Audience Research for Pandemic Flu Communications

1. Audience Research for Pandemic Flu Communications

2. Why do it? • Need to learn: • How hard-to-reach communities get information, especially during emergencies • Who would be most trusted to give public health messages to specific groups • Need to frame and deliver messages about pandemic flu that are: • Culturally appropriate • Relevant to diverse communities • Respond to needs and concerns of specific groups

3. Determine what you want to know Possible topics: • Media usage • Sources of health information • Trusted leaders • Beliefs and knowledge about illness • Beliefs and customs about death • Reactions to possible pandemic measures • Attitudes toward government and public health

4. Select target audiences Possible criteria: • What groups are most difficult to reach (e.g., most isolated, least trusting of government)? • What are the largest language groups? • Which groups are not well connected to advocates or social services that could otherwise provide information? • Which groups do you know least about? • Do you have partnerships with organizations serving any potential target communities?

5. Options for Research Methods

6. Consider Partnership withCommunity-Based Organizations (CBOs)

7. Key informant interviews:Who to interview? • Look for individuals immersed and trusted in the target communities • They may or may not identify as members of the target communities • Do you have partners in the community whose staff could be interviewed? • Ask interviewees for suggestions for other interviewees • Possible interviewees: CBO staff (social service agencies, advocacy groups, neighborhood organizations), medical interpreters, clergy and religious leaders, ethnic media publishers

8. Key informant interviews:Developing an interview guide • Develop a standardized interview guide that explores issues of interest with open-ended questions • Make sure questions don’t inadvertently place value or judgment on the issue at hand • Allow interviewers to improvise questions according to the direction of the interview, but highlight the critical questions that must be asked in each interview • Train all interviewers by going over the interview guide together and explaining what kind of information you’re seeking with each question (this will help interviewers probe more deeply) • Do test interviews to 1) make sure your questions are understandable and elicit in-depth answers, and 2) your instructions are clear

9. Tips for key informant interviews • Provide informed consent for all interviews • Introduce yourself and the project before starting the interview • Audio record the interview and jot down notes on key items (notes are very helpful when the audio quality is poor) • Conduct the interview in as quiet a room as possible

10. Key informant interviews:Language considerations Options if the target audience speaks a language other than English: • Interview bilingual individuals • Interview key informants who are immersed in community, but also speak English • Use simultaneous interpretation (expensive!) • Recruit bilingual interviewers (need to translate the interview guide and transcriptions of the interviews)

11. Q-Method: What is it? • Q method is an approach and a method to understanding different opinions that people have about a particular topic • It uses a combination of qualitative and quantitative tools to characterize opinion types • Participants are presented with a set of opinion statements on cards and asked to “sort” or rank the opinion statements along a continuum (such as “most important” to “least important”)

12. Q-Method: What is it useful? • Q-method is excellent at uncovering nuances in opinions across different people • Subjects who do the Q-sort have an opportunity to systematically think through their opinions about a topic • Most people really enjoy doing the Q-sort – it’s fun to do

13. Q-Method: Where can I get moreinformation on the method? • Q-method has a key website for anyone interested in Q method http://www.qmethod.org/ • The site has links to bibliographies, tutorials, and articles on Q, as well as a list serv http://www.lsoft.com/SCRIPTS/WL.EXE?SL1=Q-METHOD&H=LISTSERV.KENT.EDU)

14. Example of Q-sort activity 1) We created 31 opinion statements related to pandemic flu, based on key informant interviews 2) Participants were each given a set of the opinion statements, written on cards, and a game-board showing “most important” to “least important” 3) Using the cards and gameboard, participants individually ranked the statements from most important to least important. (See the Focus Group Guide for the script used for the Q-sort activity)

15. Example of Q-sort opinion statements

16. Example of Q-sort “gameboard” Most Important Least Important

17. Value of the Q-sort activity to focusgroup interviews • Creates an aggregate “snapshot” of an individual’s opinions • Forces participants to think about their own values and priorities related to pandemic flu • Reduces the influence of other participants on an individual’s opinions • Provides rich starting place for discussion

18. Analyzing the Q-sort • Q sorts can be analyzed using free software available at http://www.lrz-muenchen.de/~schmolck/qmethod/ • The sorts are correlated and factor analyzed into “types” of people who view the topic the same way • This analysis is not done at the focus group, but is completed after all the interviews are finished

19. Focus Groups • Group dynamic can stimulate rich discussion of issues, but requires skilled facilitation • May be preferred over one-on-one interviews in group-oriented cultures (such as some Native American, Asian, and Latino cultures)

20. Planning for focus groups • Develop a standardized focus group guide • Try to host focus groups within the target audience’s community • Allow time for debriefing with facilitators and note-takers to capture their impressions • A health educator should provide a simple overview presentation of pandemic flu • Provide preparedness action steps

21. Training for focus group facilitatorsand note-takers Ideas and tips for training: • Model a focus group, with facilitators and note-takers acting as participants • Then go over the focus group guide, point-by-point, to explain what key information you seek at each discussion point • Provide time for practicing • Give clear instructions on the role of both the facilitator and note-taker • Provide examples of what notes should look like for the note-takers and give feedback on practice notes

22. Focus group tips • Provide an incentive (gift card, free meal, cash) • Consider renting audio equipment • Ensure that focus groups are held in a quiet space • Inform recruited participants in advance that children may not attend focus groups (provide child care if possible)

23. Focus groups on other languages • Translate all materials for facilitators and participants • Recruit bilingual CBO staff or public health staff to facilitate and take notes • Transcription and translation of focus group recordings is most accurate, but very expensive • Simultaneous interpretation could be distracting • Another option is to ask bilingual facilitators and note-takers to listen to the audio recordings with you and provide their interpretations of what was said

24. Resources in the APC toolkit • Key Informant Interview Guide • Consent Form (English, Spanish, Vietnamese) • Focus Group Guide (English, Spanish, Vietnamese) • Focus Group Tips for Facilitators and Note Takers • Game Board (English, Spanish, Vietnamese) • Q-Statements (English, Spanish, Vietnamese) • Q-Answers • “What Do You Pay Attention To?” Survey (English, Spanish, Vietnamese) • Information Sources Survey (English, Spanish, Vietnamese) • Introduction to Pandemic Flu (English, Spanish, Vietnamese) • Pandemic Flu PowerPoint Presentation (English, Spanish, Vietnamese) • Preliminary Findings • Audience Research Lessons Learned