AI Related Booklet Pretest Study

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AI Related Booklet Pretest Study (administrative
medical workers)
Date February 2009 Prepared for Academy for
Educational Development Research Team SIAR
Research and Consulting Qualitative Team
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Objectives and Methodology
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Background info and purpose of the research

• Background information
• The U.S. Agency for International Development has
  awarded Academy for Educational Development
  (hereinafter, AED) a global Task Order to conduct
  behavior change communications activities on
  avian influenza prevention and containment and
  response to pandemic influenza. In Azerbaijan,
  target audiences for these communication
  activities include small rural backyard poultry
  farmers (Sector 4), small commercial farmers
  (Sector 3), first responders to public health or
  natural disasters, and human and animal health
  officials.
• Purpose of the research
• As a second step of the Azerbaijani part of the
  project, AED has concluded contract with SIAR
  Research and Consulting Group (hereinafter, SIAR)
  to conduct qualitative research aimed at
  pretesting the booklet among specific target
  groups, namely healthcare workers and
  administrative workers of health institutions.
  More specifically, the goal was to understand
• ..to what extent the text in the booklet is
  understandable and applicable
• ..the lucidity of the text
• ..to what extent the picture used in the booklet
  are relevant
• ..the weak sides of the booklet and define ways
  of its development

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Methodology
Method Qualitative Research
Technique Focus Group Discussions
Timing February, 2009
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Sample design
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Perception
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Perception General opinion about 1st paragraph
This part is about H5N1 virus, symptoms of AI
disease, measures which should be taken to
protect patients, employees and people around
us. Majority of respondents in Baku and regions
perceive symptoms listed in the leaflet to
negatively (or from negative to neutral in
regions), because they were too general and do
not characterize the disease.

• Suggested measures
• To provide more detailed information on both
  mentioned and other symptoms and ways of
  transmission.

Information on being transmitted by droplet, it
should be explained in details Baku
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Perception General opinion about 2nd paragraph
Second paragraph is about self-protection
(namely, hand washing, using personal protection
means (especially, masks and gloves), etc.). AI
suspected people should wear masks or close mouth
with clean piece of material and should not be in
same wards with others or should be in 1 meter
distance from others. Information about hand
washing for 15-20 seconds seems to be unreal.

• Suggested measures
• The part should be shortened (written more
  concrete). For instance, wear gloves and mask
  or keep up cleanness. It would be remembered
  better.
• Information really necessary for administrative
  medical workers should be provided. E.g. it was
  mentioned that all medical workers knew given
  information and in department of infectious
  diseases it is ordinary procedure, regardless of
  whether it is AI or not.

If washing hands helps in killing infections
people would not use gloves Baku
It is for people who are going on
transport Baku
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Perception General opinion about 3rd paragraph
Part named Main points is related to providing
information to patients and visitors about ways
of preventing spread of AI (or other
diseases). It was considered to be important,
but information in this part related to notices
about not spitting on the floor after cough or
sneezing as it is naturally enough. Some
sentences appear to be long and complicated.

• Suggested measures
• First point should be divided to sub points.
• Sentences should be shorter and easier.

Very long and complicated sentences Baku
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Perception General opinion about 4th paragraph

• This paragraph consists of
• Napkins, soap, water, towels and dustbins for
  patients and their family members
• Enough reserve of personal protection means for
  all medical workers, visitors and patients
• Commemorative booklets of proper hand washing,
  usage of personal protection means for workers

• Suggested measures
• Antiseptic napkins should be mentioned in the
  text, because water and soap is not available
  everywhere, and these napkins are also more
  effective than water and soap.
• Repetition is better to be avoided Partially 2nd
  point is repeated, it is not necessary. It would
  be good to explain what FMV include.
• This part should also provide information on any
  other special cleaning means.
• Last point is unnecessary as hand washing was
  already mentioned before and as they are aware of
  how to wash hands. 1st point is the most
  important.

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Perception General opinion about 5th paragraph

• 5th paragraph is about system that every medical
  institution should work out to identify possible
  AI cases and respective information provision.
• Suggested measures
• The sentence For instance, it is important
  to.. is not grammatically linked to the text
  given in the bullet points form.
• Long sentences should be divided into small ones
• Information should be properly divided into
  points 3rd point should be divided into two
  parts as there is information of different types.
• The part should be generally shorter and more
  concrete. It is important part.
• Some information (second sentence in the third
  point) is mentioned to be intended for medical
  workers.

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Perception General opinion about 6th paragraph

• 6th paragraph was about Instructions of Ministry
  of Health.
• Suggested measures
• Advices should be more concrete
• Measures to be taken during outbreak should be
  mentioned
• There should be no repetition (symptoms)
• Tests are very necessary and description of them
  should be inserted

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Lucidity of text
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Lucidity of text

• Text of the leaflet was quite understandable (it
  is understandable for everybody). Most of
  respondents stated that they were aware of the
  given information. Mostly respondents did not
  learn anything new from the leaflet (besides N-95
  mask and H5N1 virus in some cases). Cleaning
  wards, wearing masks and other procedures and
  advices are followed daily regardless of AI
  outbreak. Respondents in Baku were much more
  irritated by the leaflet than respondents in the
  regions. In general, the booklet is credible.
  Given advices should be followed.
• Suggested measures
• Divide long sentences into small ones
• Different type of Information should be divided
  into points

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Perception of pictures and its fitting to the
text. Effectiveness of explanation of some ideas
by pictures
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Perception of pictures and its fitting to the
text. Effectiveness of explanation of some ideas
by pictures.

• Pictures and text were mentioned to be important
  equally, mutually complementary. Because pictures
  make people get interested and attract. Majority
  of respondents stated that it would be much
  better if pictures are commented / named. All
  pictures fit text (for Baku respondents besides
  1st picture on the last page). Photos are better
  than pictures. Pictures should not be repeated
  along the leaflet (1st and 2nd ones).
• Suggested measures
• First 2 pictures are quite understandable for
  respondents in regions
• 2nd scene should be reflected better, it is quite
  primitive. Several times respondents mentioned
  that it seems that the patient is standing, but
  he should lie.
• 3rd picture Person should wash hands under
  running water. There should be tap in the picture
  and a soap pictured near the tap / the soap
  reflected in hands is not understandable. Liquid
  soap should be used instead of bar soap.
• Next 2 pictures reflecting person wearing mask
  were considered to be necessary, but the shoe
  covers should be added.

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Perception of pictures and its fitting to the
text. Effectiveness of explanation of some ideas
by pictures.

• Suggested measures
• Picture reflecting lying person should be more
  interesting. Box should be pictured better, his
  being isolated should be noted better, the
  picture needs a comment. If it is a dropper near
  him, it should be reflected better.
• Picture reflecting medical garbage box The box
  should be on the floor, the doctor throwing it
  away should wear doctor's smock (Regions). The
  box looks like postal box. Syringe in hand is not
  credible, should be shown opened. Information
  regarding throwing the bag away or burning it
  should be given.
• Picture with napkins should also reflect dustbin
  / garbage box. Reflected bottle should be somehow
  named (Baku ), it is not understandable what it
  is (majority guessed that it is liquid soap).
• Last picture does not fit the text because it
  reflects people, none of which looks like medical
  worker or representative of healthcare
  institutions.

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Whether the leaflet can be better
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Whether the leaflet can be better

• Suggested measure
• More information regarding actions during AI
  outbreak
• More concrete symptoms
• More thorough information should be provided
• Not to give repetitious information.
• Main points should be stressed via bold or
  underline.
• The leaflet should be changed as it seems to be
  for ordinary people, but not for medical workers.
• Any number (hot line), place to address when
  there is an AI outbreak information on
  specialized clinics should be added.
• The text should be more concrete and shorter.
• There should be information on which concrete
  tests to pass and which measures to take.
• Pictures should be replaced by photos (suggested
  in Baku) which should be commented.
• More concrete information should be added in the
  last part regarding tests and laboratory.

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Thank you for attention!