Translational Behavioral Medicine

, Volume 4, Issue 2, pp 201–208 | Cite as

Using qualitative comparative analysis to understand and quantify translation and implementation

  • Heather Kane
  • Megan A Lewis
  • Pamela A Williams
  • Leila C Kahwati
Original research


Understanding the factors that facilitate implementation of behavioral medicine programs into practice can advance translational science. Often, translation or implementation studies use case study methods with small sample sizes. Methodological approaches that systematize findings from these types of studies are needed to improve rigor and advance the field. Qualitative comparative analysis (QCA) is a method and analytical approach that can advance implementation science. QCA offers an approach for rigorously conducting translational and implementation research limited by a small number of cases. We describe the methodological and analytic approach for using QCA and provide examples of its use in the health and health services literature. QCA brings together qualitative or quantitative data derived from cases to identify necessary and sufficient conditions for an outcome. QCA offers advantages for researchers interested in analyzing complex programs and for practitioners interested in developing programs that achieve successful health outcomes.


Qualitative comparative analysis (QCA) Methods for translational and implementation research Case study 


  1. 1.
    Ragin CC. The comparative method: moving beyond qualitative and quantitative strategies. Berkeley, CA: The University of California Press; 1987.Google Scholar
  2. 2.
    Ragin CC. Using qualitative comparative analysis to study causal complexity. Health Serv Res. 1999; 34(5 Pt 2): 1225-1239.PubMedCentralPubMedGoogle Scholar
  3. 3.
    Ragin CC. Fuzzy-set social science. Chicago: The University of Chicago Press; 2000.Google Scholar
  4. 4.
    Ragin CC. Redesigning social inquiry: fuzzy sets and beyond. Chicago, IL: University of Chicago Press; 2008.CrossRefGoogle Scholar
  5. 5.
    Glasgow RE, Vinson C, Chambers D, et al. National Institutes of Health approaches to dissemination and implementation science: current and future directions. Am J Public Health. 2012; 102: 1274-1281.PubMedCrossRefGoogle Scholar
  6. 6.
    Kon A. The clinical and translational science award (CTSA) consortium and the translational research model. Am J Bioeth. 2008; 8(3): 58-63.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Tufts Clinical and Translational Science Institute. What is translational science? Available at Accessibility verified July 10, 2012
  8. 8.
    Yin RK. Case study research: design and methods. 4th ed. Thousand Oaks: Sage Publications; 2009.Google Scholar
  9. 9.
    Kahwati LC, Lewis MA, Kane H, et al. Best practices in the Veterans Health Administration’s MOVE! weight management program. Am J Prev Med. 2011; 41(5): 457-464.PubMedCrossRefGoogle Scholar
  10. 10.
    Ford EW, Duncan WJ, Ginter PM. Health departments’ implementation of public health’s core functions: an assessment of health impacts. Public Health. 2005; 119: 11-21.PubMedCrossRefGoogle Scholar
  11. 11.
    Blackman T, Wistow JN, Byrne D. A qualitative comparative analysis of factors associated with trends in narrowing health inequalities in England. Soc Sci Med. 2011; 72(12): 1965-1974.PubMedCrossRefGoogle Scholar
  12. 12.
    Dy SM, Garg P, Nyberg D, et al. Critical pathway effectiveness: assessing the impact of patient, hospital care, and pathway characteristics using qualitative comparative analysis. Health Serv Res. 2005; 40(2): 499-516.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Thygeson NM, Solberg LI, Asche SE, et al. Using fuzzy set qualitative comparative analysis (fs/QCA) to explore the relationship between medical “homeness” and quality. Health Serv Res. 2011. doi:10.1111/j:1475-6773.2011.01303.x. pre-publication web version.PubMedCentralGoogle Scholar
  14. 14.
    Schneider CQ, Wagemann C. Set-theoretic methods for the social sciences: a guide to qualitative comparative analysis. Cambridge: Cambridge University Press; 2012.CrossRefGoogle Scholar
  15. 15.
    Longest KC, Thoits PA. Gender, the stress process, and health: A configurational approach. Soc Mental Health. 2012; published, online 6 July 2012.Google Scholar
  16. 16.
    Berg-Schlosser D, De Meur G. Comparative research design: case and variable selection. In RC Rihoux Benoit & C Ragin (Eds.), configurational comparative methods: qualitative comparative analysis (QCA), and related techniques. Thousand Oaks: SAGE Publications; 2009.Google Scholar
  17. 17.
    Rihoux Benoit RC, Ragin CC, eds. Configurational comparative methods: qualitative comparative analysis (QCA) and related techniques. Thousand Oaks: SAGE Publications; 2009.Google Scholar
  18. 18.
    Caren N, Panofsky A. TQCA. A technique for adding temporality to qualitative comparative analysis. Sociol Methods Res. 2005; 34(2): 147-172.CrossRefGoogle Scholar
  19. 19.
    Weiner BJ, Jacobs SR, Minasian LM, et al. Organizational designs for achieving high treatment trial enrollment: a fuzzy-set analysis of the community clinical oncology program. J Oncol Pract. 2012; 8(5): 288-290.Google Scholar
  20. 20.
    Schensul JJ, Chandran D, Singh SK, et al. The use of qualitative comparative analysis for critical event research in alcohol and HIV in Mumbai, India. AIDS Behav. 2010; 14: S113-S125. doi:10.1007/s10461-010-9736-6.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Chuang E, Dill J, Morgan JC, et al. A configurational approach to the relationship between high-performance work practices and frontline health care worker outcomes. Health Serv Res. 2012; 47(4): 1460-1481.PubMedCrossRefGoogle Scholar
  22. 22.
    Harkreader S, Imershein AW. The conditions for state action in Florida’s health care market. J Health Soc Behav. 1999; 40(2): 159-174.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Behavioral Medicine 2014

Authors and Affiliations

  • Heather Kane
    • 1
  • Megan A Lewis
    • 1
  • Pamela A Williams
    • 1
  • Leila C Kahwati
    • 1
  1. 1.RTI InternationalDurhamUSA

Personalised recommendations