Tracie Culp Harrison

Qualitative research is central to understanding aging-related experiences, yet expectations for rigor are often unclear and inconsistently applied across studies. Here, we introduce the Rigor in Qualitative Research Framework, developed through a structured review of qualitative quality frameworks and reporting guidance and application to qualitative articles published in Innovation in Aging. We identified ten domains of qualitative rigor that reflect core areas across qualitative approaches: methodological coherence, relevance and contribution, contextual sensitivity and transferability, researcher reflexivity and positioning, participant/data-item selection and composition, ethical and relational integrity, data generation quality and richness, analytic rigor and transparency, interpretive credibility and evidence linkage, and reporting clarity, coherence, and usability. We then examined how these domains are described and operationalized in 39 published qualitative studies from 2020-2025 in Innovation in Aging, identifying exemplars in how rigor is enacted in practice. Findings suggest that existing frameworks provide broad coverage of key domains but differ in scope, emphasis, and level of guidance; qualitative studies thus vary in how clearly and consistently these domains are articulated. In response, our proposed framework integrates these domains into a structure supporting both evaluation and application, while remaining flexible to different epistemological and methodological traditions. The Rigor in Qualitative Research Framework is intended to guide study design, analysis, and reporting, and to support more consistent evaluation during peer review, providing a practical reference point for qualitative research across applied health and gerontology.

BACKGROUND Abstract Adults aging with the diagnosis of a schizophrenia spectrum disorder, like all those with disabilities, are often overlooked and unidentified in health surveys and reports; indeed they have sometimes been labeled an “invisible population” (Molinari & Roker, 2014, p. 1; Office of Disease Prevention and Health Promotion, n.d.). Important focuses of research on this population include (1) their high levels of morbidity, accelerated aging, and decreased life expectancy in comparison with other older adults, and (2) difficulties, reported by formal caregivers, related to unpreparedness to work effectively with this population (Muralidharan et al., 2019; Walker & Harrison, 2024). In this article, with a focus on the perceptions of older adults diagnosed with a schizophrenia spectrum disorder (schizophrenia and schizoaffective disorders), we present a scoping review of the quality and frequency of qualitative research conducted with this population. We ask the following research question: In the last 10 years, what qualitative research studies have shared the experiences and perceptions of older adults diagnosed with a schizophrenia spectrum disorder? We share our analysis and interpretation of the reviewed studies by considering perspectives of recovery and person-centered care. OBJECTIVE In this literature review, we therefore examine the qualitative research conducted on the perceptions of older adults diagnosed with schizophrenia spectrum disorders; the perspectives of recovery and person-centered care guide our analysis and interpretation. We have chosen to honor the perspective of person-centered care in our review as we agree with its tenants that research should be accomplished along-side or “with” the participant and not “on” that participant (Fazio et al., 2018; Walker & Harrison, 2024). We are also in favor of viewing women diagnosed with schizophrenia spectrum disorders with the model of recovery which believes they may improve, progress, and have capacity to reach their full life potential (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023). METHODS A scoping review is a research method used to “map the extent, range, and nature of the literature, as well as to determine the possible gaps in the literature” (Mak & Thomas, 2022, p.1; Thomas et al., 2017). Using a scoping review we first defined our research question. Our research question was as follows: In the last 10 years, what qualitative research studies have shared the experiences and perceptions of older adults diagnosed with a schizophrenia spectrum disorder? Our next step in the review process was to conduct a data search using the following databases in the last 10 years: Academic Search Complete, PubMed, CINAHL, APA PsycInfo, APA PsycArticles, the Cochrane Library, and ProQuest Dissertations and Theses. Our choice of the last 10 years aligned with the time since the release of the Diagnostic Manual of Mental Disorders, Fifth Edition (APA, 2013), the standard used across disciplines to classify and communicate with health care providers regarding mental disorders. Key search terms were “schizophrenia,” “older adults,” “perceptions,” and “qualitative research”; we screened for inclusion with “English,” “human,” and “age 65+ years.” Given these criteria, 22 articles were retrieved. Overlapping studies were excluded, as were studies that were not conducted as qualitative research. Studies that focused on qualitative responses of caregivers or health care workers were also excluded. After applying the exclusion criteria, nine results remained. The articles were sorted with the goal of identifying research questions that sought the perceptions of older adults with the diagnosis of schizophrenia spectrum disorders, given the major findings of each article. The articles were then reviewed in order to determine qualitative study objectives, research question, identified theses, samples and ages of participants (i.e., were studies specific to older adults—those at least 65 years of age?), race/ethnicity of participants, theoretical framework, and study findings. Using the Johns Hopkins Evidenced-Based Practice Model of Analysis which is a five-level rating system to evaluate evidence, the articles rated at a level III due to their qualitative focus (Bradley University, 2025; Dang et al., 2022). RESULTS Results Race/ethnicity and setting The nine studies were conducted in Australia (1 study, 11%), the U.S. (3 studies, 33%), the United Kingdom (2 studies, ,22%), Italy (1 study, 11%), the Netherlands (1 study, 11%), and Sweden (1 study, 11%). Six of the studies (66.6%) did not report the race or ethnicity of participants. In the three studies that did, White, European American, or British White participants predominated: European Americans, 60%; White, 50%, and British White 94%, respectively. Black participants in the respective studies represented 17%, 33%, and 6%. Other races identified in the study with European Americans included Asian/Pacific Islanders, 11%; Native Americans, 8%; and Hispanic, 3.6%. In the study with White participants, other races included Caribbean Immigrants, 1.6%. Yet Black individuals are often diagnosed with a schizophrenia spectrum disorder at a rate varying from 2.4 to 4 times that for the general population (Olbert et al., 2018; Schwartz & Blankenship, 2014). The represents a gap in research. A worthy goal for researchers would be to balance demographic factors in their studies to align with current racial/ethnic prevalence, in order to gather specific data to inform solutions for specific populations. It is also difficult to measure the utility and potential transferability of studies that do not report participants’ racial/ethnic characteristics, as was the case in 66% of the studies in this review. Age Groups Of...

Background: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients’ lives. Objective: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. Methods: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. Results: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. Discussion: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.

Attention has recently been given to the role of race in many aspects of the research process; however, minimal has been written to critique the role of race in qualitative fieldnotes. This gap creates potential conflicts about representation that can exclude marginalized communities and call into question findings when race is ignored in the research process. To successfully address potential investigator biases with a lens towards social justice and equity in healthcare, a critique of foundational methods is required. Here we posit that a qualitative health researchers’ primary tool is their fieldnotes because they contextualize findings and serve as a method to learn through systematic interpretation of local meanings revealed by participants. Here, we provide researchers guidance for teaching and writing fieldnotes that speak to current nuances of observations and interactions with participants. Definitions related to race and ethnicity, the importance of applying appropriate sensitizing frameworks, followed by a discussion of how to use fieldnotes in findings are covered. We include (1) a call for more preparation of novice researchers and a challenge for established researchers to update expertise for collecting and using fieldnotes in the research process, (2) guidance on negotiating difficult situations, and (3) the significance of language in creating credibility in findings when addressing race in qualitative research.

Background and Objectives: Individuals with schizophrenia spectrum disorders must manage residual symptoms as they age, and they may experience premature or accelerated aging in comparison with those without their diagnosis. To explore their life course perspectives, we interviewed institutionalized adults aging with schizophrenia spectrum disorders in middle and older age. Research Design and Methods: We used an exploratory descriptive design and qualitative methods. Participants answered semistructured, open-ended questions about perceptions of their mental illness along the life course. Results: Participants (N = 30, age 45–83 years) were from an acute care psychiatric facility and a long-term care facility: 16 (53%) men, 14 (47%) women; 6 (20%) Hispanic, 10 (33%) African American, 14 (47%) non-Hispanic White. Participants’ life course included traumas from violence, homelessness, and stigma; psychiatric symptoms such as worry and sadness; and age-related physiological symptoms including illness, loss of strength, falls, and incontinence, with falls and incontinence reported only in long-term care. Aging within institutionalization included lack of privacy and autonomy, and isolation (less socialization). Participants provided insights for potential improvements. Discussion and Implications: Because these aging adults are experts on their own care, researchers should continue to seek their input to inform their healthcare.

This is the first known comparative assessment of the associations of epigenetic age estimates with the prevalence of rheumatoid arthritis. We used data available in Gene Expression Omnibus (GSE42861) from the Swedish Epidemiological Investigation of Rheumatoid Arthritis study. Information regarding RA diagnosis and 450K DNA methylation (DNAm) of 18-to-70-year-old participants was available. Utilizing Horvath’s online DNAm Age Calculator, we determined the DNAm estimate of Telomere length (DNAmTL), Hannum’s epigenetic age, Horvath’s 2013 and 2018 epigenetic ages, PhenoAge, GrimAge, and the respective age-acceleration measures. The association of RA prevalence with epigenetic age measures was assessed using linear regression, adjusting for sex and smoking status. The p-values were corrected for multiple testing using a false discovery rate. We identified statistically significant associations of RA with Horvath 2013 age acceleration (Estimate:-1.34; FDR p-value: 1.0 × 10 ^-2), Horvath 2018 age acceleration (Estimate:-1.32; FDR p-value: 4.0 × 10 ^-5), extrinsic age acceleration (Estimate: 1.34; FDR p-value: 1.0 × 10 ^-2), PhenoAge acceleration (Estimate: 2.31; FDR p-value: 1.1 × 10 ^-5), GrimAge (Estimate: 2.54; FDR p-value: 1.0 × 10 ^-2), and GrimAge acceleration (Estimate: 3.15; FDR p-value: 1.7 × 10 ^-17). Of note, the raw and age-adjusted GrimAge surrogate DNAm protein components were significantly higher in RA cases than controls. Interestingly, the first-generation measures were associated only with women. No sex-specific effects were identified for PhenoAge or GrimAge accelerations. In this cross-sectional assessment, the second-generation clocks show promise as markers of biological aging, with higher epigenetic age acceleration observed in RA cases compared to healthy controls.

The life-history narratives of 10 Mexican American men with mobility limitations, age 55–77 years (mean = 63.8, SD = 5.8), were explored using a qualitatively driven, life-history mixed-methods study to understand perceptions of mobility limitations over the life course. Within that methodological and paradigmatic framework, conceptualizations of alterity and masculinity guided interpretation of data. Through an iterative, thematic analysis, we detail the way the men’s lives were influenced by growing familial responsibility with age. Quantitative data were integrated into themes of narrative inheritance, family, and masculinity. It was posited that masculinity with mobility limitations shaped and was shaped by ethnic identity and responsibility. This has implications for understanding the experience of Mexican American men over the life course.

Background: A gap in research about the trajectories of function among men and women aging with functional limitations because of multiple sclerosis (MS) hinders ability to plan for future needs. Objectives: Using a biopsychosocial model, we characterize how men and women with MS report changes over time in their function and test how person-level differences in age, diagnosis duration, and sex influence perceived function. Methods: A longitudinal study with multiple waves of surveys was used to collect data on participant perceptions of function, as well as demographic and contextual variables. Self-reported functional limitation was measured over a decade. The study participants were community residing with physician-diagnosed MS. Results: The people with MS had a diagnosis duration of about 13 years and were around 51 years of age, on average, at the start of the study. They were primarily women and non-Hispanic White. We analyzed the data using mixed-effects models. Subject-specific, functional limitation trajectories were described best with a quadratic growth model. Relative to men, women reported lower functional limitation and greater between-person variation and rates of acceleration in functional limitation scores. Discussion: Results suggest function progressed through two pathways for over a decade, particularly closer to diagnoses. Variability in trajectories between individuals based on sex and years since diagnosis of disease indicates that men and women with MS may experience perceptions of their function with age differently. This has implications for clinician advice to men and women with MS.

People aging with disability and people of retirement age depend upon their respective states to follow the philosophical tenets of independent living (IL) to remain self-sufficient in their communities with a high quality of life. Independent living services are specified, programmatic sets of services funded by the Administration for Community Living (ACL) in line with expressly stated goals for implementation by state agencies for their state indepdent living centers (SILCSs) to implement through a State Plan for Independent Living (SPIL). Designated state agencies are required to submit their SPIL every three years to maintain funding through the ACL. This policy analysis of funded state plans for inclusion of people with disability aimed to determine which SPILs promote the IL philosophies of consumer choice and control. To this end, qualitative and quantitative content analyses were done to evaluate SPIL's inclusion of IL philosophies. Specifically, the consumer choice and control philosophy, involvement of people with disability, as well as the coherency of IL services from state to state were reviewed. The results of this paper indicate disparities in consumer choice and control initiatives across states, with approximately half of all states clearly promoting consumer control initiatives in their plans. Only three states made it clear that people with disability were involved in the SPIL development. The results give direction for nursing organizations who wish to work with and support SILCs as they advocate for person-centered approaches for people with disability.