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ORIGINAL ARTICLE
Open Access

Observe Before You Leap: Why Observation Provides Critical Insights for Formative Research and Intervention Design That You’ll Never Get From Focus Groups, Interviews, or KAP Surveys

Steven A. Harvey
Global Health: Science and Practice May 2018, GHSP-D-17-00328; https://doi.org/10.9745/GHSP-D-17-00328
Steven A. Harvey
aSocial and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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  • For correspondence: steven.harvey@jhu.edu
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This article has a correction. Please see:

  • Update of: Harvey, Observe Before You Leap: Why Observation Provides Critical Insights for Formative Research and Intervention Design That You'll Never Get From Focus Groups, Interviews, or KAP Surveys - October 03, 2018

Four case studies show how observation can uncover issues critical to making a health intervention succeed or, sometimes, reveal reasons why it is likely to fail. Observation can be particularly valuable for interventions that depend on mechanical or clinical skills; service delivery processes; effects of the built environment; and habitual tasks that practitioners find difficult to articulate.

ABSTRACT

Formative research is essential to designing both study instruments and interventions in global health. While formative research may employ many qualitative methods, focus group discussions and in-depth interviews are the most common. Observation is less common but can generate insights unlikely to emerge from any other method. This article presents 4 case studies in which observation revealed critical insights: corralling domestic poultry to reduce childhood diarrhea, promoting insecticide-treated bed nets (ITNs) to prevent malaria, evaluating skilled birth attendant competency to manage life-threatening obstetric and neonatal complications, and assessing community health worker (CHW) ability to use malaria rapid diagnostic tests (RDTs). Observation of Zambian CHWs to design malaria RDT training materials revealed a need for training on how to take finger-stick blood samples, a procedure second nature to many health workers but one that few CHWs had ever performed. In Lima, Peru, study participants reported keeping their birds corralled “all the time,” but observers frequently found them loose, a difference potentially explained by an alternative interpretation of the phrase “all the time” to mean “all the time (except at some specific seemingly obvious times).” In the Peruvian Amazon, observation revealed a potential limitation of bed net efficacy due to the built environment: In houses constructed on stilts, many people sleep directly on the floor, allowing mosquitoes to bite from below through gaps in the floorboards. Observation forms and checklists from each case study are included as supplemental files; these may serve as models for designing new observation guides. The case studies illustrate the value of observation to clearly understanding clinical practices and skills, details about how people carry out certain tasks, routine behaviors people would most likely not think to describe in an interview, and environmental barriers that must be overcome if an intervention is to succeed. Observation provides a way to triangulate for social desirability bias and to measure details that interview or focus group participants are unlikely to recognize, remember, or be able to describe with precision.

  • Received: 2017 Aug 19.
  • Accepted: 2018 Feb 6.
  • © Harvey.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-17-00328

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Global Health: Science and Practice: 10 (2)
Global Health: Science and Practice
Vol. 10, No. 2
April 28, 2022
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Observe Before You Leap: Why Observation Provides Critical Insights for Formative Research and Intervention Design That You’ll Never Get From Focus Groups, Interviews, or KAP Surveys
Steven A. Harvey
Global Health: Science and Practice May 2018, GHSP-D-17-00328; DOI: 10.9745/GHSP-D-17-00328

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Observe Before You Leap: Why Observation Provides Critical Insights for Formative Research and Intervention Design That You’ll Never Get From Focus Groups, Interviews, or KAP Surveys
Steven A. Harvey
Global Health: Science and Practice May 2018, GHSP-D-17-00328; DOI: 10.9745/GHSP-D-17-00328
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