Improving the Ethics Review of Qualitative Health Research: A Comparison of Review Practices and Suggestions for Improvement by Researchers and Members of Research Ethics Committees.

Most qualitative health research is subject to ethics review and approval by a research ethics committee (REC). While many studies have identified the challenges that current ethics review practices pose to qualitative health research, there is currently a call to move the research focus from the shortcomings of ethics review practices to the possibilities for improvement. The aim of this grounded theory study was to identify possibilities for improvement of current ethics review practices which can count on endorsement from qualitative health researchers and members of REC alike. To this end, we developed interventions for improving review practices through a comparative analysis of qualitative health researchers' experiences with review practices and REC members' discussions about how their review practices operate. Data collection proceeded by means of problem-centered interviews with seven qualitative health researchers and three focus group discussions with 14 REC members in Germany. Our analysis shows two overarching dimensions in the ethics review practice related to the distribution of responsibility for ethically legitimate research and the reasons for ethical concerns about qualitative health research studies. While there was disagreement about concrete suggestions for improvement, our analysis shows that researchers and REC members pursue three shared overarching aims: increasing expertise in qualitative methods among REC members and researchers, improving communication between researchers and RECs, and tailoring ethics review procedures to qualitative health research. We conclude that researchers and REC members need to promote collaboration and collegiality to ensure ethically appropriate review practices for qualitative health research.