El pragmaticismo

3.2.1 Constructionist Perspective

An exploratory qualitative study was conducted to examine the context of adolescents’ SRH help-seeking behaviour in Grenada. Exploratory qualitative research, according to Patton (2002 p.193), is a reasonable starting point for research, “in new fields of study where little work has been done, few definitive hypotheses exist and little is known about the nature of the phenomenon.” The dearth of research in the Grenada context regarding ASRH and help-seeking behaviour (section 1.3) lends itself to exploratory research utilizing qualitative methods, because my goal is to understand “questions about the ‘what’,

‘how’ and ‘why’” (Green and Thorogood, 2009) of ASRH help-seeking in Grenada. As a result, quantitative research with its focus on “measurement and analysis of the causal relationships between variables” (Denzin and Yvonna, 2000 p.8) is not appropriate to achieve the aim of this study.

Qualitative research has been used successfully to explore SRH topics with adolescents (section 4.2.1) across various settings globally (e.g. Hyde et al., 2005; Gibson, 2007; Morrissey and Higgs, 2006; Barker and Rich, 1992; MacPhail and Campbell, 2001; Kempadoo and Dunn, 2001). Several perspectives are used to guide qualitative research design (see Box 3-1). Patton (2002) refers to these perspectives as “theoretical perspectives” and criticizes their use as being “arguable and somewhat arbitrary” (p.80). Nonetheless, Patton uses ‘foundational questions’ to distinguish between the different perspectives. However to avoid confusion with

the use of theoretical perspectives discussed in section 2.6, methodological perspectives will be used in this thesis, and Patton’s foundational questions in Box 3-1 were used to help choose the most appropriate perspective for this research.

Box 3-1 Theoretical perspectives and their distinguishing foundational questions

Source: (Patton, 2002)

While this research can be undertaken using a number of the different perspectives, these would be inappropriate. To conduct an ethnographic study using observational methods would be difficult, as it would not be possible to prospectively observe SRH help-seeking behaviour as a process, given the duration of the study. However, an ethnographic study would be feasible if the main interest was in observing end-point utilization of sources of help.

Phenomenology, which allows for examining the meaning of help-seeking for adolescents provided a good perspective, however, meaning making alone is insufficient to achieve the goals of the study. Grounded theory was also considered (Charmaz, 2006; Glaser and Strauss, 1967); however, there are help-seeking theories that provide a good starting point to guide ASRH help-seeking behaviour research in Grenada (section 2.6). Furthermore, my primary interest was not theory development. Based on the assumption that SRH behaviours of adolescents in Grenada are influenced by social and cultural values, a social constructionist perspective was the most relevant approach to guide the research design. A social constructionist perspective recognizes the importance of social and cultural values in social systems in which behaviour occur (Gama, 2009).

Ethnography

What is the culture of the group of people?

Social construction and constructivism

How have the people in this setting constructed reality? What are their reported perceptions,

“truths,” explanations, beliefs, and worldview? What are the consequences of their constructions for their behaviours and for those with whom they interact?

Phenomenology

What are the meaning, structure, and essence of the lived experience of this phenomenon for this person or group of people?

Heuristic Inquiry

What is my experience of this phenomenon and the essential experience of others who also experience this phenomenon intensely?

In this thesis social constructionism is used, although some authors use the term interchangeably (Bryman, 2008; Green and Thorogood, 2009). Patton (2002) and Michael Crotty (1979 cited in Patton 2002) are among the few authors who attempt to distinguish the subtleties. Social constructivism/constructionism include the tenet that perception is “made up” and shaped by sociocultural, linguistic, historical, and political processes (Patton, 2002;

Green and Thorogood, 2009; Schwandt, 2000). Furthermore, Patton’s foundational questions specific to the constructionist/constructivist are relevant to this study, and are reflected in the research questions. Grenadian adolescents and stakeholders perceptions/constructions related to ASRH help-seeking are accessed by interrogating contexts (Figure 2-5) to understand how as groups and individuals, sense is made of the phenomena of help-seeking for SRH and what if any consequences result from these constructions.

Although social constructionists tend to present an unbiased view of the multiple constructions of different groups, they are usually presumed to serve the interests of the powerful (Patton, 2002). As such, this research takes a critical approach in an attempt to give voice to adolescents’ perspectives and situation, as they are the less dominant and powerless group (Patton, 2002) compared to adult key informants, who are generally considered the more powerful group. The nature of the study with its focus on adolescents required special consideration as sensitive research, which is discussed in section 3.2.2 below.

3.2.2 Sensitive Research

The current research is considered sensitive, because according to Wellings et al.

(2000 p.256), “it requires disclosure of behaviours or attitudes which would normally be kept private and personal, which might result in offence or lead to social censure or disapproval, and/or which might cause the respondent discomfort to express.” Adolescent sexuality, described as taboo and leading to social disapproval, often results in discomfort to express in diverse contexts (MacPhail and Campbell, 2001; Kempadoo and Dunn, 2001). While this study did not interrogate adolescents’ sexual behaviour, help-seeking behaviour was related to the sexual behaviour of adolescent participants or others they may know, which had implications for their social identity. Furthermore, the small geographic size of Grenada, in addition to the small numbers of ASRH-related organization and programs could result in potential negative impact of the study for organizations and groups of adolescents. As a result, conducting this sensitive research had implications for the choice of methods used for data gathering.