First week down

Definitely a productive first week spent piloting the interview questions with my research assistants. It is so important to get this part right. Because the women with whom we will speak likely have little or no formal education and have therefore not learned English in school, we will be translating the quantitative questions and interpreting the qualitative questions into the local dialect of Twi. This is a super iterative process that requires writing, trialing, reflection, and rewriting the questions until we feel that they are presented in a way that the women are answering the question that we intended them to. If the women provide a response due to a misunderstanding of the question, then we are potentially introducing bias into the study that could impact our results and reduce the quality of our work.

For example, during one session of piloting the interview, we asked a woman living with fistula how she feels about others treating her in a certain way. Based on the way the question was interpreted into Twi by the research assistant though, the woman thought she was being asked about her sexual interactions-- as the phrasing seemed to reference how she feels others. This shows the importance of piloting the questions to make sure the interview tool is as valid as possible from the start.

However, even if your interview tool is perfect, you still need well trained research assistants to be able to pick up on important parts of the women's responses and ask for them to elaborate or explain. This is a crucial skill for qualitative research. For example, in another piloting session, a woman when asked if she felt life was worth living responded that since she had attempted surgery and it had not been successful, she 'even thought of taking medication.' Here it seems the woman was sharing that she had contemplated suicide because her life spent managing her fistula was so difficult but the research assistant did not understand this in real time and missed the opportunity to confirm this is what she meant and to ask her to elaborate. This provided a teaching moment and also highlighted the motivation for this work. Women with this condition are dealing with so much and need hope and a solution to help them manage-- particularly if they were unable to be repaired.

Over the next two weeks, our plans are to transcribe all the pilot interviews and make edits to the interview questions. I will debrief with the research team and seek feedback/expert opinion from my dissertation committee. We will continue to train the research assistants in best practices in qualitative interviewing and plan to be ready to begin recruitment and formal data collection shortly thereafter.