Biomedicalization and the Practice of Culture: Globalization and Type 2 Diabetes in the United States and Japan

By Mari Armstrong-Hough | Go to book overview

Methodological Appendix

In this appendix, I describe my methodological orientation and debts, the practical methods used to collect the data used in this book, and the data itself. I conclude with a section noting my own place in the communities that took me in, taught me, and offered up professional and personal experiences for this project.


Methodology

This project is an inductive, qualitative, comparative study of the plurality of biomedicine (Kleinman 1995) that used an inductive “grounded theory” approach to producing and interpreting sociological knowledge from interview data. In grounded theory, data collection tools are continually reevaluated and redeveloped throughout the collection process (Charmaz 1983, 1990, 1991; Glaser & Strauss 1967; Lofland & Lofland 1984; Strauss 1987). As a comparative, case-based study, it relied on data from a variety of sources, including themes and categories emerging from these interviews, to generate a clearer understanding of the relationship between biomedicalization, globalization, biomedical practice, and context.

Grounded theory can mean many things. There are three major approaches to grounded theory to choose from, not to mention a variety of alternative approaches (Miller & Salkind 2002). Even among the three best-recognized approaches, there remain significant differences in epistemologica! commitment and assessment of methodological rigor. Of these three, the most rigid approach embraces a systematic design, with prescribed data analysis steps that include open coding, axial coding, selective coding, and finally the production of an explicit, visual representation of the theory generated (Strauss & Corbin 1990; Miller & Salkind 2002). The more flexible emerging design formed as a critique of this rigid procedural approach. Glaser (1992) emphasizes that the point of grounded theory is to allow categories to emerge from the data, rather than to rely on preconceived categories and constantly submit to rigid procedures. A third and final approach, constructivist design, rejects clearly delineated analytical stages, diagrams that “obscure” experience, and overdetermined theoretical constructs (Charmaz 1990, 2000; Miller & Salkind 2002).

My approach was closest to that of Charmaz (2000) or Lamont (2000), but combines elements of all three of these variants. Though the size and linguistic complexity of my data led me to rely on a methodical approach toward organizing and analyzing, including open and axial coding along the lines of Strauss and Corbin (1990) for the first 143 interviews, I believe that the flexible, interpretive approach of Charmaz (1990, 1991, 2000) is more sensitive to the subjective experience of participants. To the extent possible in a project with a single researcher for hundreds of participants sharing their ideas in two languages, I attempted to emulate Charmaz’s close attention to

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