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PhD Plan of Analysis Seminar_apurva_pandya 29feb2012
1. HIV Counseling Practices:
Experiences and Perspectives of Counselors Working with
Targeted Interventions in Gujarat
Plan of Analysis Seminar
Apurva Pandya , MA Shagufa Kapadia, PhD
Researcher Professor and Research Guide
Department of Human Development and Family Studies
Faculty of Family and Community Sciences,
M S University of Baroda, Vadodara
1
29 February 2012
2. HIV/AIDS Context
Global Context
33.2 Million people are National Context
living with HIV
Local Context
Everyday 6800 people get Total 1,81,785 people are Oldest Targeted
HIV infection. living with HIV (June,2007). Interventions in the county
Moderate HIV
Negative impact on life
prevalence
(low life expectancy, Concentrated epidemic
increase orphans,
economic crisis, stigma
and discrimination).
2
3. Global and National Response To
HIV/AIDS
HIV Prevention Approaches
Medical Approach
Social Approach
Behavioral Approach
Developmental Approach
Reduced in HIV Prevalence across the globe….
Experience of HIV prevention and control
Maintained moderate HIV prevalence
Scarcity of researches on counseling within Targeted
Interventions 3
4. HIV/AIDS Context
And
Relevance of Present Research
HIV prevalence and experience of implementation
of targeted interventions (program maturity)
create a right context to explore
counseling practices, counselors experiences and
perspectives on HIV prevention counseling.
4
5. Research Questions
How do counselors practice HIV counseling services
within targeted intervention?
How do counselors use or develop counseling skills
and techniques?
How do counselors deal with challenges in everyday
counseling practice?
What are counselors’ perspectives on current HIV
counseling practice and their capacity building?
Does the experience of HIV counseling enable
development of a personal counseling approach?
5
6. Examine counselors’ personal and professional
experiences of providing HIV counseling services.
Understand their
perspectives on current
practices and capacity
building.
Research Objectives
Evolve indigenous practices and a culturally
appropriate working model for HIV counseling. 6
7. Research Design
Research Methodology: Grounded Theory (GT).
It helps in discovery of new information (Glaser and Strauss 1967).
Develop theoretical formulations (Byrne 2001) , and
Establish framework for future exploration (Strauss & Corbin, 1990).
Universe:
Counselors working with Targeted Interventions in the state of Gujarat and
their clients
Sample Size:
Total 14 counselors working with Targeted Interventions were interviewed
Total 4 counselors’ sessions including two follow up sessions were observed
Sampling Technique:
Theoretical Sampling
Data Collection Tools:
In-depth interview protocol and naturalistic observation protocol 9
7
8. Data Collection Through Various Methods
To Gain Demographic
Information, Understand
Knowledge and Beliefs of
Counselors─HIV/AIDS, Targeted To Understand Counseling
Types of Research Data
Interventions, Risk populations, Effectiveness, Clients’
and Counseling, Feedback and Perceptions of
Existing HIV counseling practices Counseling
Text Visual
Narrative
To Understand
Process of
In-depth Interview Brief Interview of Counseling
Counseling documents of Counselors Clients
For example, daily diary,
registers Observational Field Photographs Participants
Observation of
Notes Counseling sessions
To Understand Recording To Understand Counseling Context and
and documentation of
counseling process Organizational Environment
8
9. Phase I
Theoretical Saturation
Research Design Phase II
and Research
Questions Data Collection & Phase III
Primary Data Analysis
Validation Phase IV
Constant Phase V
Comparison
Theoretical
Conceptualization Phase VI
Organization of data
and Interpretation
Methodological Saturation
Process of Data Collection and Analysis
From Broader Follow Reviewed cases and Generated Theoretical Integrate and Interpret
Interviews,
Questions up Data Used Constant Concepts Concepts, Member check,
Reviews and
To Collection Comparisons Method External Audit
Observations
Narrow and Recoded the (Manual and
Specific Questions data, Validated Computerized Coding,
Developed
Coding, Recoding by Two
categories, coding
external Persons)
Theoretical
Sampling Establish Establish Validity Discovery of Theory Establish Authenticity and
Reliability Generalizability
9
10. Theoretical Sampling
Sampling method for In-depth Interviews
Targeted Interventions across 6 Regional Deputy Director (RDD) regions
in the state
Listed MSM TI, FSW TI, Core Composite (MSM/FSW) TI and IDU TI from
each region
Shortlisted qualified, trained counselors having at-least two years of
experience
Recruited qualified, trained and experienced counselors as well as
Auxiliary Nurse Midwife (ANM) and community counselors
Sampling method Participant Observation of Counseling Sessions
Shortlisted best practicing counselors from each typology
Recruited counselors for participant observation 10
11
11. Demographic Profile Of Respondents
Typology of Gender Education Experience in TI Training
Targeted
Interventions M F Upto Gradua MSW MA 2years >2 years 2 times >2
12th tion times
IDU 1 1 1 1
MSM 5 2 1 2 2 3 1 4
FSW 1 4 1 4 1 4 2 3
CC 2 1 1 1 1 1 2 3
Total 8 6 2 2 7 3 5 9 4 10
11
12. Analytical Issues And Its Management
Sr. Analytical Issues Management
No.
1 Threat to Theoretical Validity Remained open and receptive to
respondents responses
Remained Open to contradictory
evidence
2 Threat to Interpretive Validity Researcher remained aware about
Researchers’ bias to interpret data perspectives and beliefs the research
brings to the research project.
Recoding of the data by external person
External Audit of the result and
discussion will be carried out
3 Threat to Descriptive Validity Audio -taping interviews and detailed,
concrete, and chronological field notes
during the interview process
Member check method was used to
ensure description validity.
Technical literature review will be done
once coding is completed
13. Analytical Issues And Its Management
Sr. Analytical Issues Management
No.
4 Threat to Generlizaiblity of the Methodological triangulation was used
result and theory triangulation will be applied
Development of resource materials on
HIV counseling theory, theoretical
strategies
Development of training module
5 Reliability of the research findings Although the uniqueness of this particular
(Ability to replicate study to similar study mitigates against exact replication,
situations) it would be possible to conduct a similar
study using a different site thereby adding
to the body of literature on counseling
practices with most-at-risk population.
13 13
14. Process Of Coding
Levels Coding Process
1 Initial coding Naming each word, line or segment of data
Word by word Define actions on which they rest
Line by line Identify tacit assumptions (underlying assumptions)
Incident to incident Compare data with data
Constant Comparison Identify gaps in the data
In vivo code: participants Note: Remain open to all possible theoretical direction
special term
2 Focused Coding Synthesized and explained larger segment of the data,
These codes are more Compared people’s experiences, actions, and interpretations
directive, selective and
conceptual
3 Axial Coding Developed link between Initial and Focused Coding,
(Link between category and Reassemble them in new ways
subcategory)
relates categories to
subcategories
4 Theoretical Coding Specified the relationship between emerging codes and themes
coding that follows the
codes selected during initial
14
17. Example Of Initial Coding
Sr. No. Initial Coding Verbatim
1 Provide informations “When one has unsafe sexual practices with multiple
on STIs/HIV partners, s/he has many chances to transmit STI from his/her
sexual partners and at the end sexual s/het transmits STIs to
his/her marital partner and other sexual partners.”
2 Provide prevention “Different kinds of STIs. Some are very painful while some are
messages not. All STIs can be treated and cured if you take immediate
medical treatment. We can have STIs anytime; therefore we
need to get regular medical check-up, blood test and if we
have STI, we must take immediate treatment.”
3 Provide information to “Since you are involved in risk behaviors, you need to go for
take action in order to HIV test, and STI screening. It’s free for you. What do you
reduce STI/HIV risk think? Should you go or not?”
behaviour (advice)
17
18. Example Of Focused Coding
Sr. No. Focused Coding Verbatim
1 Need based general “We cannot know whether HIV virus based on face or body.
information sharing Even after HIV infection, individuals remain healthy for many
years. Only way to know about HIV status in our body is blood
test for HIV. HIV test is very important for two reasons: 1) To
know whether we have HIV 2) If we do not have HIV, take
appropriate measures to prevent us from HIV infection.”
2 Need based “When you use condoms, it prevents you from getting STIs
prevention including HIV, prevent unwanted pregnancies of your partner,
information sharing and increase pleasure.”
3 Providing Need based “Since you are involved in risk behaviors, you need to go for
instructions regarding HIV test, and STI screening. It’s free for you. What do you
HIV/AIDS/STIs think? Should you go or not?”
18 18
19. Example Of Axial Coding
Sr. No. Axial Coding Verbatim
1 Opportunistic “When you use condoms, it prevents you from getting STIs
Information Sharing including HIV, prevent unwanted pregnancies of your partner,
and increase pleasure.”
2 Opportunistic “Since you are involved in risk behaviors, you need to go for
Instructions HIV test, and STI screening. It’s free for you. What do you
think? Should you go or not?”
19 19
20. Example of Theoretical Coding
Sr. No. Theoretical Coding Verbatim
1 Opportunistic specific “When you use condoms, it prevents you from getting STIs
knowledge enhancing including HIV, prevent unwanted pregnancies of your partner,
information Sharing and increase pleasure.”
2 Opportunistic decision “Since you are involved in risk behaviors, you need to go for
sharing HIV test, and STI screening. It’s free for you. What do you
think? Should you go or not?”
2020
21. Coding Progression
Initial Coding Focused Coding Axial Coding Theoretical
Coding
Providing general Opportunistic
information about Specific
HIV Knowledge
Need based Opportunistic
Enhancing
information sharing
Providing information information sharing Information
to reduce risks Sharing
Providing Need based
Providing informations instructions regarding Opportunistic Opportunistic
to take actions HIV/AIDS/STIs Instructions decision sharing
21
22. I Indigenous Counseling Skills &Techniques
Share Information that enhances
Opportunistic Knowledge Enhancing
knowledge on HIV/AIDS/STIs
Information Sharing
when necessary
Opportunistic Decision Making Take decision on behalf of
clients and share with clients
Explanation Explain HIV/AIDS/STIs
Demonstration Communication & Games
Story Telling Telling a story of a person who had
similar problem and counseling helped
Giving Example Giving example of a person who
changed his/her behavior 22
23. Indigenous Counseling Process
Building Relationship Self Introduction, Organizational
R
Introduction, Counselor’s Role
a
p
p Assess Risks, Take Personal & Sexual History
Understanding Problems o
r
t
Provide Risk Reduction Strategies
Discuss Alternatives F
o
r Develop plan to execute appropriate risk
m reduction strategies
a
Prepare Action Plan
t
i Plan follow up meeting to assess
o
development
n
Follow Up
23
24. Experiential Emphasis on
Role Plays of
Learning Practice
Difficult
Sessions
Counselors’ Reflections On Capacity Building
Opportunity Case Analysis of
to Share History & Counseling
Experience Case Study Data
24
25. Indigenous Counseling Practice
Counselors’ Training and
Characteristics Experience
Indigenous Counseling Practice
Counseling Set up Indigenous Skills
and Organization and Techniques
Environment
25
26. Future Work
Approach Analysis & Discussion
Interpret data
Linking data with Training Counselors Received and
Theories
Conceptualize indigenous HIV Counseling Model or a
theory
Discuss the Data
Get External Audit
26
27. THANK YOU VERY MUCH
FOR LISTENING
TO THE SEMINAR !!
I welcome
your comments
and suggestions!
27
Notes de l'éditeur
Move the conceptual framework slide before the objectives (that is, after the rationale).