Move the conceptual framework slide before the objectives (that is, after the rationale).
Transcript of "PhD Plan of Analysis Seminar_apurva_pandya 29feb2012"
HIV Counseling Practices: Experiences and Perspectives of Counselors Working with Targeted Interventions in Gujarat Plan of Analysis SeminarApurva Pandya , MA Shagufa Kapadia, PhDResearcher Professor and Research Guide Department of Human Development and Family Studies Faculty of Family and Community Sciences, M S University of Baroda, Vadodara 1 29 February 2012
HIV/AIDS ContextGlobal Context33.2 Million people are National Contextliving with HIV Local ContextEveryday 6800 people get Total 1,81,785 people are Oldest TargetedHIV infection. living with HIV (June,2007). Interventions in the county Moderate HIVNegative impact on life prevalence (low life expectancy, Concentrated epidemicincrease orphans,economic crisis, stigmaand discrimination). 2
Global and National Response To HIV/AIDS HIV Prevention Approaches Medical Approach Social Approach Behavioral Approach Developmental Approach Reduced in HIV Prevalence across the globe….Experience of HIV prevention and controlMaintained moderate HIV prevalenceScarcity of researches on counseling within TargetedInterventions 3
HIV/AIDS Context And Relevance of Present Research HIV prevalence and experience of implementation of targeted interventions (program maturity) create a right context to explorecounseling practices, counselors experiences and perspectives on HIV prevention counseling. 4
Research QuestionsHow do counselors practice HIV counseling services within targeted intervention?How do counselors use or develop counseling skills and techniques?How do counselors deal with challenges in everyday counseling practice?What are counselors’ perspectives on current HIV counseling practice and their capacity building?Does the experience of HIV counseling enable development of a personal counseling approach? 5
Examine counselors’ personal and professionalexperiences of providing HIV counseling services.Understand theirperspectives on currentpractices and capacitybuilding.Research Objectives Evolve indigenous practices and a culturally appropriate working model for HIV counseling. 6
Research DesignResearch Methodology: Grounded Theory (GT).It helps in discovery of new information (Glaser and Strauss 1967).Develop theoretical formulations (Byrne 2001) , andEstablish framework for future exploration (Strauss & Corbin, 1990).Universe:Counselors working with Targeted Interventions in the state of Gujarat andtheir clientsSample Size:Total 14 counselors working with Targeted Interventions were interviewedTotal 4 counselors’ sessions including two follow up sessions were observedSampling Technique:Theoretical SamplingData Collection Tools:In-depth interview protocol and naturalistic observation protocol 9 7
Data Collection Through Various MethodsTo Gain DemographicInformation, UnderstandKnowledge and Beliefs ofCounselors─HIV/AIDS, Targeted To Understand Counseling Types of Research DataInterventions, Risk populations, Effectiveness, Clients’and Counseling, Feedback and Perceptions ofExisting HIV counseling practices Counseling Text Visual Narrative To Understand Process of In-depth Interview Brief Interview of Counseling Counseling documents of Counselors Clients For example, daily diary, registers Observational Field Photographs Participants Observation of Notes Counseling sessionsTo Understand Recording To Understand Counseling Context andand documentation ofcounseling process Organizational Environment 8
Phase I Theoretical SaturationResearch Design Phase IIand ResearchQuestions Data Collection & Phase III Primary Data Analysis Validation Phase IV Constant Phase V Comparison Theoretical Conceptualization Phase VI Organization of data and Interpretation Methodological Saturation Process of Data Collection and AnalysisFrom Broader Follow Reviewed cases and Generated Theoretical Integrate and Interpret Interviews,Questions up Data Used Constant Concepts Concepts, Member check, Reviews andTo Collection Comparisons Method External Audit ObservationsNarrow and Recoded the (Manual andSpecific Questions data, Validated Computerized Coding, Developed Coding, Recoding by Two categories, coding external Persons) Theoretical Sampling Establish Establish Validity Discovery of Theory Establish Authenticity and Reliability Generalizability 9
Theoretical SamplingSampling method for In-depth InterviewsTargeted Interventions across 6 Regional Deputy Director (RDD) regions in the stateListed MSM TI, FSW TI, Core Composite (MSM/FSW) TI and IDU TI from each regionShortlisted qualified, trained counselors having at-least two years of experienceRecruited qualified, trained and experienced counselors as well as Auxiliary Nurse Midwife (ANM) and community counselorsSampling method Participant Observation of Counseling SessionsShortlisted best practicing counselors from each typologyRecruited counselors for participant observation 10 11
Demographic Profile Of RespondentsTypology of Gender Education Experience in TI TrainingTargetedInterventions M F Upto Gradua MSW MA 2years >2 years 2 times >2 12th tion timesIDU 1 1 1 1MSM 5 2 1 2 2 3 1 4FSW 1 4 1 4 1 4 2 3CC 2 1 1 1 1 1 2 3Total 8 6 2 2 7 3 5 9 4 10 11
Analytical Issues And Its ManagementSr. Analytical Issues ManagementNo.1 Threat to Theoretical Validity Remained open and receptive to respondents responses Remained Open to contradictory evidence2 Threat to Interpretive Validity Researcher remained aware about Researchers’ bias to interpret data perspectives and beliefs the research brings to the research project. Recoding of the data by external person External Audit of the result and discussion will be carried out3 Threat to Descriptive Validity Audio -taping interviews and detailed, concrete, and chronological field notes during the interview process Member check method was used to ensure description validity. Technical literature review will be done once coding is completed
Analytical Issues And Its ManagementSr. Analytical Issues ManagementNo.4 Threat to Generlizaiblity of the Methodological triangulation was used result and theory triangulation will be applied Development of resource materials on HIV counseling theory, theoretical strategies Development of training module5 Reliability of the research findings Although the uniqueness of this particular (Ability to replicate study to similar study mitigates against exact replication, situations) it would be possible to conduct a similar study using a different site thereby adding to the body of literature on counseling practices with most-at-risk population. 13 13
Process Of CodingLevels Coding Process1 Initial coding Naming each word, line or segment of data Word by word Define actions on which they rest Line by line Identify tacit assumptions (underlying assumptions) Incident to incident Compare data with data Constant Comparison Identify gaps in the data In vivo code: participants Note: Remain open to all possible theoretical direction special term2 Focused Coding Synthesized and explained larger segment of the data, These codes are more Compared people’s experiences, actions, and interpretations directive, selective and conceptual3 Axial Coding Developed link between Initial and Focused Coding, (Link between category and Reassemble them in new ways subcategory) relates categories to subcategories4 Theoretical Coding Specified the relationship between emerging codes and themes coding that follows the codes selected during initial 14
Example Of Initial CodingSr. No. Initial Coding Verbatim1 Provide informations “When one has unsafe sexual practices with multiple on STIs/HIV partners, s/he has many chances to transmit STI from his/her sexual partners and at the end sexual s/het transmits STIs to his/her marital partner and other sexual partners.”2 Provide prevention “Different kinds of STIs. Some are very painful while some are messages not. All STIs can be treated and cured if you take immediate medical treatment. We can have STIs anytime; therefore we need to get regular medical check-up, blood test and if we have STI, we must take immediate treatment.”3 Provide information to “Since you are involved in risk behaviors, you need to go for take action in order to HIV test, and STI screening. It’s free for you. What do you reduce STI/HIV risk think? Should you go or not?” behaviour (advice) 17
Example Of Focused CodingSr. No. Focused Coding Verbatim1 Need based general “We cannot know whether HIV virus based on face or body. information sharing Even after HIV infection, individuals remain healthy for many years. Only way to know about HIV status in our body is blood test for HIV. HIV test is very important for two reasons: 1) To know whether we have HIV 2) If we do not have HIV, take appropriate measures to prevent us from HIV infection.”2 Need based “When you use condoms, it prevents you from getting STIs prevention including HIV, prevent unwanted pregnancies of your partner, information sharing and increase pleasure.”3 Providing Need based “Since you are involved in risk behaviors, you need to go for instructions regarding HIV test, and STI screening. It’s free for you. What do you HIV/AIDS/STIs think? Should you go or not?” 18 18
Example Of Axial CodingSr. No. Axial Coding Verbatim1 Opportunistic “When you use condoms, it prevents you from getting STIs Information Sharing including HIV, prevent unwanted pregnancies of your partner, and increase pleasure.”2 Opportunistic “Since you are involved in risk behaviors, you need to go for Instructions HIV test, and STI screening. It’s free for you. What do you think? Should you go or not?” 19 19
Example of Theoretical CodingSr. No. Theoretical Coding Verbatim1 Opportunistic specific “When you use condoms, it prevents you from getting STIs knowledge enhancing including HIV, prevent unwanted pregnancies of your partner, information Sharing and increase pleasure.”2 Opportunistic decision “Since you are involved in risk behaviors, you need to go for sharing HIV test, and STI screening. It’s free for you. What do you think? Should you go or not?” 2020
Coding ProgressionInitial Coding Focused Coding Axial Coding Theoretical CodingProviding general Opportunisticinformation about SpecificHIV Knowledge Need based Opportunistic Enhancing information sharingProviding information information sharing Informationto reduce risks Sharing Providing Need basedProviding informations instructions regarding Opportunistic Opportunisticto take actions HIV/AIDS/STIs Instructions decision sharing 21
I Indigenous Counseling Skills &Techniques Share Information that enhancesOpportunistic Knowledge Enhancing knowledge on HIV/AIDS/STIsInformation Sharing when necessary Opportunistic Decision Making Take decision on behalf of clients and share with clients Explanation Explain HIV/AIDS/STIs Demonstration Communication & Games Story Telling Telling a story of a person who had similar problem and counseling helped Giving Example Giving example of a person who changed his/her behavior 22
Indigenous Counseling Process Building Relationship Self Introduction, Organizational R Introduction, Counselor’s Role a p p Assess Risks, Take Personal & Sexual History Understanding Problems o r t Provide Risk Reduction Strategies Discuss Alternatives F o r Develop plan to execute appropriate risk m reduction strategies a Prepare Action Plan t i Plan follow up meeting to assess o development n Follow Up 23
Experiential Emphasis on Role Plays of Learning Practice Difficult SessionsCounselors’ Reflections On Capacity Building Opportunity Case Analysis of to Share History & Counseling Experience Case Study Data 24
Indigenous Counseling Practice Counselors’ Training and Characteristics Experience Indigenous Counseling Practice Counseling Set up Indigenous Skills and Organization and Techniques Environment 25
Future WorkApproach Analysis & DiscussionInterpret dataLinking data with Training Counselors Received and TheoriesConceptualize indigenous HIV Counseling Model or a theoryDiscuss the DataGet External Audit 26
THANK YOU VERY MUCH FOR LISTENING TO THE SEMINAR !! I welcome your comments and suggestions! 27
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