CORE Group Spring Meeting

Joy Miller Del Rosso

The Manoff GroupMay 10, 2011

Trials of Improved Practices

(TIPs)

About TIPS True/False

TIPS is a relatively new qualitative research technique

TIPs is a stand-alone formative research technique

The concept of TIPs was drawn from commercial market

research

TIPs is a technique that can be implemented by almost

anyone

TIPs should always be implemented through a series of three

household visits

The “results” obtained through the TIPs trials are highly

predictive of actual behavior change

Pre-launch consumer market product

research

› “will people in the market buy/use it?”

Behavioral psychology—motivators and

barriers to changing behaviors

› what are the factors that have helped

facilitate practicing a behavior and what

are the factors that make a behavior difficult

to do?

Understand the behavior in natural

context

Participants have specialized knowledge

of what works best for them

Research is a negotiation between

investigator and participant

People asked to change their behaviors

should have a say in what that behavior

is

Indonesia Nutrition Communication and Behavior Change Project (1979)› Researchers visited homes to conduct in-

depth, open-ended interviews with mothers

› Reached agreement with mothers on what dietary changes would improve her child’s nutrient intake—based on dietary recall outcomes and age of the child

› Researchers returned in a week to see if the mother had tried out the practice, modified it and if she liked it, etc.

Trying potential program actions before

part of program

Learning in advance if lack of resources

was a significant limitation

Providing opportunity to offer

suggestions based on something

concrete/participants had actually tried

rather than something hypothetical

TIPs for Nutrition

Determine

Behavioral

Priorities

Test

Feasible

Behaviors

Implementation

Design

Behavioral

Strategy

Issue/

Problem

Situational Analysis

Focus Group Discussion

In-Depth Interviews

other formative

research

Identify

“Ideal”

Behaviors or

Essential

Nutrition Actions

TIPS

Compliance TIPs: basic practices or

products have been determined and

TIPs identifies ways to facilitate series of

behaviors

Negotiation TIPs: mainly used in maternal

and infant feeding—identifies best

choices among a number of different

actions that could yield nutrition benefits

Problem: Pregnant women were not

taking their iron pills

TIPS Learning: Remembering to take an

iron pill every day was an unanticipated

problem

Strategy: Needed to come up with way

to remind women to take their pills

Problem: Program was promoting consumption of dark green leafy vegetables and trying to convince mothers that young children could digest them.

TIPs Learning: Mothers were only concerned about digestibility for children 5-12 months. The main barrier for mothers; they thought children did not like dark green leafy vegetables.

Strategy: Identify and promote ways to make dark green leafy vegetables more appetizing.

Problem: None of the children in the TIPs trial from 6-23 months had adequate calorie intake.

TIPs Learning: Almost all of the mothers rejected the advice to make complementary food thicker. But almost all of the mothers accepted the idea of adding a little palm oil, ground nuts or other nutrient-dense food; this had same nutritional benefit.

Strategy: Change the message

Initial Visit

(Day 1)

Counseling Visit

(Day 2)

Follow-up Visit

(Day 6-10)

Background

information

Feeding practices

24-hour recall

Food frequency (of

other regularly

consumed foods)

Feedback on

practices

Recommendations

and initial response

Negotiation and

motivation

Discussion with

others, if needed

Agreement on

specific practices to

try

Changes since last visit

24-hour recall

Outcome and response

to trial

Modifications

Adoption of practice

Ensures participant group input in program planning

Focuses on behaviors, not just knowledge and on the program, not just research

Allows determination of feasible (not ideal) behaviors

Ability to make much more specificrecommendations

Preliminary technically acceptable

solutions to problems

Understanding of current problems to

help guide technically appropriate

responses

Length of trial must match nature of

behaviors to be changed

Able household researchers—capacity

to negotiate

About TIPS True/False

TIPS is a relatively new qualitative research technique F

TIPs is a stand-alone formative research technique F

The concept of TIPs was drawn from commercial market

research

T

TIPs is a technique that can be implemented by almost

anyone

F

TIPs should always be implemented through a series of three

household visits

F

The “results” obtained through the TIPs trials are highly

predictive of actual behavior change

T