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Item Implications of male circumcision for women in Papua New Guinea: a transformational grounded theory study(BioMed Central, 27/07/2017) Redman MacLaren M; Mills JE; Tommbe R; MacLaren; Speare R; McBride WJBACKGROUND: Male circumcision reduces the risk of female-to-male transmission of human immunodeficiency virus (HIV) and is being explored for HIV prevention in Papua New Guinea (PNG). PNG has a concentrated HIV epidemic which is largely heterosexually transmitted. There are a diverse range of male circumcision and penile modification practices across PNG. Exploring the implications of male circumcision for women in PNG is important to inform evidence-based health policy that will result in positive, intended consequences. METHODS: The transformational grounded theory study incorporated participatory action research and decolonizing methodologies. In Phase One, an existing data set from a male circumcision study of 861 male and 519 female participants was theoretically sampled and analyzed for women's understanding and experience of male circumcision. In Phase Two of the study, primary data were co-generated with 64 women in seven interpretive focus group discussions and 11 semi-structured interviews to develop a theoretical model of the processes used by women to manage the outcomes of male circumcision. In Phase Three participants assisted to refine the developing transformational grounded theory and identify actions required to improve health. RESULTS: Many women know a lot about male circumcision and penile modification and the consequences for themselves, their families and communities. Their ability to act on this knowledge is determined by numerous social, cultural and economic factors. A transformational grounded theory was developed with connecting categories of: Women Know a Lot, Increasing Knowledge; Increasing Options; and Acting on Choices. Properties and dimensions of each category are represented in the model, along with the intervening condition of Safety. The condition of Safety contextualises the overarching lived realty for women in PNG, enables the inclusion of men in the transformational grounded theory model, and helps to explain relationships between men and women. The theory presents the core category as Power of Choice. CONCLUSIONS: This transformational grounded theory provides a means to explore how women experience male circumcision and penile modification in PNG, including for HIV prevention. Women who have had opportunities for education have a greater range of choices and an increased opportunity to act upon these choices. However, women can only exercise their power of choice in the context of safety. The concept of Peace drawn from the Social Determinants of Health is applied in order to extend the explanatory power of the transformational grounded theory. This study shows that women's ambivalence about male circumcision is often related to lack of safety, a consequence of gender inequality in PNG.Item Meeting in the Middle: Using Lingua Franca in Cross-Language Qualitative Health Research in Papua New Guinea(SAGE Journals for the International Institute for Qualitative Methodology (IIQM) at the University of Alberta, Canada, 30/10/2019) Redman-MacLaren M; Mafile'o T; Tommbe R; MacLaren DWith words as data, qualitative researchers rely upon language to understand the meaning participants make of the phenomena under study. Cross-language research requires communication about and between linguistic systems, with language a site of power. This article describes the use of the lingua franca of Tok Pisin in a study conducted to explore the implications of male circumcision for human immunodeficiency virus (HIV) prevention for women in Papua New Guinea. Utilizing a transformational grounded theory methodology, researchers conducted an analysis of data from an HIV prevention study. Researchers then facilitated individual interviews and interpretive focus groups to explore preliminary categories identified during the analysis. Most focus groups and interviews were conducted in the local lingua franca Tok Pisin, which is neither the researchers’ nor most participants’ first language. Audio recordings were transcribed and analyzed. Researchers returned to research participants to discuss research findings and recommendations. Following critical reflection by the authors and further discussions with participants, it was evident that using Tok Pisin enriched the research process and findings. Using the lingua franca of Tok Pisin enabled interaction in a language closer to the lived experience of participants, devolved the power of the researcher, and was consistent with decolonizing methodologies. Participants reported the use of Tok Pisin, em i tasim (pilim) bun bilong mipela, “it touches our bones,” and enabled a flow of conversation with the researchers that engendered trust. It is critical researchers address hierarchies of language in order to enable cogeneration of quality research findings.