Dr. Marlaine Figueroa Gray

Designing rigorous qualitative studies across the full arc of a project — from conceptual framing and methodology to analysis, write-up, and dissemination.

Research approaches centered on dignity and participant voice, with particular depth
in serious illness, end-of-life care, and substance use.

Consultation on the ethical and practical use of AI in qualitative research — including narrative data, sensitive populations, and end-of-life contexts.

A sustained focus on personhood, meaning, and legacy: what matters most to people at the end of life, and how that knowledge gets documented and used.

My Approach

Collaborative

Research is stronger when every voice at the table is heard. I work as a genuine partner within research teams — supporting all members, investing in the development of junior scientists, and bringing multiple perspectives to bear on study design, interpretation, and meaning. Rigor is a collective achievement.

Patient-centered

Understanding the patient experience requires centering human dignity — in how questions are framed, how consent is approached, how findings are returned to communities. Drawing on decades of work alongside people living with serious illness, I keep the research anchored to what actually matters to them.

Trauma Informed

Serious illness, end-of-life experience, and substance use all carry histories that shape how people engage with researchers — and how safe they feel telling their truth. My approach is grounded in an understanding of how trauma shapes narrative and memory, and I hold that awareness across every stage of a study. Clinical pastoral education at Harborview Medical Center has deepened this practice: I bring to research the same quality of presence that spiritual care requires — the capacity to sit with difficult material and create conditions in which people can speak honestly.

Dementia, Kinlessness, and Methodological Innovation

This line of research examines the experiences of kinless older adults — those with no living spouse or children — at the time of dementia onset. Working with Janelle Taylor (University of Toronto) and Lily Shapiro (KPWHRI), along with a multidisciplinary team, I contributed to two studies drawing on the Adult Changes in Thought longitudinal cohort.

The first, published in the Journals of Gerontology (2023), documented the circumstances and unmet needs of this population; the second, in the Journal of Aging Studies (2023), developed a methodological approach using medical records and administrative documents as ethnographic data — a way of bringing systematically excluded people into qualitative inquiry.

This work has opened a promising new direction: using natural language processing to identify clinically relevant text, including chart notes and patient portal messages, as a basis for qualitative research with hard-to-reach populations. Manuscripts are in progress.

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Selected Areas of Inquiry

Cancer, Young Adults, and Patient-Centered care

Adolescents and young adults with cancer occupy an understudied space — their needs differ from both pediatric and older adult patients, and existing care models have rarely centered their experience. A qualitative interview study in the Journal of Adolescent and Young Adult Oncology (2018) found that AYAs with advanced cancer navigated a difficult tension between hope and risk, often in the context of unclear prognostic communication, and wanted honest support in facing mortality alongside continued treatment.

A subsequent study in Cancers (2024) engaged AYA survivors to identify eight domains critical to holistic survivorship care and developed a conceptual model that places the patient and their support systems at the center — rather than the health system — and emphasizes the need for sustained navigation over time.

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Legacy and serious illness

A scoping review published in BMJ Supportive & Palliative Care (2024) synthesized three decades of literature and identified three intersecting legacy goals — how people wish to be remembered as individuals, in their relationships, and through their impact on others — finding these goals to be central, not incidental, to medical decision-making.

A following qualitative interview study in The Permanente Journal (2025) brought these questions into clinical practice, finding that serious illness often sharpened legacy goals even as illness and its treatment threatened people's ability to achieve them. Participants wanted to discuss legacy with their care teams — and believed their care would look different if teams understood what they hoped to leave behind.

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Explore collaboration

Schedule a free 1:1 introductory session with me to discuss your research project.

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