Putting my argument up front would have made my presentation better

I attended a workshop by Nick Hopwood on presenting qualitative research. It was full of tips and strategies – check out the storify – and useful frameworks; Hammersley’s framework for critical review of ethnography (reminding me again that I need to read Hammerlsey) and Kamler and Thompson’s framework for writing abstracts from their ‘Helping doctoral students write’ book (which I promptly ordered).

‘No’ by JDAC available at https://www.flickr.com/photos/jdac/15747357176 under a Creative Commons Attribution 2.0. Full terms at http://creativecommons.org/licenses/by/2.0.
‘No’ by JDAC available at https://www.flickr.com/photos/jdac/15747357176 under a Creative Commons Attribution 2.0. Full terms at http://creativecommons.org/licenses/by/2.0.

I’m a keen reader of Nick’s blog and have used his tips for conference presentations. For my last conference however, I failed to implement one: ‘turn it upside down’; that is, state my argument at the beginning rather than pull it all together at the end. This was because I love a good mystery novel and my co-presenter wasn’t keen.

At the workshop, Nick asked us to review a recent presentation in light of what we’d just learnt. I used this last conference presentation. And funnily enough, I could see how much better it would have been if I had turned it upside down. Here’s why.

The logic for turning the presentation upside down is that it helps you achieve your key motivation for presenting at all – give the audience a clear sense of your key take-home message. If someone pulls the plug on you 10 minutes in (maybe because the previous presenter rambled on), at least they know your argument. And Nick insists the audience is less likely to fall asleep. Luckily, I got the whole 12 minutes allotted at my conference presentation, and as far as I could tell, everyone stayed awake.

After the workshop three compelling reasons to ‘turn it upside down’ occurred to me.

First, if I’d made my big statement upfront then the audience might have been more engaged, curious as to how I’m going to convince them (i.e. the mechanism for ‘the audience is less likely to fall asleep’).

Second, it would have meant the rest of the content would be more likely to be relevant to that argument and not just self-justifying waffle about methods or demonstrations of how clever and well-read I am (no of course I didn’t do that).

The best reason I could think of? Making my argument up front would have given the audience time to digest it. Usually – and indeed in my case – the key argument is in the last slide or two. That gives them about a minute to catch it and process it before the chair calls for questions. This might be the reason for the measly post-presentation discussion at so many conferences. If I’d put it up front, they would have had a whole 10 or 11 minutes to think about my argument, in context, in relation to my data, and more importantly for engagement, in relation to their experience and knowledge of the phenomena. So I’m convinced by Nick’s advice.

But there is a problem. Putting your argument up front means you have to have one. I’m not being flippant here. How many qual presentations have you been to where the main game seemed to be to describe what participants said? You get to the end and think, well gee people really thought some stuff / felt some stuff / needed some stuff. But it can be a bit meh, you’re not sure what it all means, why it matters. I find this kind of qual research depressing; I am sure I have been guilty of it.

Making an argument is scary (people might disagree with you!). Arguments involve taking a stand, saying, this is how we should think about this phenomena. They require I work to persuade you, generally through presenting evidence, like my data analysis. If you think of it, data interpretation in basically an argument. I am claiming that mine is the best (or at least, most productive) way to understand what this participant means. Moving from description to interpretation can be a difficult things students to accomplish. It requires they develop confidence in their ability to interpret (not easy at all). Some tips I give my students:

Lyn Richards uses a great metaphor in her book ‘How to handle qualitative data’ for understanding the difference between data description and interpretation:

‘Somebody’s dead, they were shot and there’s a gun on the ground’ is the beginning of the detective’s questions. We hardly expect the enquiry to end with the facts of a dead body and discarded gun.

In her book ‘How to write a journal article in 12 weeks‘, Wendy Laura Belcher draws on a similar metaphor when talking about making arguments in papers:

Present evidence that supports your case, cross-examine evidence that doesn’t support your case, ignore evidence that is irrelevant to your case, and make sure the jury always knows whom you are accusing of what and why.

So, write the lawyer’s brief not the detective’s report. Can you imagine a prosecuting barrister standing up on front of the judge and jury and not telling them who they think did it? Or, to return to my topic, holding the punchline for the end? I would speculate that if you give the argument up front the audience starts doing some of the work for you – they know where you’re going so they are looking for the links. Hey’ that’s four reasons to put your argument first.

Last piece of advice from Wendy Laura Belcher to relieve you of some argument making anxiety:

Arguments don’t need to be unassailable or bullet proof, just interesting.

Sexual risk and health care seeking behaviour in young Aboriginal and Torres Strait Islander people in north Queensland

The Indigenous Resiliency Project was part of the International Collaborative Indigenous Health Research Partnership (ID: 361621), a trilateral partnership between the National Health and Medical Research Council of Australia, the Canadian Institutes of Health Research, and the Health Research Council of New Zealand. There were parallel projects in Canada and New Zealand; together we aimed to examine the role of resilience in protecting Indigenous populations against sexually transmitted and blood-borne infections.

In the qualitative arm we conducted community-based participatory projects with two communities. Check out the findings below:

In 2010 we used the qualitative work as the basis for community surveys. Again, researchers worked closely with community, in this case the Townsville Aboriginal and Torres Strait Islander Health Service. The cross-sectional survey covered location of usual residence, recent and past sexual activity, alcohol and other drug use, history of selected health outcomes and health service utilisation. We trained five young local Aboriginal and Torres Strait Islander people in research ethics and survey methodology. These peer researchers collected surveys from Aboriginal and/or Torres Strait Islander people aged 16 to 24 years at the Townsville Show, sporting events, shopping centres, a health service open day and a NAIDOC parade and community event.

Check out what we found: Scott, R, Foster, R, Oliver, L, Olsen, A, Mooney-Somers, J, Mathers, B, Micallef, J, Kaldor, J and Maher, L (accepted 22/10/2014). Sexual risk and health care seeking behaviour in young Aboriginal and Torres Strait Islander people in north Queensland. Sexual Health

Note: this is a pre-copyedited, author-produced PDF of the accepted article; I’ll post the link to the definitive publisher-authenticated version as soon as it is released.

Flipping PhD Supervision

I find something useful in every blog NIck Hopwood writes. And a week later I realise it was two useful things. Lots of useful ideas here

Nick Hopwood

First up this is not just about PhD supervision, but supervision of research degrees, whether Masters, PhD, Professional Doctorates etc. PhD in the title is just a convenient shorthand.

One of the interesting things that has been going on where I work is ‘Learning2014’. This is UTS’ approach to changing teaching and learning across all our campuses (including the online ones) and disciplines. One of the features of this concerns ‘New Approaches’ to pedagogy, and within this, a key idea is ‘flipped learning’.

Flipped learning is gaining currency as a way to describe certain ideas about what might happen before a key pedagogical interaction, such as a lecture or tutorial. While the term feels relatively new, it builds on key ideas that have informed teaching and learning for a long time.

Admittedly, I was initially a little cynical (as I tend to be about most things)…

View original post 1,087 more words

Lesbian and bisexual women and Pap smears – some good news but concerns remain

I attended the Australasian Sexual Health conference in Sydney to share our recent analysis of data from SWASH on Pap smear testing rates for lesbian, bisexual and queer (LBQ) women. The work was initiated by a medical student from Scotland, Catriona Douglas, who did an research internship with me earlier  this year. We looked at changes in testing between 2002 and 2012, comparisons between LBQ women and the general population in NSW, and predictors of test attendance among LBQ women in NSW. This is what we found:

Sexual Health SWASH pap smear poster FINAL print

Citation: Douglas C, Deacon R, Mooney-Somers J (2014) Pap smear rates among Australian lesbian and bisexual women: some good news but disparities persist. Poster presented at Australasian Sexual Health Conference, Sydney. Download the poster here.

We’ve just started to get some media interest.

Gay New Network (SX magazine in Sydney)


Research into teaching: Identifying the attributes of a graduate ‘qualitative researcher’

My colleague Assoc Prof Stacy Carter and I have just been awarded Research into Teaching seed funding from the School of Public Health, University of Sydney to conduct a project “Identifying the attributes of a graduate ‘qualitative researcher’”. The seed funding will be matched by funds from the Qualitative Health Research program, and the project will be conducted in 2015.

Our plan is to conduct interviews with students past and present, employers and PhD supervisors so we can review how well the Master of Qualitative Health Research (MQHR) curriculum meets the learning needs of students and those who employ or supervise them. We’ll explore how University of Sydney graduate attributes (scholarship; global citizenship; lifelong learning) are expressed in the MQHR, and identify any unique attributes for the QHR graduate… that’s where we’ll identify attributes of a graduate ‘qualitative researcher’.

Why not start us off: What attributes does a qualitative researcher need?

Learning about viral hepatitis and Indigenous people

Since 2010, I’ve been part of an NHMRC Centre for Research Excellence in Aboriginal health – REACCH (Research Excellence in Aboriginal Community Controlled Health). The collaboration is jointly managed by the Kirby Institute at UNSW and the National Aboriginal Community Controlled Health Organisation (NACCHO); there are four participating Aboriginal community-controlled health services:

Nunkuwarrin Yunti in South Australia
Aboriginal Medical Service Western Sydney
Victorian Aboriginal Health Service
Goondir Health Services in Queensland

Our research focuses on sexually transmitted infections and blood-borne viruses; each health service has developed projects that meet local priorities but we have also undertaken complex analyses of data from the services’ patient information management systems (for example this paper on hepatitis b).

This week I’m at the inaugural World Indigenous Peoples’ Conference on Viral Hepatitis in Alice Springs, with several REACCH colleagues. Viral hepatitis is a significant health burden for Aboriginal and Torres Strait Islander people (eg the rate of help c is increasing, in contrast to non-Indigenous people). Check out the twitter conversation via #IndigHVConf . Yesterday I presented on clients’ experiences of hep c treatment undertaken within a community setting – Nunkuwarrin Yunti.

Later in the week the World Indigenous Peoples’ conf makes way for the 9th Australian Viral Hepatitis Conference. I’m presenting on Friday on what made the community-based hep c treatment program acceptable to clients (hint: it was everything a hospital wasn’t). I’ll post the twitter hash tag here when things kick off.

Tobacco-control project targeting lesbians, bisexual and queer women

The Cancer Institute NSW (the cancer control agency for NSW) awarded an Evidence to Practice grant to ACON (NSW’s leading health-promotion organisation specialising in HIV and LGBTI health). I’m delighted to be the research partner on the grant.

The grant is titled “Tobacco-control project targeting lesbians, bisexual and queer (LBQ) women” and will run until mid-2016. The grant was awarded on evidence from the research I’ve been doing with ACON (and colleague Rachel Deacon) in the SWASH project that shows lesbian and bisexual women in Sydney are smoking at twice the rate of their heterosexual peers, and that rates have changed little despite significant mainstream public health interventions.

This grant is a real win. It is a testament to ACON’s commitment to this area, their strategic plan for 2013-2018 outlined a range of commitments to addressing smoking in LGBTI communities, including:

“seek funding to use our considerable social marketing expertise to identify and address the current high rates of smoking in our communities.”

It is also a testament to the Cancer Institute’s responsiveness to an area that has long been neglected in Australia (compared to the US, for example). And I’ve really pleased that the SWASH survey was key to providing an evidence base for a lack of movement in smoking rates among lesbian and bisexual women in Sydney.

The project will use ACON’s expertise in community-based social marketing to develop a smoking intervention to be delivered online and through community spaces and events. Will update here as the project progresses….

The last outing for the Growing Up with Cancer project

In July, my Growing Up with Cancer (GUWC) project colleague Peter and I attend the 8th International Conference on Teenage and Young Adult Cancer Medicine. It was held at the Royal Society of Medicine in London and what a glorious venue for this project’s last outing!

The conference organisers staged a full exhibition of the Growing Up with Cancer self-portraits (experience all the artworks here) and featured the project in the conference programme.

GUWC self-portraits on show at the International Conference on Cancer in Teenagers and Young Adults
GUWC self-portraits on show at the International Conference on Cancer in Teenagers and Young Adults
GUWC self-portraits on show at the International Conference on Cancer in Teenagers and Young Adults
GUWC self-portraits on show at the International Conference on Cancer in Teenagers and Young Adults

We also presented three conference posters on the research process and the project findings. (If you’d like to quote or use these posters – please acknowledge them correctly)

What healthy young people think about youth cancer – Mooney-Somers, J & Lewis, P. “Little Annabel Harvey and her fight with cancer”: healthy young people’s representations of youth cancer. 8th International conference on teenage and young adult cancer medicine, London July 2104

Using creative methods in research with young people – Mooney-Somers, J & Smith, K. Beyond the Illustration of Research Data: Using professionally facilitated image making techniques to enable participants to describe, enhance and extend data originally captured using traditional text-based methods of research. 8th International conference on teenage and young adult cancer medicine, London July 2104 

Telling friends and partners that you had cancer – Lewis, P & Mooney-Somers, J. Becoming a survivor – young people disclosing cancer to new acquaintances and romantic partners. 8th International conference on teenage and young adult cancer medicine, London July 2104


Thinking about chlamydia management at Australian family planning clinics

Very pleased to be able to share the Chlamydia testing and management – FINAL REPORT. This is the outcome of a project that assessed chlamydia testing, contact management and re-testing practices of clinicians at Australian family planning clinics. The project was funded by a National Health and Medical Research Council (NHMRC) Program Grant, and run by The Kirby Institute, UNSW. But the project could not have happened without the support of the management and senior staff of Family Planning organisations. We used a mixed methods approach – a survey of 168 clinicians (run by Joanne Micallef) and 11 focus groups with 70 clinicians (run by me).

Family planning organisations in Australia are state-based non-government organisations and clinics offering a variety of sexual and reproductive health services. There are 29 family planning clinics located across all Australian states and territories. These clinics have high case loads of young, sexually active women (primarily) and men at risk of chlamydia infection.

We’ve presented some findings at the Sexual Health conference in Darwin last year and we’re working on manuscripts. But here are the headlines:


  • Screening for chlamydia was perceived by clinicians as routine and a priority.
  • Chlamydia screening facilitators:
    • high community awareness of chlamydia;
    • communicating to clients that chlamydia testing is normal;
    • good relationship between FPC/clinicians and client;
    • providing easy access to screening; and
    • the ability to offer screening without a physical examination.
  • Evaluating the success of chlamydia screening:
    • clinicians felt confident that chlamydia screening was going well at both the individual and FPC level;
    • clients widely accept the offer to be screened for chlamydia;
    • informal review of clinic notes by clinicians reassured them that screening was occurring; and
    • formal reviews through audits challenged the clinicians’ perception of chlamydia screening rates.
  • Challenges of chlamydia screening:
    • clients being considered low or no risk;
    • refusal by clients and dealing with decliners;
    • clinicians worrying that clients may be offended by screening offer so not offering.
  • Clinicians raised concerns about over-testing for chlamydia.


  • Three quarters of clinicians suggested contact tracing the sexual partner(s) of clients in the 6 months prior to the chlamydia diagnosis.
  • Family planning clinicians were proactive in managing contacts of their clients:
    • almost all clinicians would encourage clients to tell partner(s)
    • three quarters would assist clients by providing a brochure containing information on chlamydia.
  • The Let Them Know website has become an important partner notification tool for family planning clinicians.
  • The Let Them Know website is a part of routine practice for many clinicians.
  • Use of the website varied between jurisdictions.
  • For clinicians not using the website, there is a desire to have access to this resource.
  • Contact managementfacilitators:
    • preparing clients for a positive test result;
    • low level of stigma associated with chlamydia; and
    • easy access to chlamydia screening for partners of clients.
  • Evaluating the success of contact management:
    • it is difficult to determine if clients notified their partner(s) and if partner(s) are tested and treated; and
    • there are few indicators for determining the success of contact management.
  • Challenges of contact management:
    • uncertainty around what is expected from clinicians; and
    • clinicians’ doubt around the importance of contact management for chlamydia.
  • The majority of clinicians acknowledged the benefits of patient delivered partner therapy although only 35% of clinicians ever used it. Most clinicians had concerns about using PDPT and its legal status was a major impediment to the uptake of the strategy.


  • Only 22% of clinicians recommend annual testing to all clients.
  • The majority (88%) of clinicians recommend clients return for retesting three months after a diagnosis of chlamydia.
  • The most common strategies for chlamydia retesting included recommending retesting at the time of initial treatment, explaining the importance of retesting after treatment and explaining the risk of repeat infection.
  • Most retesting was opportunistic; that is, a clinician noticed a recent positive chlamydia test recorded in a file and suggested a retest.
  • Evaluating the success of retesting:
    • it is difficult to determine the number of clients who return for retesting; and
    • clinicians were confident that new reminder systems were successful in getting clients to return for retesting.
  • Challenges to retesting:
    • clients often don’t return for retesting;
    • clinicians rely on opportunistic screening as retesting when clients return to the clinic;
    • uncertainty around the value of retesting for chlamydia; and
    • clinicians’ view that proactive retesting reminders undermine client responsibility.
  • ‘Proactive’ client reminder systems had mixed support from clinicians

Resilience, butching it up in Sri Lanka and family therapists’ beliefs about conversion therapy

This is the first of my Garden Fence blogs, sharing recent research on lesbian and bisexual women’s health (read more about what I’m trying to do, here)

Studies about lesbian, bisexual women (and sometimes men, and sometimes trans* people):

Resilience in Lesbian, Gay, and Bisexual Individuals. Kwon P. Personality and Social Psychology Review. 2013

Abstract: To promote psychological health among lesbian, gay, and bisexual (LGB) individuals, more comprehensive research on resilience factors in LGB individuals is needed. This article presents a theoretical framework based on the existing literature, with an eye toward guiding future research in this area. Social support clearly serves as a resilience factor for LGB individuals, in part through its ability to lower reactivity to prejudice. Social support is particularly effective when it specifically supports people’s sexual orientation and is congruent with individuals’ developmental needs. The ability to accept emotions and to process them in an insightful manner also buffers the negative impact of prejudice. In addition, hope and optimism allow LGB individuals to maintain psychological health when faced with prejudice.

Nice point: “For psychologists who engage in research or practice with the aim of improving the well-being of LGB individuals, it is not enough to understand the factors that lead to suffering in this population. It is also of paramount importance to under – stand the attributes that lead to flourishing and fulfillment in LGB individuals“

Butching it up: an analysis of same-sex female masculinity in Sri Lanka. Kuru-Utumpala J. Culture, Health & Sexuality. 2013;15(sup2):S153-S65

Abstract: This paper seeks to examine the embodiment of female masculinity as experienced by 12 gender-non-conforming lesbians in Sri Lanka. By drawing on western feminist and queer theories, it critiques western theories in relation to a non-western subjectivity, attempting to unravel the seemingly empowering, albeit problematic, category of female masculinity. Data gathered through qualitative interviews address one key research question: how do gender-non-conforming lesbians in Sri Lankan embody female masculinity? As the discussion unfolds, this paper analyses the ways they view themselves, the extent to which their actions and behaviours fit within a masculine framework and the ways in which notions of desire are felt and understood in relation to their understanding of gender. In terms of theory, the analysis is located in social constructivist theory, while drawing on a postmodernist approach. Theoretically, the concept of female masculinity allows a woman embodying masculinity to dislodge men and maleness from it. The reality within a SriLankan experience, however, can at times be different, as this paper reveals.

An Exploration of Family Therapists’ Beliefs about the Ethics of Conversion Therapy: The Influence of Negative Beliefs and Clinical Competence With Lesbian, Gay, and Bisexual Clients McGeorge, C. R., Carlson, T. S. and Toomey, R. B. (2013), Journal of Marital and Family Therapy.

Abstract: The majority of the literature on conversion therapy has focused on clients’ experiences and rationales for seeking such therapy. This study sought to explore differences in the beliefs and clinical competence of therapists who practice and believe in the ethics of conversion therapy and those who do not. The sample for this study included 762 family therapists who were members of the American Association of Marriage and Family Therapy. Data were collected using electronic surveys that assessed participants’ negative beliefs about and perceived clinical competence with lesbian, gay, and bisexual (LGB) individuals. Results indicate that those who believe in the ethics of and/or practice conversion therapy report statistically higher levels of negative beliefs about LGB individuals and lower levels of clinical competence working with LGB clients. Implications for clinical practice and organizational policy are discussed.

Scary finding: One in five family therapists said it was ethical to practice conversion therapy and they would if presented with the opportunity. Unsurprisingly, these people have statistically lower “levels of clinical competence working with LGB clients and higher levels of negative beliefs about LGB individually”; making their beliefs inconsistent with the professional organisation they are members of (American Association for Marriage and Family Therapy).

Studies that mention lesbian and bisexual women:

Women wearing white: Discourses of menstruation and the experience of menarche Jackson, Theresa E & Joffe Falmagne, Rachel. Feminism & Psychology August 2013 23: 379-398, first published on February 5, 2013

Abstract: This study examines how dominant societal discourses of menstruation are appropriated, rejected, or interpreted as adolescent girls make meaning of their menarche. Thirteen women ages 18–21 participated in flexible in-depth interviews to retrospectively recount their menarcheal experience. A variation of the Reading Guide was used for primary data analysis, which identified four themes highlighting girls’ ambivalence regarding menarche. Participants were conflicted at menarche about their putative status as ‘women’; used imprecise, distancing language when discussing menstruation; engaged in material and discursive practices of concealing menstruation; and referenced a community of menstrual suffering. Further, discourse analysis of participants’ talk suggests their continued discomfort. We argue that girls experience menarche ambivalently in relation to menstrual taboos, body shame and emergent womanhood. Negative discourses of menstruation and women’s bodies converge to set girls on a problematic gendered trajectory at menarche that can be expected to inform meaning making and experiences across the lifespan.

Relevant points for LBQ women’s health: (2 bisexual women in the sample). The authors cite literature showing lesbian and bisexual women are more likely to report positive feelings associated with menstruation: in relation to sxuaol activity during menstruation (Allen KR and Goldberg AE (2009) Sexual activity during menstruation: A qualitative study. Journal of Sex Research 46: 1–11; Fahs B (2011) Sex during menstruation: Race, sexual identity, and women’s accounts of pleasure and disgust. Feminism & Psychology 21: 155–178). They also cite literature showing lesbian women experience “more support and responsiveness from their partners in regards to a variety of premenstrual changes or distress” (Ussher JM and Perz J (2008) Empathy, egalitarianism and emotion work in the relational negotiation of PMS: The experience of women in lesbian relationships. Feminism & Psychology 18: 87–111)

Self-Reported Preconception Care of HIV-Positive Women of Reproductive Potential: A Retrospective Study. Loutfy MR, Blitz S, Zhang Y, Hart TA, Walmsley SL, Smaill FM, et al. Journal of the International Association of Providers of AIDS Care (JIAPAC). 2013.

Abstract: Objectives: We determined the proportion and correlates of self-reported pregnancy planning discussions (that is preconception counseling) that HIV-positive women reported to their family physicians (FPs), HIV specialists, and obstetrician/gynecologists (OB/Gyns). Methods: In a cross-sectional substudy, HIV-positive women of reproductive potential were asked whether their care providers discussed pregnancy planning. Logistic regression was used to calculate odds ratios for the correlates of preconception counseling.  Results: A total of 431 eligible participants (median age 38, interquartile range = 32-43) reported having discussion with a physician (92% FP, 96% HIV specialists, and 45% OB/Gyns). In all, 34%, 41%, and 38% had their pregnancy planning discussion with FP, HIV specialist, and Ob/Gyns, respectively; 51% overall. In the multivariable model, significant correlates of preconception counseling were age (P = .02), marital status (P < .01), number of years living in Canada (P < .001), and age of youngest child (P < .01).  Conclusions: Preconception care in our cohort was suboptimal. We recommend that counseling on healthy preconception should be part of routine HIV care.

Relevant points for LBQ women’s health: HIV positive lesbian bisexual and other identifying women were slightly more likely to have received preconception counselling; although there was no discussion of this finding in the text. (Survey questions were (1) ‘‘Has your family doctor talked to you about pregnancy planning?’’ (2) ‘‘Has your HIV specialist talked to you about pregnancy planning?’’ and (3) ‘‘Has your OB/Gyn talked to you about pregnancy planning?’)


If you can’t get access to the full text – or it’s not free – Email Me for access suggestions.