Planning Qualitative Research Outside the U.S.

Planning Qualitative Research Outside the United States

The Challenge

Organizing and conducting qualitative research in healthcare markets outside the US can be an exciting experience – but the process can present challenges even to the seasoned researcher.

Medical respondents worldwide may be used to different research procedures (or simply not accustomed to market research at all). And while good market research companies can be found in nearly every country to support your project, you can save time and money – and obtain more information – if you are familiar with the way things are done before moving ahead.

Here are some tips for planning medical market research outside the United States, drawn from the experience of InforMedix over the past 20 years.

Screening and Recruiting

Finding your respondents in an unfamiliar country can be harder than you might expect. As you write screening questions, keep in mind factors like these:

  • The person who handles a particular diagnosis or therapy may not be the same as in the US, and so the person you want as a respondent can vary from one country to another.
  • Critical terminology in the screening criteria may not mean exactly what it is intended to mean in another language.
  • Professional activities and locations of medical practice rarely match the structures we are familiar with in the US. For example, in some countries, leading physicians spend a very large fraction of their time in teaching and administration – factors that might screen them out with a proper US-designed screener. Similarly, screening criteria that specify inpatient or outpatient activity may have to be revised in some foreign countries.

Suggestions for recruiting:

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  1. Make every effort to involve sales and marketing managers in the foreign country, in the process of defining proper research respondents. Discuss with “the locals” what the goals of the study are, and what type of discussion you expect to have with respondents. They should be able to provide advice about where and how patients are treated, who makes the decisions on products and procedures, and how the cost of medical care is covered.
  2. Have the screener translated, and then have it translated back to English. Be sure it says what you expect it to say. Insist that the interview goals and each of the screening criteria are explained to the recruiters in the country where research will take place.
  3. Include in the screener a question like “Would you be able to discuss with us ____(your topic)____, for 60 minutes, explaining your own experience with this procedure/patient type/therapy?” This is a “catch-all” question that should verify that the respondent will know what you are talking about.
  4. Learn something in advance about the overall healthcare system in the target country – who pays for healthcare, whether or not patients have insurance, and so on.

Moderating

Companies that manufacture complex medical devices hardly ever field research that is as straightforward as comparable consumer or pharmaceutical projects. Medical products research cannot be successful if an uninitiated moderator tries to handle groups or interviews after only a quick reading of the discussion guide. And multinational work is not the right place to gamble that a new moderator can do well with your particular topic.

In our product areas, obtaining good market research information with groups or interviews requires that the moderator knows quite a lot about the product or procedure being discussed. Consider prepping the moderator with…

  • A detailed written statement of the project goals
  • Discussion guides in English and the local language. See if the moderator is willing to translate the discussion guide him/herself.
  • An orientation conference call, with time for both the moderator and your marketing people to ask each other questions.
  • A/V recordings of prior interviews using the same discussion guide.

InforMedix has had the most success with moderating interviews or groups in the US, and then moving to London or Manchester, with the same English-speaking moderator. (Many medical professionals in other countries can also participate in English-language research.) These sessions may be a convenient training opportunity for German- or French-speaking moderators, who can watch behind the glass as they prepare to moderate in their own country.

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Simultaneous Translation

“Simtrans” is one of the wonders of foreign-language qualitative research; a skilled translator behind the glass can make the session seem to happen in English. These translators seem to need much less training than moderators, but they always ask (at the very least) for the discussion guide in both languages, and some briefing.

The translator is also a valuable resource in orientation meetings conducted for a foreign moderator. They are able to talk over fine points of the discussion guide in both languages, conveying information goals and product details from visiting Americans, and medicating question-and-answer sessions with the moderator-in-training.

Reporting

InforMedix provides comprehensive reporting on multi-country projects by attending all foreign interview and group sessions, and ensuring that quality moderating and translating is part of every assignment. As in the US, foreign market researchers offer audio and video recording, and frequently deliver both the English and the foreign-language soundtrack.

Transcripts are also a standard part of reporting, and this requires skilled translation to English from each other language used in the project.

Some of the most interesting results come from market research investigations that yield comparisons between findings in the US and multiple other countries. Due to variation in healthcare systems and practices, this country-based segmentation may be the primary method of subdividing and grouping the respondents.

A warning: Resist the temptation to ask for consolidated results for multi-country zones like “Europe”, “Asia” or “Latin America”. Instead, learning the differences between research findings in individual countries will be worth the effort, when the conclusions are applied to product development, marketing, and sales.

Incentives

Allow the local researchers in each country recommend honoraria for respondents. Experience with setting incentive levels in the US provides little guidance as to the amount of the proper incentive in other countries. In some countries, the recommended incentive seems surprisingly small from a US perspective; in others, it may seem extremely high.

We have seen researchers in various countries provide honoraria such as cash, checks, gift cards and certificates, and gift-wrapped presents.

Confidentiality

With increasing restrictions in the US over the past few years, this country is approaching the high level of confidentiality proscribed in most European countries. Germany and Italy are especially wary about communication between manufacturers and clinicians, and this includes communication through market research recruiters and moderators.

Learn in advance whether or not you may offer a cash incentive to medical professionals in these countries, and do not expect to be given the name or employer of every respondent.

The Subcontracting Network

By now it may be obvious that a multi-country project can involve many specialized research vendors, and the depth and breadth of these networks should not surprise you. Even the largest multinational market research companies will probably not have the staff on board to handle every aspect of a large project in many countries.
InforMedix Marketing Research, based in the US, offers core competencies in…

  1. developing project goals, methodology, screeners and discussion guides
  2. moderating
  3. analysis and reporting

Inside and outside the US, most other activities involve a series of contracted specialists. The resources engaged for a multi-country project may look like this:

Subcontractor Network

InforMedix engages local market research companies and their own networks of companies and individuals to configure the most skilled and most economical team for individual projects.