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Synthesising Qualitative Research Methods (Observation and Participation) to Provide Deeper Understandings of Substance Use: A Commentary

A central tenet of qualitative research is to gain an understanding of the social worlds of others and to unpack the concomitant livedexperiences of a particular phenomenon in order to develop an appreciation of the way in which people negotiate relational aspects of daily life [1]. Accordingly, for this reason, qualitative research has been frequently used as a way of informing and developing social policy and/or issues relating to health improvement [2]. The field of substance use and drug dependency typically intersects these fields of policy and health improvement. As such, there now exists a wealth of policyfocused, substance-use related literature that may be traced back to the Chicago School of urban sociology [3].


Introduction
A central tenet of qualitative research is to gain an understanding of the social worlds of others and to unpack the concomitant livedexperiences of a particular phenomenon in order to develop an appreciation of the way in which people negotiate relational aspects of daily life [1]. Accordingly, for this reason, qualitative research has been frequently used as a way of informing and developing social policy and/or issues relating to health improvement [2]. The field of substance use and drug dependency typically intersects these fields of policy and health improvement. As such, there now exists a wealth of policyfocused, substance-use related literature that may be traced back to the Chicago School of urban sociology [3].
Indeed, qualitative research within the contemporary field of drugs and alcohol is now an established method and is employed with regularity on a truly global scale [4]. Such research, for example, typically seeks to identify strengths and weaknesses of existing drug policies; provide a critique of current drug policy or seek to inform harm reduction approaches to a particular drug-related health issue. Perhaps one of the most understated triumphs of qualitative research in modern times has been the various successes in informing the war against HIV/AIDS in which many innovative researchers have identified the social relationships and related situations that amplify opportunities for viral infection [5][6][7].
Qualitative research contains a vast array of methods within its toolkit. Amongst these are various forms of interview techniques (structured, semi-structured, unstructured, focus groups), visual methods (photography and video), ethnography and various forms of observation. However, perhaps one of the most unassuming tools within the qualitative researcher's kitbag is that of observant participation. Whilst this may be a term easily confused with the more widespread participant observation, it is equally important to emphasise that the two methods are literally (social) worlds apart in terms of their design and delivery. More accurately, the data made available from each approach are correspondingly oppositional as a result of the methodological orientation attached to each method.
In order to explain this difference, one may regard the two methods from the disciplinary standpoint of anthropology. Pike for example presents an awareness of 'etic' and 'emic' perspectives of social behaviour [8]. That is, an etic perspective typically prioritises the viewpoint from the outside of a particular social phenomenon, in which the researcher attempts to interpret agency from an external, detached position. In contrast, an emic view of the same situation will require a researcher to adopt a perspective from the inside that would interpret this worldview from this internal cultural position. Observational methods can therefore provide opportunities to obtain emic and etic perspectives, depending on the positional stance of the researcher involved. For example, Wacquant's renowned ethnographic study of an urban boxing gym provided opportunities for him to be emotionally and physically engaged with the pugilistic fraternity, through participant observation methods [9]. However, as Wacquant also states, this work also involved 'push(ing) the logic of participant observation to the point where it becomes inverted and turns into observant participation' [10]. In this regard, Wacquant became immersed within a 'learning by doing' process in which he was able to observe and experience his pugilist colleagues, but also observe and experience his corporeal 'self ' (and relationships with others) within the same ethnographic project. Whereas some may choose to regard this as a feature of 'going native' , Wacquant describes this as 'going native armed' (ibid) in which his academic and epistemic reflexivity facilitated deeper cultural understandings of living in the ghetto.
Accordingly, as noted by Tedlock, the distinction between participant observation and observant participation is one that establishes a 'representational transformation' [11]. More accurately, this transformation is one that sees the former's focus upon the reflexive self (or the centring of the other) in an ethnographic text become re-presented by an ethnographic narrative that focuses upon the corporeal and emotional relationship of the Self with the other in the latter. Wacquant further illustrates these distinctions to elaborate how participant observation within the boxing gym may have demonstrated Bourdieu's habitus theory as a topic of inquiry; but it was his observant participation within the gym that revealed habitus as a tool of inquiry, (in which the embodiment of craft and emotion interconnected with the lived experience outside of the gym in the wider world of the ghetto) [12]. In terms of a research method, this distinction may be simplified further, as participant observation essentially involves 'the acquisition of a new role in an unfamiliar setting for a given person, (whereas) observant participation prioritises existing roles in order to conduct research within familiar/unfamiliar settings' [13]. However, it is the reflexive prominence of transformational representation (and the self 's physical and emotional connection to the other) that underpins the ethnographic craft of observant participation.
To illustrate this latter distinction, one may consider the role of each method in attempting to understand the injecting practices of a cohort of street-involved people. In such circumstances, participant observation may involve the researcher adopting some form of social role within this cohort and become participant in particular drugrelated activity. However, such a radical approach to understanding injecting drug use would be unlikely to receive ethical approval (or even research funding) within UK universities! As an alternative, the researcher may adopt participant observation roles within the services and facilities frequented by/for people who inject drugs and obtain a qualitative view of injecting episodes from this equally privileged position. For example, one may become attached to an outreach service that provides sustenance to those that are roofless. In this regard, the participant observer may become privy to street-based injecting environments via this organisational attachment and therefore view the environments concerned from a distinctly etic perspective. (Additionally, this position may provide opportunities to understand the topic of Parkin's 'street-based injecting habitus') [14]. As a further alternative, the researcher may also consider observant participation as method of accessing the same target population. In this regard, the researcher would maintain the familiar role of researcher within unfamiliar settings (e.g. places/premises used for injecting purposes) with research participants who are also cohort members (people who inject drugs). For example, the observant participator may accompany people who inject drugs to street-based injecting environments and be given a commentary on how such places shape and mould the craft of injecting within [14]. In the latter case, the researcher's view may be subject to a process of representational transformation due to the way in which knowledge is created by physical co-presence, sensory perceptions, corporeal engagement with the environment and an emotional connection with Others in 'injecting places' . To paraphrase Wacquant, this physical attachment to the sensory and material world by observant participation provides opportunities for the researcher to become more familiar with the street-based injecting habitus (which involves the technique of learning by doing/feeling/sensing); as habitus becomes a tool, as well as a topic, of a more corporeal-connected ethnographic inquiry.
Indeed, the value and worth of this dual perspective became evident in the author's own ethnographic work in street-based injecting use during 2006-2012. As noted elsewhere [15], multiple understandings of injecting episodes (including social significance, relational value and assorted spatial harms/hazards) emerged from the range of qualitative methods employed. However, a synthesis of participant observation (with drug-service personnel) and observant participation (with people who inject drugs) contributed greatly towards a combined understanding of drug-related issues that was perhaps greater than the sum of findings obtained from a series of qualitative researches that may prioritise a single method of inquiry [13]. That is to say, an understanding of the craft of a street-based injecting habitus was made possible through the interrogation of emic/etic perspectives, through representational transformations as well as the shaping of an ethnographic monologue of the 'Other' that complemented the ethnographic dialogue between/with self and other.
Cumulatively these varying epistemological and ontological perspectives sought to explicate the character and process of the ethnographic encounter whilst simultaneously highlight the topic and tool of a particular form of habitus [14].
Accordingly, those currently working in the field of dependence at applied levels (whether research-related or within treatment/ rehabilitation settings) may wish to consider a similar synthesis of qualitative research methods in attempts to understand particular phenomenon. Indeed, with a more applied attention upon observant participation one would anticipate an alternative paradigm to emerge in which established understandings of particular social realities are further complemented, enriched and developed from less traditional perspectives.