A Case Study of Institutional Gatekeeping and Hard-to-Reach Populations in Health Research

• In Event: 4370 - Care at the End of Life

Abstract

Hard-to-reach populations are defined based on individual characteristics, such physical or social location, stigmatized or disenfranchised status, or unknown sampling parameters. At the same time, gatekeeping is generally treated as a one-time passage to access a setting, and as unrelated to whether a population is hard-to-reach. In this paper, we present an authoethnographic case study of our own experience using qualitative methods to study hospice decision making to showcase how the two are intimately related. Despite our reliance on classic qualitative methodological strategies, we faced many challenges in collecting data. As a result of ongoing, multi-faceted institutionalized gatekeeping, our research population became hard(er) to reach for reasons having more to do with organizational features than individual characteristics. Implications of these trends extend beyond concluding that qualitative research may become ever more difficult and time-consuming to conduct. Rather, they translate to problems with sampling, representativeness, validity, feasibility, funding, and, mostly critically, the types of questions that can be asked and answered in social science study designs: entire research agendas are potentially at risk within medical sociology.

Authors

• Karen Lutfey Spencer, University of Colorado-Denver

• Emily Allia Hammad Mrig, University of Colorado-Denver