specialization has commonly led to intensive elaborations of highly specific methods to extract information in minute detail from closely defined phenomena. In some ways, anthropology is in competition with these trends and has to accommodate the assumptions and the biases behind those paradigms. Much of the research conducted in medical schools, research institutes, and corporate research and development laboratories focuses on well-defined (mostly quantitative or probabilistic) boundaries within established disciplines. In the context of both multidisciplinary (multiple disciplines individually focused on a problem at the same time) and transdisciplinary (approaches that synthesize across disciplines) traditional disciplines can form synergistic relationships that unify results from the laboratory to the everyday human condition. In this context, the anthropological approach is often described as inductive research which attempts to build (or find, or identify) theory during the data gathering process. Atheoretical or emergent theory studies conducted by sociologists (cf. Corbin & Strauss 1990), or anthropologists (cf. Agar 1980; Spradley 1980) start out with very few assumptions about how the phenomena to be studied fit together to produce explanatory schema. This lack of assumptions (an attempt at neutrality, if not objectivity) allows the investigator to collect information and examples of the studied phenomena wherever and in whatever condition they may be found, without making a priori assumptions about what should be, or must be, or ought to be found. For example, in a study of needle use among injecting drug users (IDUs), it became clear through participant observation that needle “sharing” was inadequate as a descriptive term for use of contaminated injection paraphernalia (Page 1990) because the term sharing suggested an exchange or mutual use of the injection equipment. By not accepting the “sharing” gloss which had general acceptance among health researchers before going into the field, it was possible for the investigator to identify more accurately the kinds of risky behavior that took place among IDUs. These behaviors included use of “pooled” syringes (Page et al. 1990), transfer of drugs from syringe to syringe (Inciardi and Page 1991), use of common water containers (Page et al. 1990) and cookers, and cottons. In fact, sharing in the sense of passing a used needle from one person to another did not occur in any of the observational settings reported in these articles. Subsequent investigations by Koester (1994) and Jose et al. (1993) have supported the development of a theoretical concept of “indirect contamination” by these and other means. On a practical level, when drug users were told to “not share needles,” they could reply that they were not sharing, yet they were still becoming infected. The successful prevention campaigns that resulted from this applied approach were modified to fit the reality of the risks, so eventually people were cautioned to not share directly or indirectly, with considerably more success than the old messages that were not effectively changing behavior.
USING THEORY AND APPLYING METHODS: THE MARRIAGE OF MIDRANGE THEORY AND THEORETICALLY DRIVEN METHODS TO ACCOMPLISH CHANGE
There is a crucial relationship between theory and methods in all of the social sciences. In applied medical anthropology, the theory–methods connection is primarily associated with testable midrange theory, rather than with the broader grand anthropological theory discussed above. Applied ethnographic methods are the primary levers by which medical anthropologists justify moving the world a little closer to where it ought to be. The theory provides a framework for understanding and praxis, while the methods provide a transparent and defensible process for linking theory with reality. This linkage also helps address the question of “whose vision of” ‘ought to be’ is one that is finally implemented, ranging from top down research on public health issues to fully implemented community based participatory designs. With the possible exception of the “constant comparative method” most applied medical anthropology methods are direct decedents of focused ethnographic midrange theories with links back to grand theory.
THE IMPORTANCE OF BEING ABLE TO TELL PEOPLE HOW YOU ARE GOING TO DO SOMETHING: METHODS IN APPLIED MEDICAL ANTHROPOLOGY
Once a decision is made to conduct an applied medical anthropology project, it becomes necessary to clearly describe the basic “who, what, when, where why and how” of applied anthropological research. These elements are the core methodological components of applied medical anthropology. Theory frames the research and provides the overall direction that focuses the process. Methods become the active connection between theory and analysis. The “who” element is the sampling process (Trotter 2012). It is the systematic process for selecting the individuals and groups that are going to tell their important cultural stories and provide the basic findings that can result in some type of problem-solving applied action. The “what” dimension is the cultural domain (area of everyday life) that people are describing. The “where and when” elements of anthropological methods are the physical and temporal contexts that surround the individuals and their actions. The anthropological “how” of applied anthropology methods is a complex mix of interviewing, observations, participation, explanation, validation, and cultural learning that allows the anthropologist to match what people say and do, when they say and do it, and where these activities occur with the theory that will explain it. And finally, the “why” dimension of ethnographic methods is the opportunity for all of the participants (researchers and researched) to explain, interpret, and clarify what is happening from each stakeholders’ point of view.
There is a vast literature on human field research design, site entry, methodology, informant relationships, and the personal effects of field studies on the researcher. Older references tend to contain practical advice that is slowly being lost for new generations of more theoretically driven ethnographers. Newer works tend to assume knowledge of these classics, and expend their efforts refining theory, describing advanced methods, or defending the descriptive nature of ethnographic techniques in an increasingly quantified world. One of the earliest works describing the practical art and the science of ethnographic field studies comes from the Proceedings of the Royal Anthropological Institute of Great Britain and Ireland (Urry 1972). but also includes Kroeber’s, Anthropology Today (Kroeber 1953) which defined a significant portion of the continuing anthropological research focus for generations of ethnographic studies. However, the period circa 1970 is clearly the benchmark era for systematic methods development in US anthropological studies. This time period also coincides with the rapid emergence and impact of applied medical anthropology in the United States. The link between foundational methods training and successful application is clear. Classic works from that time describe the ethnographic research process, its effects on the researcher, and the practical conditions one could expect to encounter in the field. Examples are Epstein’s Craft of Social Anthropology (Epstein 1967), the Glazer and Strauss (1967) text, The Discovery of Grounded, and Spradley and McCurdy’s (1972) The Cultural Experience: Ethnography in Complex. These works mark the initial formalization of ethnographic studies. Other “circa ‘70” books provide behind the scenes details about field research; a necessary complement to works which describe theory and methodology, but leave out the human factor. One edited volume, Marginal Natives: Anthropologists at Work (Freilich 1977), contains a detailed history of field work theory and research designs. Other classics of this period include works with practical advice for fieldwork survival by Rosalie Wax (1971) Doing Fieldwork: Warnings and Advice; Beteille and Maden’s Encounter and Experience, Personal Accounts of Fieldwork (Beteille and Maden, eds. 1975), which contain advice about overcoming the problems of doing research in foreign countries. In a more generic vein, a seminal text which links ethnographic research with larger theoretical concerns during this time period is the Pelto’s (1978) Anthropological Research: The Structure of Inquiry. Revisions in formal approaches to ethnographic research methods, training, and theory then begin to appear on about a ten-year cycle. Jumping forward to the present, the most commonly used ethnographic methodological texts are Bernard’s (2011) Research Methods in Anthropology: Qualitative and Quantitative Approaches and Le Compte’s and Schensul (1999, 2010) Ethnographer’s Toolkit, which is a multi-authored resource set for designing and conducting ethnographic research, including essential ethnographic methods. Specific theory and methods combinations are also extensively explored in the Journal of Field Methods, which provides up-to-date discussions of both midrange (testable) anthropological theory and methods.1 These works
