in this multi-part Naturocrit Podcast Episode 015, aka s02e05, retitled from “The JACM 2019 Special Issue on Naturopathy” to “A Qualitative Content Analysis of Curated World Naturopathic Federation Publications and Reports Employing the Online Misinformation Engagement Framework within a Paradigm of Methodological Naturalism,” I'll be sharing a study I've recently written in a semi-scholarly manner.
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In this second part of Episode 015 Part C, I'll cover the study/project steps 1 through 15 which is title, introduction and methods.
001. Standard Introduction:
Welcome to, as that robot voice says, The Naturocrit Podcast, and thank you for boldly listening.
What ARE we even talking about?
Well, this podcast series is my take on naturopathic medicine, an area I've been studying for about thirty-three years, including my time in so-called 'scientific nonsectarian naturopathic medical school'.
My approach is a pairing of scientific skepticism and a deep knowledge of naturopathy's intimate details.
In previous episodes of this series, I established that naturopathy is, essentially, a kind of knowledge blending, misrepresentation, and irrationality.
I have termed naturopathy both 'an epistemic conflation falsely posing itself as an epistemic delineation' and 'the naturopathillogical':
the science-exterior is mixed with what is scientific, then that whole muddle is absurdly claimed to be science as an entire category, while particular sectarian science-ejected oath-obligations and -requirements are coded or camouflaged, therein effectively disguising naturopathy's system of beliefs in public view.
Naturopathy's ultimate achievement is a profound erosion of scientific integrity and freedom of belief packaged in the marketing veneers "natural, holistic, integrative and alternative" and improperly embedded in the academic category "science".
002. Introduction [Synopsis]:
In this Episode 015 Part C2, I’ll be sharing a study or project I’ve recently completed titled:
“A Qualitative Content Analysis of Curated World Naturopathic Federation Publications and Reports Employing the Online Misinformation Engagement Framework Within a Paradigm of Methodological Naturalism.”
This Part C2 will cover the sections on Title, Introduction, and Methods which are [SRQR] steps 1 through 15.
I will exclude the abstract and create that at the end of this audio manifestation of the study.
Both of which will be within the Naturocrit Podcast uploads area of Archive.org.
003. Dedication:
This is dedicated to my 8th-grade general science teacher Mr. Rotondaro who had this unforgettable mantra:
004. Organizational Model:
The primary organizing model that I’ll be conforming to for this project is the 21-item “Standards for Reporting Qualitative Research” (SRQR) checklist by way of O’Brien et al., 2014 which was published in the journal Academic Medicine.
The article’s title is “Standards for Reporting Qualitative Research: A Synthesis of Recommendations” and the authors were O'Brien, Harris, Beckman, Reed, and Cook.
These sections do vary greatly in length, and they may be at times somewhat more expansive than their section title for narrative benefit and/or due to my own psychology’s inflexibility!
An editor’s nightmare!
Yet, I will use the SRQR as my rough guide.
An editor’s hope!
If, and when, step contents are towards the long side of things, there may be reminders of what step is the current step.
And, I can only hope, the blended, erosive, irrational nature of naturopathy has not infected me in the sense of impeding an ability to analyze and an ability to delineate.
The SRQR contains the following large topical areas: title and abstract, introduction, methods, results/findings, discussion, and other.
005. Title and abstract sections:
SRQR Step 01 – Title:
“A Qualitative Content Analysis of Curated World Naturopathic Federation Publications and Reports Employing the Online Misinformation Engagement Framework Within a Paradigm of Methodological Naturalism.”
SRQR Step 02 – Abstract:
Pending.
Sidebar:
I’ll begin, with this part that follows and onwards, to include in-text citations.
Each podcast episode part’s bibliography will be available within a PDF document within the Naturocrit Podcast collection at Archive.org and each will be titled “naturocrit_podcast_e015c_references” with a number after the c corresponding to the audio part [yet to occur].
006. Introduction sections:
SRQR Step 03 – Problem Formulation:
Step 03a - Description and Significance of the Problem/Phenomenon Studied:
Broadly, misinformation and disinformation are deemed an ocean-sized (Osborne & Pimentel, 2022) and an unfortunately defining characteristic of the contemporary online environment (Geers et al., 2024).
Observed negative aspects of this milieu include the fostering of extremist political sentiments, concerns about a decrease in human autonomy, and increases in conversational incivility (Kozyreva et al., 2020).
Of primary concern as sources of online misinformation are search engines, social media, and retail web pages due to issues of traffic volume and communicative velocity (Office of the Surgeon General, 2021).
Within that WEF Report, as a discrete area, misinformation and disinformation are ranked number one in their short-term 2-year assessment and number five in their 10-year assessment (World Economic Forum, 2025).
Particularly through the lens of public health, misinformation and disinformation have been labeled an infodemic (Berg, 2022).
The World Naturopathic Federation (WNF) is an apex international or global entity that owes its inception and 2014 incorporation in Canada to naturopaths from 20 countries including the U.S., Canada, and Australia (Lloyd, 2018).
As patterned from the American-Canadian naturopathy educational, practice, explanatory, and regulatory model (Snider & Zeff, 2019), the WNF is in the midst of a years-long process of building up membership committed to a global standard (Dunn et al., 2021).
U.S., Canadian, and Australian naturopathy will feature prominently within this study due to their English-language basis, online presence, contributions to the data that will be investigated, and global influence.
In these three geographical areas, organized naturopathy explicitly states that naturopathy is health science either by way of specified degree language selection such as in Australia (Endeavour College of Natural Health, n.d.), specified school naming such as in the United States (National University of Health Sciences, n.d.), or through provincial naturopathy professional organization labeling in Canada (British Columbia Naturopathic Doctors, n.d.).
That fringe epistemic claim is not without contention in terms of mainstream thought.
For instance, in sum or preponderantly, when viewed through the points of view that rely on rigorous science, reasoning, and professional healthcare standards, the essential naturopathic claim and therapeutic aim – the ‘glue’ that holds the cornucopia together known as vitalism (Patel et al., 2024) – is regarded as either science-discarded (Wilson, 2013) or not subject to scientific support (Simpson & Young, 2020).
Though of epistemically contentious status, in the United States, twenty-six “jurisdictions” legally regulate naturopathy, while in Canada six provinces are regulated (Association of Accredited Naturopathic Medical Colleges, n.d.).
Australian naturopathy, similar in nationwide organizational uniformity to the U.S. and Canada, has recently adopted the American-Canadian model in a granular fashion, particularly in terms of WNF naturopathy’s essential principles, beliefs, explanatory language, practices, and canon (Australian Register of Naturopaths and Herbalists, n.d.a).
There, naturopathy as a practice is yet to become a legally regulated profession at the state or national level, though, there are government-regulated schools that train naturopaths (Australian Register of Naturopaths and Herbalists, n.d.b).
Obviously, clarification and the identification of potential risks and harms are needed.
Patients, consumers, citizens, potential students of naturopathy, researchers, and other stakeholders such as members of the healthcare systems in each country deserve transparent and truthful information regarding and from naturopathy that minimally respects the concepts of informed consent and merchantability.
Sidebar:
Therein, Appendix A is a specific list of the documents which I will call the World Naturopathic Federation Material (WNFM) and Appendix C will be an amalgamation of sources which I have termed a triangulation which will serve as a literature review and a preponderance.
After all, we must establish a fiduciary point!
I plan to employ that triangulation in other future studies or projects that use other data sets and frameworks.
Close sidebar.
Step 003b - Review of Relevant Theory and Empirical Work:
In the past several decades, naturopathy or naturopathic medicine has successfully organized itself in such countries as the United States, Canada, and Australia (Steel et al., 2020).
This has occurred within a self-categorization of science in the areas of healthcare publication (Smith & Logan, 2002), academics (Sonoran University of Health Sciences, n.d.a), and legislation (State of Connecticut General Assembly, n.d.).
Yet naturopathy, in its essence, when assessed through scientific, medical, healthcare, and philosophical processes and institutions, is most often termed erroneous (Atwood, 2003), false (Murdoch et al., 2016), avoidant (Malo et al., 2023), incompatible (State of Connecticut Department of Public Health, 2017), and hollow (Hermes, 2018).
One interpretation of this complex landscape is a co-opting of science towards either the inadvertent or deliberate spreading of false science, as respectively, misinformation or disinformation.
Conversely, naturopaths in the United States (Smith, 2024), Canada (Atkinson, 2023), and Australia (Mason, n.d.) claim criticism of naturopathy’s science status should be regarded as myth.
At the pinnacle of such organized naturopathy is the WNF, which estimates that as of 2021 75,000 to 100,000 naturopaths practice in 81 countries.
Globally, over 90 educational and 20 research entities exist (Dunn et al., 2021).
The WNF maintains an online repository of publications and reports they have generated since 2015, and which are the centerpiece of this study (World Naturopathic Federation, n.d.).
The WNF adamantly refutes the designation of ‘not science-based’ that generally is placed upon naturopathy within a recent document -- not part of this study’s data set -- defending vitalism (World Naturopathic Federation, 2024).
Step 03c - Problem Statement:
Particularly since the COVID-19 pandemic, healthcare misinformation and disinformation have gained prominence (Barua et al., 2020).
For instance, highly effective and safe COVID-19 vaccines lead the overall decline in public support for such highly effective and safe interventions as vaccination, as measured midway through 2024 (University of Pennsylvania Annenberg Public Policy Center, 2024).
Usual mitigating strategies concerning misinformation and disinformation are centered around social and market sources as opposed to institutional sources and processes (Suarez-Lledo & Alvarez-Galvez, 2021).
Healthcare as an institution, particularly its branches of medicine and nursing, and the overall associated scientific rigors of all healthcare, has been polled to garner very high levels of societal trust (Harris, 2023).
A recent poll by the Pew Research Center, for instance, found that a majority, 78%, of Americans are slightly more likely to believe that medical scientists have the public’s best interest as a goal in terms of their activities.
Scientist were found to be held in higher regard than journalists, elected officials, religious leaders, police officers, school principals, and business leaders (Tyson & Kennedy, 2024).
If misinformation and disinformation have, to use the language of the past pandemic, jumped species and gained a foothold within institutional healthcare publication, academic, and legislative contexts as opposed to just social media, marketplace, and similar consumption contexts, the condition of the rule of law, science, and medicine, and healthcare overall are at risk from erosion of trust and integrity.
Concomitant harms may then ensue due to the institutionalization of misinformation and disinformation and those harms may be different from presently-expected social media and commerce-derived misinformation and disinformation harms.
Institutions are generally expected to function in protective as opposed to exploitative capacities (Dobreva, 2018).
The aspect of possibly institutionalized naturopathy misinformation could be a tangible reversal of that expectation.
Harmful effects may range from a condition of institutional degradation to that of perceived institutional betrayal (Smith, 2017) enveloping the areas of healthcare, science, public health, relevant publication contexts, areas of law, and the integrity of regulation.
SRQR Step 04 – Purpose or Research Questions:
Step 04a – Purpose of Study:
Through online, public, non-social media sources primarily by way of the WNF’s curated guidance reports and documents page (see Appendix A), and as triangulated by way of legal, healthcare publication, and academic publicly available sites from the three geographic areas mentioned (see Appendix C), the status of naturopathy within the parameters of misinformation, disinformation, institutionalization, and harmfulness will be holistically analyzed.
Granularly, this study investigates and evaluates whether, or not, the practices and beliefs known as naturopathy are presently communicated as misinformation and disinformation, if naturopathy has become institutionalized, determine potential naturopathy-specific harms, and evaluate whether a recently proposed framework is suitable to aid in identification and prevention of such a situation.
Most broadly, this study seeks to: identify potential online, nonsocial, nonmarket-based healthcare misinformation and disinformation; determine whether such has achieved institutionalization; evaluate the harms involved; and offer preventative solutions.
Additionally, the study seeks to postulate whether there are novel harms due to a source’s institutionalized context.
Because harmful online information is a contemporary epidemic/infodemic that usually originates from sources that are noninstitutionalized, an important aspect of this study is to attempt to determine if institutionalized misinformation and disinformation exist within that specific, curated, promotional, and explanatory WNF material.
The study will seek to consider whether such, if true, is a more intractable, potent, and strategically unanswered form of harmful online misinformation and disinformation.
This is achieved through assessment of the curated guidance publications and reports of naturopathy’s highest-level global organization, the World Naturopathic Federation (WNF) (World Naturopathic Federation, n.d.).
Strategically tailored mitigations or remediations based on best known practices will then be explored if deemed necessary.
004b - Research questions:
RQ1. Are the contents of curated online World Naturopathic Federation material misinformation?
RQ2. What harms could WNF misinformation entail?
RQ3. Does the Online Misinformation Engagement Framework (OMEF) adequately identify and remedy such potential WNF misinformation?
007. Methods sections:
SRQR Step 5 – Qualitative Approach and Research Paradigm:
Step 005a – Qualitative Approach:
Content analysis.
Historically, content analysis is defined as a systematic, flexible, rigorous, replicable, and extensive categorization approach to document analysis.
Content analysis began in the 1950s to study mass communicative material through the use of analytical constructs or rules of inference to answer particular research questions (White & March, 2006).
For this study, Roller and Lavrakas's definition of qualitative content analysis (QCA) will be utilized which is “the systematic reduction of content, analyzed with specific attention to the context in which it is created, to identify themes and extract meaningful interpretations of the data” (Roller & Lavrakas, 2015; Roller, 2019; Paris et al., 2024).
This study’s design will examine its dataset through the typical content analysis steps of textual coding, labeling, categorizing, pattern identification, and theme identification (Jacobsen, 2020).
Themes or patterns will be identified through the steps of a holistic reading of the text in question, analysis through fragmentation of the text and coding of meaningful subsections, and elaboration and refinement of the emerging code system (Biggs et al., 2021).
Evaluation, particularly in terms of the research question’s concern for misinformation within a claimed science context, will include considerations of textual cohesion, coherence, intentionality, acceptability, informativity, situationality, and intertextuality (White & March, 2006).
This will be achieved through conventional, directed, and summative content analysis processes (Hsieh & Shannon, 2005).
Broadly, the study’s overall qualitative content analysis processes will be sensitive to issues of credibility, dependability, transferability, and confirmability (Jacobsen, 2020; Bengtsson, 2016).
Step 005b – Guiding Theory:
Conceptual, relational, and proximity content analytical theories and conventional, directed, summative approaches will be employed (Hsieh & Shannon, 2005) towards testing the suitability of a newly developed unifying framework concerning identification of and redress concerning online information, the Online Misinformation Engagement Framework (OMEF) (Geers et al., 2024).
These three theories and three approaches for their application will guide the testing of the OMEF upon the WNF information/message/materials.
The OMEF will be evaluated comprehensively for suitability or weakness in terms of identification and remediation of misinformation.
Four core stages are identified within the OMEF framework.
They are source selection, information selection, evaluation, and reaction.
Typically, social media and marketplace misinformation detection and abatement strategies involve the last two stages concerning evaluations of the accuracy of information and participants’ reactions or willingness to recommend and share information (Geers et al., 2024).
In some sense, the last two stages are about consumption, response, and contagion.
As to whether naturopathy has attained an institutionalized status and is simultaneously misinformation, this more robust framework may allow for considerations of the former aspect, institutionalization, through its farther upstream first two stages of source selection and information selection.
These first two stages more primarily concern exposure, prevention, inoculation, and attenuation.
Step 005c – Research Paradigm:
The research paradigm of this study is methodological naturalism [MN] (Forrest, 2017; Viney, 2007; Jones, 2005).
MN is a means of stating, explicitly, the standard scientific footprint.
In the 2005 intelligent design case in Dover, PA, Judge Jones summated the testimony of expert philosophy of science witnesses in his opinion that included a well-accepted science demarcation with the statement “methodological naturalism is a 'ground rule' of science today which requires scientists to seek explanations in the world around us based upon what we can observe, test, replicate, and verify" (Jones, 2005, p. 65).
Sidebar:
As my dedication states, ‘we must be organized, systematized, self-testing and self-correcting.’
End sidebar.
MN is also succinctly stated as “an empirical outlook and an appeal to public methods” (Smith, 2017).
The research paradigm of this study, therein, regards knowledge deemed science as explanations derived from the empirical or observed, and then vetted by the public means of testing, replication, and verification.
As tangible examples of this typical and well-accepted demarcation, the positions “why creationism fails as a scientific theory” and “why science fails as a religion” are quite illuminating.
For the former, ‘creationism failing as science’, there is a reliance on unfalsifiable and untestable explanations and subjective beliefs involving supernatural forces or entities such a creator or spirits, a lack of predictions that can be tested, and a lack of observable phenomena that scientific methods can be applied towards (Google Search, 2024a [that’s from their AI response]).
For the latter, ‘science failing as religion’, this occurs due to science’s reliance upon empirical evidence derived from observations of the natural world, experimentation, explanations that are testable, and independent verification (Google Search, 2024b [also from their AI response]).
Step 005d – Rationale:
The qualitative approach of content analysis was chosen to examine the textual or written data that has been selected for the study due to its suitability regarding textual/verbalized/articulated material within a textual data set (Columbia University Irving Medical Center Mailman School of Public Health, n.d.).
The three theories and three approaches will provide for robust investigation and illumination of relational concerns regarding facticity and mistruths that potentially exist within the selected data.
The framework that has been selected is potentially the best that has been proposed, as it is an amalgamation of previous offerings, yet, it has not been tested and doing so will be this study’s contribution to the field and phenomenon.
This is a health science paper, and yet, it is important to be explicit concerning its epistemic boundaries.
Health science can vary regarding how close it hews to the ethos of scientific inquiry.
Additionally, due to naturopathy’s claim of being “natural” and “health science”, the MN explication [checked] and emphasis as standard scientific process is felt to be necessary.
The highly vetted findings of a preeminent legal case and a mainstream search engine’s AI provision were chosen as sources to define those epistemic boundaries and the processes within due to their very Bayesian representativeness regarding demarcations, aka their middle-of-the-road positions or as stated above, their position as the ‘standard scientific footprint.’
SRQR Step 6 – Researcher Characteristics and Reflexivity:
The author attended naturopathy school for four years in the U.S. between the years 1998-2000, but, ceased the degree pursuit after careful evaluation of naturopathy’s integrity.
Subsequently, the author taught physician office medical assistant curricula for twenty years and has held various physician-office vocational credentials.
SRQR Step 7 – Context:
The author feels he has professional and societal obligations to share his long-accumulated knowledge of naturopathy.
SRQR Step 8 – Sampling Strategy:
The data set, termed the WNFM, is the PDFs the WNF has deliberately collected and publicly presented as explanatory and promotional material.
This amounts to an approximately 1300-page PDF when combined.
Other WNF pages have been used for triangulation, when appropriate, but were not a part of the QualCoder software-facilitated process.
This entire data set has been employed.
It was chosen as a deliberate, public-facing, communication-oriented, nonsocial media, textual, and representative messaging collection that the organization itself has assembled.
SRQR Step 9 - Ethical Issues Pertaining to Human Subjects:
The materials that are the data set are not subject to human subject ethical concerns.
Additionally, they were created for public consumption by the WNF.
SRQR Step 10 – Data Collection Methods:
The WNF Publications and Reports PDF documents [see Appendix A] were accessed and downloaded May 21, 2024.
The collection does not have any 2024 uploaded documents, and this was checked as late as November 3, 2024 [may have changed].
SRQR Step 11 – Data Collection Instruments and Technologies:
The instrument for this study, the codes and their hierarchical organization, was generated from the WNFM through QualCoder 3.5.
This coding scheme represents the contents of the WNFM.
SRQR Step 12 – Units of Study:
The total number of individual documents included as the WNFM is 31 and their combined page count is 1290.
The large documents are, from largest to smallest:
The 754-page 2021 document titled “Naturopathy: Practice, Effectiveness, Economics and Safety” also referred to by the WNF as the Health Technology Assessment;
The 100-page 2017 document “WNF White Paper: Naturopathic Philosophies, Principles and Theories” ;
The 70-page 2015 document “World Naturopathic Federation Report”;
The 43-page 2016 document “WNF – Naturopathic Roots Report.”
SRQR Step 13 – Data Processing:
The downloaded individual PDFs were OCR’d through PaperPort.
One PDF of 754 pages, titled “Naturopathy, Practice, Effectiveness Economics & Safety,” was split into 32 more manageable parts using Adobe software to aid with prevention of lag when coding within QualCoder.
The PDF files were then imported into QualCoder resulting in a single project of 62 text files.
The text files were verified against the original PDFs’ contents.
SRQR Step 14 – Data Analysis:
An initial conceptual analysis was performed on the WNFM as a combined PDF (see Appendix B.).
This was a manual search process of the PDF to assess frequency of words and word elements after a close reading of the material.
This conceptual analysis was then used to generate the triangulation (see Appendix C.).
Coding, overall, was an iterative process which relied on the conceptual analysis, the triangulation, and the author’s expertise.
SRQR Step 15 – Techniques to Enhance Trustworthiness:
The triangulation (see Appendix C.) is the central verification of common knowledge pertaining to the naturopathy contents in relation to science.
This has been the Naturocrit Podcast Episode 015 Part C2.
In part C3, I will cover SRQR 16, which are the main findings of the content analysis’s coding process.
[continues]
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