“Found” Data: Qualitative Content Analysis of Medical Examiner Records to Explore the Context of Infant Injury Deaths

Abstract

This case study provides an account of a content analysis of medical examiner records that arose from an epidemiological study of sleep-related infant injury deaths in New York City. In examining the records, which included standardized forms, memos, and handwritten notes based on interviews with caregivers, health care personnel, and social service workers, we discovered that in cases where infants were put to sleep on an unsafe sleep surface, the Office of the Chief Medical Examiner personnel conducting the investigation often noted a crib or bassinet present in the home. The following research question arose: Why would a caregiver opt not to use the crib or bassinet that was available to them? This question dovetailed with reports of poor living conditions by staff dispatched by various home visiting programs to provide safe sleep education and free cribs for low-income families. By conducting a content analysis of the narrative portions of the Office of the Chief Medical Examiner files, we were able to explore how environmental influences related to poor housing, such as crowding, lack of temperature control, and pest infestation, affected how caregivers placed their infants to sleep. Although the content analysis was not a part of the original research plan, allowing for the creative connection between our real-world observations and the puzzle that emerged from the "found" qualitative data to take place was one of the greatest lessons learned from this research project.

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