Interviewing adolescent girls about sexual and reproductive health: a qualitative study exploring how best to ask questions in structured follow-up interviews in a randomized controlled trial in Zambia

Background Numerous studies have documented inconsistent reporting of sexual behaviour by adolescents. The validity and reliability of self-reported data on issues considered sensitive, incriminating or embarrassing, is prone to social-desirability bias. Some studies have found that Audio Computer-Assisted Self Interviewing (ACASI) that removes the personal interaction involved in face-to-face interviews, decreases item non-response and increases reporting of sensitive behaviours, but others have found inconsistent or contradictory results. To reduce social desirability bias in the reporting of sensitive behaviours, face-to-face interviews were combined with ACASI in a cluster randomized trial involving adolescents in Zambia. Methods To explore adolescent girls’ experiences and opinions of being interviewed about sexual and reproductive health, we combined Focus Group Discussions with girl participants and individual semi-structured interviews with teachers. This study was done after the participants had been interviewed for the 6th time since recruitment. Young, female research assistants who had conducted interviews for the trial were also interviewed for this study. Results Respondents explained often feeling shy, embarrassed or uncomfortable when asked questions about sex, pregnancy and abortion face-to-face. Questions on sexual activity elicited feelings of shame, and teachers, research assistants and girls alike noted that direct questions about sexual activities limit what the participant girls may be willing to share. Responding to more indirect questions in relation to the context of a romantic relationship was slightly easier. Efforts by interviewers to signal that they did not judge the participants for their behavior and increased familiarity with the interviewer reduced discomfort over time. Although some appreciated the opportunity to respond to questions on their own, the privacy offered by ACASI also provided an opportunity to give false answers. Answering on tablets could be challenging, but participants were reluctant to ask for assistance for fear of being judged as not conversant with technology. Conclusion Strategies to avoid using overly direct language and descriptive words, asking questions within the context of a romantic relationship and a focus on establishing familiarity and trust can reduce reporting bias. For the use of ACASI, considerations must be given to the context and characteristics of the study population.

Edinburgh Postnatal Depression Scale (EPDS) for screening for depression in the first year post delivery in a low-resourced rural setting in Kenya

Postnatal depression is one of the most common mental disorders among postnatal mothers and may have severe consequences for mothers and their children. Locally validated screening tools that can be self- or lay interviewer-administered are required to identify at-risk women, especially in settings with no mental health specialists. This study aimed to assess the validity and reliability of a culturally adapted version of the Edinburgh Postnatal Depression Scale (EPDS) in a local dialect (Kamba) in a Kenyan setting. Trained research assistants administered the local-language version of self-report scales (EPDS) to a sample of 544 Kamba-speaking women. The same scale was re-administered to the same research participants two weeks later by the same research assistants. The test scores were compared with an external ‘gold standard’ according to the DSM-IV criteria Mini-International Neuropsychiatric Interview for adults (MINI-Plus). The EPDS had an area under the curve (AUC) of 0.867 with 95% C.I of 0.836 to 0.894, with a cut-off point of ≥11, sensitivity of 81.0% (95% C.I 70.6–89.0) and specificity of 82.6% (95% CI 78.8–85.9). The positive predictive value (PPV) and negative predictive value (NPV) were 44.1% and 96.2%, respectively. The internal reliability was 0.852 and the test-retest reliability was 0.496. The EPDS showed good utility in detecting depressive disorder in Kamba-speaking postnatal women. It does not have to be administered by mental health workers (who are few in low- and middle-income countries); rather, this can be done by a trained lay interviewer.

Test-Wiseness and Multiple-Choice Accounting Questions: Implications for Instructors

This study examines “test-wiseness” rules-of-thumb accounting students may use when they cannot answer a multiple-choice question. The effectiveness of the rules is poorly understood, but they rely largely on preventable flaws in question design. After identifying eleven relevant rules, we had graduate research assistants employ the rules on unfamiliar material, to test whether the rules can be effective when used by capable students who have not studied the material. Three of the rules demonstrate positive results, and participants are able to recognize the more valuable ones. Additionally, we survey accounting majors at two universities to assess general familiarity and belief in the rules. We find that they have well-formed ideas of the relative usefulness, which are consistent between universities. The results provide some insights into the issues question writers should consider, so as to avoid vulnerability to test-wiseness or even turn the rules to their advantage when composing questions.

Inuit wellness: A better understanding of the principles that guide actions and an overview of practices

By imposing non-Inuit ways of doing within households and communities, colonization has created a rift between generations and impacted the transmission of Inuit practices and knowledge. Inuit care-providers continue to support their fellow community members with individual and collective approaches to wellbeing. The objectives and design of the current project were developed with community members who play an active role in mobilization and wellness. Inuit and non-Inuit research assistants conducted 14 individual interviews and 2 group interviews (total of 19 participants) with key informants involved in community wellness work. Then an Elder (third author) shared her knowledge regarding traditional practices. In this study we describe three underlying principles regarding wellness practices as well as five approaches and the mechanisms by which these approaches seem to impact personal and collective wellbeing. This study highlights how Inuit culture and knowledge can support children, family and community wellbeing in the ways of being together and of taking care of each other. The study responds to an expressed desire named by our partners to document Inuit approaches as well as the principles and practices underlying such approaches and how they are related to self-determination.

Picturing the researcher: Using photovoice to document the research assistant experience during the COVID-19 pandemic

The article is a reflection by two graduate research assistants (GRAs) who experienced the effects of the COVID-19 pandemic on the in-person interactions through which qualitative researchers usually learn about human experiences. With in-person research curtailed, the authors were compelled to think creatively and find other ways to continue their research and develop meaning. The researchers reflected on their experiences as GRAs for the study ‘Thriving in Canada: Learning from the (photo) voices of women living on a low income engaged in action research to improve access to health and social services’. Taking advantage of pandemic-related study delays, the researchers explored the photovoice method in more depth and used photovoice to document their own lived experience as GRAs, and their learning. They practised self-reflexivity and worked to improve their visual-based photovoice facilitation skills. This illustrated essay is the story of the authors’ experiences over the past year working as GRAs during the COVID-19 global pandemic.

Non-probative Photos Promote the Truth of Positive Claims

<p>People’s judgments are prone to the influence of feelings, even cognitive feelings such as the ease with which related information comes to mind (Alter & Oppenheimer, 2009; Schwarz & Clore, 2007). In 14 experiments, we¹ found evidence that non-probative photos — ones that relate to what people are evaluating, but that provide no relevant information for their task — produce cognitive feelings that lead people to evaluate claims more positively. In Part 1, we examined the extent to which photos promote the truth of positive and negative claims. People saw the names of several fictitious wines. Some wine names appeared with a photo that depicted the noun in the name; other wine names appeared without a photo. For each wine people decided whether a positive or a negative claim about it was true. Photos selectively promoted the truth of positive claims, did so most when they could help people comprehend wine names, and swayed people’s judgments about the taste of wines. In Part 2, we showed that those findings translated to when people judged claims about their own (and other people’s) experiences. People “interacted” with several unfamiliar animals (on a computer). Later, people saw the animal names again, sometimes with a photo of the animal and sometimes alone, and decided whether it was true that they (or other people) had positive or negative experiences with the animals. Photos selectively led people to think positive claims were true, and exerted their strongest effects when they could most help people bring related thoughts and images to mind². ¹ Although the research in this thesis is my own, I conducted it in a lab and supervised a team comprised of research assistants and honors students. I also received advice and direction from my supervisors. Therefore, I often use the word “we” in this thesis to reflect that fact. As you will also see, I use the word “we” in a different context to refer to what is known (or not known) in the wider scientific community. ² Portions of this thesis were adapted from: Cardwell, Newman, Garry, Mantonakis, & Beckett (manuscript under review). Photos that increase feelings of learning promote positive evaluations. Cardwell, Henkel, & Garry (manuscript in preparation). Non-probative photos lead people to believe positive claims about their recent pasts. But I have expanded on the introduction, results and discussion.</p>

The order of questions on a test affects how well students believe they performed

<p>We know that students are more optimistic about their performance after they take a test that progresses from the easiest to hardest questions than after taking one that progresses in the opposite order¹. In fact, these “Easy-Hard” students are more optimistic than “Hard-Easy” students even when the two groups perform equally. The literature explains this question order bias as a result of students’ failing to sufficiently adjust, in the face of new information, their extreme initial impressions about the test. In the first two of six studies, we investigated the possibility that a biased memory for individual questions on the test is an alternative mechanism driving the question order bias. The pattern of results was inconsistent with this mechanism, but fit with the established impression-based mechanism. In the next four studies, we addressed the role that the number of test questions plays in determining the size of the question order bias, discovered that warning students is only a partially effective method for reducing the bias, and established a more precise estimate of the bias’ size. Taken together, this work provides evidence that the question order bias is a robust phenomenon, likely driven by insufficient adjustment from extreme initial impressions. ¹ Although the research in this thesis is my own, I conducted it in a lab and supervised a team comprised of research assistants and honours students. I also received advice and direction from my supervisors. Therefore, I often use the word “we” in this thesis to reflect these facts.</p>

The order of questions on a test affects how well students believe they performed

<p>We know that students are more optimistic about their performance after they take a test that progresses from the easiest to hardest questions than after taking one that progresses in the opposite order¹. In fact, these “Easy-Hard” students are more optimistic than “Hard-Easy” students even when the two groups perform equally. The literature explains this question order bias as a result of students’ failing to sufficiently adjust, in the face of new information, their extreme initial impressions about the test. In the first two of six studies, we investigated the possibility that a biased memory for individual questions on the test is an alternative mechanism driving the question order bias. The pattern of results was inconsistent with this mechanism, but fit with the established impression-based mechanism. In the next four studies, we addressed the role that the number of test questions plays in determining the size of the question order bias, discovered that warning students is only a partially effective method for reducing the bias, and established a more precise estimate of the bias’ size. Taken together, this work provides evidence that the question order bias is a robust phenomenon, likely driven by insufficient adjustment from extreme initial impressions. ¹ Although the research in this thesis is my own, I conducted it in a lab and supervised a team comprised of research assistants and honours students. I also received advice and direction from my supervisors. Therefore, I often use the word “we” in this thesis to reflect these facts.</p>

Non-probative Photos Promote the Truth of Positive Claims

<p>People’s judgments are prone to the influence of feelings, even cognitive feelings such as the ease with which related information comes to mind (Alter & Oppenheimer, 2009; Schwarz & Clore, 2007). In 14 experiments, we¹ found evidence that non-probative photos — ones that relate to what people are evaluating, but that provide no relevant information for their task — produce cognitive feelings that lead people to evaluate claims more positively. In Part 1, we examined the extent to which photos promote the truth of positive and negative claims. People saw the names of several fictitious wines. Some wine names appeared with a photo that depicted the noun in the name; other wine names appeared without a photo. For each wine people decided whether a positive or a negative claim about it was true. Photos selectively promoted the truth of positive claims, did so most when they could help people comprehend wine names, and swayed people’s judgments about the taste of wines. In Part 2, we showed that those findings translated to when people judged claims about their own (and other people’s) experiences. People “interacted” with several unfamiliar animals (on a computer). Later, people saw the animal names again, sometimes with a photo of the animal and sometimes alone, and decided whether it was true that they (or other people) had positive or negative experiences with the animals. Photos selectively led people to think positive claims were true, and exerted their strongest effects when they could most help people bring related thoughts and images to mind². ¹ Although the research in this thesis is my own, I conducted it in a lab and supervised a team comprised of research assistants and honors students. I also received advice and direction from my supervisors. Therefore, I often use the word “we” in this thesis to reflect that fact. As you will also see, I use the word “we” in a different context to refer to what is known (or not known) in the wider scientific community. ² Portions of this thesis were adapted from: Cardwell, Newman, Garry, Mantonakis, & Beckett (manuscript under review). Photos that increase feelings of learning promote positive evaluations. Cardwell, Henkel, & Garry (manuscript in preparation). Non-probative photos lead people to believe positive claims about their recent pasts. But I have expanded on the introduction, results and discussion.</p>