Designing an ethnographic interview for evaluation of micronutrient powder trial: Challenges and opportunities for implementation science

Abstract

The evidence base for micronutrient powder (MNP) interventions predominantly consists of quantitative studies focused on measuring coverage, utilization, and/or biological outcomes. We need other types of studies to broaden the scope of our knowledge about determinants of MNP programme effectiveness. Addressing this knowledge gap, this paper focuses on the process of designing an ethnographic research protocol to obtain caregivers' perspectives on the factors that influenced their use of intervention delivery services and their adherence to MNP recommendations. The research was undertaken within the context of formative evaluations conducted in Mozambique and Ethiopia. Ethnography provides a means for acquiring and interpreting this knowledge and is an approach particularly well suited for formative evaluation to understand the response of a population to new interventions and programme delivery processes. We describe decisions made and challenges encountered in developing the protocol, and their implications for advancing methodology in implementation research science. In addition to a core team of three investigators, we added an “advisory group” of 10 experts to advise us as we developed the protocol. The advisory group reviewed multiple drafts of the interview protocol and participated in mock interviews. In the protocol development process, we faced the issues and made decisions about concerned gaps in content, cultural adaptations and comprehension, and interview guide structure and format. Differences between the core team and the advisory group in methodological approaches to the structure and content of questions call attention to the importance of establishing greater communication among implementation scientists working in nutrition interventions.

Using Community-Based Participatory Research Methods to Inform the Development of Medically Tailored Food Kits for Hispanic/Latine Adults with Hypertension: A Qualitative Study

“…Ethnographic research was conducted to address a knowledge gap in individuals’ perspectives regarding culturally appropriate F/V for chronic disease management, allowing for the researchers to learn about preferences and barriers for a migrant Hispanic/ Latine population. This method is particularly effective to provide formative interventions and cross-cultural understanding [ 23 ]. Each interview included an introduction to the purpose of the study, the researcher’s role in the community health clinic and university, the objectives of the interview being conducted, the anticipated duration of the interview, the right to refuse to answer any questions that cause discomfort, and empowering the participants to share their opinions with the intent of learning from the patients.…”

Health Help-Seeking Behavior: The Scavengers’ Perspective

“…Based on the feedback received from the scavengers, a revision was carried out by breaking down the complicated questions into simpler ones. It eventually improved the structure and the content of the interview guide [ 38 ]. The final list of well-planned, open-ended and pretested questions, including probes, was beneficial for this study as it increased the interviewer’s confidence level, made her more focused towards interviewees’ responses and less preoccupied with what to ask next and how to ask it [ 39 ].…”

Ethiopian mothers' experiences with micronutrient powders: Perspectives from continuing and noncontinuing users

“…In this study, we used in‐depth interviews with open‐ended, guided questions, which were administered with extensive probing to expand and interpret the initial responses. Our interview protocol contained four modules that covered a range of issues including demographic and socio‐economic status (SES) characteristics; experiences receiving Desta and participating in BCC activities; motivation for initiating and continuing to feed Desta; motivation for discontinuing Desta; preparation of food with Desta; perceived changes in food mixed with Desta; perceived reactions of child when fed food with Desta, initially and over time; caregiver responses when a child refuses to eat food mixed with Desta; beliefs about how to keep children healthy; beliefs about the benefits of Desta; perceived changes as a results of the child consuming Desta; and how programme delivery of Desta could be improved (Schnefke et al, ). Interviews were conducted in mothers' homes from November to December 2016 and averaged 2–3 hr.…”