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Imagine that you’re analyzing survey responses with regard to the use of bednets for prevention of malaria. You find that a large proportion of respondents report not using bednets. However, you have no data about why they are not using bednets. What approach(es) might you use in order to figure out why respondents are not using bednets?
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There are several approaches that I might use in order to figure out why respondents are not using bednets, including:
Qualitative interviews: In the context of understanding why respondents are not using bednets for malaria prevention, conducting qualitative interviews with a sample of non-users could provide valuable insights into the specific barriers or facilitators that are impacting their decision not to use bednets.
During a qualitative interview, we will typically ask open-ended questions that allow the participant to share their thoughts and feelings in their own words. These interviews are usually conducted in a private setting and may be recorded for later transcription and analysis. We will likely have a list of topics to cover during the interview, but they should also be flexible and willing to explore new topics that come up during the conversation.
For example, in the context of bednet use, we might ask questions such as: “Can you tell me about a time when you did not use a bednet?” or “What are your thoughts and feelings about bednets?” These types of open-ended questions allow the participants to share their personal experiences and perspectives, which can provide valuable insights into the reasons why they are not using bednets.
Focus group discussions: In the context of bednet use, we could bring together a group of non-users to discuss their experiences and perceptions related to bednet use.
This method allows for a natural conversation to occur, and allows for us to observe the interactions and dynamics of the group. It provides a platform for non-users to share their experiences, concerns, and barriers to bednet use in a supportive and non-judgmental environment. Through this method, we could identify common themes among non-users and gain a deeper understanding of the reasons behind their lack of use of bednets. Additionally, we can also observe the non-verbal cues of the participants and the dynamics of the group, which may provide additional insights.Follow-up surveys: Follow-up surveys involve conducting additional surveys with non-users after a certain period of time has passed. This approach allows us to track changes in bednet use over time, and identify factors that may have influenced the decision of non-users to start or continue not using bednets. For example, if a follow-up survey is conducted a few months after the initial survey, and non-users report starting to use bednets, we can investigate the reasons for this change. Follow-up surveys can be useful in identifying factors that may be associated with changes in bednet use over time such as access to information, socio-economic status and education level. Additionally, follow-up surveys can help us to understand how non-users may have been influenced by interventions or other efforts to increase bednet use.
Monitoring and evaluation data analysis: Monitoring and Evaluation (M&E) is an important aspect of understanding the effectiveness of any intervention, including the use of bednets for malaria prevention. M&E data can provide a wealth of information about the availability and accessibility of bednets, as well as their distribution coverage. This can give insight into potential barriers to bednet use. For example, if a survey shows that bednets are not available in certain areas, or if distribution coverage data shows that a large number of bednets are not being distributed to the target population, it can be inferred that the lack of availability of bednets is a barrier to bednet use in those areas. Furthermore, M&E data can also provide information about the effectiveness of distribution strategies, which can be used to improve the distribution and coverage of bednets in the future.
Literature review: In this case, the topic would be factors associated with bednet use in similar settings or populations. The purpose of conducting a systematic literature review is to gather information from existing research in order to identify patterns, themes and gaps in knowledge.
For example, if I were conducting a systematic literature review on bednet use in Myanmar, I would search for studies that have been conducted in the South-East Asia region and that have investigated factors associated with bednet use. I would then analyze these studies to identify common themes and patterns in the data. This could include identifying factors that have been consistently associated with bednet use or non-use in the region, as well as identifying gaps in knowledge where further research is needed.
By conducting a systematic literature review, I can gain a better understanding of the existing research on bednet use and identify potential barriers to bednet use in similar settings or populations. This can help inform the design and implementation of future interventions to promote bednet use and help prevent malaria.
The goal is to use a combination of methods, to triangulate data and find the root cause of non-compliance but as with most project, it will also depend on the budget, timeframe and primary research question of the project.
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In case the quantitative study revealed that the vast majority of people did not use their bed nets to prevent mosquito bites, then, the qualitative method I need to undertake comprises multiple approaches and is under sequence way in order to answer the research question deeply and comprehensively.
First, I need to undergo a participant observation to indirectly situate the environmental and social causes, as well as find other questionable conditions that need to be confirmed in the further methods. By this observation, I probably will make sense of the hot temperature of the region, the poverty situation that is seen by building contour, the way people set their beds which enables bed nets are difficult to mount or their habits about sleeping outside the house. Those variables will not directly lead to the conclusion but will be explored and confirmed under the second sequence approach by conducting a Focus Group Discussion (FGD).
The FGD I would like to execute involves at least two or three different groups where one group consists of five to six participants. Subjects come from previous quantitative research, so I will consider the previously filled-out questionnaire to do selection and hold recruitment for FGD. FGD allows me to gain a wide variety of participants’ reasons and exchange viewpoints among people, as well as discuss agreements or disagreements between people. Moreover, FGD enables allow cross-reading results to confirm the different directions of answers among groups. I will probably get reasons about uncomfortable when sleeping under a mosquito net, mosquito nets blocking the wind, not being able to buy a mosquito net, assumptions about mosquito density being low, or the same answers as observation results.
The analysis of FGD will combine both condensing and displaying techniques. It is important to transcript the audio into the next and not publish its original audio or video to maintain information confidentiality and for participants’ safety purposes. Transcription enables me to outline the quotes and summary of notes. FGD results might be explorative where reasons answering why people did not apply the bed nets can be figured out using comparative word cloud or bulleted summaries. On other hand, participants may also present a causality between reasons in which the mind mapping will be very useful for data visualization.
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In order to understand the reasons for not using bed-nets in particular populations, i would perform qualitative research. In-depth interviews can be used as a tool for gathering data on people’s beliefs and opinions.
In-depth interviews could be directly target to interested participants from the previous quantitative research which could be the non use of bed-nets in populations. The designed interview questions could gain non-numerical data which is an opportunity to understand why people aren’t using bed-nets. Attitudes and data from the participants could reveal more comparison than the quantitative research. However, with the small sample size of in-depth interviews, informants and questions should be selected cautiously to represent the population and to be effective tools, respectively. Bias such as selection bias and interviewer bias should be considered.
Themes, patterns and relationships among non use of bed-nets participants might be found for better understanding and possibly create hypotheses for further quantitative tests.
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From my point of view, qualitative research can help us figure out why people do not using bednets. I would like to start with the literature review to determine whether previous studies that mentioned about the reasons for not using bednets. This will help us conceptualize and summarize the potential reasons to ask them.
Next, we will select the population to ask them the questions. Systematic, nonprobability sampling is the approach to people who are not using bednets and who are the target population of the study. The sample size should initially be around 12-26 subject; however, it can be expanded if there are many different reasons of not using bednets and there is heterogeneity of gathered information.
There are many possible methods of collecting data. Commonly used methods are interviews and focus group discussions. The interviews should be semi-structured so that we provide the potential reasons that we have reviewed from the previous studies. If there is another reason besides our lists, in-depth interviews regarding that reason should be used. Convenient atmosphere should be created to make respondents speak freely.
Another common method is a focus group discussion. The advantages of this method are less time consuming, the ability of sharing ideas between participants, etc. However, there may be a limit to sharing their ideas if they are strange to each other.
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For me, I would start by identify the biases or confounders in the survey response first. The preliminary data from the survey may guide the modality of the next step to find out the answer.
The next step would be “qualitative research” to study to reason of not using bednets in depth.However, the qualitative research itself could be divided into multiple approach including the individual interview of informants, individual interview of key informants, focus group discussion. Since many people response to the survey as not using bednets. I would prefer using focus group to get the holistic view of the community. The interview could be conducted in semi-structured format. Some question maybe derived from the assumption from the survey.
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For me, I would first conduct a thorough search for any existing research in the same area. Ideally, I would uncover previously studied information that would save time and resources. However, if I am unable to find suitable research, I may need to conduct additional qualitative studies.
I think, prioritizing between the depth of information required and the time it takes is crucial. In cases where the information is highly sensitive and requires in-depth analysis, conducting an in-depth interview is necessary. However, when it comes to data on the use of bednets, which is not highly sensitive, I will begin by launching an open-ended questionnaire to comprehend why most people choose not to use bednets. Subsequently, I will categorize the reasons and conduct focus group studies to discuss them in each group.
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I would decide to do a qualitative study in order to understand the reason why people don’t use bednets for prevention of malaria.
First, I will try to review literature with regard to the topic of study whether are there any conclusions or factors reported on why respondents don’t use bednets. After that I would go for a semi-structure interview by doing a focus group discussion.
By having focus group participants who are in the studied/exposed community. In addition, asking open-ended questions to allow them answers freely in many directions, and to know their attitudes, feelings and beliefs. However, the answers could potentially lead ones agree and change dynamic of the interview. Thus, researchers should have a well plan structure questions in order to keep on track to the point and conclusion. Nevertheless, an in-depth interview might also perform only for key informants (e.g. community leaders) who could provide researcher for a better understanding and reason on why they don’t use bednets.
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The very first thing that came up into my mind and I believe, most of the time, when you are facing some problems which is hard to figure out is to ask! That is probably be the same as this case. However, this task can not simply done by just asking questions in a larger population. We need a systematic way to explore such problems..through research!
In this case, I may start with some review about this bednets system whether about how it is built, what it does, platform availability, target users’ information, etc. After we have identified essential topics about them, then we could start by deploying a simple questionnaire consists of multiple questions which could be the validated questionnaire –– TAM, for instance. This is called a cross-sectional (conducted in one point of time), quantitative (measurable) research. After that, we can skim through responses and we may conduct further focus group discussion in order to explore insights in the particular group with extreme response, for example, lowest possible score in some aspect or areas by using an open-ended question. Nonetheless, we need to predefine and anticipate possible confounder factors, biases to ensure an integrity and quality of the research.
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If we don’t have data on why respondents don’t use bednets, we can use one or more of the following to gather more information to help us to understand the data:
Get a consultation from local experts: Experts in malaria prevention, such as public health officials and non-governmental organizations (NGOs) working in the field These experts may be able to offer advice on ways to increase bednet use and have valuable insights into the factors that influence its use.
Conduct interviews or follow-up surveys: We can conduct follow-up surveys or interviews with them. This may assist you in comprehending the reasons for their behavior.
Discussions in focus groups: With groups of people who do not use bednets, we can hold focus groups to learn more about their reasons for not using them. Using this strategy, you can learn about the most common reasons people don’t use bednets and find behavior patterns.
Literature review: We can conduct a literature review to gather information on factors that have been shown to affect bednet use. Bednet availability and accessibility, as well as other socioeconomic and cultural factors, are all examples of this.
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To figure out why respondents are not using bednets, I’d rather start from literature review. This topic is quite common problem, about mosquito related disease prevention. So, there might be previous published literature in large database such as Pubmed, for the reason or barriers to bednets or mosquito net use. Then with those information, probably there are main factors such as , social factor, individual factor, environment/temperature factors, and bednets availability, we can further dig and sort out the proper approach for particular factors in the list. Then we can conduct a cross-sectional survey of barriers or factors in not using bednets, we will get quantitative data. For understanding more on some factors, we can now conduct some qualitative data for example in-depth interview with head of the village, focus group discussion with those who use and those who do not use the bednets.
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To understand why respondents are not using bednets for malaria prevention, I suggest conducting a review of existing research as a first step. This can help identify common reasons for not using bednets to prevent malaria. Additionally, if the demographic data are collected, analyzing demographic data, such as age, gender, education level, and socioeconomic status, if available, may reveal patterns in not using bednets. Another approach is to conduct follow-up interviews or surveys with respondents who reported not using bednets (focus group). These interviews, possibly via phone call or in-person interview, can provide deeper insights into the reasons why respondents are not using bednets to prevent malaria.
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I would start figuring this problem by
1. Research more articles and research papers relating to this problem.
2. Perform interview with specialists especially local experts.
3. Conduct interview. I would go for semi-structured interviews that can provide me both expected answer and might provide unexpected views from the respondents.
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