Dear Drs. Kang and Ko:We thank Gao and colleagues for their interest in our paper entitled “Cancer Perceptions Among Smokeless Tobacco Users: A Qualitative Study of US Firefighters” [1]. We will now respond to the issues raised in the letter by Gao and colleagues [2] and clarify aspects of our methodology in relation to these concerns.First, Gao and colleagues stated that negative personal responses might make other participants feel uncomfortable participating in focus groups. As described in our methods, we conducted individual phone interviews with participants in their private setting. We did not conduct any focus groups. Thus, participant opinions were not influenced or affected by other participants. Before the interviews, we explained the study procedures and provided issues relating to the confidentiality, anonymity, and voluntary nature of the data collection. We also encouraged participants to discuss their ideas freely regarding SLT use. Thus, the results reported in our paper were indeed our participants' opinion. One of the several advantages of conducting telephone interviews is that individuals are more likely to provide personal information or admit socially deviant behavior than in-person interviews [3].Second, Gao and colleagues noted some critical technological limitations in our study for using NVivo as the automated transcription assistant, such as the discrepancies between recording tapes and transcripts. However, we used NVivo software for in-depth analysis in our paper, not transcription. As stated in Section 2.4 Approach to analysis [1], the interview recordings were transcribed verbatim before uploading to NVivo, a qualitative data analysis program that allows the researchers to highlight and code data into themes and subthemes. We also had two coauthors review the transcribed documents to address the inaccuracies between recoding tapes and transcriptions from the transcription service company and to purposely capture the meaning behind the transcribed text.Third, we agreed with Gao and colleagues' remarks regarding power disparity between higher and lower rank firefighters when participating in group discussion. However, we conducted individual telephone interviews with participants, not focus groups, after agreeing to participate in the study. Thus, as our colleagues were concerned, power disparity or group thinking was unlikely to occur in our individual interviews. From our past experiences with group discussion/focus groups, we typically conduct different sessions with firefighters and fire chiefs [4]. These power differentials were part of the reason we chose to conduct individual interviews rather than focus groups.We appreciate the critics from Gao and colleagues for their view on the phone interview study. They listed some valid issues related to telephone interviews but there also disadvantages associated with in-person interviews. In addition, some of the limitations to phone interviews they listed, such as the interview being prematurely ended for any reason, simply never happened.We thank the editors for their assistance and for allowing us to response our colleagues for their comments regarding our paper. We look forward to hearing from you. If you have any questions, please feel free to email me at nui@hopehri.com.
Funding
This work was supported by the ; Grant number: 129326-MRSG-1610401-CPPB.
Conflicts of interest
All authors have no conflicts of interest to declare.