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How to write qualitative research questions.

11 min read Here’s how to write effective qualitative research questions for your projects, and why getting it right matters so much.

What is qualitative research?

Qualitative research is a blanket term covering a wide range of research methods and theoretical framing approaches. The unifying factor in all these types of qualitative study is that they deal with data that cannot be counted. Typically this means things like people’s stories, feelings, opinions and emotions , and the meanings they ascribe to their experiences.

Qualitative study is one of two main categories of research, the other being quantitative research. Quantitative research deals with numerical data – that which can be counted and quantified, and which is mostly concerned with trends and patterns in large-scale datasets.

What are research questions?

Research questions are questions you are trying to answer with your research. To put it another way, your research question is the reason for your study, and the beginning point for your research design. There is normally only one research question per study, although if your project is very complex, you may have multiple research questions that are closely linked to one central question.

A good qualitative research question sums up your research objective. It’s a way of expressing the central question of your research, identifying your particular topic and the central issue you are examining.

Research questions are quite different from survey questions, questions used in focus groups or interview questions. A long list of questions is used in these types of study, as opposed to one central question. Additionally, interview or survey questions are asked of participants, whereas research questions are only for the researcher to maintain a clear understanding of the research design.

Research questions are used in both qualitative and quantitative research , although what makes a good research question might vary between the two.

In fact, the type of research questions you are asking can help you decide whether you need to take a quantitative or qualitative approach to your research project.

Discover the fundamentals of qualitative research

Quantitative vs. qualitative research questions

Writing research questions is very important in both qualitative and quantitative research, but the research questions that perform best in the two types of studies are quite different.

Quantitative research questions

Quantitative research questions usually relate to quantities, similarities and differences.

It might reflect the researchers’ interest in determining whether relationships between variables exist, and if so whether they are statistically significant. Or it may focus on establishing differences between things through comparison, and using statistical analysis to determine whether those differences are meaningful or due to chance.

• How much? This kind of research question is one of the simplest. It focuses on quantifying something. For example:

How many Yoruba speakers are there in the state of Maine?

• What is the connection?

This type of quantitative research question examines how one variable affects another.

For example:

How does a low level of sunlight affect the mood scores (1-10) of Antarctic explorers during winter?

• What is the difference? Quantitative research questions in this category identify two categories and measure the difference between them using numerical data.

Do white cats stay cooler than tabby cats in hot weather?

If your research question fits into one of the above categories, you’re probably going to be doing a quantitative study.

Qualitative research questions

Qualitative research questions focus on exploring phenomena, meanings and experiences.

Unlike quantitative research, qualitative research isn’t about finding causal relationships between variables. So although qualitative research questions might touch on topics that involve one variable influencing another, or looking at the difference between things, finding and quantifying those relationships isn’t the primary objective.

In fact, you as a qualitative researcher might end up studying a very similar topic to your colleague who is doing a quantitative study, but your areas of focus will be quite different. Your research methods will also be different – they might include focus groups, ethnography studies, and other kinds of qualitative study.

A few example qualitative research questions:

• What is it like being an Antarctic explorer during winter?
• What are the experiences of Yoruba speakers in the USA?
• How do white cat owners describe their pets?

Qualitative research question types

Marshall and Rossman (1989) identified 4 qualitative research question types, each with its own typical research strategy and methods.

• Exploratory questions

Exploratory questions are used when relatively little is known about the research topic. The process researchers follow when pursuing exploratory questions might involve interviewing participants, holding focus groups, or diving deep with a case study.

• Explanatory questions

With explanatory questions, the research topic is approached with a view to understanding the causes that lie behind phenomena. However, unlike a quantitative project, the focus of explanatory questions is on qualitative analysis of multiple interconnected factors that have influenced a particular group or area, rather than a provable causal link between dependent and independent variables.

• Descriptive questions

As the name suggests, descriptive questions aim to document and record what is happening. In answering descriptive questions , researchers might interact directly with participants with surveys or interviews, as well as using observational studies and ethnography studies that collect data on how participants interact with their wider environment.

• Predictive questions

Predictive questions start from the phenomena of interest and investigate what ramifications it might have in the future. Answering predictive questions may involve looking back as well as forward, with content analysis, questionnaires and studies of non-verbal communication (kinesics).

Why are good qualitative research questions important?

We know research questions are very important. But what makes them so essential? (And is that question a qualitative or quantitative one?)

Getting your qualitative research questions right has a number of benefits.

• It defines your qualitative research project Qualitative research questions definitively nail down the research population, the thing you’re examining, and what the nature of your answer will be.This means you can explain your research project to other people both inside and outside your business or organization. That could be critical when it comes to securing funding for your project, recruiting participants and members of your research team, and ultimately for publishing your results. It can also help you assess right the ethical considerations for your population of study.
• It maintains focus Good qualitative research questions help researchers to stick to the area of focus as they carry out their research. Keeping the research question in mind will help them steer away from tangents during their research or while they are carrying out qualitative research interviews. This holds true whatever the qualitative methods are, whether it’s a focus group, survey, thematic analysis or other type of inquiry.That doesn’t mean the research project can’t morph and change during its execution – sometimes this is acceptable and even welcome – but having a research question helps demarcate the starting point for the research. It can be referred back to if the scope and focus of the project does change.
• It helps make sure your outcomes are achievable

Because qualitative research questions help determine the kind of results you’re going to get, it helps make sure those results are achievable. By formulating good qualitative research questions in advance, you can make sure the things you want to know and the way you’re going to investigate them are grounded in practical reality. Otherwise, you may be at risk of taking on a research project that can’t be satisfactorily completed.

Developing good qualitative research questions

All researchers use research questions to define their parameters, keep their study on track and maintain focus on the research topic. This is especially important with qualitative questions, where there may be exploratory or inductive methods in use that introduce researchers to new and interesting areas of inquiry. Here are some tips for writing good qualitative research questions.

1. Keep it specific

Broader research questions are difficult to act on. They may also be open to interpretation, or leave some parameters undefined.

Strong example: How do Baby Boomers in the USA feel about their gender identity?

Weak example: Do people feel different about gender now?

2. Be original

Look for research questions that haven’t been widely addressed by others already.

Strong example: What are the effects of video calling on women’s experiences of work?

Weak example: Are women given less respect than men at work?

3. Make it research-worthy

Don’t ask a question that can be answered with a ‘yes’ or ‘no’, or with a quick Google search.

Strong example: What do people like and dislike about living in a highly multi-lingual country?

Weak example: What languages are spoken in India?

4. Focus your question

Don’t roll multiple topics or questions into one. Qualitative data may involve multiple topics, but your qualitative questions should be focused.

Strong example: What is the experience of disabled children and their families when using social services?

Weak example: How can we improve social services for children affected by poverty and disability?

4. Focus on your own discipline, not someone else’s

Avoid asking questions that are for the politicians, police or others to address.

Strong example: What does it feel like to be the victim of a hate crime?

Weak example: How can hate crimes be prevented?

5. Ask something researchable

Big questions, questions about hypothetical events or questions that would require vastly more resources than you have access to are not useful starting points for qualitative studies. Qualitative words or subjective ideas that lack definition are also not helpful.

Strong example: How do perceptions of physical beauty vary between today’s youth and their parents’ generation?

Weak example: Which country has the most beautiful people in it?

Related resources

Qualitative research design 12 min read, primary vs secondary research 14 min read, business research methods 12 min read, qualitative research interviews 11 min read, market intelligence 10 min read, marketing insights 11 min read, ethnographic research 11 min read, request demo.

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What’s in a Qualitative Research Question?

Qualitative research questions are driven by the need for the study. Ideally, research questions are formulated as a result of the problem and purpose, which leads to the identification of the methodology. When a qualitative methodology is chosen, research questions should be exploratory and focused on the actual phenomenon under study.

From the Dissertation Center, Chapter 1: Research Question Overview , there are several considerations when forming a qualitative research question. Qualitative research questions should

Below is an example of a qualitative phenomenological design. Note the use of the term “lived experience” in the central research question. This aligns with phenomenological design.

RQ1: “ What are the lived experiences of followers of mid-level managers in the financial services sector regarding their well-being on the job?”

If the researcher wants to focus on aspects of the theory used to support the study or dive deeper into aspects of the central RQ, sub-questions might be used. The following sub-questions could be formulated to seek further insight:

RQ1a.   “How do followers perceive the quality and adequacy of the leader-follower exchanges between themselves and their novice leaders?”

RQ1b.  “Under what conditions do leader-member exchanges affect a follower’s own level of well-being?”

Qualitative research questions also display the desire to explore or describe phenomena. Qualitative research seeks the lived experience, the personal experiences, the understandings, the meanings, and the stories associated with the concepts present in our studies.

We want to ensure our research questions are answerable and that we are not making assumptions about our sample. View the questions below:

How do healthcare providers perceive income inequality when providing care to poor patients?

In Example A, we see that there is no specificity of location or geographic areas. This could lead to findings that are varied, and the researcher may not find a clear pattern. Additionally, the question implies the focus is on “income inequality” when the actual focus is on the provision of care. The term “poor patients” can also be offensive, and most providers will not want to seem insensitive and may perceive income inequality as a challenge (of course!).

How do primary care nurses in outreach clinics describe providing quality care to residents of low-income urban neighborhoods?

In Example B, we see that there is greater specificity in the type of care provider. There is also a shift in language so that the focus is on how the individuals describe what they think about, experience, and navigate providing quality care.

Other Qualitative Research Question Examples

Vague : What are the strategies used by healthcare personnel to assist injured patients?

Try this : What is the experience of emergency room personnel in treating patients with a self-inflicted household injury?

The first question is general and vague. While in the same topic area, the second question is more precise and gives the reader a specific target population and a focus on the phenomenon they would have experienced. This question could be in line with a phenomenological study as we are seeking their experience or a case study as the ER personnel are a bounded entity.

Unclear : How do students experience progressing to college?

Try this : How do first-generation community members describe the aspects of their culture that promote aspiration to postsecondary education?

The first question does not have a focus on what progress is or what students are the focus. The second question provides a specific target population and provides the description to be provided by the participants. This question could be in line with a descriptive study.

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Qualitative Research Questions: Gain Powerful Insights + 25 Examples

We review the basics of qualitative research questions, including their key components, how to craft them effectively, & 25 example questions.

Einstein was many things—a physicist, a philosopher, and, undoubtedly, a mastermind. He also had an incredible way with words. His quote, "Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted," is particularly poignant when it comes to research. 

Some inquiries call for a quantitative approach, for counting and measuring data in order to arrive at general conclusions. Other investigations, like qualitative research, rely on deep exploration and understanding of individual cases in order to develop a greater understanding of the whole. That’s what we’re going to focus on today.

Qualitative research questions focus on the "how" and "why" of things, rather than the "what". They ask about people's experiences and perceptions , and can be used to explore a wide range of topics.

The following article will discuss the basics of qualitative research questions, including their key components, and how to craft them effectively. You'll also find 25 examples of effective qualitative research questions you can use as inspiration for your own studies.

Let’s get started!

What are qualitative research questions, and when are they used?

When researchers set out to conduct a study on a certain topic, their research is chiefly directed by an overarching question . This question provides focus for the study and helps determine what kind of data will be collected.

By starting with a question, we gain parameters and objectives for our line of research. What are we studying? For what purpose? How will we know when we’ve achieved our goals?

Of course, some of these questions can be described as quantitative in nature. When a research question is quantitative, it usually seeks to measure or calculate something in a systematic way.

For example:

• How many people in our town use the library?
• What is the average income of families in our city?
• How much does the average person weigh?

Other research questions, however—and the ones we will be focusing on in this article—are qualitative in nature. Qualitative research questions are open-ended and seek to explore a given topic in-depth.

According to the Australian & New Zealand Journal of Psychiatry , “Qualitative research aims to address questions concerned with developing an understanding of the meaning and experience dimensions of humans’ lives and social worlds.”

This type of research can be used to gain a better understanding of people’s thoughts, feelings and experiences by “addressing questions beyond ‘what works’, towards ‘what works for whom when, how and why, and focusing on intervention improvement rather than accreditation,” states one paper in Neurological Research and Practice .

Qualitative questions often produce rich data that can help researchers develop hypotheses for further quantitative study.

• What are people’s thoughts on the new library?
• How does it feel to be a first-generation student at our school?
• How do people feel about the changes taking place in our town?

As stated by a paper in Human Reproduction , “...‘qualitative’ methods are used to answer questions about experience, meaning, and perspective, most often from the standpoint of the participant. These data are usually not amenable to counting or measuring.”

Both quantitative and qualitative questions have their uses; in fact, they often complement each other. A well-designed research study will include a mix of both types of questions in order to gain a fuller understanding of the topic at hand.

If you would like to recruit unlimited participants for qualitative research for free and only pay for the interview you conduct, try using Respondent  today. 

Crafting qualitative research questions for powerful insights

Now that we have a basic understanding of what qualitative research questions are and when they are used, let’s take a look at how you can begin crafting your own.

According to a study in the International Journal of Qualitative Studies in Education, there is a certain process researchers should follow when crafting their questions, which we’ll explore in more depth.

1. Beginning the process 

Start with a point of interest or curiosity, and pose a draft question or ‘self-question’. What do you want to know about the topic at hand? What is your specific curiosity? You may find it helpful to begin by writing several questions.

For example, if you’re interested in understanding how your customer base feels about a recent change to your product, you might ask: 

• What made you decide to try the new product?
• How do you feel about the change?
• What do you think of the new design/functionality?
• What benefits do you see in the change?

2. Create one overarching, guiding question 

At this point, narrow down the draft questions into one specific question. “Sometimes, these broader research questions are not stated as questions, but rather as goals for the study.”

As an example of this, you might narrow down these three questions: 

into the following question: 

• What are our customers’ thoughts on the recent change to our product?

3. Theoretical framing 

As you read the relevant literature and apply theory to your research, the question should be altered to achieve better outcomes. Experts agree that pursuing a qualitative line of inquiry should open up the possibility for questioning your original theories and altering the conceptual framework with which the research began.

If we continue with the current example, it’s possible you may uncover new data that informs your research and changes your question. For instance, you may discover that customers’ feelings about the change are not just a reaction to the change itself, but also to how it was implemented. In this case, your question would need to reflect this new information: 

• How did customers react to the process of the change, as well as the change itself?

4. Ethical considerations 

A study in the International Journal of Qualitative Studies in Education stresses that ethics are “a central issue when a researcher proposes to study the lives of others, especially marginalized populations.” Consider how your question or inquiry will affect the people it relates to—their lives and their safety. Shape your question to avoid physical, emotional, or mental upset for the focus group.

In analyzing your question from this perspective, if you feel that it may cause harm, you should consider changing the question or ending your research project. Perhaps you’ve discovered that your question encourages harmful or invasive questioning, in which case you should reformulate it.

5. Writing the question 

The actual process of writing the question comes only after considering the above points. The purpose of crafting your research questions is to delve into what your study is specifically about” Remember that qualitative research questions are not trying to find the cause of an effect, but rather to explore the effect itself.

Your questions should be clear, concise, and understandable to those outside of your field. In addition, they should generate rich data. The questions you choose will also depend on the type of research you are conducting: 

• If you’re doing a phenomenological study, your questions might be open-ended, in order to allow participants to share their experiences in their own words.
• If you’re doing a grounded-theory study, your questions might be focused on generating a list of categories or themes.
• If you’re doing ethnography, your questions might be about understanding the culture you’re studying.

Whenyou have well-written questions, it is much easier to develop your research design and collect data that accurately reflects your inquiry.

In writing your questions, it may help you to refer to this simple flowchart process for constructing questions:

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25 examples of expertly crafted qualitative research questions

It's easy enough to cover the theory of writing a qualitative research question, but sometimes it's best if you can see the process in practice. In this section, we'll list 25 examples of B2B and B2C-related qualitative questions.

Let's begin with five questions. We'll show you the question, explain why it's considered qualitative, and then give you an example of how it can be used in research.

1. What is the customer's perception of our company's brand?

Qualitative research questions are often open-ended and invite respondents to share their thoughts and feelings on a subject. This question is qualitative because it seeks customer feedback on the company's brand. 

This question can be used in research to understand how customers feel about the company's branding, what they like and don't like about it, and whether they would recommend it to others.

2. Why do customers buy our product?

This question is also qualitative because it seeks to understand the customer's motivations for purchasing a product. It can be used in research to identify the reasons  customers buy a certain product, what needs or desires the product fulfills for them, and how they feel about the purchase after using the product.

3. How do our customers interact with our products?

Again, this question is qualitative because it seeks to understand customer behavior. In this case, it can be used in research to see how customers use the product, how they interact with it, and what emotions or thoughts the product evokes in them.

4. What are our customers' biggest frustrations with our products?

By seeking to understand customer frustrations, this question is qualitative and can provide valuable insights. It can be used in research to help identify areas in which the company needs to make improvements with its products.

5. How do our customers feel about our customer service?

Rather than asking why customers like or dislike something, this question asks how they feel. This qualitative question can provide insights into customer satisfaction or dissatisfaction with a company. 

This type of question can be used in research to understand what customers think of the company's customer service and whether they feel it meets their needs.

20 more examples to refer to when writing your question

Now that you’re aware of what makes certain questions qualitative, let's move into 20 more examples of qualitative research questions:

• How do your customers react when updates are made to your app interface?
• How do customers feel when they complete their purchase through your ecommerce site?
• What are your customers' main frustrations with your service?
• How do people feel about the quality of your products compared to those of your competitors?
• What motivates customers to refer their friends and family members to your product or service?
• What are the main benefits your customers receive from using your product or service?
• How do people feel when they finish a purchase on your website?
• What are the main motivations behind customer loyalty to your brand?
• How does your app make people feel emotionally?
• For younger generations using your app, how does it make them feel about themselves?
• What reputation do people associate with your brand?
• How inclusive do people find your app?
• In what ways are your customers' experiences unique to them?
• What are the main areas of improvement your customers would like to see in your product or service?
• How do people feel about their interactions with your tech team?
• What are the top five reasons people use your online marketplace?
• How does using your app make people feel in terms of connectedness?
• What emotions do people experience when they're using your product or service?
• Aside from the features of your product, what else about it attracts customers?
• How does your company culture make people feel?

As you can see, these kinds of questions are completely open-ended. In a way, they allow the research and discoveries made along the way to direct the research. The questions are merely a starting point from which to explore.

This video offers tips on how to write good qualitative research questions, produced by Qualitative Research Expert, Kimberly Baker.

Wrap-up: crafting your own qualitative research questions.

Over the course of this article, we've explored what qualitative research questions are, why they matter, and how they should be written. Hopefully you now have a clear understanding of how to craft your own.

Remember, qualitative research questions should always be designed to explore a certain experience or phenomena in-depth, in order to generate powerful insights. As you write your questions, be sure to keep the following in mind:

• Are you being inclusive of all relevant perspectives?
• Are your questions specific enough to generate clear answers?
• Will your questions allow for an in-depth exploration of the topic at hand?
• Do the questions reflect your research goals and objectives?

If you can answer "yes" to all of the questions above, and you've followed the tips for writing qualitative research questions we shared in this article, then you're well on your way to crafting powerful queries that will yield valuable insights.

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How to Write Qualitative Research Questions: Types & Examples

Qualitative research questions focus on depth and quality, exploring the “why and how” behind decisions, without relying on statistical tools.

Unlike quantitative research, which aims to collect tangible, measurable data from a broader demographic, qualitative analysis involves smaller, focused datasets, identifying patterns for insights.

The information collected by qualitative surveys can vary from text to images, demanding a deep understanding of the subject, and therefore, crafting precise qualitative research questions is crucial for success.

In this guide, we’ll discuss how to write effective qualitative research questions, explore various types, and highlight characteristics of good qualitative research questions.

Let’s dive in!

What Are Qualitative Research Questions?

Qualitative questions aim to understand the depth and nuances of a phenomenon, focusing on “why” and “how” rather than quantifiable measures.

They explore subjective experiences, perspectives, and behaviors, often using open-ended inquiries to gather rich, descriptive data.

Unlike quantitative questions, which seek numerical data, qualitative questions try to find out meanings, patterns, and underlying processes within a specific context.

These questions are essential for exploring complex issues, generating hypotheses, and gaining deeper insights into human behavior and phenomena.

Here’s an example of a qualitative research question:

“How do you perceive and navigate organizational culture within a tech startup environment?”

This question asks about the respondent’s subjective interpretations and experiences of organizational culture within a specific context, such as a tech startup.

It seeks to uncover insights into the values, norms, and practices that shape workplace dynamics and employee behaviors, providing qualitative data for analysis and understanding.

When Should We Use Qualitative Research Questions?

Qualitative research questions typically aim to open up conversations, encourage detailed narratives, and foster a deep understanding of the subject matter. Here are some scenarios they are best suited for:

• Exploring Complex Phenomena : When the research topic involves understanding complex processes, behaviors, or interactions that cannot be quantified easily, qualitative questions help delve into these intricate details.
• Understanding Contexts and Cultures : To grasp the nuances of different social contexts, cultures, or subcultures, qualitative research questions allow for an in-depth exploration of these environments and how they influence individuals and groups.
• Exploring Perceptions and Experiences : When the aim is to understand people’s perceptions, experiences, or feelings about a particular subject, qualitative questions facilitate capturing the depth and variety of these perspectives.
• Developing Concepts or Theories : In the early stages of research, where concepts or theories are not yet well-developed, qualitative questions can help generate hypotheses, identify variables, and develop theoretical frameworks based on observations and interpretations.
• Investigating Processes : To understand how processes unfold over time and the factors that influence these processes, qualitative questions are useful for capturing the dynamics and complexities involved.
• Seeking to Understand Change : When researching how individuals or groups experience change, adapt to new circumstances, or make decisions, qualitative research questions can provide insights into the motivations, challenges, and strategies involved.
• Studying Phenomena Not Easily Quantified : For phenomena that are not easily captured through quantitative measures, such as emotions, beliefs, or motivations, qualitative questions can probe these abstract concepts more effectively.
• Addressing Sensitive or Taboo Topics : In studies where topics may be sensitive, controversial, or taboo, qualitative research questions allow for a respectful and empathetic exploration of these subjects, providing space for participants to share their experiences in their own words.

How to Write Qualitative Research Questions?

Read this guide to learn how you can craft well-thought-out qualitative research questions:

1. Begin with Your Research Goals

The first step in formulating qualitative research questions is to have a clear understanding of what you aim to discover or understand through your research. There are two types of qualitative questionnaires or research – Ontological and Epistemological.

Finding out the nature of your research influences all aspects of your research design, including the formulation of research questions.

Subsequently:

• Identify your main objective : Consider the broader context of your study. Are you trying to explore a phenomenon, understand a process, or interpret the meanings behind behaviors? Your main objective should guide the formulation of your questions, ensuring they are aligned with what you seek to achieve.
• Focus on the ‘how’ and ‘why’ : Qualitative research is inherently exploratory and aims to understand the nuances of human behavior and experience. Starting your questions with “how” or “why” encourages a deeper investigation into the motivations, processes, and contexts underlying the subject matter. This approach facilitates an open-ended exploration, allowing participants to provide rich, detailed responses that illuminate their perspectives and experiences.

Take a quick look at the following visual for a better understanding:

So, if you are doing Ontological research, ensure that the questions focus on the “what” aspects of reality (the premise of your research) and opt for the nature of the knowledge for Epistemological research.

2. Choose the Right Structure

The structure of your research questions significantly impacts the depth and quality of data you collect. Opting for an open-ended format allows respondents the flexibility to express themselves freely, providing insights that pre-defined answers might miss.

• Open-ended format : These questions do not constrain respondents to a set of predetermined answers, unlike closed-ended questions. By allowing participants to articulate their thoughts in their own words, you can uncover nuances and complexities in their responses that might otherwise be overlooked.
• Avoid yes/no questions : Yes/no questions tend to limit the depth of responses. While they might be useful for gathering straightforward factual information, they are not conducive to exploring the depths and nuances that qualitative research seeks to uncover. Encouraging participants to elaborate on their experiences and perspectives leads to richer, more informative data.

For example, take a look at some qualitative questions examples shown in the following image:

3. Be Clear and Specific

Clarity and specificity in your questions are crucial to ensure that participants understand what is being asked and that their responses are relevant to your research objectives.

• Use clear language : Use straightforward, understandable language in your questions. Avoid jargon, acronyms, or overly technical terms that might confuse participants or lead to misinterpretation. The goal is to make your questions accessible to everyone involved in your study.
• Be specific : While maintaining the open-ended nature of qualitative questions, it’s important to narrow down your focus to specific aspects of the phenomenon you’re studying. This specificity helps guide participants’ responses and ensures that the data you collect directly relates to your research objectives.

4. Ensure Relevance and Feasibility

Each question should be carefully considered for its relevance to your research goals and its feasibility, given the constraints of your study.

• Relevance : Questions should be crafted to address the core objectives of your research directly. They should probe areas that are essential to understanding the phenomenon under investigation and should align with your theoretical framework or literature review findings.
• Feasibility : Consider the practical aspects of your research, including the time available for data collection and analysis, resources, and access to participants. Questions should be designed to elicit meaningful responses within the constraints of your study, ensuring that you can gather and analyze data effectively.

5. Focus on a Single Concept or Theme per Question

To ensure clarity and depth, each question should concentrate on a single idea or theme. However, if your main qualitative research question is tough to understand or has a complex structure, you can create sub-questions in limited numbers and with a “ladder structure”.

This will help your respondents understand the overall research objective in mind, and your research can be executed in a better manner.

For example, suppose your main question is – “What is the current state of illiteracy in your state?”

Then, you can create the following subquestions: 

“How does illiteracy block progress in your state?”

“How would you best describe the feelings you have about illiteracy in your state?”

For an even better understanding, you can see the various examples of qualitative research questions in the following image:

Types of Qualitative Research Questions With Examples

Qualitative survey questions primarily focus on a specific group of respondents that are participating in case studies, surveys, ethnography studies, etc., rather than numbers or statistics.

As a result, the questions are mostly open-ended and can be subdivided into the following types as discussed below:

1. Descriptive Questions

Descriptive research questions aim to detail the “what” of a phenomenon, providing a comprehensive overview of the context, individuals, or situations under study. These questions are foundational, helping to establish a baseline understanding of the research topic.

• What are the daily experiences of teachers in urban elementary schools?
• What strategies do small businesses employ to adapt to rapid technological changes?
• How do young adults describe their transition from college to the workforce?
• What are the coping mechanisms of families with members suffering from chronic illnesses?
• How do community leaders perceive the impact of gentrification in their neighborhoods?

2. Interpretive Questions

Interpretive questions seek to understand the “how” and “why” behind a phenomenon, focusing on the meanings people attach to their experiences. These questions delve into the subjective interpretations and perceptions of participants.

• How do survivors of natural disasters interpret their experiences of recovery and rebuilding?
• Why do individuals engage in voluntary work within their communities?
• How do parents interpret and navigate the challenges of remote schooling for their children?
• Why do consumers prefer local products over global brands in certain markets?
• How do artists interpret the influence of digital media on traditional art forms?

3. Comparative Questions

Comparative research questions are designed to explore differences and similarities between groups, settings, or time periods. These questions can help to highlight the impact of specific variables on the phenomenon under study.

• How do the strategies for managing work-life balance compare between remote and office workers?
• What are the differences in consumer behavior towards sustainable products in urban versus rural areas?
• How do parenting styles in single-parent households compare to those in dual-parent households?
• What are the similarities and differences in leadership styles across different cultures?
• How has the perception of online privacy changed among teenagers over the past decade?

4. Process-oriented Questions

These questions focus on understanding the processes or sequences of events over time. They aim to uncover the “how” of a phenomenon, tracing the development, changes, or evolution of specific situations or behaviors.

• How do non-profit organizations develop and implement community outreach programs?
• What is the process of decision-making in high-stakes business environments?
• How do individuals navigate the process of career transition after significant industry changes?
• What are the stages of adaptation for immigrants in a new country?
• How do social movements evolve from inception to national recognition?

5. Evaluative Questions

Evaluative questions aim to assess the effectiveness, value, or impact of a program, policy, or phenomenon. These questions are critical for understanding the outcomes and implications of various initiatives or situations.

• How effective are online therapy sessions compared to in-person sessions in treating anxiety?
• What is the impact of community gardening programs on neighborhood cohesion?
• How do participants evaluate the outcomes of leadership training programs in their professional development?
• What are the perceived benefits and drawbacks of telecommuting for employees and employers?
• How do residents evaluate the effectiveness of local government policies on waste management?

6. One-on-One Questions

The one-on-one questions are asked to a single person and can be thought of as individual interviews that you can conduct online via phone and video chat as well.

The main aim of such questions is to ask your customers or people in the focus group a series of questions about their purchase motivations. These questions might also come with follow-ups, and if your customers respond with some interesting fact or detail, dig deeper and explore the findings as much as you want.

• What makes you happy in regard to [your research topic]?
• If I could make a wish of yours come true, what do you desire the most?
• What do you still find hard to come to terms with?
• Have you bought [your product] before?
• If so, what was your initial motivation behind the purchase?

7. Exploratory Questions

These questions are designed to enhance your understanding of a particular topic. However, while asking exploratory questions, you must ensure that there are no preconceived notions or biases to it. The more transparent and bias-free your questions are, the better and fair results you will get.

• What is the effect of personal smart devices on today’s youth?
• Do you feel that smart devices have positively or negatively impacted you?
• How do your kids spend their weekends?
• What do you do on a typical weekend morning?

8. Predictive Questions

The predictive questions are used for qualitative research that is focused on the future outcomes of an action or a series of actions. So, you will be using past information to predict the reactions of respondents to hypothetical events that might or might not happen in the future.

These questions come in extremely handy for identifying your customers’ current brand expectations, pain points, and purchase motivation.

• Are you more likely to buy a product when a celebrity promotes it?
• Would you ever try a new product because one of your favorite celebs claims that it actually worked for them?
• Would people in your neighborhood enjoy a park with rides and exercise options?
• How often would you go to a park with your kids if it had free rides?

9. Focus Groups

These questions are mostly asked in person to the customer or respondent groups. The in-person nature of these surveys or studies ensures that the group members get a safe and comfortable environment to express their thoughts and feelings about your brand or services.

• How would you describe your ease of using our product?
• How well do you think you were able to do this task before you started using our product?
• What do you like about our promotional campaigns?
• How well do you think our ads convey the meaning?

10. In-Home Videos

Collecting video feedback from customers in their comfortable, natural settings offers a unique perspective. At home, customers are more relaxed and less concerned about their mannerisms, posture, and choice of words when responding.

This approach is partly why Vogue’s 73 Questions Series is highly popular among celebrities and viewers alike. In-home videos provide insights into customers in a relaxed environment, encouraging them to be honest and share genuine experiences.

• What was your first reaction when you used our product for the first time?
• How well do you think our product performed compared to your expectations?
• What was your worst experience with our product?
• What made you switch to our brand?

11. Online Focus Groups

Online focus groups mirror the traditional, in-person format but are conducted virtually, offering a more cost-effective and efficient approach to gathering data. This digital format extends your reach and allows a rapid collection of responses from a broader audience through online platforms.

You can utilize social media and other digital forums to create communities of respondents and initiate meaningful discussions. Once you have them started, you can simply observe the exchange of thoughts and gather massive amounts of interesting insights!

• What do you like best about our product?
• How familiar are you with this particular service or product we offer?
• What are your concerns with our product?
• What changes can we make to make our product better?

Ask the Right Qualitative Research Questions for Meaningful Insights From Your Respondents

Watch: How to Create a Survey Using ProProfs Survey Maker

By now, you might have realized that manually creating a list of qualitative research questions is a daunting task. Keeping numerous considerations in mind, it’s easy to run out of ideas while crafting qualitative survey questions.

However, investing in smart survey tools, like ProProfs Survey Maker, can significantly streamline this process, allowing you to create various types of surveys in minutes.

With this survey tool , you can generate forms, NPS surveys , tests, quizzes, and assessments.

It’s also useful for conducting polls, sidebar surveys, and in-app surveys. Offering over 100 templates and more than 1,000,000 ready-to-use examples of phenomenological research questions, this software simplifies the task immensely.

Equipped with the right tools and the professional tips shared here, you’re well-prepared to conduct thorough research studies and obtain valuable insights that drive impactful results.

Frequently Asked Questions

1. how do you choose qualitative research questions.

To choose qualitative research questions, identify your main research goal, focus on exploring ‘how’ and ‘why’ aspects, ensure questions are open-ended, and align them with your theoretical framework and methodology.

2. Why are good qualitative research questions important?

Good qualitative research questions are important because they guide the research focus, enable the exploration of depth and complexity, and facilitate the gathering of rich, detailed insights into human experiences and behaviors.

About the author

Emma David is a seasoned market research professional with 8+ years of experience. Having kick-started her journey in research, she has developed rich expertise in employee engagement, survey creation and administration, and data management. Emma believes in the power of data to shape business performance positively. She continues to help brands and businesses make strategic decisions and improve their market standing through her understanding of research methodologies.

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The Ultimate Guide to Qualitative Research - Part 1: The Basics

• Introduction and overview
• What is qualitative research?
• What is qualitative data?
• Examples of qualitative data
• Qualitative vs. quantitative research
• Mixed methods
• Qualitative research preparation
• Theoretical perspective
• Theoretical framework
• Literature reviews
• Introduction

Why are research questions so important?

Research question examples, types of qualitative research questions, writing a good research question, guiding your research through research questions.

• Conceptual framework
• Conceptual vs. theoretical framework
• Data collection
• Qualitative research methods
• Focus groups
• Observational research
• Case studies
• Ethnographical research
• Ethical considerations
• Confidentiality and privacy
• Power dynamics
• Reflexivity

Research questions

The research question plays a critical role in the research process, as it guides the study design, data collection , analysis , and interpretation of the findings.

A research paper relies on a research question to inform readers of the research topic and the research problem being addressed. Without such a question, your audience may have trouble understanding the rationale for your research project.

People can take for granted the research question as an essential part of a research project. However, explicitly detailing why researchers need a research question can help lend clarity to the research project. Here are some of the key roles that the research question plays in the research process:

Defines the scope and focus of the study

The research question helps to define the scope and focus of the study. It identifies the specific topic or issue that the researcher wants to investigate, and it sets the boundaries for the study. A research question can also help you determine if your study primarily contributes to theory or is more applied in nature. Clinical research and public health research, for example, may be more concerned with research questions that contribute to practice, while a research question focused on cognitive linguistics are aimed at developing theory.

Provides a rationale for the study

The research question provides a rationale for the study by identifying a gap or problem in existing literature or practice that the researcher wants to address. It articulates the purpose and significance of the study, and it explains why the study is important and worth conducting.

Guides the study design

The research question guides the study design by helping the researcher select appropriate research methods , sampling strategies, and data collection tools. It also helps to determine the types of data that need to be collected and the best ways to analyze and interpret the data because the principal aim of the study is to provide an answer to that research question.

Shapes the data analysis and interpretation

The research question shapes the data analysis and interpretation by guiding the selection of appropriate analytical methods and by focusing the interpretation of the findings. It helps to identify which patterns and themes in the data are more relevant and worth digging into, and it guides the development of conclusions and recommendations based on the findings.

Generates new knowledge

The research question is the starting point for generating new knowledge. By answering the research question, the researcher contributes to the body of knowledge in the field and helps to advance the understanding of the topic or issue under investigation.

Overall, the research question is a critical component of the research process, as it guides the study from start to finish and provides a foundation for generating new knowledge.

Supports the thesis statement

The thesis statement or main assertion in any research paper stems from the answers to the research question. As a result, you can think of a focused research question as a preview of what the study aims to present as a new contribution to existing knowledge.

Here area few examples of focused research questions that can help set the stage for explaining different types of research questions in qualitative research . These questions touch upon various fields and subjects, showcasing the versatility and depth of research.

• What factors contribute to the job satisfaction of remote workers in the technology industry?
• How do teachers perceive the implementation of technology in the classroom, and what challenges do they face?
• What coping strategies do refugees use to deal with the challenges of resettlement in a new country?
• How does gentrification impact the sense of community and identity among long-term residents in urban neighborhoods?
• In what ways do social media platforms influence body image and self-esteem among adolescents?
• How do family dynamics and communication patterns affect the management of type 2 diabetes in adult patients?
• What is the role of mentorship in the professional development and career success of early-career academics?
• How do patients with chronic illnesses experience and navigate the healthcare system, and what barriers do they encounter?
• What are the motivations and experiences of volunteers in disaster relief efforts, and how do these experiences impact their future involvement in humanitarian work?
• How do cultural beliefs and values shape the consumer preferences and purchasing behavior of young adults in a globalized market?
• How do individuals whose genetic factors predict a high risk for developing a specific medical condition perceive, cope with, and make lifestyle choices based on this information?

These example research questions highlight the different kinds of inquiries common to qualitative research. They also demonstrate how qualitative research can address a wide range of topics, from understanding the experiences of specific populations to examining the impact of broader social and cultural phenomena.

Also, notice that these types of research questions tend to be geared towards inductive analyses that describe a concept in depth or develop new theory. As such, qualitative research questions tend to ask "what," "why," or "how" types of questions. This contrasts with quantitative research questions that typically aim to verify an existing theory. and tend to ask "when," "how much," and "why" types of questions to nail down causal mechanisms and generalizable findings.

Whatever your research inquiry, turn to ATLAS.ti

Powerful tools to help turn your research question into meaningful analysis, starting with a free trial.

As you can see above, the research questions you ask play a critical role in shaping the direction and depth of your study. These questions are designed to explore, understand, and interpret social phenomena, rather than testing a hypothesis or quantifying data like in quantitative research. In this section, we will discuss the various types of research questions typically found in qualitative research, making it easier for you to craft appropriate questions for your study.

Descriptive questions

Descriptive research questions aim to provide a detailed account of the phenomenon being studied. These questions usually begin with "what" or "how" and seek to understand the nature, characteristics, or functions of a subject. For example, "What are the experiences of first-generation college students?" or "How do small business owners adapt to economic downturns?"

Comparative questions

Comparative questions seek to examine the similarities and differences between two or more groups, cases, or phenomena. These questions often include the words "compare," "contrast," or "differences." For example, "How do parenting practices differ between single-parent and two-parent families?" or "What are the similarities and differences in leadership styles among successful female entrepreneurs?"

Exploratory questions

Exploratory research questions are open-ended and intended to investigate new or understudied areas. These questions aim to identify patterns, relationships, or themes that may warrant further investigation. For example, "How do teenagers use social media to construct their identities?" or "What factors influence the adoption of renewable energy technologies in rural communities?"

Explanatory questions

Explanatory research questions delve deeper into the reasons or explanations behind a particular phenomenon or behavior. They often start with "why" or "how" and aim to uncover underlying motivations, beliefs, or processes. For example, "Why do some employees resist organizational change?" or "How do cultural factors influence decision-making in international business negotiations?"

Evaluative questions

Evaluative questions assess the effectiveness, impact, or outcomes of a particular intervention, program, or policy. They seek to understand the value or significance of an initiative by examining its successes, challenges, or unintended consequences. For example, "How effective is the school's anti-bullying program in reducing incidents of bullying?" or "What are the long-term impacts of a community-based health promotion campaign on residents' well-being?"

Interpretive questions

Interpretive questions focus on understanding how individuals or groups make sense of their experiences, actions, or social contexts. These questions often involve the analysis of language, symbols, or narratives to uncover the meanings and perspectives that shape human behavior. For example, "How do cancer survivors make sense of their illness journey?" or "What meanings do members of a religious community attach to their rituals and practices?"

There are mainly two overarching ways to think about how to devise a research question. Many studies are built on existing research, but others can be founded on personal experiences or pilot research.

Using the literature review

Within scholarly research, the research question is often built from your literature review . An analysis of the relevant literature reporting previous studies should allow you to identify contextual, theoretical, or methodological gaps that can be addressed in future research.

A compelling research question built on a robust literature review ultimately illustrates to your audience what is novel about your study's objectives.

Conducting pilot research

Researchers may conduct preliminary research or pilot research when they are interested in a particular topic but don't yet have a basis for forming a research question on that topic. A pilot study is a small-scale, preliminary study that is conducted in order to test the feasibility of a research design, methods, and procedures. It can help identify unresolved puzzles that merit further investigation, and pilot studies can draw attention to potential issues or problems that may arise in the full study.

One potential benefit of conducting a pilot study in qualitative research is that it can help the researcher to refine their research question. By collecting and analyzing a small amount of data, the researcher can get a better sense of the phenomenon under investigation and can develop a more focused and refined research question for the full study. The pilot study can also help the researcher to identify key themes, concepts, or variables that should be included in the research question.

In addition to helping to refine the research question, a pilot study can also help the researcher to develop a more effective data collection and analysis plan. The researcher can test different methods for collecting and analyzing data, and can make adjustments based on the results of the pilot study. This can help to ensure that the full study is conducted in the most effective and efficient manner possible.

Overall, conducting a pilot study in qualitative research can be a valuable tool for refining the research question and developing a more effective research design, methods, and procedures. It can help to ensure that the full study is conducted in a rigorous and effective manner, and can increase the likelihood of generating meaningful and useful findings.

When you write a research question for your qualitative study, consider which type of question best aligns with your research objectives and the nature of the phenomenon you are investigating. Remember, qualitative research questions should be open-ended, allowing for a range of perspectives and insights to emerge. As you progress in your research, these questions may evolve or be refined based on the data you collect, helping to guide your analysis and deepen your understanding of the topic.

Use ATLAS.ti for every step of your research project

From the research question to the key insights, ATLAS.ti is there for you. See how with a free trial.

Designing a Research Question

• First Online: 29 November 2023

Cite this chapter

• Ahmed Ibrahim 3 &
• Camille L. Bryant 3  

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This chapter discusses (1) the important role of research questions for descriptive, predictive, and causal studies across the three research paradigms (i.e., quantitative, qualitative, and mixed methods); (2) characteristics of quality research questions, and (3) three frameworks to support the development of research questions and their dissemination within scholarly work. For the latter, a description of the P opulation/ P articipants, I ntervention/ I ndependent variable, C omparison, and O utcomes (PICO) framework for quantitative research as well as variations depending on the type of research is provided. Second, we discuss the P articipants, central Ph enomenon, T ime, and S pace (PPhTS) framework for qualitative research. The combination of these frameworks is discussed for mixed-methods research. Further, templates and examples are provided to support the novice health scholar in developing research questions for applied and theoretical studies. Finally, we discuss the Create a Research Space (CARS) model for introducing research questions as part of a research study, to demonstrate how scholars can apply their knowledge when disseminating research.

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Ibrahim, A., Bryant, C.L. (2023). Designing a Research Question. In: Fitzgerald, A.S., Bosch, G. (eds) Education Scholarship in Healthcare. Springer, Cham. https://doi.org/10.1007/978-3-031-38534-6_4

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8.4 Qualitative research questions

Learning objectives.

• List the key terms associated with qualitative research questions
• Distinguish between qualitative and quantitative research questions

Qualitative research questions differ from quantitative research questions. Qualitative research questions seek to explore or describe phenomena, not provide a neat nomothetic explanation, so they are often more general and vaguely worded. They may include only one concept, though many include more than one. Instead of asking how one variable causes changes in another, we are instead trying to understand the experiences , understandings , and meanings that people have about the concepts in our research question.

Let’s work through an example from our last section. In Table 8.1, a student asked, “What is the relationship between sexual orientation or gender identity and homelessness for late adolescents in foster care?” In this question, it is pretty clear that the student believes that adolescents in foster care who identify as LGBTQ may be at greater risk for homelessness. This is a nomothetic causal relationship—LGBTQ status causes homelessness.

However, what if the student were less interested in predicting homelessness based on LGBTQ status and more interested in understanding the stories of LGBTQ foster care youth that may be at risk for homelessness? In that case, the researcher would be building an idiographic causal explanation. The youths whom the researcher interviews may share stories of how their foster families, caseworkers, and others treated them. They may share stories about how they thought of their own sexuality or gender identity and how it changed over time. They may have different ideas about what it means to transition out of foster care.

Qualitative questions usually look different than quantitative questions because they search for idiographic causal relationships. Table 8.3 below takes the final research questions from Table 8.1 and adapts them for qualitative research. The guidelines for research questions previously described in this chapter still apply, but there are some new elements to qualitative research questions that are not present in quantitative questions. First, qualitative research questions often ask about lived experience, personal experience, understanding, meaning, and stories. These keywords indicate that you will be using qualitative methods. Second, qualitative research questions may be more general and less specific. Instead of asking how one concept causes another, we are asking about how people understand or feel about a concept. They may also contain only one variable, rather than asking about relationships between multiple variables.

Qualitative research questions have one final feature that distinguishes them from quantitative research questions. They can change over the course of a study. Qualitative research is a reflexive process, one in which the researcher adapts their approach based on what participants say and do. The researcher must constantly evaluate whether their question is important and relevant to the participants. As the researcher gains information from participants, it is normal for the focus of the inquiry to shift.

For example, a qualitative researcher may want to study how a new truancy rule impacts youth at risk of expulsion. However, after interviewing some of the youth in their community, a researcher might find that the rule is actually irrelevant to their behavior and thoughts. Instead, their participants will direct the discussion to their frustration with the school administrators or their family’s economic insecurity. This is a natural part of qualitative research, and it is normal for research questions and hypothesis to evolve based on the information gleaned from participants.

Key Takeaways

• Qualitative research questions often contain words like lived experience, personal experience, understanding, meaning, and stories.
• Qualitative research questions can change and evolve as the researcher conducts the study.

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Home Market Research

Qualitative Research Questions: What it is and how to write it

Qualitative research questions are like a compass that points researchers in the right direction to find rich stories, untangle complicated social relationships, and get a clear picture of how people act in subtle ways. Unlike their quantitative counterparts, these questions go beyond numbers and figures to explore the subjective, contextual, and complex parts of the human experience.

It’s well-established that all forms of research come with their own theories and implementation methods. Qualitative research is much the same. Qualitative research is conducted to understand the thought process of both the respondents as well as researchers. It usually is conducted in a natural setup where respondents will be their true selves and would respond transparently. 

Results achieved from this research will not be generalized to the entire population but asked research questions , and their vocabulary gives away the researcher’s motive making it easier for respondents to participate in qualitative market research .

LEARN ABOUT: Research Process Steps

Qualitative research survey questions are created to understand a particular topic better or to inspect a new subject to understand the nerve of respondent experiences.

Content Index

What are qualitative research questions?

How to write qualitative research questions, types of qualitative research questions, how to choose qualitative research questions, what should be the process of forming qualitative research questions and questionnaires.

Qualitative research questions are the inquiries that lead to qualitative research studies and investigations. They are meant to help people explore and understand phenomena, experiences, meanings, and views from the participant’s point of view. 

Different from quantitative research questions, which often try to measure and quantify variables, qualitative research questions try to understand the richness and complexity of human experiences and social events.

Most qualitative research questions are open-ended and allow for in-depth study. They want more than simple yes/no answers but instead want people to talk about their thoughts, feelings, views, and experiences. These questions try to find deeper meanings, patterns, and connections in a given situation.

Here are some examples of qualitative study questions in different fields:

• In psychology: How do individuals experience and cope with traumatic events?
• In sociology: What factors influence a student’s decision to pursue higher education?
• In anthropology: How do cultural norms and values shape gender roles in a specific community?
• In education: What are the challenges faced by teachers in implementing project-based learning in the classroom?
• In healthcare: What are the experiences and perspectives of patients undergoing long-term treatment for a chronic illness?

Qualitative research questions should be straightforward, specific, and tailored to the research’s goals. They guide the process of gathering data through interviews, observations, or document analysis and give a method for analyzing and interpreting data.

Writing the right qualitative research questions requires careful thought about the research goals, the event being studied, and the wanted level of understanding. Here are some tips to help you write good qualitative research questions:

Begin with a broad research question

Start by posing an all-encompassing question that probes the subject or phenomenon of interest. Exploring and learning from the answer to this open-ended question should be possible.

Specify the research objectives

Clearly state the objectives and purposes of your research. What do you want your qualitative study to accomplish? What facets or dimensions of the subject do you wish to investigate?

Focus on the phenomenon

Decide on whatever specific subject or phenomenon you want to research. Any pertinent topic, including social behavior, cultural customs, personal experiences, and more, may be used.

Use open-ended and exploratory language

In qualitative research, open-ended questions should be used to enable participants to offer thorough and in-depth responses. Avoid yes/no questions and queries with a one-word answer. Use words like “how,” “what,” “why,” or “describe” instead to compel people to express their thoughts and experiences.

LEARN ABOUT: Qualitative Interview

Consider the context and participants

Consider your research’s background as well as the qualities of your subjects. Make sure your qualitative methods are specific to the people you will be studying so that they are pertinent and meaningful to them.

Incorporate theory and literature

Your research questions should be based on pertinent theories and available literature. This gives your investigation a theoretical foundation and places your study within the body of knowledge.

Balance breadth and depth

When formulating your research topics, try to strike a balance between depth and breadth. To fully understand the subject, you should investigate it broadly to get a variety of viewpoints and intensively delve into certain areas.

Avoid leading or biased questions

Ensure your questions are neutral and unbiased. Avoid leading participants towards a particular response. Instead, create questions that allow participants to express their thoughts and experiences freely.

Pilot test your questions

Pilot-test your research questions with a small group of people before finalizing them. This will make it easier to spot any possible problems, ambiguities, or places where clarity may be increased.

Revise and refine

Revise and clarify your research questions based on the comments and understandings received from the pilot testing. Aim for consistency, coherence, and congruence with your research goals.

Remember, qualitative market research questions should be flexible and adaptable throughout the research process. They serve as a guide but may evolve as you delve deeper into the data and discover new insights.

LEARN ABOUT: Steps in Qualitative Research

There are several types of qualitative research questions focus that can be used to guide qualitative studies. Here are some common types:

1. Descriptive questions

These questions aim to describe and understand a phenomenon or topic in detail. They focus on providing a comprehensive account of the subject matter. For example:

• What are the experiences of individuals living with chronic pain?
• How do employees perceive the organizational culture in a specific company?

2. Exploratory questions

These questions are used to explore new or under-researched areas. They seek to gain a deeper understanding of a topic or phenomenon. For example:

• What are the factors influencing consumers’ decision-making process when purchasing organic food?
• How do teachers perceive the implementation of project-based learning in the classroom?

3. Experiential questions

These questions focus on understanding individuals’ experiences, perspectives, and subjective meanings related to a particular phenomenon. They aim to capture personal experiences and emotions. For example:

• What are the challenges first-generation college students face during their transition to higher education?
• How do individuals with social anxiety disorder experience social interactions?

4. Comparative questions

These questions involve comparing and contrasting different groups, contexts, or perspectives to identify similarities, differences, or patterns. They explore variations in experiences or phenomena. For example:

• How do parenting practices differ between cultures A and B in terms of child discipline?
• What are the similarities and differences in the coping strategies used by individuals with individuals and depression questionnaire with anxiety disorders?

5. Process-oriented questions

These questions focus on understanding a phenomenon’s processes, mechanisms, or dynamics. They aim to uncover how and why certain outcomes or behaviors occur. For example:

• What are the processes by which teams in a workplace reach a consensus on decision-making?
• How does the negotiation process unfold during conflict resolution in interpersonal relationships?

6. Theoretical questions

These questions seek to generate or refine theory. They explore concepts, relationships, or theoretical frameworks to contribute to the existing body of knowledge. For example:

• How does the concept of “self-efficacy” manifest in the context of entrepreneurship?
• What underlying mechanisms explain the relationship between social support and mental health outcomes?

These are just a few examples of the types of qualitative research questions that can be used. The specific type of question you choose will depend on your research objectives, the phenomenon under investigation, and the depth of understanding you aim to achieve.

Explore Insightfully Contextual Inquiry in Qualitative Research

Choosing a good qualitative research question involves a thoughtful and systematic approach to ensure they align with the objectives of your study and allows for an in-depth exploration of the topic. Here are some steps to help you choose effective qualitative research questions:

Identify your research objectives

Clearly define the purpose of your study. What do you want to explore or understand? What specific insights or knowledge are you seeking to gain through your market research?

Review existing literature

Conduct a thorough review of relevant literature to identify existing research gaps or areas requiring further exploration. This will help you understand the current state of knowledge and inform the development of your research questions.

Brainstorm potential qualitative research question

Generate a list of potential research questions that address your research objectives. Consider different angles, perspectives, and dimensions of your topic. Creating open-ended questions that allow for in-depth exploration rather than simple yes/no answers is important.

Prioritize and refine the questions

Evaluate the generated questions based on their relevance to your research objectives, feasibility, and potential to yield meaningful insights. Prioritize the questions that are most likely to provide rich and valuable data. Refine and rephrase the questions as needed to ensure clarity and focus.

Consider the research design and methodology

Take into account the specific qualitative research design and methodology you plan to use. Different research approaches, such as ethnography, interviews, focus groups, or case studies, may require different types of research questions. Ensure that your questions align with your chosen methodology and will help you gather the desired data.

Pilot test the questions

Before finalizing your research questions, consider conducting a pilot test with a small group of participants. This will allow you to assess your questions’ clarity, appropriateness, and effectiveness. Make necessary revisions based on the feedback received.

Seek feedback

Share your research questions with colleagues, mentors, or experts in your field for feedback and suggestions. They can provide valuable insights and help you refine your questions further.

Finalize your research questions

Based on the steps above, select a set of research questions that are well-aligned with your research objectives, provide scope for exploration, and are feasible within the resources and time available for your study.

1. Mention the purpose of conducting qualitative research. It can be in the form of either of these sentences:

• This study will be on the topic of ….
• The reason for conducting this research is ….

2. Create qualitative statements with a defined objective that can be easily communicated to the target audience .

Keep these pointers in mind while designing this statement:

• Try and form single-sentence statements. Single statements can be much more effective than elaborate ones as they help in communicating important messages in an impactful manner in a short and succinct sentence.
• Clarify the purpose of conducting qualitative research in clear words so that respondents understand their contribution to this research.
• Mention the main topic of research that would prompt respondents to have a clearer idea about what they’re getting into.
• It’s the words that make all the difference. Use qualitative words that demonstrate the quality or feeling behind your purpose, such as understanding, describing, explore.
• Specify details that you would want to communicate to your respondents.
• Mention the name of the research website.

3. Other than the primary qualitative questions, you must create sub-questions so that the purpose is executed in a better manner.

• The main question might be – “What is the state of illiteracy in your state?”
• You can create sub-questions such as: “How does illiteracy hamper progress in your state?” or “How would you best describe your feelings about illiteracy?”

4. Highlight these questions using ‘qualitative’ words:

• Start the questions with “What” or “How” to make sure the respondents provide details about their feelings.
• Communicate what you’re trying to “understand,” “explore,” or “identify” using this Qualitative research online survey questionnaire.
• Questions such as “What happened” can be asked to develop a description of the topic.
• Questions about “how did respondents interpret the what happened question” can be asked to examine the outcome.
• Understand the entire qualitative research process by asking questions about “What happened to you with time?”

5. Develop a skeleton to design the primary questions and also the sub-questions. For example:

• Primary Qualitative research survey question: “How do you think _______ (the main topic of research) means?” or “Describe _____(the main topic of research) as you’ve experienced.”
• Sub-question for qualitative research: “What _________ (characteristic) does __________ (respondents) interest in as a _________ (main topic of research)?”

LEARN ABOUT: Structured Questionnaire

Qualitative research questions are key to giving research studies depth and breadth. These questions go into the details and complexities of human experiences, perceptions, and behaviors. This helps researchers get a full picture of a certain occurrence. 

Qualitative research questions are meant to explore, describe, and make sense of subjective truths. Most of the time, they are open-ended, so people can say what they think and feel in their own words. 

QuestionPro is an online poll and research platform with several tools and features that can make it easier to make and use qualitative research questions. Its easy-to-use design and variety of question types help researchers collect qualitative data quickly and easily, improving the whole research process.

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83 Qualitative Research Questions & Examples

Qualitative research questions help you understand consumer sentiment. They’re strategically designed to show organizations how and why people feel the way they do about a brand, product, or service. It looks beyond the numbers and is one of the most telling types of market research a company can do.

The UK Data Service describes this perfectly, saying, “The value of qualitative research is that it gives a voice to the lived experience .”

Read on to see seven use cases and 83 qualitative research questions, with the added bonus of examples that show how to get similar insights faster with Similarweb Research Intelligence.

What is a qualitative research question?

A qualitative research question explores a topic in-depth, aiming to better understand the subject through interviews, observations, and other non-numerical data. Qualitative research questions are open-ended, helping to uncover a target audience’s opinions, beliefs, and motivations.

How to choose qualitative research questions?

Choosing the right qualitative research questions can be incremental to the success of your research and the findings you uncover. Here’s my six-step process for choosing the best qualitative research questions.

• Start by understanding the purpose of your research. What do you want to learn? What outcome are you hoping to achieve?
• Consider who you are researching. What are their experiences, attitudes, and beliefs? How can you best capture these in your research questions ?
• Keep your questions open-ended . Qualitative research questions should not be too narrow or too broad. Aim to ask specific questions to provide meaningful answers but broad enough to allow for exploration.
• Balance your research questions. You don’t want all of your questions to be the same type. Aim to mix up your questions to get a variety of answers.
• Ensure your research questions are ethical and free from bias. Always have a second (and third) person check for unconscious bias.
• Consider the language you use. Your questions should be written in a way that is clear and easy to understand. Avoid using jargon , acronyms, or overly technical language.

Types of qualitative research questions

For a question to be considered qualitative, it usually needs to be open-ended. However, as I’ll explain, there can sometimes be a slight cross-over between quantitative and qualitative research questions.

Open-ended questions

These allow for a wide range of responses and can be formatted with multiple-choice answers or a free-text box to collect additional details. The next two types of qualitative questions are considered open questions, but each has its own style and purpose.

• Probing questions are used to delve deeper into a respondent’s thoughts, such as “Can you tell me more about why you feel that way?”
• Comparative questions ask people to compare two or more items, such as “Which product do you prefer and why?” These qualitative questions are highly useful for understanding brand awareness , competitive analysis , and more.

Closed-ended questions

These ask respondents to choose from a predetermined set of responses, such as “On a scale of 1-5, how satisfied are you with the new product?” While they’re traditionally quantitative, adding a free text box that asks for extra comments into why a specific rating was chosen will provide qualitative insights alongside their respective quantitative research question responses.

• Ranking questions get people to rank items in order of preference, such as “Please rank these products in terms of quality.” They’re advantageous in many scenarios, like product development, competitive analysis, and brand awareness.
• Likert scale questions ask people to rate items on a scale, such as “On a scale of 1-5, how satisfied are you with the new product?” Ideal for placement on websites and emails to gather quick, snappy feedback.

Qualitative research question examples

There are many applications of qualitative research and lots of ways you can put your findings to work for the success of your business. Here’s a summary of the most common use cases for qualitative questions and examples to ask.

Qualitative questions for identifying customer needs and motivations

These types of questions help you find out why customers choose products or services and what they are looking for when making a purchase.

• What factors do you consider when deciding to buy a product?
• What would make you choose one product or service over another?
• What are the most important elements of a product that you would buy?
• What features do you look for when purchasing a product?
• What qualities do you look for in a company’s products?
• Do you prefer localized or global brands when making a purchase?
• How do you determine the value of a product?
• What do you think is the most important factor when choosing a product?
• How do you decide if a product or service is worth the money?
• Do you have any specific expectations when purchasing a product?
• Do you prefer to purchase products or services online or in person?
• What kind of customer service do you expect when buying a product?
• How do you decide when it is time to switch to a different product?
• Where do you research products before you decide to buy?
• What do you think is the most important customer value when making a purchase?

Qualitative research questions to enhance customer experience

Use these questions to reveal insights into how customers interact with a company’s products or services and how those experiences can be improved.

• What aspects of our product or service do customers find most valuable?
• How do customers perceive our customer service?
• What factors are most important to customers when purchasing?
• What do customers think of our brand?
• What do customers think of our current marketing efforts?
• How do customers feel about the features and benefits of our product?
• How do customers feel about the price of our product or service?
• How could we improve the customer experience?
• What do customers think of our website or app?
• What do customers think of our customer support?
• What could we do to make our product or service easier to use?
• What do customers think of our competitors?
• What is your preferred way to access our site?
• How do customers feel about our delivery/shipping times?
• What do customers think of our loyalty programs?

Qualitative research question example for customer experience

• ‍♀️ Question: What is your preferred way to access our site?
• Insight sought: How mobile-dominant are consumers? Should you invest more in mobile optimization or mobile marketing?
• Challenges with traditional qualitative research methods: While using this type of question is ideal if you have a large database to survey when placed on a site or sent to a limited customer list, it only gives you a point-in-time perspective from a limited group of people.
• A new approach: You can get better, broader insights quicker with Similarweb Digital Research Intelligence. To fully inform your research, you need to know preferences at the industry or market level.
• ⏰ Time to insight: 30 seconds
• ✅ How it’s done: Similarweb offers multiple ways to answer this question without going through a lengthy qualitative research process. 

First, I’m going to do a website market analysis of the banking credit and lending market in the finance sector to get a clearer picture of industry benchmarks.

Here, I can view device preferences across any industry or market instantly. It shows me the device distribution for any country across any period. This clearly answers the question of how mobile dominate my target audience is , with 59.79% opting to access site via a desktop vs. 40.21% via mobile

I then use the trends section to show me the exact split between mobile and web traffic for each key player in my space. Let’s say I’m about to embark on a competitive campaign that targets customers of Chase and Bank of America ; I can see both their audiences are highly desktop dominant compared with others in their space .

Qualitative question examples for developing new products or services

Research questions like this can help you understand customer pain points and give you insights to develop products that meet those needs.

• What is the primary reason you would choose to purchase a product from our company?
• How do you currently use products or services that are similar to ours?
• Is there anything that could be improved with products currently on the market?
• What features would you like to see added to our products?
• How do you prefer to contact a customer service team?
• What do you think sets our company apart from our competitors?
• What other product or service offerings would like to see us offer?
• What type of information would help you make decisions about buying a product?
• What type of advertising methods are most effective in getting your attention?
• What is the biggest deterrent to purchasing products from us?

Qualitative research question example for service development

• ‍♀️ Question: What type of advertising methods are most effective in getting your attention?
• Insight sought: The marketing channels and/or content that performs best with a target audience .
• Challenges with traditional qualitative research methods: When using qualitative research surveys to answer questions like this, the sample size is limited, and bias could be at play.
• A better approach: The most authentic insights come from viewing real actions and results that take place in the digital world. No questions or answers are needed to uncover this intel, and the information you seek is readily available in less than a minute.
• ⏰ Time to insight: 5 minutes
• ✅ How it’s done: There are a few ways to approach this. You can either take an industry-wide perspective or hone in on specific competitors to unpack their individual successes. Here, I’ll quickly show a snapshot with a whole market perspective.

Using the market analysis element of Similarweb Digital Intelligence, I select my industry or market, which I’ve kept as banking and credit. A quick click into marketing channels shows me which channels drive the highest traffic in my market. Taking direct traffic out of the equation, for now, I can see that referrals and organic traffic are the two highest-performing channels in this market.

Similarweb allows me to view the specific referral partners and pages across these channels. 

Looking closely at referrals in this market, I’ve chosen chase.com and its five closest rivals . I select referrals in the channel traffic element of marketing channels. I see that Capital One is a clear winner, gaining almost 25 million visits due to referral partnerships.

Next, I get to see exactly who is referring traffic to Capital One and the total traffic share for each referrer. I can see the growth as a percentage and how that has changed, along with an engagement score that rates the average engagement level of that audience segment. This is particularly useful when deciding on which new referral partnerships to pursue.  

Once I’ve identified the channels and campaigns that yield the best results, I can then use Similarweb to dive into the various ad creatives and content that have the greatest impact.

These ads are just a few of those listed in the creatives section from my competitive website analysis of Capital One. You can filter this list by the specific campaign, publishers, and ad networks to view those that matter to you most. You can also discover video ad creatives in the same place too.

In just five minutes ⏰ 

• I’ve captured audience loyalty statistics across my market
• Spotted the most competitive players
• Identified the marketing channels my audience is most responsive to
• I know which content and campaigns are driving the highest traffic volume
• I’ve created a target list for new referral partners and have been able to prioritize this based on results and engagement figures from my rivals
• I can see the types of creatives that my target audience is responding to, giving me ideas for ways to generate effective copy for future campaigns

Qualitative questions to determine pricing strategies

Companies need to make sure pricing stays relevant and competitive. Use these questions to determine customer perceptions on pricing and develop pricing strategies to maximize profits and reduce churn.

• How do you feel about our pricing structure?
• How does our pricing compare to other similar products?
• What value do you feel you get from our pricing?
• How could we make our pricing more attractive?
• What would be an ideal price for our product?
• Which features of our product that you would like to see priced differently?
• What discounts or deals would you like to see us offer?
• How do you feel about the amount you have to pay for our product?

Get Faster Answers to Qualitative Research Questions with Similarweb Today

Qualitative research question example for determining pricing strategies.

• ‍♀️ Question: What discounts or deals would you like to see us offer?
• Insight sought: The promotions or campaigns that resonate with your target audience.
• Challenges with traditional qualitative research methods: Consumers don’t always recall the types of ads or campaigns they respond to. Over time, their needs and habits change. Your sample size is limited to those you ask, leaving a huge pool of unknowns at play.
• A better approach: While qualitative insights are good to know, you get the most accurate picture of the highest-performing promotion and campaigns by looking at data collected directly from the web. These analytics are real-world, real-time, and based on the collective actions of many, instead of the limited survey group you approach. By getting a complete picture across an entire market, your decisions are better informed and more aligned with current market trends and behaviors.
• ✅ How it’s done: Similarweb’s Popular Pages feature shows the content, products, campaigns, and pages with the highest growth for any website. So, if you’re trying to unpack the successes of others in your space and find out what content resonates with a target audience, there’s a far quicker way to get answers to these questions with Similarweb.

Here, I’m using Capital One as an example site. I can see trending pages on their site showing the largest increase in page views. Other filters include campaign, best-performing, and new–each of which shows you page URLs, share of traffic, and growth as a percentage. This page is particularly useful for staying on top of trending topics , campaigns, and new content being pushed out in a market by key competitors.

Qualitative research questions for product development teams

It’s vital to stay in touch with changing consumer needs. These questions can also be used for new product or service development, but this time, it’s from the perspective of a product manager or development team. 

• What are customers’ primary needs and wants for this product?
• What do customers think of our current product offerings?
• What is the most important feature or benefit of our product?
• How can we improve our product to meet customers’ needs better?
• What do customers like or dislike about our competitors’ products?
• What do customers look for when deciding between our product and a competitor’s?
• How have customer needs and wants for this product changed over time?
• What motivates customers to purchase this product?
• What is the most important thing customers want from this product?
• What features or benefits are most important when selecting a product?
• What do customers perceive to be our product’s pros and cons?
• What would make customers switch from a competitor’s product to ours?
• How do customers perceive our product in comparison to similar products?
• What do customers think of our pricing and value proposition?
• What do customers think of our product’s design, usability, and aesthetics?

Qualitative questions examples to understand customer segments

Market segmentation seeks to create groups of consumers with shared characteristics. Use these questions to learn more about different customer segments and how to target them with tailored messaging.

• What motivates customers to make a purchase?
• How do customers perceive our brand in comparison to our competitors?
• How do customers feel about our product quality?
• How do customers define quality in our products?
• What factors influence customers’ purchasing decisions ?
• What are the most important aspects of customer service?
• What do customers think of our customer service?
• What do customers think of our pricing?
• How do customers rate our product offerings?
• How do customers prefer to make purchases (online, in-store, etc.)?

Qualitative research question example for understanding customer segments

• ‍♀️ Question: Which social media channels are you most active on?
• Insight sought: Formulate a social media strategy . Specifically, the social media channels most likely to succeed with a target audience.
• Challenges with traditional qualitative research methods: Qualitative research question responses are limited to those you ask, giving you a limited sample size. Questions like this are usually at risk of some bias, and this may not be reflective of real-world actions.
• A better approach: Get a complete picture of social media preferences for an entire market or specific audience belonging to rival firms. Insights are available in real-time, and are based on the actions of many, not a select group of participants. Data is readily available, easy to understand, and expandable at a moment’s notice.
• ✅ How it’s done: Using Similarweb’s website analysis feature, you can get a clear breakdown of social media stats for your audience using the marketing channels element. It shows the percentage of visits from each channel to your site, respective growth, and specific referral pages by each platform. All data is expandable, meaning you can select any platform, period, and region to drill down and get more accurate intel, instantly.

This example shows me Bank of America’s social media distribution, with YouTube , Linkedin , and Facebook taking the top three spots, and accounting for almost 80% of traffic being driven from social media.

When doing any type of market research, it’s important to benchmark performance against industry averages and perform a social media competitive analysis to verify rival performance across the same channels.

Qualitative questions to inform competitive analysis

Organizations must assess market sentiment toward other players to compete and beat rival firms. Whether you want to increase market share , challenge industry leaders , or reduce churn, understanding how people view you vs. the competition is key.

• What is the overall perception of our competitors’ product offerings in the market?
• What attributes do our competitors prioritize in their customer experience?
• What strategies do our competitors use to differentiate their products from ours?
• How do our competitors position their products in relation to ours?
• How do our competitors’ pricing models compare to ours?
• What do consumers think of our competitors’ product quality?
• What do consumers think of our competitors’ customer service?
• What are the key drivers of purchase decisions in our market?
• What is the impact of our competitors’ marketing campaigns on our market share ? 10. How do our competitors leverage social media to promote their products?

Qualitative research question example for competitive analysis

• ‍♀️ Question: What other companies do you shop with for x?
• Insight sought: W ho are your competitors? Which of your rival’s sites do your customers visit? How loyal are consumers in your market?
• Challenges with traditional qualitative research methods:  Sample size is limited, and customers could be unwilling to reveal which competitors they shop with, or how often they around. Where finances are involved, people can act with reluctance or bias, and be unwilling to reveal other suppliers they do business with.
• A better approach: Get a complete picture of your audience’s loyalty, see who else they shop with, and how many other sites they visit in your competitive group. Find out the size of the untapped opportunity and which players are doing a better job at attracting unique visitors – without having to ask people to reveal their preferences.
• ✅ How it’s done: Similarweb website analysis shows you the competitive sites your audience visits, giving you access to data that shows cross-visitation habits, audience loyalty, and untapped potential in a matter of minutes.

Using the audience interests element of Similarweb website analysis, you can view the cross-browsing behaviors of a website’s audience instantly. You can see a matrix that shows the percentage of visitors on a target site and any rival site they may have visited.

With the Similarweb audience overlap feature, view the cross-visitation habits of an audience across specific websites. In this example, I chose chase.com and its four closest competitors to review. For each intersection, you see the number of unique visitors and the overall proportion of each site’s audience it represents. It also shows the volume of unreached potential visitors.

Here, you can see a direct comparison of the audience loyalty represented in a bar graph. It shows a breakdown of each site’s audience based on how many other sites they have visited. Those sites with the highest loyalty show fewer additional sites visited.

From the perspective of chase.com, I can see 47% of their visitors do not visit rival sites. 33% of their audience visited 1 or more sites in this group, 14% visited 2 or more sites, 4% visited 3 or more sites, and just 0.8% viewed all sites in this comparison. 

How to answer qualitative research questions with Similarweb

Similarweb Research Intelligence drastically improves market research efficiency and time to insight. Both of these can impact the bottom line and the pace at which organizations can adapt and flex when markets shift, and rivals change tactics.

Outdated practices, while still useful, take time . And with a quicker, more efficient way to garner similar insights, opting for the fast lane puts you at a competitive advantage.

With a birds-eye view of the actions and behaviors of companies and consumers across a market , you can answer certain research questions without the need to plan, do, and review extensive qualitative market research .

Wrapping up

Qualitative research methods have been around for centuries. From designing the questions to finding the best distribution channels, collecting and analyzing findings takes time to get the insights you need. Similarweb Digital Research Intelligence drastically improves efficiency and time to insight. Both of which impact the bottom line and the pace at which organizations can adapt and flex when markets shift.

Similarweb’s suite of digital intelligence solutions offers unbiased, accurate, honest insights you can trust for analyzing any industry, market, or audience.

• Methodologies used for data collection are robust, transparent, and trustworthy.
• Clear presentation of data via an easy-to-use, intuitive platform.
• It updates dynamically–giving you the freshest data about an industry or market.
• Data is available via an API – so you can plug into platforms like Tableau or PowerBI to streamline your analyses.
• Filter and refine results according to your needs.

Are quantitative or qualitative research questions best?

Both have their place and purpose in market research. Qualitative research questions seek to provide details, whereas quantitative market research gives you numerical statistics that are easier and quicker to analyze. You get more flexibility with qualitative questions, and they’re non-directional.

What are the advantages of qualitative research?

Qualitative research is advantageous because it allows researchers to better understand their subject matter by exploring people’s attitudes, behaviors, and motivations in a particular context. It also allows researchers to uncover new insights that may not have been discovered with quantitative research methods.

What are some of the challenges of qualitative research?

Qualitative research can be time-consuming and costly, typically involving in-depth interviews and focus groups. Additionally, there are challenges associated with the reliability and validity of the collected data, as there is no universal standard for interpreting the results.

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Qualitative Methods in Monitoring and Evaluation: Qualitative Research Questions

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Selecting your research topic and crafting a qualitative research question from it is the first, and possibly the hardest, step of qualitative research. You will likely start with a topic, and as you start reading and do exploratory research, hone that topic into a research question that can be answered using qualitative methods.

I suggest that students start big and then narrow their topics. As you review the literature and current events around your larger topic, you will likely discover what questions academics and policymakers are asking about that topic. You should identify your topic’s puzzles, those questions that have yet to be answered. Then you should choose one of these puzzles to meld into your research question.

Throughout this process, you should constantly remind yourself of the purpose of qualitative inquiry. As researchers, we use qualitative data collection techniques to gather rich, emic data around a topic. That data highlights experiences and perceptions that help to provide explanation. As you explore your larger topic, focus on those puzzles that need qualitative explanation. As you hone your topic into possible research questions, ask yourself why qualitative data collection techniques would be the best way to provide insight into your topic and answer your research question. This is actually harder than you might think, as many of us tend towards the quantitative. Usually, crafting a qualitative research question means asking a why or a what explains question, NOT a how or a descriptive question.

The best qualitative research questions are:

• Interesting to you. Depending on the purpose of your research and your research output, you will likely spend a lot of time on your topic. Pick a topic that you find interesting, so that you will be engaged throughout the research process.
• Original. When we conduct primary research, we are not summarizing the research of others. We are coming up with our own research question and qualitative design to answer it. Your qualitative research could identify a brand new topic, or it could take a new spin on an old topic, or look at a new topic in a different light.
• Answerable. Your research question should be answerable using qualitative methods. Not every research question can and should be answered using qualitative data collection techniques. You should craft a question that is best answered using qualitative research.
• Manageable. Your research question should be manageable within your time, space, and budget constraints. Craft a question that fits within the purpose and scope of your research. Some qualitative questions might take an article length paper to answer, and some may take a book! Some questions might require a longer time to answer, travel that you are not able to do, or a larger budget than you have to support your research. Craft your question with these constraints and parameters in mind.

Once you have a research question, you will need to draft your qualitative research design. Your design will need to provide specifics on the qualitative data collection techniques you intend to use to answer your research question. You should think in advance about what kinds of data you will need, and what qualitative data collection techniques would be most useful to gather it. You have a number of tools available in your qualitative data collection toolkit, and you need to figure out which is most appropriate for your data collection need. You might use observation, participant observation , interviews , focus groups , or participatory tools , for example. You also need to think through how you will address missing or incomplete data, and how you will manage and analyze the data that you collect.

Qualitative Questions and Evaluation

When we conduct an evaluation , we usually start by crafting a logic model or Logical Framework (LogFrame) . As evaluators, we usually ask qualitative questions that help us to understand an organization’s logic model or to populate its LogFrame. We might ask a broad question such as: What explains this organization’s theory of change? Such a broad question would also have support questions such as: What does this organization do? Why does it do it that way? What are some examples of projects? How are those projects managed? Who are the beneficiaries? What are this organization’s challenges? What are this organization’s risks and assumptions?

Good qualitative research questions that help us to craft an evaluation might include questions around program need, and program conceptualization and design (Rossi, Lipsey, and Freeman, 2004). Depending on the purpose of the evaluation and your evaluation design, you might ask process-focused questions such as who, what, when, where, why, and how; or you might ask outcome focused questions around changes, effects, and impacts.

Your qualitative research and the answers to all of these questions could help you to develop a LogFrame that you could use to guide a future evaluation that asks questions around program operations and service delivery, program outcomes, or program cost efficiency. Your evaluation design would include evaluation questions that likely have a mixed method element that uses a combination of qualitative and quantitative data and methods to help measure progress or change. Our evaluation questions are not necessarily qualitative in nature; they are often questions that require mixed methods or quantitative tools and analyses to answer. However, we often use qualitative research questions and data collection techniques to help us craft our evaluation questions, LogFrame, and evaluation design.

Rossi, Peter, Mark Lipsey, and Howard Freeman. Evaluation: A Systematic Approach. 7th edition. Thousand Oaks, SAGE, 2004.

About The Author

Dr. Beverly Peters has more than twenty years of experience teaching, conducting qualitative research, and managing community development, microcredit, infrastructure, and democratization projects in several countries in Africa. As a consultant, Dr. Peters worked on EU and USAID funded infrastructure, education, and microcredit projects in South Africa and Mozambique. She also conceptualized and developed the proposal for Darfur Peace and Development Organization’s women’s crisis center, a center that provides physical and economic assistance to women survivors of violence in the IDP camps in Darfur. Dr. Peters has a Ph.D. from the University of Pittsburgh. Learn more about Dr. Peters.

To learn more about American University’s online MS in Measurement & Evaluation or Graduate Certificate in Project Monitoring & Evaluation, request more information or call us toll free at 855-725-7614.

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100 Questions (and Answers) About Qualitative Research

• Lisa M. Given - Swinburne University, Australia, Charles Sturt University, Australia, RMIT University, Melbourne, Australia

“This is a great companion book for a course on qualitative methods and it is also a great resource as a ‘ready-reference,’ which should be a required companion for all graduate students who will be taking qualitative research methods.”

“It provides an overview of the subject on the nuances of qualitative research.”

“ Very precise in helping students determine if their study is appropriate for this type of research design.”

“The book appears to provide the right combination of breadth and depth . There are a lot of topics covered, but the book seems to provide a succinct, snapshot-like answer for each question.”

“A book like this can provide a useful supplement to major texts and be used as a reference.”

Lisa M. Given

Qualitative Study

Affiliations.

• 1 University of Nebraska Medical Center
• 2 GDB Research and Statistical Consulting
• 3 GDB Research and Statistical Consulting/McLaren Macomb Hospital
• PMID: 29262162
• Bookshelf ID: NBK470395

Qualitative research is a type of research that explores and provides deeper insights into real-world problems. Instead of collecting numerical data points or intervene or introduce treatments just like in quantitative research, qualitative research helps generate hypotheses as well as further investigate and understand quantitative data. Qualitative research gathers participants' experiences, perceptions, and behavior. It answers the hows and whys instead of how many or how much. It could be structured as a stand-alone study, purely relying on qualitative data or it could be part of mixed-methods research that combines qualitative and quantitative data. This review introduces the readers to some basic concepts, definitions, terminology, and application of qualitative research.

Qualitative research at its core, ask open-ended questions whose answers are not easily put into numbers such as ‘how’ and ‘why’. Due to the open-ended nature of the research questions at hand, qualitative research design is often not linear in the same way quantitative design is. One of the strengths of qualitative research is its ability to explain processes and patterns of human behavior that can be difficult to quantify. Phenomena such as experiences, attitudes, and behaviors can be difficult to accurately capture quantitatively, whereas a qualitative approach allows participants themselves to explain how, why, or what they were thinking, feeling, and experiencing at a certain time or during an event of interest. Quantifying qualitative data certainly is possible, but at its core, qualitative data is looking for themes and patterns that can be difficult to quantify and it is important to ensure that the context and narrative of qualitative work are not lost by trying to quantify something that is not meant to be quantified.

However, while qualitative research is sometimes placed in opposition to quantitative research, where they are necessarily opposites and therefore ‘compete’ against each other and the philosophical paradigms associated with each, qualitative and quantitative work are not necessarily opposites nor are they incompatible. While qualitative and quantitative approaches are different, they are not necessarily opposites, and they are certainly not mutually exclusive. For instance, qualitative research can help expand and deepen understanding of data or results obtained from quantitative analysis. For example, say a quantitative analysis has determined that there is a correlation between length of stay and level of patient satisfaction, but why does this correlation exist? This dual-focus scenario shows one way in which qualitative and quantitative research could be integrated together.

Examples of Qualitative Research Approaches

Ethnography

Ethnography as a research design has its origins in social and cultural anthropology, and involves the researcher being directly immersed in the participant’s environment. Through this immersion, the ethnographer can use a variety of data collection techniques with the aim of being able to produce a comprehensive account of the social phenomena that occurred during the research period. That is to say, the researcher’s aim with ethnography is to immerse themselves into the research population and come out of it with accounts of actions, behaviors, events, etc. through the eyes of someone involved in the population. Direct involvement of the researcher with the target population is one benefit of ethnographic research because it can then be possible to find data that is otherwise very difficult to extract and record.

Grounded Theory

Grounded Theory is the “generation of a theoretical model through the experience of observing a study population and developing a comparative analysis of their speech and behavior.” As opposed to quantitative research which is deductive and tests or verifies an existing theory, grounded theory research is inductive and therefore lends itself to research that is aiming to study social interactions or experiences. In essence, Grounded Theory’s goal is to explain for example how and why an event occurs or how and why people might behave a certain way. Through observing the population, a researcher using the Grounded Theory approach can then develop a theory to explain the phenomena of interest.

Phenomenology

Phenomenology is defined as the “study of the meaning of phenomena or the study of the particular”. At first glance, it might seem that Grounded Theory and Phenomenology are quite similar, but upon careful examination, the differences can be seen. At its core, phenomenology looks to investigate experiences from the perspective of the individual. Phenomenology is essentially looking into the ‘lived experiences’ of the participants and aims to examine how and why participants behaved a certain way, from their perspective . Herein lies one of the main differences between Grounded Theory and Phenomenology. Grounded Theory aims to develop a theory for social phenomena through an examination of various data sources whereas Phenomenology focuses on describing and explaining an event or phenomena from the perspective of those who have experienced it.

Narrative Research

One of qualitative research’s strengths lies in its ability to tell a story, often from the perspective of those directly involved in it. Reporting on qualitative research involves including details and descriptions of the setting involved and quotes from participants. This detail is called ‘thick’ or ‘rich’ description and is a strength of qualitative research. Narrative research is rife with the possibilities of ‘thick’ description as this approach weaves together a sequence of events, usually from just one or two individuals, in the hopes of creating a cohesive story, or narrative. While it might seem like a waste of time to focus on such a specific, individual level, understanding one or two people’s narratives for an event or phenomenon can help to inform researchers about the influences that helped shape that narrative. The tension or conflict of differing narratives can be “opportunities for innovation”.

Research Paradigm

Research paradigms are the assumptions, norms, and standards that underpin different approaches to research. Essentially, research paradigms are the ‘worldview’ that inform research. It is valuable for researchers, both qualitative and quantitative, to understand what paradigm they are working within because understanding the theoretical basis of research paradigms allows researchers to understand the strengths and weaknesses of the approach being used and adjust accordingly. Different paradigms have different ontology and epistemologies . Ontology is defined as the "assumptions about the nature of reality” whereas epistemology is defined as the “assumptions about the nature of knowledge” that inform the work researchers do. It is important to understand the ontological and epistemological foundations of the research paradigm researchers are working within to allow for a full understanding of the approach being used and the assumptions that underpin the approach as a whole. Further, it is crucial that researchers understand their own ontological and epistemological assumptions about the world in general because their assumptions about the world will necessarily impact how they interact with research. A discussion of the research paradigm is not complete without describing positivist, postpositivist, and constructivist philosophies.

Positivist vs Postpositivist

To further understand qualitative research, we need to discuss positivist and postpositivist frameworks. Positivism is a philosophy that the scientific method can and should be applied to social as well as natural sciences. Essentially, positivist thinking insists that the social sciences should use natural science methods in its research which stems from positivist ontology that there is an objective reality that exists that is fully independent of our perception of the world as individuals. Quantitative research is rooted in positivist philosophy, which can be seen in the value it places on concepts such as causality, generalizability, and replicability.

Conversely, postpositivists argue that social reality can never be one hundred percent explained but it could be approximated. Indeed, qualitative researchers have been insisting that there are “fundamental limits to the extent to which the methods and procedures of the natural sciences could be applied to the social world” and therefore postpositivist philosophy is often associated with qualitative research. An example of positivist versus postpositivist values in research might be that positivist philosophies value hypothesis-testing, whereas postpositivist philosophies value the ability to formulate a substantive theory.

Constructivist

Constructivism is a subcategory of postpositivism. Most researchers invested in postpositivist research are constructivist as well, meaning they think there is no objective external reality that exists but rather that reality is constructed. Constructivism is a theoretical lens that emphasizes the dynamic nature of our world. “Constructivism contends that individuals’ views are directly influenced by their experiences, and it is these individual experiences and views that shape their perspective of reality”. Essentially, Constructivist thought focuses on how ‘reality’ is not a fixed certainty and experiences, interactions, and backgrounds give people a unique view of the world. Constructivism contends, unlike in positivist views, that there is not necessarily an ‘objective’ reality we all experience. This is the ‘relativist’ ontological view that reality and the world we live in are dynamic and socially constructed. Therefore, qualitative scientific knowledge can be inductive as well as deductive.”

So why is it important to understand the differences in assumptions that different philosophies and approaches to research have? Fundamentally, the assumptions underpinning the research tools a researcher selects provide an overall base for the assumptions the rest of the research will have and can even change the role of the researcher themselves. For example, is the researcher an ‘objective’ observer such as in positivist quantitative work? Or is the researcher an active participant in the research itself, as in postpositivist qualitative work? Understanding the philosophical base of the research undertaken allows researchers to fully understand the implications of their work and their role within the research, as well as reflect on their own positionality and bias as it pertains to the research they are conducting.

Data Sampling

The better the sample represents the intended study population, the more likely the researcher is to encompass the varying factors at play. The following are examples of participant sampling and selection:

Purposive sampling- selection based on the researcher’s rationale in terms of being the most informative.

Criterion sampling-selection based on pre-identified factors.

Convenience sampling- selection based on availability.

Snowball sampling- the selection is by referral from other participants or people who know potential participants.

Extreme case sampling- targeted selection of rare cases.

Typical case sampling-selection based on regular or average participants.

Data Collection and Analysis

Qualitative research uses several techniques including interviews, focus groups, and observation. [1] [2] [3] Interviews may be unstructured, with open-ended questions on a topic and the interviewer adapts to the responses. Structured interviews have a predetermined number of questions that every participant is asked. It is usually one on one and is appropriate for sensitive topics or topics needing an in-depth exploration. Focus groups are often held with 8-12 target participants and are used when group dynamics and collective views on a topic are desired. Researchers can be a participant-observer to share the experiences of the subject or a non-participant or detached observer.

While quantitative research design prescribes a controlled environment for data collection, qualitative data collection may be in a central location or in the environment of the participants, depending on the study goals and design. Qualitative research could amount to a large amount of data. Data is transcribed which may then be coded manually or with the use of Computer Assisted Qualitative Data Analysis Software or CAQDAS such as ATLAS.ti or NVivo.

After the coding process, qualitative research results could be in various formats. It could be a synthesis and interpretation presented with excerpts from the data. Results also could be in the form of themes and theory or model development.

Dissemination

To standardize and facilitate the dissemination of qualitative research outcomes, the healthcare team can use two reporting standards. The Consolidated Criteria for Reporting Qualitative Research or COREQ is a 32-item checklist for interviews and focus groups. The Standards for Reporting Qualitative Research (SRQR) is a checklist covering a wider range of qualitative research.

Examples of Application

Many times a research question will start with qualitative research. The qualitative research will help generate the research hypothesis which can be tested with quantitative methods. After the data is collected and analyzed with quantitative methods, a set of qualitative methods can be used to dive deeper into the data for a better understanding of what the numbers truly mean and their implications. The qualitative methods can then help clarify the quantitative data and also help refine the hypothesis for future research. Furthermore, with qualitative research researchers can explore subjects that are poorly studied with quantitative methods. These include opinions, individual's actions, and social science research.

A good qualitative study design starts with a goal or objective. This should be clearly defined or stated. The target population needs to be specified. A method for obtaining information from the study population must be carefully detailed to ensure there are no omissions of part of the target population. A proper collection method should be selected which will help obtain the desired information without overly limiting the collected data because many times, the information sought is not well compartmentalized or obtained. Finally, the design should ensure adequate methods for analyzing the data. An example may help better clarify some of the various aspects of qualitative research.

A researcher wants to decrease the number of teenagers who smoke in their community. The researcher could begin by asking current teen smokers why they started smoking through structured or unstructured interviews (qualitative research). The researcher can also get together a group of current teenage smokers and conduct a focus group to help brainstorm factors that may have prevented them from starting to smoke (qualitative research).

In this example, the researcher has used qualitative research methods (interviews and focus groups) to generate a list of ideas of both why teens start to smoke as well as factors that may have prevented them from starting to smoke. Next, the researcher compiles this data. The research found that, hypothetically, peer pressure, health issues, cost, being considered “cool,” and rebellious behavior all might increase or decrease the likelihood of teens starting to smoke.

The researcher creates a survey asking teen participants to rank how important each of the above factors is in either starting smoking (for current smokers) or not smoking (for current non-smokers). This survey provides specific numbers (ranked importance of each factor) and is thus a quantitative research tool.

The researcher can use the results of the survey to focus efforts on the one or two highest-ranked factors. Let us say the researcher found that health was the major factor that keeps teens from starting to smoke, and peer pressure was the major factor that contributed to teens to start smoking. The researcher can go back to qualitative research methods to dive deeper into each of these for more information. The researcher wants to focus on how to keep teens from starting to smoke, so they focus on the peer pressure aspect.

The researcher can conduct interviews and/or focus groups (qualitative research) about what types and forms of peer pressure are commonly encountered, where the peer pressure comes from, and where smoking first starts. The researcher hypothetically finds that peer pressure often occurs after school at the local teen hangouts, mostly the local park. The researcher also hypothetically finds that peer pressure comes from older, current smokers who provide the cigarettes.

The researcher could further explore this observation made at the local teen hangouts (qualitative research) and take notes regarding who is smoking, who is not, and what observable factors are at play for peer pressure of smoking. The researcher finds a local park where many local teenagers hang out and see that a shady, overgrown area of the park is where the smokers tend to hang out. The researcher notes the smoking teenagers buy their cigarettes from a local convenience store adjacent to the park where the clerk does not check identification before selling cigarettes. These observations fall under qualitative research.

If the researcher returns to the park and counts how many individuals smoke in each region of the park, this numerical data would be quantitative research. Based on the researcher's efforts thus far, they conclude that local teen smoking and teenagers who start to smoke may decrease if there are fewer overgrown areas of the park and the local convenience store does not sell cigarettes to underage individuals.

The researcher could try to have the parks department reassess the shady areas to make them less conducive to the smokers or identify how to limit the sales of cigarettes to underage individuals by the convenience store. The researcher would then cycle back to qualitative methods of asking at-risk population their perceptions of the changes, what factors are still at play, as well as quantitative research that includes teen smoking rates in the community, the incidence of new teen smokers, among others.

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Writing Survey Questions

Perhaps the most important part of the survey process is the creation of questions that accurately measure the opinions, experiences and behaviors of the public. Accurate random sampling will be wasted if the information gathered is built on a shaky foundation of ambiguous or biased questions. Creating good measures involves both writing good questions and organizing them to form the questionnaire.

Questionnaire design is a multistage process that requires attention to many details at once. Designing the questionnaire is complicated because surveys can ask about topics in varying degrees of detail, questions can be asked in different ways, and questions asked earlier in a survey may influence how people respond to later questions. Researchers are also often interested in measuring change over time and therefore must be attentive to how opinions or behaviors have been measured in prior surveys.

Surveyors may conduct pilot tests or focus groups in the early stages of questionnaire development in order to better understand how people think about an issue or comprehend a question. Pretesting a survey is an essential step in the questionnaire design process to evaluate how people respond to the overall questionnaire and specific questions, especially when questions are being introduced for the first time.

For many years, surveyors approached questionnaire design as an art, but substantial research over the past forty years has demonstrated that there is a lot of science involved in crafting a good survey questionnaire. Here, we discuss the pitfalls and best practices of designing questionnaires.

Question development

There are several steps involved in developing a survey questionnaire. The first is identifying what topics will be covered in the survey. For Pew Research Center surveys, this involves thinking about what is happening in our nation and the world and what will be relevant to the public, policymakers and the media. We also track opinion on a variety of issues over time so we often ensure that we update these trends on a regular basis to better understand whether people’s opinions are changing.

At Pew Research Center, questionnaire development is a collaborative and iterative process where staff meet to discuss drafts of the questionnaire several times over the course of its development. We frequently test new survey questions ahead of time through qualitative research methods such as  focus groups , cognitive interviews, pretesting (often using an  online, opt-in sample ), or a combination of these approaches. Researchers use insights from this testing to refine questions before they are asked in a production survey, such as on the ATP.

Measuring change over time

Many surveyors want to track changes over time in people’s attitudes, opinions and behaviors. To measure change, questions are asked at two or more points in time. A cross-sectional design surveys different people in the same population at multiple points in time. A panel, such as the ATP, surveys the same people over time. However, it is common for the set of people in survey panels to change over time as new panelists are added and some prior panelists drop out. Many of the questions in Pew Research Center surveys have been asked in prior polls. Asking the same questions at different points in time allows us to report on changes in the overall views of the general public (or a subset of the public, such as registered voters, men or Black Americans), or what we call “trending the data”.

When measuring change over time, it is important to use the same question wording and to be sensitive to where the question is asked in the questionnaire to maintain a similar context as when the question was asked previously (see  question wording  and  question order  for further information). All of our survey reports include a topline questionnaire that provides the exact question wording and sequencing, along with results from the current survey and previous surveys in which we asked the question.

The Center’s transition from conducting U.S. surveys by live telephone interviewing to an online panel (around 2014 to 2020) complicated some opinion trends, but not others. Opinion trends that ask about sensitive topics (e.g., personal finances or attending religious services ) or that elicited volunteered answers (e.g., “neither” or “don’t know”) over the phone tended to show larger differences than other trends when shifting from phone polls to the online ATP. The Center adopted several strategies for coping with changes to data trends that may be related to this change in methodology. If there is evidence suggesting that a change in a trend stems from switching from phone to online measurement, Center reports flag that possibility for readers to try to head off confusion or erroneous conclusions.

Open- and closed-ended questions

One of the most significant decisions that can affect how people answer questions is whether the question is posed as an open-ended question, where respondents provide a response in their own words, or a closed-ended question, where they are asked to choose from a list of answer choices.

For example, in a poll conducted after the 2008 presidential election, people responded very differently to two versions of the question: “What one issue mattered most to you in deciding how you voted for president?” One was closed-ended and the other open-ended. In the closed-ended version, respondents were provided five options and could volunteer an option not on the list.

When explicitly offered the economy as a response, more than half of respondents (58%) chose this answer; only 35% of those who responded to the open-ended version volunteered the economy. Moreover, among those asked the closed-ended version, fewer than one-in-ten (8%) provided a response other than the five they were read. By contrast, fully 43% of those asked the open-ended version provided a response not listed in the closed-ended version of the question. All of the other issues were chosen at least slightly more often when explicitly offered in the closed-ended version than in the open-ended version. (Also see  “High Marks for the Campaign, a High Bar for Obama”  for more information.)

Researchers will sometimes conduct a pilot study using open-ended questions to discover which answers are most common. They will then develop closed-ended questions based off that pilot study that include the most common responses as answer choices. In this way, the questions may better reflect what the public is thinking, how they view a particular issue, or bring certain issues to light that the researchers may not have been aware of.

When asking closed-ended questions, the choice of options provided, how each option is described, the number of response options offered, and the order in which options are read can all influence how people respond. One example of the impact of how categories are defined can be found in a Pew Research Center poll conducted in January 2002. When half of the sample was asked whether it was “more important for President Bush to focus on domestic policy or foreign policy,” 52% chose domestic policy while only 34% said foreign policy. When the category “foreign policy” was narrowed to a specific aspect – “the war on terrorism” – far more people chose it; only 33% chose domestic policy while 52% chose the war on terrorism.

In most circumstances, the number of answer choices should be kept to a relatively small number – just four or perhaps five at most – especially in telephone surveys. Psychological research indicates that people have a hard time keeping more than this number of choices in mind at one time. When the question is asking about an objective fact and/or demographics, such as the religious affiliation of the respondent, more categories can be used. In fact, they are encouraged to ensure inclusivity. For example, Pew Research Center’s standard religion questions include more than 12 different categories, beginning with the most common affiliations (Protestant and Catholic). Most respondents have no trouble with this question because they can expect to see their religious group within that list in a self-administered survey.

In addition to the number and choice of response options offered, the order of answer categories can influence how people respond to closed-ended questions. Research suggests that in telephone surveys respondents more frequently choose items heard later in a list (a “recency effect”), and in self-administered surveys, they tend to choose items at the top of the list (a “primacy” effect).

Because of concerns about the effects of category order on responses to closed-ended questions, many sets of response options in Pew Research Center’s surveys are programmed to be randomized to ensure that the options are not asked in the same order for each respondent. Rotating or randomizing means that questions or items in a list are not asked in the same order to each respondent. Answers to questions are sometimes affected by questions that precede them. By presenting questions in a different order to each respondent, we ensure that each question gets asked in the same context as every other question the same number of times (e.g., first, last or any position in between). This does not eliminate the potential impact of previous questions on the current question, but it does ensure that this bias is spread randomly across all of the questions or items in the list. For instance, in the example discussed above about what issue mattered most in people’s vote, the order of the five issues in the closed-ended version of the question was randomized so that no one issue appeared early or late in the list for all respondents. Randomization of response items does not eliminate order effects, but it does ensure that this type of bias is spread randomly.

Questions with ordinal response categories – those with an underlying order (e.g., excellent, good, only fair, poor OR very favorable, mostly favorable, mostly unfavorable, very unfavorable) – are generally not randomized because the order of the categories conveys important information to help respondents answer the question. Generally, these types of scales should be presented in order so respondents can easily place their responses along the continuum, but the order can be reversed for some respondents. For example, in one of Pew Research Center’s questions about abortion, half of the sample is asked whether abortion should be “legal in all cases, legal in most cases, illegal in most cases, illegal in all cases,” while the other half of the sample is asked the same question with the response categories read in reverse order, starting with “illegal in all cases.” Again, reversing the order does not eliminate the recency effect but distributes it randomly across the population.

Question wording

The choice of words and phrases in a question is critical in expressing the meaning and intent of the question to the respondent and ensuring that all respondents interpret the question the same way. Even small wording differences can substantially affect the answers people provide.

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An example of a wording difference that had a significant impact on responses comes from a January 2003 Pew Research Center survey. When people were asked whether they would “favor or oppose taking military action in Iraq to end Saddam Hussein’s rule,” 68% said they favored military action while 25% said they opposed military action. However, when asked whether they would “favor or oppose taking military action in Iraq to end Saddam Hussein’s rule  even if it meant that U.S. forces might suffer thousands of casualties, ” responses were dramatically different; only 43% said they favored military action, while 48% said they opposed it. The introduction of U.S. casualties altered the context of the question and influenced whether people favored or opposed military action in Iraq.

There has been a substantial amount of research to gauge the impact of different ways of asking questions and how to minimize differences in the way respondents interpret what is being asked. The issues related to question wording are more numerous than can be treated adequately in this short space, but below are a few of the important things to consider:

First, it is important to ask questions that are clear and specific and that each respondent will be able to answer. If a question is open-ended, it should be evident to respondents that they can answer in their own words and what type of response they should provide (an issue or problem, a month, number of days, etc.). Closed-ended questions should include all reasonable responses (i.e., the list of options is exhaustive) and the response categories should not overlap (i.e., response options should be mutually exclusive). Further, it is important to discern when it is best to use forced-choice close-ended questions (often denoted with a radio button in online surveys) versus “select-all-that-apply” lists (or check-all boxes). A 2019 Center study found that forced-choice questions tend to yield more accurate responses, especially for sensitive questions.  Based on that research, the Center generally avoids using select-all-that-apply questions.

It is also important to ask only one question at a time. Questions that ask respondents to evaluate more than one concept (known as double-barreled questions) – such as “How much confidence do you have in President Obama to handle domestic and foreign policy?” – are difficult for respondents to answer and often lead to responses that are difficult to interpret. In this example, it would be more effective to ask two separate questions, one about domestic policy and another about foreign policy.

In general, questions that use simple and concrete language are more easily understood by respondents. It is especially important to consider the education level of the survey population when thinking about how easy it will be for respondents to interpret and answer a question. Double negatives (e.g., do you favor or oppose  not  allowing gays and lesbians to legally marry) or unfamiliar abbreviations or jargon (e.g., ANWR instead of Arctic National Wildlife Refuge) can result in respondent confusion and should be avoided.

Similarly, it is important to consider whether certain words may be viewed as biased or potentially offensive to some respondents, as well as the emotional reaction that some words may provoke. For example, in a 2005 Pew Research Center survey, 51% of respondents said they favored “making it legal for doctors to give terminally ill patients the means to end their lives,” but only 44% said they favored “making it legal for doctors to assist terminally ill patients in committing suicide.” Although both versions of the question are asking about the same thing, the reaction of respondents was different. In another example, respondents have reacted differently to questions using the word “welfare” as opposed to the more generic “assistance to the poor.” Several experiments have shown that there is much greater public support for expanding “assistance to the poor” than for expanding “welfare.”

We often write two versions of a question and ask half of the survey sample one version of the question and the other half the second version. Thus, we say we have two  forms  of the questionnaire. Respondents are assigned randomly to receive either form, so we can assume that the two groups of respondents are essentially identical. On questions where two versions are used, significant differences in the answers between the two forms tell us that the difference is a result of the way we worded the two versions.

One of the most common formats used in survey questions is the “agree-disagree” format. In this type of question, respondents are asked whether they agree or disagree with a particular statement. Research has shown that, compared with the better educated and better informed, less educated and less informed respondents have a greater tendency to agree with such statements. This is sometimes called an “acquiescence bias” (since some kinds of respondents are more likely to acquiesce to the assertion than are others). This behavior is even more pronounced when there’s an interviewer present, rather than when the survey is self-administered. A better practice is to offer respondents a choice between alternative statements. A Pew Research Center experiment with one of its routinely asked values questions illustrates the difference that question format can make. Not only does the forced choice format yield a very different result overall from the agree-disagree format, but the pattern of answers between respondents with more or less formal education also tends to be very different.

One other challenge in developing questionnaires is what is called “social desirability bias.” People have a natural tendency to want to be accepted and liked, and this may lead people to provide inaccurate answers to questions that deal with sensitive subjects. Research has shown that respondents understate alcohol and drug use, tax evasion and racial bias. They also may overstate church attendance, charitable contributions and the likelihood that they will vote in an election. Researchers attempt to account for this potential bias in crafting questions about these topics. For instance, when Pew Research Center surveys ask about past voting behavior, it is important to note that circumstances may have prevented the respondent from voting: “In the 2012 presidential election between Barack Obama and Mitt Romney, did things come up that kept you from voting, or did you happen to vote?” The choice of response options can also make it easier for people to be honest. For example, a question about church attendance might include three of six response options that indicate infrequent attendance. Research has also shown that social desirability bias can be greater when an interviewer is present (e.g., telephone and face-to-face surveys) than when respondents complete the survey themselves (e.g., paper and web surveys).

Lastly, because slight modifications in question wording can affect responses, identical question wording should be used when the intention is to compare results to those from earlier surveys. Similarly, because question wording and responses can vary based on the mode used to survey respondents, researchers should carefully evaluate the likely effects on trend measurements if a different survey mode will be used to assess change in opinion over time.

Question order

Once the survey questions are developed, particular attention should be paid to how they are ordered in the questionnaire. Surveyors must be attentive to how questions early in a questionnaire may have unintended effects on how respondents answer subsequent questions. Researchers have demonstrated that the order in which questions are asked can influence how people respond; earlier questions can unintentionally provide context for the questions that follow (these effects are called “order effects”).

One kind of order effect can be seen in responses to open-ended questions. Pew Research Center surveys generally ask open-ended questions about national problems, opinions about leaders and similar topics near the beginning of the questionnaire. If closed-ended questions that relate to the topic are placed before the open-ended question, respondents are much more likely to mention concepts or considerations raised in those earlier questions when responding to the open-ended question.

For closed-ended opinion questions, there are two main types of order effects: contrast effects ( where the order results in greater differences in responses), and assimilation effects (where responses are more similar as a result of their order).

An example of a contrast effect can be seen in a Pew Research Center poll conducted in October 2003, a dozen years before same-sex marriage was legalized in the U.S. That poll found that people were more likely to favor allowing gays and lesbians to enter into legal agreements that give them the same rights as married couples when this question was asked after one about whether they favored or opposed allowing gays and lesbians to marry (45% favored legal agreements when asked after the marriage question, but 37% favored legal agreements without the immediate preceding context of a question about same-sex marriage). Responses to the question about same-sex marriage, meanwhile, were not significantly affected by its placement before or after the legal agreements question.

Another experiment embedded in a December 2008 Pew Research Center poll also resulted in a contrast effect. When people were asked “All in all, are you satisfied or dissatisfied with the way things are going in this country today?” immediately after having been asked “Do you approve or disapprove of the way George W. Bush is handling his job as president?”; 88% said they were dissatisfied, compared with only 78% without the context of the prior question.

Responses to presidential approval remained relatively unchanged whether national satisfaction was asked before or after it. A similar finding occurred in December 2004 when both satisfaction and presidential approval were much higher (57% were dissatisfied when Bush approval was asked first vs. 51% when general satisfaction was asked first).

Several studies also have shown that asking a more specific question before a more general question (e.g., asking about happiness with one’s marriage before asking about one’s overall happiness) can result in a contrast effect. Although some exceptions have been found, people tend to avoid redundancy by excluding the more specific question from the general rating.

Assimilation effects occur when responses to two questions are more consistent or closer together because of their placement in the questionnaire. We found an example of an assimilation effect in a Pew Research Center poll conducted in November 2008 when we asked whether Republican leaders should work with Obama or stand up to him on important issues and whether Democratic leaders should work with Republican leaders or stand up to them on important issues. People were more likely to say that Republican leaders should work with Obama when the question was preceded by the one asking what Democratic leaders should do in working with Republican leaders (81% vs. 66%). However, when people were first asked about Republican leaders working with Obama, fewer said that Democratic leaders should work with Republican leaders (71% vs. 82%).

The order questions are asked is of particular importance when tracking trends over time. As a result, care should be taken to ensure that the context is similar each time a question is asked. Modifying the context of the question could call into question any observed changes over time (see  measuring change over time  for more information).

A questionnaire, like a conversation, should be grouped by topic and unfold in a logical order. It is often helpful to begin the survey with simple questions that respondents will find interesting and engaging. Throughout the survey, an effort should be made to keep the survey interesting and not overburden respondents with several difficult questions right after one another. Demographic questions such as income, education or age should not be asked near the beginning of a survey unless they are needed to determine eligibility for the survey or for routing respondents through particular sections of the questionnaire. Even then, it is best to precede such items with more interesting and engaging questions. One virtue of survey panels like the ATP is that demographic questions usually only need to be asked once a year, not in each survey.

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• J Indian Assoc Pediatr Surg
• v.24(1); Jan-Mar 2019

Formulation of Research Question – Stepwise Approach

Simmi k. ratan.

Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India

1 Department of Community Medicine, North Delhi Municipal Corporation Medical College, New Delhi, India

2 Department of Pediatric Surgery, Batra Hospital and Research Centre, New Delhi, India

Formulation of research question (RQ) is an essentiality before starting any research. It aims to explore an existing uncertainty in an area of concern and points to a need for deliberate investigation. It is, therefore, pertinent to formulate a good RQ. The present paper aims to discuss the process of formulation of RQ with stepwise approach. The characteristics of good RQ are expressed by acronym “FINERMAPS” expanded as feasible, interesting, novel, ethical, relevant, manageable, appropriate, potential value, publishability, and systematic. A RQ can address different formats depending on the aspect to be evaluated. Based on this, there can be different types of RQ such as based on the existence of the phenomenon, description and classification, composition, relationship, comparative, and causality. To develop a RQ, one needs to begin by identifying the subject of interest and then do preliminary research on that subject. The researcher then defines what still needs to be known in that particular subject and assesses the implied questions. After narrowing the focus and scope of the research subject, researcher frames a RQ and then evaluates it. Thus, conception to formulation of RQ is very systematic process and has to be performed meticulously as research guided by such question can have wider impact in the field of social and health research by leading to formulation of policies for the benefit of larger population.

I NTRODUCTION

A good research question (RQ) forms backbone of a good research, which in turn is vital in unraveling mysteries of nature and giving insight into a problem.[ 1 , 2 , 3 , 4 ] RQ identifies the problem to be studied and guides to the methodology. It leads to building up of an appropriate hypothesis (Hs). Hence, RQ aims to explore an existing uncertainty in an area of concern and points to a need for deliberate investigation. A good RQ helps support a focused arguable thesis and construction of a logical argument. Hence, formulation of a good RQ is undoubtedly one of the first critical steps in the research process, especially in the field of social and health research, where the systematic generation of knowledge that can be used to promote, restore, maintain, and/or protect health of individuals and populations.[ 1 , 3 , 4 ] Basically, the research can be classified as action, applied, basic, clinical, empirical, administrative, theoretical, or qualitative or quantitative research, depending on its purpose.[ 2 ]

Research plays an important role in developing clinical practices and instituting new health policies. Hence, there is a need for a logical scientific approach as research has an important goal of generating new claims.[ 1 ]

C HARACTERISTICS OF G OOD R ESEARCH Q UESTION

“The most successful research topics are narrowly focused and carefully defined but are important parts of a broad-ranging, complex problem.”

A good RQ is an asset as it:

• Details the problem statement
• Further describes and refines the issue under study
• Adds focus to the problem statement
• Guides data collection and analysis
• Sets context of research.

Hence, while writing RQ, it is important to see if it is relevant to the existing time frame and conditions. For example, the impact of “odd-even” vehicle formula in decreasing the level of air particulate pollution in various districts of Delhi.

A good research is represented by acronym FINERMAPS[ 5 ]

Interesting.

• Appropriate
• Potential value and publishability
• Systematic.

Feasibility means that it is within the ability of the investigator to carry out. It should be backed by an appropriate number of subjects and methodology as well as time and funds to reach the conclusions. One needs to be realistic about the scope and scale of the project. One has to have access to the people, gadgets, documents, statistics, etc. One should be able to relate the concepts of the RQ to the observations, phenomena, indicators, or variables that one can access. One should be clear that the collection of data and the proceedings of project can be completed within the limited time and resources available to the investigator. Sometimes, a RQ appears feasible, but when fieldwork or study gets started, it proves otherwise. In this situation, it is important to write up the problems honestly and to reflect on what has been learned. One should try to discuss with more experienced colleagues or the supervisor so as to develop a contingency plan to anticipate possible problems while working on a RQ and find possible solutions in such situations.

This is essential that one has a real grounded interest in one's RQ and one can explore this and back it up with academic and intellectual debate. This interest will motivate one to keep going with RQ.

The question should not simply copy questions investigated by other workers but should have scope to be investigated. It may aim at confirming or refuting the already established findings, establish new facts, or find new aspects of the established facts. It should show imagination of the researcher. Above all, the question has to be simple and clear. The complexity of a question can frequently hide unclear thoughts and lead to a confused research process. A very elaborate RQ, or a question which is not differentiated into different parts, may hide concepts that are contradictory or not relevant. This needs to be clear and thought-through. Having one key question with several subcomponents will guide your research.

This is the foremost requirement of any RQ and is mandatory to get clearance from appropriate authorities before stating research on the question. Further, the RQ should be such that it minimizes the risk of harm to the participants in the research, protect the privacy and maintain their confidentiality, and provide the participants right to withdraw from research. It should also guide in avoiding deceptive practices in research.

The question should of academic and intellectual interest to people in the field you have chosen to study. The question preferably should arise from issues raised in the current situation, literature, or in practice. It should establish a clear purpose for the research in relation to the chosen field. For example, filling a gap in knowledge, analyzing academic assumptions or professional practice, monitoring a development in practice, comparing different approaches, or testing theories within a specific population are some of the relevant RQs.

Manageable (M): It has the similar essence as of feasibility but mainly means that the following research can be managed by the researcher.

Appropriate (A): RQ should be appropriate logically and scientifically for the community and institution.

Potential value and publishability (P): The study can make significant health impact in clinical and community practices. Therefore, research should aim for significant economic impact to reduce unnecessary or excessive costs. Furthermore, the proposed study should exist within a clinical, consumer, or policy-making context that is amenable to evidence-based change. Above all, a good RQ must address a topic that has clear implications for resolving important dilemmas in health and health-care decisions made by one or more stakeholder groups.

Systematic (S): Research is structured with specified steps to be taken in a specified sequence in accordance with the well-defined set of rules though it does not rule out creative thinking.

Example of RQ: Would the topical skin application of oil as a skin barrier reduces hypothermia in preterm infants? This question fulfills the criteria of a good RQ, that is, feasible, interesting, novel, ethical, and relevant.

Types of research question

A RQ can address different formats depending on the aspect to be evaluated.[ 6 ] For example:

• Existence: This is designed to uphold the existence of a particular phenomenon or to rule out rival explanation, for example, can neonates perceive pain?
• Description and classification: This type of question encompasses statement of uniqueness, for example, what are characteristics and types of neuropathic bladders?
• Composition: It calls for breakdown of whole into components, for example, what are stages of reflux nephropathy?
• Relationship: Evaluate relation between variables, for example, association between tumor rupture and recurrence rates in Wilm's tumor
• Descriptive—comparative: Expected that researcher will ensure that all is same between groups except issue in question, for example, Are germ cell tumors occurring in gonads more aggressive than those occurring in extragonadal sites?
• Causality: Does deletion of p53 leads to worse outcome in patients with neuroblastoma?
• Causality—comparative: Such questions frequently aim to see effect of two rival treatments, for example, does adding surgical resection improves survival rate outcome in children with neuroblastoma than with chemotherapy alone?
• Causality–Comparative interactions: Does immunotherapy leads to better survival outcome in neuroblastoma Stage IV S than with chemotherapy in the setting of adverse genetic profile than without it? (Does X cause more changes in Y than those caused by Z under certain condition and not under other conditions).

How to develop a research question

• Begin by identifying a broader subject of interest that lends itself to investigate, for example, hormone levels among hypospadias
• Do preliminary research on the general topic to find out what research has already been done and what literature already exists.[ 7 ] Therefore, one should begin with “information gaps” (What do you already know about the problem? For example, studies with results on testosterone levels among hypospadias
• What do you still need to know? (e.g., levels of other reproductive hormones among hypospadias)
• What are the implied questions: The need to know about a problem will lead to few implied questions. Each general question should lead to more specific questions (e.g., how hormone levels differ among isolated hypospadias with respect to that in normal population)
• Narrow the scope and focus of research (e.g., assessment of reproductive hormone levels among isolated hypospadias and hypospadias those with associated anomalies)
• Is RQ clear? With so much research available on any given topic, RQs must be as clear as possible in order to be effective in helping the writer direct his or her research
• Is the RQ focused? RQs must be specific enough to be well covered in the space available
• Is the RQ complex? RQs should not be answerable with a simple “yes” or “no” or by easily found facts. They should, instead, require both research and analysis on the part of the writer
• Is the RQ one that is of interest to the researcher and potentially useful to others? Is it a new issue or problem that needs to be solved or is it attempting to shed light on previously researched topic
• Is the RQ researchable? Consider the available time frame and the required resources. Is the methodology to conduct the research feasible?
• Is the RQ measurable and will the process produce data that can be supported or contradicted?
• Is the RQ too broad or too narrow?
• Create Hs: After formulating RQ, think where research is likely to be progressing? What kind of argument is likely to be made/supported? What would it mean if the research disputed the planned argument? At this step, one can well be on the way to have a focus for the research and construction of a thesis. Hs consists of more specific predictions about the nature and direction of the relationship between two variables. It is a predictive statement about the outcome of the research, dictate the method, and design of the research[ 1 ]
• Understand implications of your research: This is important for application: whether one achieves to fill gap in knowledge and how the results of the research have practical implications, for example, to develop health policies or improve educational policies.[ 1 , 8 ]

Brainstorm/Concept map for formulating research question

• First, identify what types of studies have been done in the past?
• Is there a unique area that is yet to be investigated or is there a particular question that may be worth replicating?
• Begin to narrow the topic by asking open-ended “how” and “why” questions
• Evaluate the question
• Develop a Hypothesis (Hs)
• Write down the RQ.

Writing down the research question

• State the question in your own words
• Write down the RQ as completely as possible.

For example, Evaluation of reproductive hormonal profile in children presenting with isolated hypospadias)

• Divide your question into concepts. Narrow to two or three concepts (reproductive hormonal profile, isolated hypospadias, compare with normal/not isolated hypospadias–implied)
• Specify the population to be studied (children with isolated hypospadias)
• Refer to the exposure or intervention to be investigated, if any
• Reflect the outcome of interest (hormonal profile).

Another example of a research question

Would the topical skin application of oil as a skin barrier reduces hypothermia in preterm infants? Apart from fulfilling the criteria of a good RQ, that is, feasible, interesting, novel, ethical, and relevant, it also details about the intervention done (topical skin application of oil), rationale of intervention (as a skin barrier), population to be studied (preterm infants), and outcome (reduces hypothermia).

Other important points to be heeded to while framing research question

• Make reference to a population when a relationship is expected among a certain type of subjects
• RQs and Hs should be made as specific as possible
• Avoid words or terms that do not add to the meaning of RQs and Hs
• Stick to what will be studied, not implications
• Name the variables in the order in which they occur/will be measured
• Avoid the words significant/”prove”
• Avoid using two different terms to refer to the same variable.

Some of the other problems and their possible solutions have been discussed in Table 1 .

Potential problems and solutions while making research question

G OING B EYOND F ORMULATION OF R ESEARCH Q UESTION–THE P ATH A HEAD

Once RQ is formulated, a Hs can be developed. Hs means transformation of a RQ into an operational analog.[ 1 ] It means a statement as to what prediction one makes about the phenomenon to be examined.[ 4 ] More often, for case–control trial, null Hs is generated which is later accepted or refuted.

A strong Hs should have following characteristics:

• Give insight into a RQ
• Are testable and measurable by the proposed experiments
• Have logical basis
• Follows the most likely outcome, not the exceptional outcome.

E XAMPLES OF R ESEARCH Q UESTION AND H YPOTHESIS

Research question-1.

• Does reduced gap between the two segments of the esophagus in patients of esophageal atresia reduces the mortality and morbidity of such patients?

Hypothesis-1

• Reduced gap between the two segments of the esophagus in patients of esophageal atresia reduces the mortality and morbidity of such patients
• In pediatric patients with esophageal atresia, gap of <2 cm between two segments of the esophagus and proper mobilization of proximal pouch reduces the morbidity and mortality among such patients.

Research question-2

• Does application of mitomycin C improves the outcome in patient of corrosive esophageal strictures?

Hypothesis-2

In patients aged 2–9 years with corrosive esophageal strictures, 34 applications of mitomycin C in dosage of 0.4 mg/ml for 5 min over a period of 6 months improve the outcome in terms of symptomatic and radiological relief. Some other examples of good and bad RQs have been shown in Table 2 .

Examples of few bad (left-hand side column) and few good (right-hand side) research questions

R ESEARCH Q UESTION AND S TUDY D ESIGN

RQ determines study design, for example, the question aimed to find the incidence of a disease in population will lead to conducting a survey; to find risk factors for a disease will need case–control study or a cohort study. RQ may also culminate into clinical trial.[ 9 , 10 ] For example, effect of administration of folic acid tablet in the perinatal period in decreasing incidence of neural tube defect. Accordingly, Hs is framed.

Appropriate statistical calculations are instituted to generate sample size. The subject inclusion, exclusion criteria and time frame of research are carefully defined. The detailed subject information sheet and pro forma are carefully defined. Moreover, research is set off few examples of research methodology guided by RQ:

• Incidence of anorectal malformations among adolescent females (hospital-based survey)
• Risk factors for the development of spontaneous pneumoperitoneum in pediatric patients (case–control design and cohort study)
• Effect of technique of extramucosal ureteric reimplantation without the creation of submucosal tunnel for the preservation of upper tract in bladder exstrophy (clinical trial).

The results of the research are then be available for wider applications for health and social life

C ONCLUSION

A good RQ needs thorough literature search and deep insight into the specific area/problem to be investigated. A RQ has to be focused yet simple. Research guided by such question can have wider impact in the field of social and health research by leading to formulation of policies for the benefit of larger population.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

R EFERENCES

This paper is in the following e-collection/theme issue:

Published on 23.4.2024 in Vol 26 (2024)

This is a member publication of University of Oxford (Jisc)

Empowering School Staff to Support Pupil Mental Health Through a Brief, Interactive Web-Based Training Program: Mixed Methods Study

Authors of this article:

Original Paper

• Emma Soneson 1, 2 , PhD   ; 
• Emma Howarth 3 , PhD   ; 
• Alison Weir 4, 5 , MA, MSc   ; 
• Peter B Jones 2 * , PhD   ; 
• Mina Fazel 1 * , DM  

1 Department of Psychiatry, University of Oxford, Oxford, United Kingdom

2 Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom

3 School of Psychology, University of East London, London, United Kingdom

4 Faculty of Education, University of Cambridge, Cambridge, United Kingdom

5 Howard Community Academy, Anglian Learning multi-academy trust, Bury St Edmunds, United Kingdom

*these authors contributed equally

Corresponding Author:

Emma Soneson, PhD

Department of Psychiatry

University of Oxford

Warneford Lane

Oxford, OX3 7JX

United Kingdom

Phone: 44 1865 613127

Email: [email protected]

Background: Schools in the United Kingdom and elsewhere are expected to protect and promote pupil mental health. However, many school staff members do not feel confident in identifying and responding to pupil mental health difficulties and report wanting additional training in this area.

Objective: We aimed to explore the feasibility of Kognito’s At-Risk for Elementary School Educators , a brief, interactive web-based training program that uses a simulation-based approach to improve school staff’s knowledge and skills in supporting pupil mental health.

Methods: We conducted a mixed methods, nonrandomized feasibility study of At-Risk for Elementary School Educators in 6 UK primary schools. Our outcomes were (1) school staff’s self-efficacy and preparedness to identify and respond to pupil mental health difficulties, (2) school staff’s identification of mental health difficulties and increased risk of mental health difficulties, (3) mental health support for identified pupils (including conversations about concerns, documentation of concerns, in-class and in-school support, and referral and access to specialist mental health services), and (4) the acceptability and practicality of the training. We assessed these outcomes using a series of questionnaires completed at baseline (T1), 1 week after the training (T2), and 3 months after the training (T3), as well as semistructured qualitative interviews. Following guidance for feasibility studies, we assessed quantitative outcomes across time points by comparing medians and IQRs and analyzed qualitative data using reflexive thematic analysis.

Results: A total of 108 teachers and teaching assistants (TAs) completed T1 questionnaires, 89 (82.4%) completed T2 questionnaires, and 70 (64.8%) completed T3 questionnaires; 54 (50%) completed all 3. Eight school staff members, including teachers, TAs, mental health leads, and senior leaders, participated in the interviews. School staff reported greater confidence and preparedness in identifying and responding to mental health difficulties after completing the training. The proportion of pupils whom they identified as having mental health difficulties or increased risk declined slightly over time (median T1 =10%; median T2 =10%; median T3 =7.4%), but findings suggested a slight increase in accuracy compared with a validated screening measure (the Strengths and Difficulties Questionnaire). In-school mental health support outcomes for identified pupils improved after the training, with increases in formal documentation and communication of concerns as well as provision of in-class and in-school support. Referrals and access to external mental health services remained constant. The qualitative findings indicated that school staff perceived the training as useful, practical, and acceptable.

Conclusions: The findings suggest that brief, interactive web-based training programs such as At-Risk for Elementary School Educators are a feasible means to improve the identification of and response to mental health difficulties in UK primary schools. Such training may help address the high prevalence of mental health difficulties in this age group by helping facilitate access to care and support.

Introduction

In recent years, there has been an increased emphasis on the role of schools in supporting children’s mental health [ 1 - 3 ]. This enhanced focus has been driven in large part by an apparent increase in mental health difficulties (including behavioral, social, and emotional difficulties) present in school-aged populations [ 4 - 6 ]—a concern that became increasingly prominent in the context of the COVID-19 pandemic and the associated school closures and social distancing measures [ 7 , 8 ]. There is also a growing recognition of the many unique advantages of using the school setting to promote and protect pupil mental health [ 9 ]. First, most lifetime disorders begin during the schooling years [ 10 ], which suggests that schools may be an ideal setting for early identification and intervention. Second, schools have access to most children, meaning that they are an important component of any public health approach to address child mental health difficulties [ 11 - 14 ]. Third, schools benefit from prolonged engagement with pupils, which can facilitate the implementation of mental health promotion and prevention strategies as well as support and interventions for pupils with identified mental health needs [ 12 ]. Finally, mental health support in schools is often more accessible to families than other types of support [ 15 ].

However, while school staff are increasingly expected to support children’s mental health [ 1 ], many do not feel prepared to do so [ 16 - 19 ] due in part to receiving limited training and supervision in this area [ 20 ]. Therefore, improving school staff’s confidence and preparedness are important considerations for supporting them in taking an expanded role in pupil mental health [ 21 ]. Most schools offer some form of mental health training [ 22 , 23 ], but many staff members believe that they could benefit from additional training [ 18 - 20 , 24 - 26 ]. One area where staff training may be particularly beneficial is the identification of and first response to pupils who have mental health difficulties or who are believed to be at increased risk of developing them. However, although there is evidence suggesting that school staff, parents, and practitioners see such training as an acceptable, feasible, and potentially useful way to support pupil mental health [ 20 , 27 - 29 ], empirical evidence for the effectiveness of such training is limited and focuses primarily on intermediate outcomes (eg, staff knowledge and confidence) rather than downstream outcomes (eg, accurate identification, access to support, and mental health outcomes) [ 30 , 31 ]. Furthermore, there are several potential barriers to implementing training programs in schools, including time, cost, and resource requirements [ 28 ].

At-Risk for Elementary School Educators : A Brief, Interactive Web-Based Training

Training programs that address these barriers may be beneficial for supporting schools in identifying and responding to pupil mental health difficulties. Brief, interactive web-based training programs are a particularly promising avenue as they have the potential to be more affordable, flexible, and scalable than other training formats. One such training is At-Risk for Elementary School Educators (hereinafter, At-Risk ), a virtual simulation-based program developed by the American company Kognito [ 32 ]. The program, which has been completed by >125,000 teachers in the United States, aims to improve pupil mental health by “[building] awareness, knowledge, and skills about mental health, and [preparing] users to lead real-life conversations with pupils, parents, and caregivers about their concerns and available support” [ 33 ].

The program addresses many common implementation barriers to school-based mental health training. For example, At-Risk only requires approximately 1 hour to complete, which is much shorter than many other available training programs [ 31 , 34 ]. This comparatively low time commitment may address the concern that training programs are overly time intensive and, thus, make the training more feasible for busy schools [ 28 , 34 , 35 ]. The web-based format of At-Risk may also address concerns about school-based mental health programs being resource intensive [ 28 ]. Nearly all school mental health training programs documented in the literature are face-to-face sessions led by external facilitators [ 34 , 36 ], with only a few examples of web-based training [ 37 - 39 ]. For schools with limited budgets, programs requiring external facilitators can prove unsustainable and have limited scalability. In terms of financial resources, the costs of At-Risk vary depending on the number of licenses purchased, but the maximum cost is approximately £22 (US $30) per user, a price point that is feasible for many UK schools. In the United States, there have been many examples of bulk purchases at the district or state level that have made the training even more affordable per teacher. In many areas, the training is even free at point of use due to state- or district-wide licensing agreements [ 40 ].

To date, 3 randomized studies have examined the effectiveness and acceptability of At-Risk among samples of American teachers [ 17 , 41 ] and teachers in training [ 42 ] across school years. Each study found high satisfaction ratings, with between 75% and 85% of participants rating the training as useful, well constructed, relevant, and easy to use, and nearly all (88%-95%) reporting that they would recommend it to colleagues. The training also improved teachers’ self-rated preparedness, self-efficacy, and likelihood of identifying and discussing concerns about pupils’ mental health and referring them to appropriate support when needed. These improvements were reflected in the teachers’ behaviors—compared with teachers in the control group , those who completed At-Risk self-reported significantly more helping behaviors (eg, identifying psychological distress, discussing concerns with pupils and parents, and consulting with parents about options for care and support) and gatekeeping behaviors (ie, connecting pupils with care and support) after the training and at 3 months after the training. The findings of these studies indicate that At-Risk may help improve teachers’ ability to identify and respond to pupil mental health needs and lead to positive behavior change in terms of discussing concerns and facilitating access to care and support.

At-Risk in a UK Context: Considerations for Transportability

These 3 studies suggest that At-Risk may be a promising intervention for improving children’s mental health; however, there is still much to be learned about the training’s effectiveness, feasibility, and acceptability. Furthermore, to date, no evaluation of the training has been conducted outside the United States. There is increasing focus on the influence of context on the effectiveness of complex interventions [ 43 - 48 ], and while some interventions have shown success in terms of transportability [ 48 ], other interventions that have evidence of effectiveness in one context have demonstrated null or even negative effects in another [ 46 ]. Furthermore, information that could inform “transportability” is often not collected as part of evaluations [ 44 ], making it difficult to determine the likelihood of success in a new setting.

There are many contextual differences between the United States and the United Kingdom that could mean that school-based interventions developed in one country may not translate well to the other. Cross-country differences in education systems and (mental) health services are particularly relevant to this study. Differences in the education system include the length and content of initial teacher training, the number and roles of teaching assistants (TAs), and school funding structures. There are also key differences in the structure and availability of school-based mental health provision. In the United States, schools often have staff whose sole or at least main responsibility is mental health, such as school psychologists. While these roles are becoming more common in the United Kingdom with the implementation of the Green Paper recommendations [ 1 ], in most UK primary schools, mental health is included within the broader roles of the special educational needs coordinator (SENCo) and pastoral team. Finally, differences in the wider health care systems across the countries also mean that the process and outcomes of external referrals to specialist mental health services vary across settings, another fact that may influence the transportability of school-based interventions such as At-Risk.

Given these uncertainties regarding intervention transportability, additional evaluation of At-Risk is needed to understand whether it is a potentially useful and feasible tool to improve the identification of and response to mental health difficulties in UK primary schools. To explore the potential value of the training in this new context, we conducted a mixed methods feasibility study of At-Risk in 6 UK primary schools covering pupils aged 4 to 11 years . We aimed to examine the influence of At-Risk on staff confidence and preparedness, identification of pupils with mental health difficulties or increased risk of developing mental health difficulties, mental health support outcomes for identified children, and intervention acceptability and practicality.

Study Design

We used a mixed methods, nonrandomized, pretest-posttest study design to explore the feasibility of At-Risk in UK primary schools. While feasibility studies are acknowledged as a key stage of intervention design and evaluation [ 49 , 50 ], there is no universally agreed-upon definition of a feasibility study [ 50 , 51 ]. Therefore, we focused on 3 criteria from the guidance by Bowen et al [ 52 ]: acceptability, practicality, and limited effectiveness testing.

Intervention: At-Risk for Elementary School Educators

At-Risk is a web-based training that is delivered individually and requires only a log-in and internet connection. Using a simulation-based teaching model, the training aims to (1) improve mental health awareness and knowledge, (2) empower users to approach pupils about what they have noticed, (3) impart skills to have meaningful conversations with pupils and parents, and (4) train users to refer pupils to further support. The diagram in Figure 1 illustrates how the training might lead to improved mental health outcomes for pupils.

The simulation begins with an introduction by a virtual coach, who defines and explains how to recognize the warning signs of psychological distress and specific mental health difficulties and provides guidance and practical advice for discussing and acting upon concerns. Users then practice 2 virtual scenarios. The first scenario involves a fifth-grade (UK Year 6; ages of 10-11 years) teacher speaking with the parent of a pupil showing signs of behavioral difficulties. The second involves a third-grade (UK Year 4; ages of 8-9 years) teacher speaking with a pupil showing signs of emotional difficulties. During the conversations, users choose what to say via drop-down menus organized into categories (eg, “bring up concerns” or “ask a question”) and phrases (eg, “Mia sometimes seems a little agitated in class”). Throughout the conversation, users receive feedback through a “comfort bar” (based on how the pupil or parent perceives the conversation), opportunities to “see” the thoughts of the pupil or parent, and suggestions from the virtual coach.

Importantly, there is no one “right” way to conduct the conversations, and several approaches can lead to a positive outcome. Throughout the conversation, users can “undo” actions to backtrack after receiving an undesirable response or to explore what the response would have been had they chosen another option. At the end of each conversation, the pupil or parent provides feedback on the conversation. The training finishes with a short segment on connecting pupils with further support.

For this feasibility study, we used an unmodified version of the training (ie, the standard training designed for American schools, not tailored to the UK context) provided free of cost by Kognito. The potential need for adaptation and tailoring was an important consideration that we explicitly examined as part of our exploration of the acceptability and practicality of At-Risk in this new setting.

Recruitment

We originally sought to purposively sample 5 primary schools from Cambridgeshire or Norfolk that (1) had a higher-than-average proportion of pupils eligible for free school meals or (2) were located in an area in the top tertile of deprivation as measured using the Index of Multiple Deprivation [ 53 ], which we calculated with the publicly available Schools, pupils and their characteristics data [ 54 ]. We emailed headteachers, SENCos, and mental health leads from 131 candidate schools in September and October 2019 about participating in the study. To increase recruitment, we contacted additional schools in January 2020 for a study start date of March 2020. However, the study was suspended in March 2020 due to the in-person school closures associated with the onset of the COVID-19 pandemic. As some of the participating schools dropped out due to the pandemic, we reopened recruitment for a January 2021 study start date. In this round, we did not restrict participation by the 2 deprivation criteria described previously (ie, free school meal eligibility and Index of Multiple Deprivation), so any UK-based mainstream primary school was eligible to participate. The January 2021 start date was again delayed by the pandemic, but there was no subsequent recruitment.

Teachers and TAs

Schools were responsible for recruiting individual teachers and TAs to participate in the training. We encouraged schools to invite all teachers and TAs to participate, but schools made a variety of decisions in this regard. Three schools (schools D, E, and F) had all staff complete the training during inset (in-service training) days or other designated times, 2 schools (schools A and C) had staff volunteer to participate, and 1 school (school B) selected 2 to 3 staff members in each year group to participate.

Measures and Materials

School characteristics.

The characteristics of the participating schools, including school type, school sex (ie, whether they were single or mixed sex), urbanicity, head count, area-level deprivation, level of free school meal eligibility, ethnic composition, and proportion of pupils with special educational needs, were obtained from publicly available data from the Department for Education [ 54 , 55 ].

Teacher and TA Identification Form

The purpose of the Teacher and TA Identification Form ( Multimedia Appendix 1 ) was to understand which pupils participants would identify as having mental health difficulties or an increased risk of developing mental health difficulties. As systematic reviews in this area have identified no suitable questionnaires [ 28 , 30 ], we developed a bespoke questionnaire, which was reviewed by a school staff advisory group to ensure accuracy and relevance. The questionnaire begins with instructions, including explanations and examples of what is meant by “mental health difficulties or risk for mental health difficulties.” Full definitions are provided in Multimedia Appendix 1 , but in brief, “mental health difficulties” are described as “behavioural and social-emotional problems” regardless of formal diagnosis, and “risk for mental health difficulties” is described as experiences that increase the chance of a child developing mental health difficulties in the future.

For all pupils in their class, participants first indicated whether they thought a pupil had mental health difficulties or increased risk. If yes, they answered 9 subsequent questions about mental health support outcomes. The first four outcomes were about communication of concerns, namely whether they had (1) formally documented their concerns with the school, (2) communicated concerns to the SENCo, pastoral care lead, or mental health lead, (3) communicated concerns to another member of the school staff, or (4) communicated concerns to the child or their parents. The next five outcomes pertained to the provision of mental health support, namely whether the pupil (5) received in-class support; (6) received in-school support or had an in-house support plan; (7) had documented social, emotional, and mental health (SEMH) status (a type of special educational need focused on mental health difficulties); (8) had been referred to external mental health services; or (9) had access to external mental health services.

Strengths and Difficulties Questionnaire

The teacher-report Strengths and Difficulties Questionnaire (SDQ) [ 56 - 59 ] served as the comparator for findings about teachers’ and TAs’ identification of pupils. The SDQ includes 25 positive and negative psychological attributes across 5 scales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. The first 4 scales add up to a Total Difficulties Score (0-40, with higher scores representing greater difficulties). The SDQ has demonstrated acceptable psychometric properties in primary school samples [ 60 ]. It is important to note that the SDQ is not an exact comparator as it measures a narrower concept than the Teacher and TA Identification Form (which also includes increased risk ). However, this comparison could potentially yield valuable information regarding feasibility .

Pre- and Posttraining Surveys

Kognito uses pre- and posttraining surveys to assess their training. These surveys (based on the validated Gatekeeper Behavior Scale [ 61 ]) explore teachers’ self-efficacy in identifying and responding to mental health difficulties and whether their attitudes, self-efficacy, or practice have changed since completing the At-Risk training. The posttraining survey also includes questions on perceptions of the training’s impact. We independently (ie, with no input from Kognito) reviewed the merits of these questionnaires and decided to use them in this study because (1) they covered relevant and useful concepts related to our aims and (2) using them increased comparability to the other 3 US-based studies of At-Risk . We slightly adapted the surveys to make them more relevant to the UK context ( Multimedia Appendix 2 ).

Interview Schedules

For the pretraining interviews with SENCos and mental health leads, we developed a topic guide about current practice ( Multimedia Appendix 3 ) with the specific purpose of creating Mental Health Resource Maps for each school (refer to the Procedures section). The main topics pertained to formal and informal procedures for when staff members suspect that a child might have mental health difficulties or increased risk, as well as the types of support available.

For the posttraining interviews with teachers, TAs, and strategic stakeholders (ie, those with key leadership roles, including senior leadership teams [SLTs], school governors, and SENCos and mental health leads), we developed 3 separate topic guides ( Multimedia Appendix 3 ), which were informed by our research questions, systematic reviews [ 28 , 30 ], and the Consolidated Framework for Implementation Research [ 62 , 63 ]. For teachers and TAs who completed At-Risk and strategic stakeholders, interview topics included the acceptability of the training, the practicality of implementing it in schools, the utility of further refinement and testing, possible harms associated with the training (if any), and suggestions for adaptations. For teachers and TAs who did not complete the training, topics included reasons for not completing it, barriers to acceptability and practicality, and suggestions for adaptations.

Interviews With SENCos and Mental Health Leads

We conducted a pretraining interview with each school’s SENCo or mental health lead to develop a “Mental Health Resource Map” with information on referral processes and available support. These maps served an ethical purpose by ensuring that pupils identified as potentially having mental health difficulties would have the best possible chance of being linked to care and support.

Completing At-Risk

Schools’ timelines for the study varied due to the pandemic and other commitments. School D completed the training in December 2020; school E completed the training in March 2021; schools B, C, and F completed the training in May 2021; and school A completed the training in June 2021. At baseline (T1), participants completed a Teacher and TA Identification Form and the pretraining survey. They then completed the At-Risk training. We encouraged schools to designate specific time for the training, which 3 schools (schools D, E, and F) did. One week after training (T2), participants were asked to complete a second Teacher and TA Identification Form and the posttraining survey. Three months after the training or at the end of the school year (whichever came first; T3), participants completed a third Teacher and TA Identification Form as well as SDQs for all pupils. All questionnaires were completed on the University of Cambridge Qualtrics platform (Qualtrics International Inc).

Feedback Provision

After T2, we provided all SENCos and mental health leads but not teachers or TAs with feedback regarding which children had been identified as having mental health difficulties or increased risk. After T3, we provided SDQ scores for each child as well as whole-class distributions (where available). This feedback was provided to ensure the ethical conduct of the study.

Interviews With Teachers, TAs, and Strategic Stakeholders

We aimed to recruit at least 3 teachers or TAs who completed the training per school, 3 to 5 teachers or TAs who had not completed the training across all schools, and up to 3 strategic stakeholders per school for posttraining semistructured interviews. Schools contacted staff members directly with an invitation to complete a virtual interview.

Quantitative Outcomes

Analytical samples.

For the main analysis, participants were included if they (1) completed at least the pretraining (T1) questionnaires and the training itself and (2) had what we judged to be a typical number of children they regularly worked with. For the latter criterion, given that the average UK primary school class size is approximately 27 to 28 pupils [ 64 ], we excluded teachers and TAs who worked with <10 children (as we suspected this would not be a random selection of pupils and would therefore influence aggregate identification rates) and those who worked with >60 children (as we believed that it would be difficult for a teacher or TA to know >2 classes’ worth of children well enough to make accurate judgments about their mental health).

Teacher and TA Self-Efficacy and Preparedness

To assess teachers’ and TAs’ preparedness, self-efficacy, and perceptions of training impact, we calculated the absolute and relative frequencies of responses to the pre- and posttraining surveys. Participants were eligible for inclusion in this analysis only if they had pretraining (T1) data.

Identification Outcomes

On the basis of the Teacher and TA Identification Forms, we calculated the number and percentage of pupils in each class whom teachers and TAs perceived as having mental health difficulties or increased risk at each time point. We summarized these across all participants using medians and IQRs.

We then calculated SDQ scores, which we compared with responses from the Teacher and TA Identification Form by calculating (1) the median and IQR for the percentage of children identified by participants who did not have elevated SDQ scores and (2) the median and IQR for the percentage of children with elevated SDQ scores who were not identified by participants. To be included in these analyses, participants had to have completed all 3 time points. For the first outcome, they had to have completed an SDQ for all children they identified in the Teacher and TA Identification Form . For the second outcome, they had to have completed SDQs for at least 80% of their class. Where it was possible to match pupil IDs between teachers and TAs, we pooled SDQ data such that, if one participant did not meet the inclusion criteria themselves, they could still be included if the SDQ data were available from another staff member working with the same children.

Mental Health Support Outcomes

Finally, for each time point, we calculated medians and IQRs for the proportion of identified children with each of the 9 mental health support outcomes (refer to the Teacher and TA Identification Form section for the outcomes) .

Sensitivity Analyses

We also conducted 2 post hoc sensitivity analyses. The first sensitivity analysis excluded all participants from school D. When we prepared feedback for school D (the first school to complete the training), we learned that most participants at the school had misinterpreted the Teacher and TA Identification Form. We edited the form and instructions accordingly to address this issue, but therefore, school D participants completed a slightly different form than the other schools. The second sensitivity analysis was a complete case analysis intended to explore observed differences in outcomes according to whether participants had completed all 3 time points. For the analysis of outcomes pertaining to preparedness, self-efficacy, and perceptions of training impact, we included all participants who completed the surveys at least at T1 and T2.

Statistical Analysis

For all quantitative outcomes, we focused on preliminary, descriptive comparisons across the 3 time points and did not perform any formal hypothesis testing. This aligns with established recommendations for feasibility studies, which generally lack the statistical power necessary for a clear interpretation of hypothesis-testing results [ 65 - 68 ]. We conducted all quantitative analyses in R (version 4.0.3; R Foundation for Statistical Computing) [ 69 ] except for the comparison of Teacher and TA Identification Forms and SDQ scores, for which we used Microsoft Excel (Microsoft Corp). We created all plots using the ggplot2 [ 70 ] and likert packages [ 71 ]. To score the SDQs, we used the freely available R code on the Youthinmind website [ 72 ].

Qualitative Outcomes

We considered 3 analysis approaches for the interview and qualitative questionnaire data: content analysis [ 73 ], framework analysis [ 74 ], and reflexive thematic analysis [ 75 , 76 ]. We initially decided to use content analysis for the survey comments and reflexive thematic analysis for the interviews; however, as we familiarized ourselves with the data, we realized that there was significant overlap between the survey comments and interviews and decided that analyzing them separately was not a useful distinction. As our main aim was to generate insights into the program and its future potential, we decided to use the 6-phase reflexive thematic analysis by Braun and Clarke [ 76 ] for all qualitative data due to its flexibility and ability to generate themes both inductively and deductively. ES developed the initial themes, and MF and EH helped clarify and enrich them. ES and MF worked together to name and refine the themes before the final write-up. We managed and coded all qualitative data in ATLAS.ti (version 9.1.3; ATLAS.ti Scientific Software Development GmbH) and additionally created manual thematic maps to better visualize and understand patterns between our data.

Ethical Considerations

This study was approved by the University of Cambridge Psychology Research Ethics Committee (PRE 2019.076). We obtained active informed consent from all teachers and TAs who took part in the study. We used an opt-out model for parental consent whereby parents received (directly from the schools via their preferred communication routes) an information sheet detailing study aims, procedures, how data would be used, and the right to opt their child out of participation. Parents had 2 weeks to opt their child out of the study by returning a hard copy of the opt-out form or emailing or calling the school. Schools kept track of all opt-outs and instructed teachers and TAs not to include these children in their forms. All quantitative data were collected using anonymous pupil and staff identifiers generated by the participating schools, and all qualitative data were deidentified before analysis, with identifiable information stored on secure servers at the University of Cambridge. Teachers and TAs received £20 (approximately US $28) vouchers for completing the training and questionnaires for at least 2 of the 3 time points and an additional £10 (approximately US $14) for taking part in an interview. School staff members who created the anonymous identifiers received £10 (approximately US $14) vouchers to thank them for their time.

Participants

A total of 6 schools participated in this study (Table S1 in Multimedia Appendix 4 [ 40 ]). Among these 6 schools, there were 4 (67%) from Cambridgeshire and 1 (17%) each from Greater London and Merseyside; 5 (83%) were located in urban areas and 1 (17%) was located in a rural area. All but 1 school (5/6, 83%) were situated in areas of above-average deprivation, and 50% (3/6) of the schools had a higher-than-average proportion of pupils eligible for free school meals. In total, 67% (4/6) of the schools had a high proportion of White pupils (>80%), and 33% (2/6) of the schools were more diverse, with approximately 20% of pupils from Black, Black British, Caribbean, or African backgrounds (school B) or Asian or Asian British backgrounds (school E).

A total of 108 teachers and TAs completed the T1 questionnaires and the training itself, 89 (82.4%) completed the T2 questionnaires, and 70 (64.8%) completed the T3 questionnaires ( Table 1 ), with 54 (50%) having completed all 3. After excluding those teachers and TAs who did not meet the inclusion criteria for the analyses, the final analytical samples were as follows:

• Main analysis of identification and mental health support outcomes: n=97 at T1, n=75 at T2, and n=57 at T3.
• Main analysis of preparedness, self-efficacy, and training impact outcomes: n=107 at T1 and n=83 at T2.
• Main analysis comparing identification outcomes with SDQ scores: n=28 and n=25 (refer to the following section).
• Complete case sensitivity analysis: n=51 at T1, T2, and T3.
• Sensitivity analysis excluding all teachers and TAs from school D: n=70 at T1, n=54 at T2, and n=41 at T3.

Compared with the 2019-2020 national workforce statistics for teachers and TAs working in state-funded nursery and primary schools [ 77 ], our sample had a similar proportion of women (81/89, 91% in our sample vs 90.9% nationally) and a slightly higher proportion of White staff members (82/89, 92% in our sample vs 90.5% nationally).

A total of 7.4% (8/108) of school staff members from 67% (4/6) of the schools completed an interview ( Table 2 ).

a N=89 because this information was collected only at T2.

b N NA =4 (number with missing data for this question).

c Percentages add up to >100 because some participants had multiple roles.

d SENCo: special educational needs coordinator.

e N NA =7 (number with missing data for this question).

a PSHE: Personal, Social, Health and Economic.

b SENCo: special educational needs coordinator.

c TA: teaching assistant.

d HLTA: higher-level teaching assistant.

Pretest-posttest changes suggested that participating in the training was beneficial for the staff and that they had positive perceptions of the training. Findings regarding preparedness ( Figure 2 ) suggest improvements across all domains of recognizing and acting upon concerns about pupils’ mental health, particularly in terms of using key communication strategies and working with parents. Findings regarding self-efficacy ( Figure 3 ) suggest that participants were more confident in their abilities to discuss their concerns about pupils’ mental health after the training than before. Again, the largest changes were observed in discussing concerns with parents and applying key communication strategies. Finally, findings regarding teachers’ and TAs’ perceptions of the impact of applying the skills of the training ( Figure 4 ) suggest that they were generally positive about the possible effects of the training on pupil outcomes (ie, attendance and academic success), teacher-pupil rapport, and the classroom environment. The results from the complete case analysis ( Multimedia Appendix 5 ) were nearly identical to those of the main analysis (all differences were ≤3 percentage points in magnitude).

In terms of how many pupils were identified as having mental health difficulties or increased risk, participants identified similar proportions of their pupils before and immediately after the training and then fewer over time. The median percentage of pupils whom participants believed had mental health difficulties or increased risk was 10% (IQR 6.7%-18.2%) at T1, 10% (IQR 4.5%-16.7%) at T2, and 7.4% (IQR 5.0%-16.7%) at T3. The directions of change were similar for both sensitivity analyses (whereby teachers and TAs identified fewer children over time), with slight differences. For the sensitivity analysis excluding school D ( Multimedia Appendix 6 ), the percentages were slightly (approximately 2 percentage points) higher. For the complete case analysis, the decrease was also notable 1 week after the training, decreasing from 10% (IQR 6.7%-17.3%) at T1 to 8% (IQR 3.9%-16.7%) at T2 and 7.4% (IQR 5.7%-16.7%) at T3.

In terms of the accuracy of identification, it seems that teachers and TAs became slightly more accurate over time in comparison to pupils’ SDQ scores (although it is important to acknowledge the limitations described in the Methods section regarding questionnaire comparability). The median percentage of children identified by participants who did not have elevated SDQ scores was 40% (IQR 0%-50%) at T1, 27.2% (IQR 0%-50%) at T2, and 25% (IQR 0%-50%) at T3. The median percentage of children with elevated SDQ scores who were not identified by participants was 68.8% (IQR 42.9%-87.5%) at T1, 66.7% (IQR 50%-88.2%) at T2, and 57.1% (IQR 33.3%-87.5%) at T3. In the sensitivity analysis excluding school D, the results were similar (typically within 5 percentage points); one small difference was that the median percentage of children identified by teachers and TAs who did not have elevated SDQ scores was 0% (IQR 0%-50%) at T2. The results of the complete case analysis were identical to those of the main analysis.

Overall, the findings suggest that the training may be beneficial for facilitating conversations and access to school-based support (but not external support) for pupils with identified mental health difficulties or increased risk. Figure 5 presents the findings for the 9 mental health support outcomes among identified children across the 3 study time points. As with before the training, there was typically a wide variation in outcomes.

A comparison across time points suggests that participants formally documented their concerns and spoke with the SENCo, pastoral lead, or mental health lead for a greater proportion of identified pupils after the training than before. For example, at T1, teachers and TAs documented concerns for a median of 50% (IQR 0%-100%) of identified pupils; this increased to 56.3% (IQR 4.2%-100%) at T2 and 75.7% (IQR 0%-100%) at T3. The equivalent statistics for speaking with the SENCo, pastoral lead, or mental health lead were a median of 66.7% (IQR 16.7%-100%) at T1, 75% (IQR 50.0%-100%) at T2, and 95.5% (IQR 50.0%-100%) at T3. There was no change in speaking with another staff member, but this was because nearly all participants did so across all time points. Finally, the percentage of pupils whom teachers and TAs spoke with (or whose parents they spoke with) also increased after the training, with a median of 33.3% (IQR 0%-87.5%) at T1, 61.9% (IQR 0%-100%) at T2, and 50% (IQR 0%-100%) at T3.

A comparison across time points also suggests increases in school-based support for identified children after the training compared with before. The median percentage of pupils identified by teachers and TAs who received in-class support increased from 75% (IQR 35.4%-100%) at T1 to 100% at T2 and T3 (IQR 50%-100% and 66.7%-100%, respectively). There was a more modest increase in the receipt of in-school support or in-house support plans, with a median of 40% (IQR 0%-71.4%) of identified pupils receiving them at T1 compared with 50% at T2 and T3 (IQR 3.6%-100% and 8.3%-81.4%, respectively). There was very little change in documented SEMH status or referral or access to specialist mental health services. For each of these outcomes, the median percentage of identified pupils was 0% across time points.

The findings from the sensitivity analyses were similar to those of the main analysis in terms of direction, although improvements across time in the complete case analysis ( Multimedia Appendix 5 ) tended to be more modest than for the main analysis.

Acceptability and Practicality

Quantitative findings.

Quantitative data from the posttraining survey showed that participants were generally positive about the training. Of the 83 participants who completed the survey, 53 (64%) rated it as “good” and 13 (16%) rated it as “very good.” An additional 17% (14/83) rated it as “fair,” 2% (2/83) rated it as “poor”, and 1% (1/83) as “very poor.” A total of 84% (70/83) of the teachers and TAs said that the scenarios in the training were relevant to them. Finally, most participants (74/83, 89%) would recommend the training to other educators.

Qualitative Findings

Qualitative data also suggested that school staff generally found the training practical and acceptable. We generated three themes from our survey and interview data:

• Individual fit: positive perceptions, self-efficacy, and change.
• Institutional fit: alignment with school values and context.
• Taking it forward: improvements and implementation.

Additional findings on possible harms are presented in Multimedia Appendix 7 .

Individual Fit: Positive Perceptions, Self-Efficacy, and Change

In general, participants perceived the program to be a “good fit” with their personal philosophies and practice. Regarding the training itself, many appreciated the included scenarios, particularly in terms of their relevance to their practice. The format of the training—primarily that it was web-based and required active role-play—was also viewed as useful, engaging, and novel and might have contributed to its perceived usefulness. For example, one teacher commented:

The interactive elements of the training were brilliant and something which I have never encountered before! [Survey respondent (SR) 56; school E]

One teacher and well-being lead described:

I think it definitely made you think. [...] you had to really think about what was being said and the response that you would give, reflecting back on sort of the knowledge that they’d given you beforehand, so I thought that was good. [Interviewee 1]

Other participants suggested that opportunities to practice skills during the training improved the likelihood of using those skills in day-to-day practice.

Participants also believed that they had learned a lot from the training, especially in terms of skills and strategies. These included but were not limited to the skills within the At-Risk “EASING” strategy (check your Emotions, Ask for permission, be Specific, use I statements, keep it Neutral, and show Genuine curiosity). Importantly, there was evidence that participants had also applied new skills. Several participants described having new conversations with pupils or parents facilitated by the skills and strategies from the training. For example, one teacher described:

It was that permission thing [...] I wanted to ask [a child] about his home life [...] and kind of he just cried and didn’t want to speak about it anymore, and then when I asked him if we were OK to talk about it, he said, “Actually no, because I think I’m going to cry again,” so then we left it. And then he came to me the following week, and [...] said, “Can we talk about it now?” [...] so actually me asking that, it was the wrong time for him to talk about it, he wasn’t ready, he would have just been emotional, and wouldn’t have been able to get his words out, and actually the week after, him coming to me and saying, “Can we have a little chat,” works perfectly [...] And now we’re more aware of his situation. [Interviewee 2]

This skill seems to have enabled this pupil to have this conversation with the teacher in a manner (in terms of time, place, and identified person) that suited him. Other participants provided similar examples, referencing how skills from the training had facilitated better outcomes.

However, it is important to note that the perceived usefulness of the training varied. Most notably, some participants indicated that their previous training or role made the training less impactful. Illustratively, when asked how the training had impacted their practice, one TA responded:

Having previously received similar training, due to my role, I do not have any recent cases where the training would have changed the way I carried out discussions. [SR 60; school E]

Institutional Fit: Alignment With School Values and Context

Sustainable school-based programs should also align with the values of the school more broadly. Participants often referenced the importance of schools’ prioritization of pupil mental health. For example, one teacher described:

[Mental health is] a conversation which is constantly ongoing and trying to constantly better our practices and make sure we’re looking after them as best as we can and spotting things as best we can as well. [Interviewee 3]

This description demonstrates how prioritizing mental health can promote the critical evaluation of related school practices as well as the additional provision of training opportunities. In many cases, support from the SLT led to formal recognition of pupil mental health within school policies or plans. One strategic stakeholder explained:

I think because our school have well-being and mental health as such a focus, SLT are very supportive of doing things like this and they’re very accommodating. So when I said we had the training and people were going to have to take part in the training, it was very flexible, although they had other ones lined up, they were quite happy to move things around to make things work. And I think, the fact it is such a priority in our school definitely makes that easier. [Interviewee 1]

In this school, mental health and well-being were one of three main school priorities. As indicated previously, direction setting from the SLT is key to ensuring momentum and impetus. However, as others noted, it is important that support from the SLT is genuine rather than being “just another tick box” (Interviewee 4) exercise.

Another facet of institutional fit pertained to the practical aspects of the training. Schools are time- and resource-limited settings, so mental health training needs to fit within this context. The format of At-Risk, especially its flexibility and relatively low time requirements, was viewed as beneficial, with comments such as “For the amount of time [...] I got a huge amount from it” (Interviewee 4). Others made direct comparisons with other training courses. For example, one higher-level TA had previously completed a 1-day, in-person training course with a similar purpose to that of At-Risk. While she preferred the in-person training, she listed the benefits of both types:

[In the in-person training] you can then query and question to your trainer, so you’ve got that interaction, so that obviously isn’t there, is it, on the computer one. [...] if I was looking from a management point of view, I would say, budgetary, I’m sure it’s cheaper [...] to use [At-Risk], not just cheaper as in [...] money, [...] but also cheaper in time [...] So probably if I was looking [...] with my management hat on, I would say the computer-based [training] would get the same message, or similar message, across for a wider audience for probably a cheaper cost. [Interviewee 7]

In terms of efficiency, this participant highlighted the favorable input-to-output ratio of At-Risk , which could allow more staff members to participate in training. This quote also highlights that schools could use At-Risk flexibly. For example, schools might assign staff members to different training programs based on their roles and previous experience, with more intensive, in-person training for staff members with more significant mental health roles and At-Risk for those with fewer responsibilities or less experience.

Taking It Forward: Improvements and Implementation

Participants offered key insights into how to take the training forward in terms of both changes to the training itself and how best to implement it, primarily by tailoring it to the UK context. In terms of language, there was some reference to the American accent, but more so, participants highlighted the need to adapt some of the terminology and signposting resources to reflect UK support systems. They also made suggestions about additional training that could be useful with different topics (such as bullying) and age groups (particularly for younger children).

In addition to improvements and adaptations to the training itself, participants illustrated the importance of implementation. A common theme was that, to maximize impact, the training should include follow-up discussions or live workshopping. One teacher suggested:

I think some kind of “live” element to conclude the training—to have a “real” person to ask questions to as part of a group video chat could have been useful. Also, maybe to ask advice about particular scenarios that we may have found ourselves in in the past. [SR 56; school E]

By facilitating greater engagement and critical thinking, a live element could enhance the impact of the training and potentially make At-Risk more acceptable to those who generally prefer face-to-face training. Participants indicated that someone internal, for example, the SENCo, would be best placed to lead a live element and would enable staff to practice role-playing based on situations and scenarios specific to each school.

There was also wide acknowledgment that any training had to lie within a strong support system. This began with having a clear referral pathway for identified concerns, which was viewed as important for facilitating access to support. In some cases, teachers and TAs were able to find new ways to support children after completing the training. However, in many cases, participants—and strategic stakeholders in particular—explained that support had not always been readily available. For example, one strategic stakeholder recounted what happened after the training:

A lot of them are people saying to me, “What are you going to do about it?” about different children. And I, because some of our support staff don’t know the sort of route for getting extra support, or they’re really shocked to find actually there’s nothing out there for these children...it’s about what we can do in school, and I think people have been really quite shocked about that. You know, they just presume I can make a phone call and these children will get face-to-face counselling. [Interviewee 5]

This shows the importance of embedding the training within a wider support system, including collaboration with external agencies. However, many interviewees referenced the systemic issues that schools face in helping pupils access specialist support, particularly in terms of the high thresholds and long waiting lists that exist for many external services. While schools may be able to provide beneficial support for children, particularly for those with lower-level difficulties, this indicates an ongoing area of need for schools and their pupils.

Summary of Findings

This study offers the first UK evidence for Kognito’s At-Risk for Elementary School Educators , extending findings from 3 US-based trials and providing needed evidence regarding the potential utility, acceptability, and practicality of brief, interactive web-based mental health training for school staff. Overall, the findings showed that At-Risk is a feasible means of improving the identification of and response to pupil mental health difficulties in UK primary schools. Quantitative findings showed that staff preparedness and self-efficacy in identifying and responding to mental health difficulties increased after the training. Identification rates did not increase (and, in fact, decreased at the 3-month follow-up), but there was some suggestion that teachers’ and TAs’ identification became slightly more accurate in comparison with SDQ scores. Crucially, for those pupils identified as having mental health difficulties or increased risk, in-school mental health support outcomes (ie, documentation or discussion of concerns, conversations with pupils and parents, and in-class and in-school support) increased after the training, but more “downstream” outcomes (ie, documented SEMH status and referral and access to external mental health services) did not. Qualitative findings indicated that participants generally found the training acceptable and practical, with many explaining how they intended to use or had already used the skills they learned to improve their practice. Participants also suggested several useful improvements for the training and its implementation, including making it more relevant to the United Kingdom, adding more scenarios, and including a live element in the implementation of the training.

Findings regarding confidence and preparedness reflect those of the 3 US-based studies of At-Risk [ 17 , 41 , 42 ] and the wider literature surrounding teacher mental health training [ 31 ]. In general, mental health training seems to be effective in improving staff confidence. For example, 2 Australian-based studies [ 37 , 78 ] found that secondary school teachers who completed training felt more confident discussing their concerns and helping pupils with their mental health. Another UK-based study of a psychoeducational training program to improve recognition of depression in secondary schools [ 79 ] found significant pretest-posttest improvements in teacher confidence in their knowledge of symptoms, ability to recognize symptoms, and knowledge about how to speak with pupils about their mental health. However, not all studies have shown an impact, with a prominent UK-based study of mental health first aid training finding no effect on educators’ confidence in helping pupils with their mental health [ 80 ].

The general decrease in the proportion of pupils identified as having mental health difficulties or increased risk stands in contrast to previous studies of At-Risk , which found that school staff identified significantly more pupils of concern after completing the training [ 17 , 41 ]. Evidence of the effect of other training programs on identification is extremely limited [ 30 , 31 , 36 ], and differences in context, training content and delivery, baseline knowledge, and outcome measurement make it difficult to compare findings across studies. Two vignette-based studies showed little effect of either mental health first aid [ 78 ] or psychoeducational [ 81 ] training on identification (although each study also reported high recognition of difficulties before the training), whereas studies focused on real-world identification have shown mixed results [ 79 , 82 ]. However, changes in the proportion of identified pupils must be contextualized within the accuracy of identification. There are consequences of both over- and underidentification [ 83 , 84 ], most notably in terms of inefficient allocation of limited mental health support resources. While comparison with the SDQ suggested that there was some improvement in terms of the accuracy of identification following the training, underidentification remained a substantial challenge, with between one-half and two-thirds of pupils with elevated SDQ scores remaining unidentified by teachers and TAs. The underidentification of children with mental health difficulties in educational settings, particularly for children with internalizing as opposed to externalizing problems [ 85 ], has been well documented in the literature [ 30 ], and it is likely that a combination of identification models is required to address this challenge [ 27 , 29 ].

Promisingly, the training appeared to be useful in terms of connecting pupils with care and support, an outcome not frequently measured in other studies [ 30 , 31 , 34 ]. First, the findings suggested that participants had conversations about or documented concerns for a greater proportion of identified pupils following the training, which reflects findings from previous studies of At-Risk [ 17 , 41 ]. This is a rather unique outcome in the literature as other training evaluations have found no difference between training and control groups in terms of conversations with pupils and colleagues [ 78 ]. Importantly, this study went beyond conversations to include outcomes pertaining to in-school and external support. The increases in in-class and in-school support for identified pupils reflect findings of the UK-based study by Kidger et al [ 80 ] of mental health first aid training and the Australian-based pilot study by Parker et al [ 37 ] of a web-based training program, each of which found a positive effect of the training on helping behaviors. Although in-class and in-school support seemed to increase following the training, it is notable that referrals and access to specialist services did not. There are several plausible explanations for this finding. For example, it is likely that school staff were already aware of children with the most severe mental health difficulties and were confident and able to support newly identified pupils—who might have had lower-level mental health difficulties—within the school setting. However, if the training did lead to the identification of children who might benefit from specialist care, there are many barriers to accessing such support (eg, availability and long waiting lists) that might have influenced these outcomes, as reflected in both the qualitative interviews and the wider literature [ 23 , 86 ].

In addition, quantitative and qualitative findings suggested that the program was a good fit for individuals and schools, which aligns with previous research on the acceptability and perceived need for mental health training for school staff [ 18 , 20 , 27 - 29 , 87 , 88 ]. The training’s format seemed to be a key contributor to its feasibility. With a few exceptions [ 37 , 39 , 89 ], the web-based simulation-based format of At-Risk is unique among training programs and is well aligned with teachers’ preferences. For example, in their focus group study of UK secondary school teachers, Shelemy et al [ 20 ] found that participants wanted engaging, interactive, and concise training that included practical strategies and illustrative case studies, all of which are central to At-Risk . While the authors found that teachers disagreed over the usefulness of web-based training, it is possible that these concerns would have decreased during the COVID-19 pandemic as staff became more accepting of web-based opportunities to learn.

Qualitative findings also demonstrated the importance of school context and culture, which have been highlighted in previous research [ 27 ]. In particular, participants noted the importance of school culture in adopting mental health interventions into regular practice. In their systematic review, Moore et al [ 90 ] identified school culture, values, and policies as key facilitators of sustaining mental health interventions. A related area of focus was support from the SLT. This support is a well-recognized factor contributing to intervention success and sustainability for several reasons, including these leaders’ practical role in communicating about interventions and allocating specific time and resources to them [ 43 , 90 , 91 ]. However, it is important to recognize that mental health training for school staff may be even more needed and impactful in schools where mental health is not as much of a priority.

Limitations

Our mixed methods approach, wide range of outcomes, and diverse sample of participating schools offer rich information regarding the feasibility of At-Risk in the United Kingdom. These strengths notwithstanding, there are also several limitations to consider when interpreting the findings. The nonrandomized design, while common for feasibility studies, prevents any conclusions regarding causality and also limits the exploration of other factors that may have influenced outcomes (eg, providing teachers and TAs with the Mental Health Resource Maps or SENCos and mental health leads with feedback on identified pupils). In terms of recruitment and retention, the study had 50% (54/108) attrition. Several factors may have influenced this, including the increased pressure on school staff due to the COVID-19 pandemic, the timing of the study within the school year, and the requirement to communicate with participants only via the study link person. While we tried to explore the effect of attrition through a complete case sensitivity analysis, we lacked important information on the characteristics of those who dropped out as this information was collected only at T2. Furthermore, we were only able to recruit 8 staff members for the posttraining interviews, which was far below our recruitment target. Low participation rates could again be due to several factors, including the impact of the COVID-19 pandemic or competing priorities. Of note, we were not able to recruit anyone who did not complete the training, any headteachers, or any staff from 2 of the schools (schools A and D). This could mean that we lack viewpoints that may be important for understanding the feasibility and utility of the training.

There were also limitations associated with the study measures. While the Teacher and TA Identification Form was informed by the literature and reviewed by our primary school staff advisory group, its validity and reliability are unknown. In addition, the questionnaire only measured mental health support outcomes for those pupils identified as having mental health difficulties or increased risk. Therefore, we do not have information on those who were not identified. The measure is also based on teacher and TA reports and so may not have complete information about all types of support that pupils receive. Another important limitation pertains to the comparator used to assess the identification outcomes. To understand the potential utility of the training program, it is important to have a robust comparator. While we chose to use the teacher-report SDQ, it would also have been interesting to compare identification outcomes with parent-rated mental health difficulties, particularly in light of the low interrater agreement of common measures of child mental health difficulties [ 92 ]. An even stronger comparator would be to assess the teacher and TA identification outcomes against a clinical interview; however, this was not feasible in this study.

Finally, at the time of writing, At-Risk is currently not available for use as Kognito restructures its offerings. This demonstrates a trend that unfortunately is a common occurrence in the field of mental health, whereby many evidence-based digital tools are not available to potential end users [ 93 ]. Nonetheless, the learnings from this feasibility study offer rich information on what type of content and format may be useful for training programs in this area and, as such, can support further development and evaluation in the field.

Implications for Practice

Studies have consistently demonstrated that school staff would appreciate additional training on how best to support pupil mental health [ 18 , 20 , 87 , 88 ]. However, to be scalable, such programs must be realistic in terms of time, cost, and resource requirements [ 28 , 90 , 91 ]. Contextualized within the wider literature on school-based mental health interventions, the findings from this study suggest that mental health training is a feasible option for upskilling school staff to identify and respond to pupil mental health difficulties. They further highlight several specific factors that might positively contribute to feasibility and scalability, many of which are reflected in the broader literature on mental health training [ 20 , 28 ]. For example, teachers and TAs appreciated that the training actively engaged them in learning and applying new skills and that it used realistic examples to demonstrate the real-world applicability of the training, whereas school leaders identified the relatively low time and cost requirements and flexibility as key factors that could make the training feasible for their school context.

However, this is not to say that there are no implementation barriers associated with At-Risk or similar training programs. While the resources required to implement At-Risk are relatively low compared with other training programs, they must still be considered within the context of other school priorities. As demonstrated in the interviews and the wider literature [ 3 , 43 , 90 , 91 ], support from school leadership is essential for securing the time and budget required to implement a training such as At-Risk , and in schools where mental health is not a priority, there are likely to be many barriers to implementation . Even in schools with strong support from the leadership team, it may be difficult to find the requisite budget, time, and human resources to devote to the training. Finally, as is the case with any school-based mental health intervention, it is important that schools do not take sole responsibility for pupils’ mental health. Active partnership between schools and mental health services is key to ensuring that schools feel empowered and supported in this role [ 21 , 90 , 94 ]. While the schools in this study worked hard to support pupils as best they could, interviewees expressed frustration about the difficulty of accessing external support for children who could benefit from it. This is not an uncommon theme in the wider literature surrounding school-based interventions [ 20 , 23 , 91 ] and is a key consideration for scaling up training programs.

Implications for Future Research

The promising findings of this study suggest that additional research is needed to explore the role of scalable mental health training in supporting schools to protect and promote children’s mental health. On the basis of gaps in the literature, particular areas of interest include training for primary school staff (as most are focused on secondary school staff), web-based training (as opposed to traditional time- and resource-intensive in-person training), and training that takes a “whole school approach” by including all school staff members (rather than only teachers). This final area is especially interesting as findings from this study and others [ 27 ] have highlighted stakeholders’ preference that training programs include all school staff members. While our study jointly analyzed findings for teachers and TAs, future research would do well to consider how the unique roles and perspectives of these professionals—as well as other staff members within the school setting—might influence outcomes. Furthermore, future research should be more inclusive about their choice of outcomes, as too often evaluations of school staff training programs have focused on intermediate outcomes such as knowledge or confidence [ 31 ] without considering more “downstream” outcomes such as access to support. Finally, as demonstrated in our study, there is great value in using mixed methods approaches and including information about wider issues of feasibility and implementation, and studies that take this broader lens can help identify programs that are scalable, sustainable, and effective.

Conclusions

School staff would welcome additional mental health training to enable them to respond to pupil mental health difficulties, but there are many barriers to implementing such training at scale. Therefore, training programs that have relatively low time and resource requirements have great potential to fulfill an unmet need in schools. This mixed methods feasibility study showed that At-Risk for Elementary School Educators —an example of a brief, interactive web-based training program—is a feasible means of empowering school staff to accurately identify and respond to pupil mental health difficulties and increased risk.

Acknowledgments

The authors would like to thank Professor Paul Ramchandani for his input in the design of this study, the Cambridge Mental Health in Schools Advisory Group for sharing their views and advice throughout the study, and the staff at the 6 schools that took part in this study for their time and effort. This study was funded by the UK Research and Innovation Emerging Minds network (grant ES/S004726/2), and the training was provided to the schools free of cost by Kognito. ES was funded by a Gates Cambridge Scholarship (grant OPP1144) for the duration of the study. MF is funded by the National Institute for Health and Care Research (NIHR) Oxford and Thames Valley Applied Research Collaboration at the Oxford Health National Health Service (NHS) Foundation Trust. PBJ is funded by the NIHR (grant 0616-20003). All research in the Cambridge Department of Psychiatry is supported by the NIHR Applied Research Collaboration East of England and the Cambridge Biomedical Research Centre at the Cambridgeshire and Peterborough NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, or the Bill & Melinda Gates Foundation.

Data Availability

The data sets generated during and analyzed during this study are not publicly available due to restrictions associated with our ethics approvals but are available from the corresponding author on reasonable request.

Conflicts of Interest

Kognito is a for-profit company. After reviewing their questionnaires on preparedness and self-efficacy and having found them rigorous and unbiased, we independently decided to include them as outcomes in our study. Kognito had no role in the study design, analysis, or publication. PBJ was a scientific advisory board member for MSD. All other authors declare no other conflicts of interest.

Teacher and Teaching Assistant Identification Form.

Kognito pre- and posttraining surveys.

Interview topic guides.

School characteristics.

Results from complete case sensitivity analysis.

Results from the sensitivity analysis excluding school D.

Quantitative and qualitative findings pertaining to the potential harms of At-Risk.

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Abbreviations

Edited by T Leung; submitted 24.02.23; peer-reviewed by E Widnall, B Fernandes, J Burns, K Cohen; comments to author 27.08.23; accepted 01.03.24; published 23.04.24.

©Emma Soneson, Emma Howarth, Alison Weir, Peter B Jones, Mina Fazel. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 23.04.2024.

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