Combining apples and oranges? Synthesizing quantitative and qualitative data from EcoZD studies

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Combining apples and oranges? Synthesizing quantitative and qualitative data from EcoZD studies Silvia Alonso 1, Seng Sokerya 2, Nguyen Ngoc Thuy 3 and Jeff Gilbert 1 1. International Livestock Research Institute, ILRI 2. Centre for Agriculture & Livestock Development Cambodia (CelAgrid), Phnom Penh, Cambodia 3. Nong Lam University, Ho Chi Minh, Vietnam

EcoHealth research: Multidisciplinarity Holistic approaches Participation EcoZD all this to be applied to investigation of a zoonotic disease transmission problem 2

Quickly said Qualitative research: Participatory rural appraisals (PRA) Focus group discussions (FGD) Quantitative research: Observational studies Randomized clinical trials Summary report but Statistical analysis 3

Mixed method research intentionally integrate or combine quantitative and qualitative data to maximize the strengths of each, to answer questions that are inadequately answered by one approach. (Ozawa and Pongpirul, 2013) it allows researchers to view problems from multiple perspectives, contextualize information, develop a more complete understanding of a problem, triangulate results, quantify hard to measure constructs, provide illustrations of context for trends, examine processes/experiences along with outcomes and capture a macro picture of a system. (Ozawa and Pongpirul, 2013) Increasing literature mixed methods as a distinct research approach EcoHealth to engage and contribute!!! 4

What do mixed methods contribute?: Complementarity one type of data illustrates/explains findings on the other Development one type of data informs the use of the other method Initiation identify areas of incongruence to generate new insights / research questions Expansion each method suited to explore different aspect of a research question Triangulation corroborate findings 5

Livestock keeping and acute diarrhea in Cambodia 2 Provinces 4 Districts 8 villages Quantitative methods (questionnaire and biological sampling) Evidence and investigate risk factors for zoonotic transmission Qualitative methods (PRA and FGD) capture socio economic aspects linked to disease occurrence and spread Numerical output report Summary of observations 6

Quantitative methods (questionnaire and biological sampling) 400 Households reporting diarrhea in past 2 weeks Questionnaire on household characteristics, food consumption and hygiene practices Fecal samples diarrhea cases Fecal samples cattle/pig/chicken Tests: Salmonella spp, E. coli 0157, Shigella spp, Plesiomonas, Aeromonas, Vibrio spp Qualitative methods (PRA and FGD) In each village: Village layout (map) 4 5 villagers interviewed Household layout Seasonal calendar: production, water availability and illness Livelihood mapping Wealth ranking 7

Biological samples: Human cases - Shigella spp and E. coli 0157 (most isolations in high bloody diarrhea incidence areas) Animals E. coli 0157 and Salmonella spp (only in high bloody diarrhea incidence areas) No correlation with pathogen presence in household animals Questionnaire: Animal raising practices similar across study sites Risk factor analysis: suggests raising animals / pig-cattle consumption are NOT risk factors. Duck/fish consumption potential RF. Eating sick animals, vegetables, use surface/lake water 8

Participatory rural appraisal: Sickness - Vegetables and not-boiled water. Food other than from animals!! Farmers did not consume meat from their animals! (market). Obvious HH distribution in village associated with wealth. Different animal raising practices according to season - not captured in the QUANTI study. Chemicals mentioned often, neglected in QUANTI study. 9

Help make sense of hard to explain quantitative findings Captures complexity Help design the research question Water identified as potential important source (QUALI) QUANTI to explore more in detail Identifying the problem Get acquainted with the context Inform participants about study Guide design of intervention/control strategies Good complement of small studies 10

CONCLUDING REMARKS: EcoHealth researchers need to expand interest/skills on mixed methods (formal approaches) Need to acknowledge the reason why qualitative and quantitative research methods are needed choose the method that suit best, maybe you don t need mixed methods!!! If needed: incorporate explicitly in project DESIGN: how to do, how to analysis, how to integrate data 11

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