1 / 60

Formative & Baseline Study Methods

This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation In Slide Show, click on the right mouse button Select “Meeting Minder” Select the “Action Items” tab

naava
Download Presentation

Formative & Baseline Study Methods

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation • In Slide Show, click on the right mouse button • Select “Meeting Minder” • Select the “Action Items” tab • Type in action items as they come up • Click OK to dismiss this box • This will automatically create an Action Item slide at the end of your presentation with your points entered. Formative & Baseline Study Methods Befekadu Girma, M.Ph. Development Studies Associates Addis Ababa, Ethiopia Kim Witte, Ph.D. JHU/CCP JHU/PCS - Ethiopia Reproductive Health Communication Project

  2. Acknowledgements • Regional Heads • CSA • Enumerators JHU/PCS - Ethiopia Reproductive Health Communication Project

  3. Design • Sample • Males and Females Aged 15-30 • In Two Most Urban Towns in Five Regions • Addis Ababa and Environs: Akaki and Gedam-Sefer • Amhara: Bahr Dar and Gonder • Oromia: Jimma and Nazareth • SNNPR: Awassa and Arba-Minch • Tigray: Adigrat and Mekele JHU/PCS - Ethiopia Reproductive Health Communication Project

  4. Design Continued • Qualitative Research • 20 Focus Groups • 4 per region • Males 15-20, Females 15-20, Males 21-30, Females 21-30 • Quantitative Research • Face-to-Face Surveys • 800 participants total (792 completed) • b > .80, a = .05 (2 tailed tests) JHU/PCS - Ethiopia Reproductive Health Communication Project

  5. Sampling Procedures – FOCUS GROUPS • Purposively Selected to capture age, sex, demographic differences in perceptions and practices • Excluding any participants already interviewed for survey. • Average of 8 participants per group • 161 total focus group participants • Discussions lasted about 2 hours JHU/PCS - Ethiopia Reproductive Health Communication Project

  6. Sampling Procedures -- SURVEYS • Complete Random Sample • Using random numbers table • Randomly selected zone, then woreda, then kebele, then households (all from fresh lists) • Households having persons aged 15-30 were eligible for the study • Non-responses replaced by next eligible household (occurred only 5 times). • One person per household interviewed. JHU/PCS - Ethiopia Reproductive Health Communication Project

  7. Quality Control Procedures • Coordination: National & Regional • Manual Developed • Objectives, strategies, norms for study • Asking demographic, sexual questions • Family planning, HIV/AIDS issues • Procedures, precautions during survey/focus groups • Do’s and Don’ts JHU/PCS - Ethiopia Reproductive Health Communication Project

  8. Quality Control Continued • Training • Two Stages: Training of trainers, training of supervisors and interviewers • Theory, sampling techniques • Mock exercises, Practice in the field • Feedback • Completed questionnaires reviewed at the end of each day • Spot checks of interviewers/moderators throughout study by national coordinator JHU/PCS - Ethiopia Reproductive Health Communication Project

  9. Instrument Development • Questions and items developed according to theory • Based on validated and reliable items used in previous studies • Piloted and refined to fit Ethiopian culture • Focus Group Guide • Open-ended questions • Piloted and refined for flow, understandability JHU/PCS - Ethiopia Reproductive Health Communication Project

  10. Instrument Development – Cont. Survey Questionnaire • Open and close-ended items • 5-point Likert-type scales 1 2 3 4 5 Strongly Strongly Disagree Agree • Respondents adapted easily to response format • Item analysis indicated valid and reliable scales JHU/PCS - Ethiopia Reproductive Health Communication Project

  11. Analysis Procedures • Focus Groups • Audiotapes professionally transcribed • Translated ver batim into English • Research team developed Classification Scheme to code phrases/thoughts • Subgroup analysis conducted by age, sex, region • Similarities/Dissimilarities extracted • Coded material placed into tables JHU/PCS - Ethiopia Reproductive Health Communication Project

  12. Analysis Procedures • Survey Questionnaires • Pre-coded numerical responses • Open-ended items numerically coded • Data entered, cleaned in SPSS • 10% data double-entered to verify accuracy • Scales created, reliability analysis conducted for all theoretical variables • Frequencies, descriptives analyzed • T-tests, one-way ANOVA, correlations, and logistic regression analysis conducted JHU/PCS - Ethiopia Reproductive Health Communication Project

  13. TEA BREAK – 20 minutes JHU/PCS - Ethiopia Reproductive Health Communication Project

  14. Tea Break OVER Please Be Seated JHU/PCS - Ethiopia Reproductive Health Communication Project

  15. FOCUS GROUP RESULTS JHU/PCS - Ethiopia Reproductive Health Communication Project

  16. General results – Family Planning • Major Health Problems • HIV/AIDS, malaria, TB, dysentery • Most Important Health Problem • HIV/AIDS • Ideal Family Size • 12 groups preferred 2-4 children • Nazareth groups preferred 10-12 children JHU/PCS - Ethiopia Reproductive Health Communication Project

  17. Theoretical results: Family Planning • Defining the Threat: What is negative about Having More Children than Desired (if anything)? • Inability to feed, clothe, educate, provide medical care • Maternal death • Loss of hopes/dreams, poverty, family breakups • Perceived Severity – outcomes listed above serious, but rare • Perceived Susceptibility (too many children) • High for members of 12 groups • Lower risk for members of 4 groups JHU/PCS - Ethiopia Reproductive Health Communication Project

  18. Theoretical results: Family Planning • High Knowledge for Perceived Best Responses to prevent too many children • Perceived Response Efficacy: High, except for Condoms • Modern methods believed effective • Condoms -- many reservations • Perceived Self-Efficacy: Low to moderate • Inadequate knowledge re use, access • Fear of side effects • Lack of couples’ agreement • Lack of cultural or religious consent • Improper Use (failure to follow schedules, guidelines) JHU/PCS - Ethiopia Reproductive Health Communication Project

  19. Theoretical results: HIV/AIDS • Perceived Causes of HIV/AIDS: Accurate • Perceived Severity: Strong • Perceived Susceptibility: Sexually active persons, drivers, soldiers, youth, govt • Perceived Best Responses: Accurate • Perceived Response Efficacy • Monogamy 1st, then abstinence, then condoms JHU/PCS - Ethiopia Reproductive Health Communication Project

  20. Theoretical results: HIV/AIDS • Perceived Self-Efficacy: Mixed • Ambivalent toward condoms • Significant barriers • Influence of Religion • Promotes abstinence and monogamy • Mixed opinions regarding whether religion influences HIV/AIDS protection practices • Influence of Local Beliefs • Doubted HIV existence • Doubted effectiveness of condoms • Fatalistic beliefs JHU/PCS - Ethiopia Reproductive Health Communication Project

  21. Conclusions: Family Planning • High knowledge levels • Serious threats identified, but rare events • High perceptions of susceptibility to having too many children; low susc to experiencing serious threats • High response efficacy • Except condoms – very low • Low self-efficacy (esp. condoms) • Perceived anti-religious sentiments JHU/PCS - Ethiopia Reproductive Health Communication Project

  22. Conclusions: HIV/AIDS Prevention • High levels of knowledge about causes and best responses • High perceived severity • Low perceived susceptibility (others will get it, not me) • Response efficacy high, except for condoms (low) • Mixed self-efficacy perceptions; low for condoms • High perceived barriers to preventive methods • Local beliefs negatively affect prevention JHU/PCS - Ethiopia Reproductive Health Communication Project

  23. SURVEY RESULTS Dr. Kim Witte Johns Hopkins University, and, Michigan State University wittek@msu.edu JHU/PCS - Ethiopia Reproductive Health Communication Project

  24. Sample Characteristics • 74% Female, 26 % Male • 80% Orthodox, 10.4% Muslim • 49.9% Age 15-20; 51.1% Age 21-30 • 68.3% Single, 22.2% Married • 40% students, 19.1% housewives, 15.4% unemployed • 84.7% primary or secondary education • 51.6% had ever had sex • 28% had at least one child • Age at 1st Sex** • Females = 16.69 years old • Males = 18.26 years old JHU/PCS - Ethiopia Reproductive Health Communication Project

  25. Ideal Family • Preferred family size was 2 – 4 children • Last pregnancy: • Wanted to get pregnant later, 22.1% • Did not want to get pregnant at all, 12.6% • Indicates Unmet Family Planning Need JHU/PCS - Ethiopia Reproductive Health Communication Project

  26. Family Planning Awareness & Practices • 85.1% spontaneous awareness • 95.1% prompted awareness • 17% of males and 44% of females used some family planning method the “last time they had sex” JHU/PCS - Ethiopia Reproductive Health Communication Project

  27. Attitudes toward Family Planning Methods JHU/PCS - Ethiopia Reproductive Health Communication Project

  28. Intentions to Use Family Planning Methods JHU/PCS - Ethiopia Reproductive Health Communication Project

  29. FAMILY PLANNING: Perceived Threat & Efficacy JHU/PCS - Ethiopia Reproductive Health Communication Project

  30. Associations of theoretical variables and intentions • The greater one’s perceived susceptibility, the stronger one’s intentions to use the pill. (r = .14, p < .005) • The greater one’s perceived response efficacy, the stronger their intention to use family planning. (r = .16, p < .005) • The greater one’s perceived self-efficacy, the stronger their intention to use the pill. (r = .64, p < .001) • Perceived severity was unrelated to intentions to use the pill. (probable cause ceiling effects – 82% scored 4 or 5 on a five-point scale; only 12% choose a 1, 2, or 3) JHU/PCS - Ethiopia Reproductive Health Communication Project

  31. Perceived Severity from Having too Many Children • Item read having more children than wanted led “to problems,” was “harmful to their future,” led “to bad outcomes,” and led “to negative consequences.“ JHU/PCS - Ethiopia Reproductive Health Communication Project

  32. Perceived Susceptibility of Having too Many Children JHU/PCS - Ethiopia Reproductive Health Communication Project

  33. Perceived Response Efficacy for Family Planning Methods JHU/PCS - Ethiopia Reproductive Health Communication Project

  34. Perceived Self-Efficacy for Family Planning Methods JHU/PCS - Ethiopia Reproductive Health Communication Project

  35. Intentions to Use the Pill JHU/PCS - Ethiopia Reproductive Health Communication Project

  36. Defensive Avoidance toward Getting Pregnant JHU/PCS - Ethiopia Reproductive Health Communication Project

  37. Perceived Self-Efficacy for the Pill JHU/PCS - Ethiopia Reproductive Health Communication Project

  38. Mechanisms Underlying Intentions to use the Pill. • Best Fitting Model • Self-Efficacy, Susceptibility, Defensive Avoidance, being Married • c2 = 8.89, p = .35; Successfully predicts membership in fear control or danger control group 78% of the time; predicts pill usage correctly 91.2% of the time. JHU/PCS - Ethiopia Reproductive Health Communication Project

  39. Variables Underlying Perceived Self-Efficacy to Use the Pill. • Best Fitting Model - c2 = 7.18, p = .52 • Predicts group membership 76% of the time; predicts membership in high self-efficacy group 91% of the time • Subjective Norms • Other People • Religion • Barriers • Inconvenient • Talking with my partner • Past Behavior (prior usage of pill) • Response Efficacy JHU/PCS - Ethiopia Reproductive Health Communication Project

  40. Variables to target in Family Planning Messages Advocating the Pill • Increase Perceived Self-Efficacy • Increase Perceived Susceptibility to having more children than desired or having a child now when you’d rather wait • Decrease Defensive Avoidance • Reinforce High Severity Perceptions • Reinforce High Response Efficacy Perceptions JHU/PCS - Ethiopia Reproductive Health Communication Project

  41. Variables to target in Family Planning Messages Advocating the Pill • Address Subjective Norms • Other People • Religion • Barriers • Inconvenient • Talking with my partner • Convince to Try on Trial Basis • Increase Response Efficacy Perceptions JHU/PCS - Ethiopia Reproductive Health Communication Project

  42. Family Planning Messages JHU/PCS - Ethiopia Reproductive Health Communication Project

  43. HIV/AIDS Awareness & Practices • 99.2% Aware of HIV/AIDS • 97% Knew could avoid infection • Spontaneous Knowledge of methods: • Use Condoms (79%) • Be Monogamous (77.8%) • Abstain from Sex (42.5%) • Avoid unclean needles (36%) • Avoid sharing razors/blades (28.3%). JHU/PCS - Ethiopia Reproductive Health Communication Project

  44. Perceived HIV/AIDS Status - Self JHU/PCS - Ethiopia Reproductive Health Communication Project

  45. Perceived HIV Status -- Others JHU/PCS - Ethiopia Reproductive Health Communication Project

  46. Current Behaviors – I Protect (through monogamy) JHU/PCS - Ethiopia Reproductive Health Communication Project

  47. Current Behaviors – Partner Protects (through monogamy) JHU/PCS - Ethiopia Reproductive Health Communication Project

  48. Current Behaviors – I Use Condoms to Protect Self JHU/PCS - Ethiopia Reproductive Health Communication Project

  49. HIV/AIDS PREVENTION:Perceived Threat and Efficacy JHU/PCS - Ethiopia Reproductive Health Communication Project

  50. Associations of theoretical variables and condom behaviors • The greater one’s perceived susceptibility, the greater the condom use. (r = .32, p < .0001) • The greater one’s perceived response efficacy, the greater the condom use. (r = .48, p < .0001) • The greater one’s perceived self-efficacy, the greater the condom use. (r = .53, p < .0001) • The greater one’s perceived severity toward HIV/AIDS, the greater the condom use. (r = .06, p =.06; marginal significance, probably due to ceiling effect, M = 4.78 on 5-pt scale) JHU/PCS - Ethiopia Reproductive Health Communication Project

More Related