International Journal of Drug Policy 11 (2000) 29–31

Response to McKeganey

Rapid assessment and response: sound methodology forproducing timely responses

James BeebeGonzaga Uni6ersity, Spokane, WA 99258 0025, USA

Accepted 27 October 1999

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McKeganey concludes his Commentary onRapid Assessment and Response (RAR) withwhat I believe is a valid call for rigorous andindependent evaluations of the results ofrapid assessment (McKeganey, 2000). Evalu-ation, however, is also needed for other typesof action research. He joins the ranks of asmall group of critical observers of rapidassessment who note the enthusiasm of itsproponents, their general lack of perspective,and their unrealistic expectations as to whatit can achieve. McKeganey’s commentary onRAR, however, is not consistent with RARas discussed by Stimson and colleagues(Rhodes et al., 1999; Stimson et al., 1999)and in the RAR Guides produced by theWorld Health Organization (WHO, 1998;WHO/UNAIDS, 1998; WHO/UNICEF,1998). His commentary on rapid assessmentis also not consistent with my experience withrapid assessment or rapid appraisal duringthe last two decades (Beebe, 1995, 2000).Therefore, I do not believe many of his spe-cific issues with RAR are appropriate.

McKeganey appears to have concludedthat there is no significant difference in themethods employed by RAR and traditionalsocial research. According to him the onlyreal difference is RAR’s reliance on less in-formation collected more quickly. When herefers to a singular ‘‘assessor’’ implementingRAR he misses what may be the most signifi-cant difference — teams and not individualsimplement RARs and these teams shouldinclude ‘‘insiders’’. The WHO Guides (1998)consistently refer to RAR teams and includeexplicit reference to building the RAR team.

Rapid assessment substitutes intensiveteam interaction during the collection andanalysis of data for the prolonged fieldworknormally associated with social research. In-tensive teamwork is especially critical fordata collection based on triangulation andduring the iterative process of data analysisand additional data collection. Team interac-tion among team members, including ‘‘insid-ers’’ from the group under investigation, canincrease the power of triangulation exponen-tially. The process benefits from the different

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perceptions, theories, methods, and expertisefrom different academic disciplines. Individ-ual team members observe and hear differentthings and are less likely to miss the signifi-cance of the observations than a single re-searcher. The interaction of the teammembers during the data collection, thesharing of observations, the identification ofareas requiring follow-up, and joint involve-ment in questioning makes it possible for theteam to carry out triangulation at a rapidrate.

Rapid assessment often begins with infor-mation collected in advance, and then pro-gressively learns from information providedby interviews and direct observation. A rapidassessment uses iterative data analysis andthe collection of additional information. Evenas the team reviews the data collected so farand begins to consider possible conclusions,the team makes conscious decisions aboutadditional lines of inquiry. Intensive teaminteraction during this process allows theteam to benefit from the perspectives of thedifferent team members. The chances thatimportant conclusions will be missed declineas input from different team members in-creases. Team interaction for triangulation/data collection and iterative dataanalysis/additional data collection allows forthe development of a preliminary under-standing of a situation based on the insider’sperspective. Intensive team interaction, in-cluding the perspectives of the insiders, re-sults in the use of research methods in wayssignificantly different from their use by indi-vidual researchers.

McKeganey’s four specific issues are im-portant and need to be considered as part ofan evaluation of the relevance of rapid assess-ment to specific activities. His statement ofthe issues, however, suggests he may be readyto reach conclusions before the informationhas been collected and analysed. He ques-

tions whether a methodology that is relativelycheap to implement, but which produceswrong information, can be regarded as costeffecti6e. This is a valid concern for rapidassessment only if the results of the method-ology can be shown to produce ‘‘wrong’’results more frequently than traditional socialresearch. The issue of inducti6e enquiry wouldbe better defined as to whether rapid assess-ment can get at the insider’s perspective onboth the nature of the problem and possiblesolutions that are consistent with their world-view. Variability in responses does notprovide an indicator of whether this has beenachieved. While the WHO RAR guides mayoversimplify the process of triangulationfrom multiple methods, this may not be aproblem since there may not be a need forspecific guidance to practitioners on how todeal with different results. I have observedteams using conflicting information andnegative cases as beginning points for addi-tional data collection as part of an iterativedata analysis process. Finally, as notedby McKeganey, the conflict between practicaladequacy and scientific perfection entailssomething of a ‘straw-man’. Where exactpercents are needed, rapid assessment maynot be adequate. Where rough approxima-tions are adequate for initial decisions,rapid assessment may be very adequate.Where it is important to know how localpeople define the problem, what to themconstitutes ‘large’ or ‘significant,’ and theirunderstanding of an appropriate response,rapid assessment may be preferred over othertechniques that might produce more accuratenumbers.

I am in full agreement with McKeganey’sargument on the need for specificity as to thekinds of research questions that can be ex-plored using rapid assessment. I believe thatStimson et al. (1999) make a convincing casethat RAR can play a significant role in devel-

J. Beebe / International Journal of Drug Policy 11 (2000) 29–31 31

oping public health responses to drug prob-lems that go beyond assessment of problems.They make a particularly strong case forthe need for timely results in the areaof public health issues related to drug prob-lems (Rhodes et al., 1999; Stimson et al.,1999).

I would like to suggest that the most seri-ous problem with rapid assessment couldbe attempts to implement it without sufficienttime to be observant, sensitive, andeclectic. There is a need for time for multipleiteration of data analysis and additional datacollection by the team. Attempts at rapidassessment carried out with insufficient timeshould probably be called ‘‘researchtourism’’.

Robert Chambers, who helped developrapid assessment methods for rural appraisal,cautions that there is a danger that rapidassessment ‘‘could be over-sold, too rapidlyadopted, badly done, and then discredited, tosuffer an undeserved, premature burial as hasoccurred with other innovative research ap-proaches’’ (Chambers, 1991, p. 531). Myhope is that this will not be the fate of RapidAssessment and Response since I believe it is asound methodology for producing timelyresponses.

References

Beebe J. Basic concepts and techniques of rapid ap-praisal. Human Organization 1995;54:42–51.

Beebe J. RAP — Rapid Assessment Process..RAP.Walnut Creek, CA: Alta Mira Press, 2000.

Chambers R. Shortcut and participatory methods forgaining social information for projects. In: Cernea M,editor. Putting People First: Sociological Variables inRural Development, 2nd edn. Washington, DC:World Bank, 1991:515–37.

McKeganey N. Rapid assessment: really useful knowl-edge or an argument for bad science? InternationalJournal of Drug Policy 2000;11:13–8.

Rhodes T, Stimson GV, Fitch C, Ball A, Renton A.Rapid assessment, injecting drug use, and publichealth. Lancet 1999;354:65–8.

Stimson GV, Fitch C, Rhodes T, Ball A. Rapid Assess-ment and Response: methods for developing publichealth responses to drug problems. Drug and AlcoholReview 1999;18:317–25.

World Health Organization. The Rapid Assessment andResponse Guide on Injecting Drug Use (draft forfield-testing). Geneva: WHO, 1998.

World Health Organization and the United NationsJoint Programme on HIV/AIDS. The Rapid Assess-ment and Response Guide on Substance Use andSexual Risk Behaviour (draft for field-testing).Geneva: WHO/UNAIDS, 1998.

World Health Organization and United Nations Interna-tional Children’s Education Fund. The Rapid Assess-ment and Response Guide on Psychoactive SubstanceUse and Especially Vulnerable Young People (draftfor field-testing). Geneva: WHO/UNICEF, 1998.

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