Recap The Development process A Phenomena stage B

Recap …. The Development process A. Phenomena stage B. Conceptualization of the study area C. Problem clarification stage 1. Problem identification 2. Problem statement 3. Problem analysis D. E. F. G. Organizing objectives for the research Research questions Building the Research Framework Selecting the type of the research

Development phase Organizing the methodology 1. Validity and reliability 2. Ethical consideration

A. Improving the Validity and reliability of data 1. Population and sampling 2. Validity and reliability 3. Ethical consideration

Validity & Reliability • Deriving Valid and Reliable Conclusions • When research design is selected all attempts to make it to be valid and reliable. • Validity – means conclusive are true • Reliability – means in repeated attempts, conclusion have to be the same

Eliminating threats to validity in selecting research design; – By selecting appropriate design this could be performed – Descriptive studies : By sampling, the information is collected and findings used to make conclusion about the population. Proper sampling is the key to success.

Bias in information collection 1. Defective Instrument • Questionnaire : – The questions placed in logical order and vaguely phrased. Also fixed/closed questionnaire on the topics less known, open ended questionnaire without guidelines • Weighing scale substandard

2. Observer bias • In observation & interviews critical information may be missed • Therefore to reduce this – organizing observation guidelines for structured interviews – training & practicing of data collectors

3. Effect of the interviewer on the informant • Respondent may mistrust the interviewer and dodge questions. • This bias can be reduce by adequately informing the subject and assuring them about information collected are kept confidential. • Careful selection of interviewers is also important.

Ethical Consideration • The data collecting technique should will not effect any emotional or mental harm to study subjects, such as asking sensitive questions that may violate their privacy, observing informats, without their knowledge and failing to respect certain cultural values, traditions etc. • Remedy for these are – Obtaining permission before study begins, not exploring sensitive questions before developing a good relationship with the informant – Ensuring confidentiality of the data obtained. (name and address)

3. Stratified Sampling • This method is useful when a sample needs to include “Representative groups of study units with “specific characteristics” – • Urban/Rural/age limits Here the sample frame is divided into groups of “strata “according to the characteristics. – Urban / Rural • Then random or systematic sample of pre- determined sample size randomly from “each group” ( “stratum” ) – Example : “Ethnicity in Sri Lanka” – strata - 80% Singhalese , 12% Tamils ; 6% Muslims; 2% others

3. Stratified Sampling • This is only possible if the “proportion of Study population” is known in each group. • Advantage of stratified sampling is that we can take relatively large sample from relatively sample group. • This allows the researcher to obtain a larger sample that we could draw conclusions (without obtaining a larger group)

4. Cluster Sampling • The selection of “groups” in study units instead of “individual study units”. • Clusters are often geographic unit (districts, villages) or organizational units, schools, clinics, training units). • Groups of students available (ex; villages or schools) • Number of these groups are randomly selected. • This is useful without of sampling frame • Ex. ‘KAP study or FP in rural communities- list of all the villages

4. Multi-stage Sampling • Procedure is carried out in phases and usually involves more than one sampling method. • This is frequently done in “community studies” • Ex. Four stage sampling method for ‘cleanliness of latrines’ district comprised of 6 “wards” and each ward has 6 -9 villages • Select 3 wards from 6 by simple random sampling • For each selected ward select 5 “villages” by simple random • For each village select 10 “households” by systematic random sampling

4. Multi-stage Sampling • Go to the center of the village – Choose a direction in random way – toss a coin » Walk in the chosen direction, select every 3 rd household (depending on the size of the village) » Decide before hand whom to interview (ex. Oldest)

Selection of Sample size • Rough guide – 10% of population • Equations and statistical methods of calculating sampling size

Validity • Standardization of the research • Validity – How accurate the measured variable ACCURACY – Threats to validity • History • Subject loss • Selectivity • Hawthorne effect

How to reduce threats of Validity • Control group • Randomization • Pre-testing • Knowledge of events

Reliability • Repeated tests should give same results • Standardization of : – Measuring instrument and conditions is essential – Training of the research staff

II. Implantation phase

Data Analysis • Statistical methods • Computerized methods

Presentation of Results • • Simple approach Statistical significance is important Graphs / tables Indicate key findings in the conclusion

Ethical consideration in research Before you move any further look at the ethics ……!

Ethical Consideration • War crimes after world war II - 1946 • Nuremberg code- 1940 – Guidelines to voluntary consent – Withdrawal of subjects from studies – Protection of subjects from suffering , injury, disability , and death • Declaration of Helsinki – 1960 – – – Human research after laboratory tests Review of research protocols by an independent group Informed consent Conducted by professionals -qualified scientifically / medically Benefits must be more than Risks • Revisions in 1975, - 1996

Ethical Consideration National Health and Medical Research Council • NHMRC – Australia – “Ethical culture” & “Informed consent” • Strong ethical culture should demonstrate – – – honesty and interiority Respect for human participants , animals and the environment Good use of public resources in conducting research Acknowledgement of the others used in research Responsible communication of the results • Informed consent – – – Self determination Privacy & dignity Anonymity & confidentiality To fair treatment Protection and discomfort from harm

Ethics in research 1. Autonomy 2. Beneficence 3. Non-malificence 4. Privacy 5. Confidentiality 6. Veracity 7. Fidelity

1. Principle of Autonomy • Humans have the right to non – interference when making decisions about themselves • Forms the basis of ideas about privacy, confidentiality, veracity and consent

2. Principle of Beneficence • “I will use treatment for the benefit of the sick, according to my ability and judgment” Hippocratic Oath • Conduct is aimed at the good and well being of others • Principle requires that practitioners provide both appropriate treatment and an assurance that the treatment will not produce more harm than good

3. Principle of Non-malificence • “Above all do no harm” Hippocratic Oath • In health care the ethical issues of nonmalificence and beneficence are particularly apparent in decisions regarding the institution of dangerous therapy or withdrawal of therapy that is no longer thought to be beneficial.

4. Privacy • Safeguarding areas where patient does not want to reveal : – History – Examinations – Investigations

5. Confidentiality • Not reveling information collected from the patient without her / his consent : – Verbally – Examination – Records • Complicated process • Harm vs. benefit • Individual • Social • Use your common sense • Inform superiors

6. Veracity • Revealing truthful information to the patient: – As a professional – Cultural /social /Medical • Personnel Harm vs. Benefit • Complicated process • Experienced person needed

7. Fidelty • Agreement with the patient – Verbal – Non verbal

Applying Ethical Considerations in research • In research emotional or mental harm to study subjects • Even as asking sensitive questions that may violate their privacy • Observing without their knowledge • Failing to respect certain cultural values, traditions etc. • Remedy : – Obtaining permission before study begins – not exploring sensitive questions before developing a good relationship with the informant – Ensuring confidentiality of the data obtained. (name and address)

Writing the proposal Sample proposal - OUM

Work plan / Budget • • List the activities Organize the schedule Gang chart Budget

Obtaining and ethical clearance IIHS Proposal for ethical clearance

Writing the report OUM BNS guideline

Recommendations • Key findings • Relate to local environment • Further research

Thank You !