Trials of Improved Practices (TIPs) is a formative research technique where participants test feasible behaviors identified through prior research in their own homes. Researchers visit participants multiple times to provide recommendations, get feedback, and understand barriers and enablers to behavior change. TIPs helps design effective behavior change strategies by learning how behaviors work in natural contexts from those with specialized knowledge of their situation.

1. Trials of Improved Practices
(TIPs)
CORE Group Spring Meeting
Joy Miller Del Rosso
The Manoff Group
May 10, 2011

2. 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

3.  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?

4.  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

5.  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.

6.  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

7. TIPs for Nutrition
Situational Analysis
TIPS
Focus Group Discussion
In-Depth Interviews
other formative
research Determine Test Design
Behavioral Feasible Behavioral
Priorities Behaviors Strategy
Issue/
Identify
Problem “Ideal”
Behaviors or
Essential
Nutrition Actions
Implementation

8.  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

9.  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

10.  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.

11.  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

12. Initial Visit Counseling Visit Follow-up Visit
(Day 1) (Day 2) (Day 6-10)
Background Feedback on Changes since last visit
information practices 24-hour recall
Feeding practices Recommendations Outcome and response
24-hour recall and initial response to trial
Food frequency (of Negotiation and Modifications
other regularly motivation Adoption of practice
consumed foods) Discussion with
others, if needed
Agreement on
specific practices to
try

13.  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 specific
recommendations

14.  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

15. 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 T
research
TIPs is a technique that can be implemented by almost F
anyone
TIPs should always be implemented through a series of three F
household visits
The “results” obtained through the TIPs trials are highly T
predictive of actual behavior change