Qualitative health research plays a central role in exploring individuals’ experiences and perceptions of wellness, illness, and healthcare services. Visual tools are increasingly used for data elicitation. An ecomap is a visual tool that applies ecosystems theory to human communities and relationships to provide an illustration of the quality of relationships. We describe the use of ecomaps in qualitative health research. Searches across eight databases identified 407 citations. We screened them in duplicate to identify 129 publications that underwent full text review and included 73 in the final synthesis. We classified and summarized data based on iterative comparisons across sources. Benefits of using ecomaps include improving rapport and engagement with study participants, facilitating iterative question development, and highlighting the social contexts of relationships. When used in conjunction with interviews, they promote data credibility through triangulation. Investigators have used ecomaps as a tool to facilitate primary and secondary analysis of data. Researchers have adapted the ecomap to meet their health research needs. Challenges to their use include additional time and training needed to complete, and potential privacy and confidentiality concerns. Ecomaps can be useful in qualitative health research to enhance data elicitation, analysis, presentation, and to augment study rigor.


ecomap, graphic elicitation, qualitative health research, integrative review

Author Bio(s)

Veena Manja, MBBS, MSc, PhD is a cardiologist with the Veterans Affairs Northern California Health Care System, volunteer faculty at University of California, Davis and part time faculty at McMaster University. Her research focuses on evidence-based clinical decision-making prioritizing high-value patient-centered care. She is currently working in the area of deprescribing to optimize cardiovascular pharmacotherapy in elderly veterans. Please direct correspondence to cardiodoc20@gmail.com.

Ananya Nrusimha is a medical student at the University of California Davis School of Medicine who hopes to specialize in psychiatry or internal medicine. Ananya received a Bachelor of Arts with Honors from Stanford University, and has presented research at the Western Society for Pediatric Research meeting, the Pediatric Academic Societies meeting, and the American Academy of Child and Adolescent Psychiatrists meeting. Please direct correspondence to anrusimha@ucdavis.edu.

Harriet MacMillan, CM, MD, MSc, FRCPC, is a psychiatrist and pediatrician conducting family violence research. She is a member of the Offord Centre for Child Studies, a Distinguished University Professor in the Departments of Psychiatry and Behavioral Neurosciences, and of Pediatrics at McMaster University with associate membership in the Department of Health Research Methods, Evidence, and Impact. She holds the Chedoke Health Chair in Child Psychiatry. Her research focuses on the prevention of family violence including child maltreatment and intimate partner violence, and associated impairment. Please direct correspondence to macmilnh@mcmaster.ca.

Lisa Schwartz, PhD is the Arnold L Johnson Chair in Health Care Ethics at McMaster University. She is a full professor in the department of Health Evidence, Research and Impact (HEI), a member of the Centre for Health Economics and Policy Analysis (CHEPA), and an associate member of the Department of Philosophy. Her research focuses primarily in humanitarian health ethics, research ethics and ethics in medical education. Please direct correspondence to schwar@mcmaster.ca.

Susan Jack, RN, PhD, is Professor, School of Nursing and Associate Member, Department of Health Research Methods, Evidence and Impact at McMaster University. Her program of research focuses on community-based approaches to the prevention of family violence, including child maltreatment and intimate partner violence. She is experienced in designing and conducting qualitative research through the application of a range of qualitative research traditions, as well as integrating qualitative research into mixed methods studies for the purpose of intervention development and evaluation. Please direct correspondence to jacksm@mcmaster.ca.

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