By using a metascientific perspective, engaging in constant reflection, and detailing any missing theoretical assumptions of the intervention’s TOC when describing the intervention context, we have been able to develop clear guidelines for appropriate future transferability of qualitative findings that guide development of health interventions.