Achieving rigor using selected criteria to determine trustworthiness using qualitative methods has been without critical evaluation. In this article, strategies such as prolonged engagement and thick, rich description; negative case analysis; peer review or briefing; clarifying researcher bias; member checking; and, investigator triangulation and intercoder reliability are evaluated for appropriateness among an African American Appalachian rural population. Achieving rigor using qualitative methods among participants living in rural communities is time intensive requiring attention to quality versus quantity of time spent in interviews, building trusting relationships, an awareness of interviewer bias and assumptions, and appropriately evaluated strategies that enhance validity. Strategies to achieve rigor in qualitative methods should not be used as a one size fits all approach as this practice might actually diminish rigor. Among underrepresented populations, strategies should be adapted or not used at all.

African American breast and prostate cancer survivors describe their personal relationship with God as very real, close, and intimate. During their cancer trajectory, God was there with them, healing, protecting, and in control of their lives. Participants believed that God provided types of support not available from family members or friends. In return, these participants dedicated their lives to God through service in their churches or through helping others. Findings can help healthcare professionals and others in clinical practice to understand the reliance that many African American cancer survivors have on their spirituality. These findings also suggest that many African Americans perceive their survival from cancer as a gift from God. Therefore, for them, finding a way to give back is an important component of their spirituality.

To determine the types of social support that African Americans use to cope with the experience of cancer. Qualitative study using a grounded theory approach. Participants' homes in the southeastern United States. A purposeful sample of 13 African American men (aged 61-79 years) treated for prostate cancer and 15 African American women (aged 42-87 years) treated for breast cancer. Participants were selected according to key variables known to influence social support: age, gender, marital status, education, geographic region, and proximity to family. Open-ended and semistructured interviews were conducted with each participant (N = 28). Participants were interviewed until informational redundancy was achieved. Constant comparison techniques were used to identify variations of social support within and across cases. The experience of social support during diagnosis or treatment for cancer as well as post-treatment. Participants used types of social support not currently emphasized in the literature. The emotional support of "presence" was reported most frequently. Instrumental support included not only current conceptualizations but also offers of prayers, assistance to continue religious practices, and assistance to maintain social roles. Informational support included what to expect and how to manage symptoms, interpret information, and validate information received. Findings suggest the need to reconceptualize social support for African Americans with cancer and to refine instruments to include these different manifestations of social support. Researchers can use these findings in the design of culturally relevant questionnaires and interventions for this population. Clinicians can use knowledge of the types of social support valued among African American patients with cancer to develop more appropriate strategies to promote healthy outcomes for this population.

Military Medicine is AMSUS’ monthly peer-reviewed journal, with articles including scientific papers, case reports, and editorials. Its objective is to promote awareness of federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to federal healthcare.