Tag Archives: qualitative

here’s an idea — if they are trying to tell you something, make it easy for them to do so.

Posted on by hlanthorn

there’s been a good deal of press around the unfortunately insignificant results of a major HIV prevention trial with products for women in south africa, uganda and zimbabwe. the results had little to do with efficacy of the products (a pill and a gel) but rather with the fact that most of the participating women did not use the treatments as recommended – or at all.

one potential response is to improve our behavioral interventions to support adherence to treatment regimens (and prevention regimens) and integrate these methods more directly into medication trials. adherence and persistence with medication are global problems and we are just beginning to learn – with the help of health psychology and behavioral economics – how to tackle the challenge. efforts so far include high- and low-tech solutions, though not all the promises of the former, in terms of mhealth to facilitate behavior change and adherence, have yet been borne out.

another, not mutually exclusive, response would be to actually ask the women what they would like to see and use in the way of HIV prevention – a tool which should be empowering for them. the press seems full of comments like “the women are trying to tell us something!” why does it seem that, then, for a product made for them, they have to work so hard to tell us those things? why are we not hearing more sentences that start “the women told us…” that is, why, after such a big trial, am i not hearing anything about on-going qualitative and observational follow-up efforts to learn more about what exactly didn’t work about the methods offered to women?

there’s often a lot to learn from null results (that’s science, right?) but it doesn’t just come from brainstorming what went wrong. asking helps.

i don’t suggest that people are perfectly prescient about what they need or want. often, the innovations that we can’t live without now – smartphones, for example – weren’t a need or even desire that most people could have articulated 20 years ago. as such, directly asking people what it would take to get them to engage in X desirable behavior can’t determine the research agenda. but it should certainly be part of figuring it out.

i know – but couldn’t we have asked, too?

Posted on by hlanthorn

things i know & understand:

  • this is cool research from @poverty_action
  • it’s fun and important to show and know that ‘we’ (development types) have poor assumptions about what will work
  • time and budgets are always constrained
  • this comment is super-predictable coming from me. but…

when i read this:

our results showed that although the consulting intervention caused short-term changes in business practices, these impacts dissipated within a year after the consulting ended. on average, we found no long-term benefit from the consulting, and actually lower short-term profits. we believe some business people hoped the advice would work and thus took it. but better bookkeeping and other business practices potentially took time away from the physical act of sewing clothes. once profits took a hit, enterprise owners likely abandoned the practices and reverted to their previous methods. [emphasis added]

i think to myself, ‘heather, why is it that you so rarely read:’

  • “the respondents believed this program did/not have the intended effect because…” (this would be based on more qualitative research during our at the end of the study)
  • or, something along the lines of, “the respondents felt that future efforts could be improved by…” (more of that open-ended goodness)
  • or, “from our observations during the implementation of the intervention, we believe what happened is…”
  • or, “the implementers feel that x happened, that z presented serious challenges, and y could improve it in the future”
  • or, radically, “the respondents (or implementers) feel that a better way to have approached the same goal would have been…”

i am well aware that absolutely none of these things will provide definitive – or even ‘true’ – answers about what worked and why. but surely other people’s opinions besides the reseachers’ count and should be collected, despite the extra collection and analysis time? wouldn’t it be fun to have more information about why we are seeing the treatment effect that we see? among other sources, see here.