Nutritional Assessment Methods - Basic Techniques for Demographic Analysis and Sociologic Analysis (Part 2) PDF

Nutritional Assessment Methods - Basic Techniques for Demographic Analysis and Sociologic Analysis (Part 2) By Yang Wai Yew Department of Nutrition and Dietetics International Medical University Email : waiyew_yang@i...

Nutritional Assessment Methods - Basic Techniques for Demographic Analysis and Sociologic Analysis (Part 2) By Yang Wai Yew Department of Nutrition and Dietetics International Medical University Email : [email protected] DID : 2731 7579, ext 1235  LESSON OUTCOMES At the end of this lesson, you should be able to: 1. Describe population profiles in terms of demography 2. Explain indirect indicators of nutritional status based vital statistics 3. Explain techniques to calculate incidence, prevalence and burden of disease (mortality and morbidity) 4. Differentiate the use of quantitative versus qualitative methods 5. Describe qualitative methods in nutrition status assessment 6. Explain the use of focus group discussion (FGD) in nutrition surveys Basic Techniques for Demographic Analysis and Sociologic Analysis  Definition of Sociology Sociology is the science whose object is to interpret the meaning of social action Can be both topically and methodologically. Studies the human social behaviour especially the origins, organization, institutions and the development of human society Basic Techniques for Demographic Analysis and Sociologic Analysis  Sociological Research Methods - Definition Quantitative Methods Qualitative Methods Approach social phenomena through Emphasize understanding of social quantifiable evidence, and often rely on phenomena through direct observation, statistical analysis to create valid and communication with participants, or reliable general claims. analysis of texts, and may stress contextual and subjective accuracy over generality. Fundamentally an inferential effort that Fundamentally an interpretive effort that is seeks to uncover universal principles context-dependent Designed around the ability to infer from a Designed around the ability to interpret sample to a larger population. and comprehend a phenomenon from an insider, as well as an outsider perspective (from various perspectives) Basic Techniques for Demographic Analysis and Sociologic Analysis  Sociological Research Methods – Strengths & Weaknesses Quantitative Methods Qualitative Methods Strengths Statistical analysis allows Different methodologies to for generalization (to execute some extent) to others Different methodologies to execute Weaknesses Choose adequate number Subjectivity of sample that’s Difficult to replicate representative of the Researcher bias is built-in population and unavoidable In-depth, comprehensive approach to data gathering limits scope May be labour intensive, expensive Basic Techniques for Demographic Analysis and Sociologic Analysis  Sociological Research Methods – Types Quantitative Methods Qualitative Methods Anthropometric Psychosocial aspects measurements Family dynamics Biochemical determinations Dietary intake assessment Physical activity assessment Covered in earlier topics of Nutrition Assessment Methods module Basic Techniques for Demographic Analysis and Sociologic Analysis  LESSON OUTCOMES At the end of this lesson, you should be able to: 1. Describe population profiles in terms of demography 2. Explain indirect indicators of nutritional status based vital statistics 3. Explain techniques to calculate incidence, prevalence and burden of disease (mortality and morbidity) 4. Differentiate the use of quantitative versus qualitative methods 5. Describe qualitative methods in nutrition status assessment 6. Explain the use of focus group discussion (FGD) in nutrition surveys Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods There are aspects and issues in nutritional status that are not amenable to being measured in a quantitative manner: Psychosocial aspects Family dynamics Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods 1. Psychosocial Aspects Example Obesity issues: Body image - perception of oneself on weight status, misperception may occur Social values e.g. a mother may consider her overweight child as healthy Community perception of overweight as a health index Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods 2. Family dynamics Family dynamics : a family lives and interacts with one another; central element in family dynamics is family relationship. Family relationships can be affected by many factors such as: Number of children a family has Divorce; an Unemployment absent parent Alcoholism; chronic illness; Death of family disability; member substance abuse Physical/ sexual abuse Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods 2. Family dynamics Family dynamics issues that may impact on nutritional status include: Role of the mother as caretaker or gatekeeper to purchase, preparation and distribution of foods in the household. What is the perception of the father/mother of “underweight child‟? “healthy child‟? Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods of Gathering Data Methods Explanation Survey People responding to prepared questionnaires In-depth People are asked to respond series of questions which were fixed in interviews advance or respond to open- ended discussion. Field research Researchers observe and talk to people in their ordinary settings (participant while sometimes joining in their activities observation) Document study Data gathering via newspaper, articles, marriage records or diaries. Focus group An interview conducted in a non structured and natural manner discussion with a small group of respondents. Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods – Formal Interview Written questions on specific topics are posed to one respondent The responses are recorded in detail Always be truthful about the purpose of the interview Explain the objectives of the study and the reasons for the researchers‟ presence Explain the project using simple language so that respondents can understand Use moderate, friendly tone Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods – Formal Interview DON’TS 1. Make false promises Even though you want to obtain the cooperation of the family selected for the interview 2. Influence a question by injecting your attitude or belief “Good morning, Mrs A. How lovely and plump your girl is. See how nicely she grows on breast” 3. Interrupt respondent’s work Wait patiently if required, agree to respondent’s request to postpone the session if needed Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods – Formal Interview DO 1. Try to probe in an amicable way Avoid being satisfied with superficial answers or moving too quickly from one topic to another. Work towards getting more detailed responses. Use phrases like “why” Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods – Observations Is important to examine people’s events, activities, practices etc.. Observe and make notes of the community, behaviours, cultures, and specific facilities e.g. health clinic, preschool, etc.. If there is household visits or home visit, during the visit try to make the observations of family interactions and activities. Basic Techniques for Demographic Analysis and Sociologic Analysis  Qualitative Methods – Observations Components Things to Look for Interaction Between mother and child? Among the siblings? Tone of the voice Reflects respondent’s emotional state Touch Touching between mother and child/family members Eye to eye contact Whether the respondent is distracted, rarely looks at the child; are there differences in the treatments of males or females Food preparation What food is served? Is it appropriate? How is it prepared? Is it hygienic? Who feeds the child? Bottle feeding Is the bottle properly washed? Is the milk over- diluted? Do you see unfinished milk anywhere? Basic Techniques for Demographic Analysis and Sociologic Analysis POP QUIZ KNOWLEDGE CHECK # 1  LESSON OUTCOMES At the end of this lesson, you should be able to: 1. Describe population profiles in terms of demography 2. Explain indirect indicators of nutritional status based vital statistics 3. Explain techniques to calculate incidence, prevalence and burden of disease (mortality and morbidity) 4. Differentiate the use of quantitative versus qualitative methods 5. Describe qualitative methods in nutrition status assessment 6. Explain the use of focus group discussion (FGD) in nutrition surveys Basic Techniques for Demographic Analysis and Sociologic Analysis  FOCUS GROUP DISCUSSION Understand what is FGD? Able to apply its use in Nutrition research. Explain the use of FGD as a research tool and its application in intervention studies. Basic Techniques for Demographic Analysis and Sociologic Analysis  A Focus Group is …6 “Ws” What Where A carefully planned discussion In a non-threatening environment where the To obtain perceptions of a defined interest area participants are familiar with, and feel comfortable e.g. the community hall, and not a clinic when discussing health problems. Who How Approximately 7-10 people Conducted by a trained interviewer (moderator, With common characteristic relating to facilitator) discussion topic 3 focus groups are the minimum for a study to ensure a good coverage of ideas Why When To determine feelings, perceptions, beliefs Before a program begins, during a program and attitudes regarding products, services, or after a program ends programmes or opportunities FGs are effective when: Attitudes and perceptions are developed in - People have something to share part by interaction with other people (motivations) To formulate questions for a research study - The goal is to understand human To promote self-disclosure among behaviour participants FGs ineffective when: - People are divided or angry - The goal is to gather factual information - Organisation is trying to improve its image  FGD SESSION Systematic Notification Procedures: 1) Set meeting times for interviews 2) Contact potential participants by phone or in person (preferably 2 weeks before meeting time) 3) Send a personalized invitation 4) Phone (or contact) each person the day before the focus group Facilitator Recorder Observer Participant Basic Techniques for Demographic Analysis and Sociologic Analysis  FGD session: Before session Facilitator + Recorder 1st arrive on time at the meeting place ↓ Start talking informally to participants as they arrive ↓ Provide name tags ↓ Ensure the seating arrangements will facilitate participants to talk FGD session: Session Begin Recommended introduction pattern: 1. Create a thoughtful, permissive Welcome atmosphere ↓ 2. Provide the ground rules Overview and topic 3. Set the tone ↓ Set Ground rules ↓ 1st question Basic Techniques for Demographic Analysis and Sociologic Analysis  When conducting FGD session - 1 Make the introduction. Explain the roles of the facilitator and the observer/recorder. The session is tape recorded. The observer takes notes as well on the discussion. Ask participants their names for the facilitator and others to address them. Explain the session is not a lecture but an effort to gather opinions and ideas from the group for the purpose of…programme, intervention or education campaign. Basic Techniques for Demographic Analysis and Sociologic Analysis  When conducting FGD session - 2 Emphasize that their participations are important and should feel free to express themselves on the subjects discussed. Explain that the only rules of the meeting are the speaker should address the subject being discussed, and that only one person should speak at a time. Start the session by asking a question unrelated to the topic of discussion. Everyone will have the opportunity to speak on a neutral topic. Basic Techniques for Demographic Analysis and Sociologic Analysis Selecting Participants The target groups are chosen, not random selections that shares certain key characteristics Example: Older adults, obese individuals, mothers of malnourished children Selection strategies: Based on location: e.g. contact community key opinion leaders (KOL) Nominations by agency/institution/NGO Advertisement in media Incentives go participants e.g. money, food, gifts, vouchers, certificate/recognition Basic Techniques for Demographic Analysis and Sociologic Analysis The Facilitator Lead the group. Do not be led by it. - Formulate appropriate questions and react suitably and neutrally, to the comments. Emphasize that there is nor wrong or right answer. Avoid reacting to the discussions or expressing personal opinions that could influence the participants. Be aware of personal biases and prejudices among participants. Observe the participants and be conscious of the extent of their involvement and their reaction. Encourage all participants participates - do not allow few individuals to monopolize the discussion. Basic Techniques for Demographic Analysis and Sociologic Analysis The Facilitator Build rapport with the participants and gain confidence and trust, in order to probe the responses and comments more deeply. Empathies with the participants and be able to understand not only what they say but also what it means to them. Take a sincere interest in the participants and in learning about. Be flexible and open to suggestions, changes, interruptions and lack of participation. Control the time - question and answer. Control the rhythm or flow of the meeting. Basic Techniques for Demographic Analysis and Sociologic Analysis The Recorder/ Observer The Recorder presents as an observer during FGD session. Responsibility: Takes notes down during the discussion: Date of the meeting & the time it begins and ends Name and brief description of the community FGD venue and record any factors about the location that affect participants Number and some descriptive data of the participants. A general description of the group dynamics, level of participation, any dominant participant, interest level, fatigue, anxiety/ boredom Observe interruptions and distractions that occur during session. What makes the participants laugh, what makes them reluctant to answer, how the discussion is concluded. Basic Techniques for Demographic Analysis and Sociologic Analysis The Recorder/ Observer Use quotation marks to indicate the participants’ own words. Personal impressions and observations should be noted in parenthesis. Makes an effort to note the participant's own words, in the local language. May participate in the FGD session, say when Facilitator missed the comments made by the participants. Responsible to tape recording the FGD to amplify notes later. Basic Techniques for Demographic Analysis and Sociologic Analysis FGD session: Ending the session Explain that the meeting is about to end, participants will be requested to think about the discussion points They will be requested to provide comment. Relevant comments will be explored more in depth. Participants were being thank for their contributions and reaffirm that their ideas were valuable and will be used for future Listen for additional comments while having refreshments if any. Ending questions: Summary question: “Is this an adequate summary?” Final question: “Did we or have we missed anything?” Basic Techniques for Demographic Analysis and Sociologic Analysis DATA ANALYSIS The facilitator and observer will summarize the responses of the respondents and tabulate them. When analyzing focus group data, consider: Words Context Internal consistency Frequency or extensiveness of comments Intensity of the comments Specificity of responses Find the big ideas Basic Techniques for Demographic Analysis and Sociologic Analysis POP QUIZ KNOWLEDGE CHECK # 2  References & Acknowledgment Num SF. Basic Techniques for Demographic Analysis and Sociologic Analysis - Lecture Slides. 2015 Khor GL. Basic Techniques for Demographic Analysis and Sociologic Analysis - Lecture Slides. 2013 Zalilah MS, Khor GL, Sarina S, et al. The relationship between household income and dietary intakes of 1-10 year old urban Malaysian. Nutr Res Pract. 2015;9(3):278-287. Department of Statistics (2022) NTR2352 Nutrition, Lifestyle and NCDs