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Driving earlier diagnosis and care for Alzheimer’s disease

Identifying pathways to change behavior in the U.S. healthcare system

5.8 million Americans are living with Alzheimer’s disease.  By 2050, this number is projected to rise to nearly 14 million.  It’s currently the 6th leading cause of death in the U.S. and kills more people than breast cancer and prostate cancer combined. While early diagnosis can help, only 50% of those living with the disease are diagnosed. And only 16% of seniors receive regular cognitive assessments. To advance the mission of supporting more patients and families battling this disease, a key objective of the Alzheimer’s Association is to help across the health system to achieve earlier diagnosis.

To accomplish this goal, a broader understanding of the Alzheimer’s system was required. To offer this systemic perspective, it was necessary to comprehensively understand how two domains intersect.  The first being how families deal with the onset of the disease, pursue diagnosis and make decisions for care between patient and caregiver over time and progression. The second being how and where the primary health care system engages across this landscape.

The research and strategies developed were produced in collaboration with UPSTREAM, an innovation consultancy based in Austin, Texas, USA with significant experience understanding health systems and exploring opportunities for innovation that improve the lives of all stakeholders.

The research was based on system-journey methodology customized for this engagement. This technique leverages visual elements to empower a respondent to provide a rich mapping of the progress they made (or did not make) as they traversed their decisions regarding Alzheimer’s or dementia. The result is a visual map from each respondent indicating the milestones they crossed and elements that served as drivers of progression and those that served as barriers to inhibit them.

This technique was deployed qualitatively across 4 respondent groups. (1) People living with the disease (2) Caregivers in the family/personal ecosystem that are aiding the person living with the disease (3) Primary care providers engaged with patients facing the disease or symptoms and (4) Healthcare system administrators tasked with developing services to respond to patient needs.

Synthesized together, the results from each respondent group formed a singular map of the holistic Alzheimer’s system that revealed how each stakeholder integrates and the role that they play. Ultimately, this resulted in a single perspective with findings that align stakeholders to a common understanding of the challenges and opportunities to drive earlier diagnosis.

The results were further assessed by other stakeholders that validated the framework and prioritized the resulting opportunities for impact.

The research resulted in a new framework to understand the system of Alzheimer’s. This output was the first of its kind in establishing a single reference that revealed the roles of multiple stakeholders and how their interactions with the rest of the system can positively impact those with the disease or unintentionally inhibit them. This framework describes the system-journey of Alzheimers across 6 distinct stages, each defined by a milestone that signifies progress.

Equipped with a new understanding of the system, the research revealed 4 categories of barriers to earlier diagnosis that are currently present in the system – (1) Knowledge (2) Capacity (3) Incentives (4) Beliefs.  Specific findings were informed across these categories and indicated how the barrier manifests in the system, which stakeholders are involved, and where they appear across the spectrum of the framework. This provided a specific and actionable landscape of the areas where innovation initiatives could intervene to further achieve the objective of earlier diagnosis.

This research output has allowed the Alzheimer’s Association to advocate for several distinct challenges that the Alzheimer’s community can directly address to achieve earlier diagnosis of the disease and thus improved support and outcomes. These challenges are relevant for the broader healthcare system and provides others with a roadmap for change and clarity on the levers that will be most effective in driving that change. Furthermore, this common framework serves as a basis for defining metrics for the impact that various interventions will provide. The broadest impact may be that for the first time, multiple efforts can be aligned to a common perspective that optimizes the value of resources deployed towards this objective.

Efforts to directly address many of the challenges revealed by this unique research are currently underway at the Alzheimer’s Association, while others are being explored by diverse audiences across the system.

The crisis around this disease is accelerating as 1 in 3 seniors dies with Alzheimer’s or another dementia. On top of this suffering, it’s placing an unsustainable financial burden on the healthcare system and society as a whole.  In 2020, Alzheimer’s and other dementias will cost the U.S. $305 billion.  By 2050, these costs could rise as high as $1.1 trillion. The U.S. has no choice but to find more innovative opportunities to improve the system of Alzheimer’s diagnosis and care.  But before redesigning the system, we need to understand it.  That’s the impact that this project brings to the system and our society.

 

About the Author: Jeff Mulhausen, Founding Partner, Upstream Thinking, U.S.A.

 

This article is published as an entry for our Making a Difference Awards.

The 3rd edition of ESOMAR Foundation’s Making a Difference Awards are open for entries. This is a chance to applaud and reward the best examples of #marketresearch making a difference to the world’s Charities. Submit your entry here!

Research Got Talent Award Competition To Help Address Social Issues – Launches in Australia

The Association of Market and Social Research Organisations (AMSRO) and the global ESOMAR Foundation announced this week an exciting new joint project, the Research Got Talent award competition, focused on encouraging young professionals to use research to address prominent social issues.

AMSRO and ESOMAR’s aim is to recognise young researchers in the industry and showcase their work on the local and global stage.

Participation in the Research Got Talent competition will also foster closer relationships between competitors, local charities and NGOs, as participants are required to nominate a charitable cause to support as part of a practical research project.

The overarching theme of the initiative is the role of market research and insights play in supporting charities and non-profit organisations to overcome relevant and meaningful social issues. The research can focus on social issues such as gender equality, access to justice, education, improving the lives of people with disabilities, environmental issues and climate change.

Sally Joubert, AMSRO member and ESOMAR’s Australian representative, said: “The Research Got Talent award competition aims to recognise young researchers who want to make a difference. As recently witnessed via the outpouring of support for those affected by the bushfires, Australians like to give back. This competition provides a fantastic platform to enable young researchers to support a worthy cause of their choice, while simultaneously showcasing their professional talent.

“We are calling on all AMSRO and ESOMAR members to support this competition and young researchers. Don’t miss this opportunity to celebrate your employees and company on the global stage.”

The competition is open to young research professionals aged 18-35 and will run from 3 February to 30 March 2020. Project proposals may adopt traditional research methods, as well as new methods, including data analytics and analysis.

Finalists will present at the AMSRO Leaders Forum in Sydney on 6 May, with one winner selected and entered into the Research got Talent global competition. Winners from the global competition will take to the stage in Toronto at the ESOMAR Congress 2020 and showcase their projects to international industry leaders.

Entries open at 9.00am on Monday 3 February 2020. For more information, visit: https://www.amsro.com.au/research-got-talent

Winners receive return flights (departing from an Australian capital city to Toronto, Canada) and free admission to the ESOMAR Congress. A cash prize is offered to the winner of the global competition.

The Research Got Talent Initiative was pioneered by market research associations in India and Hong Kong and saw great success in connecting a range of stakeholders and ultimately showcasing the positive impact of the insights sector.

To enter, visit the AMSRO Research Got Talent online portal here.

The first edition of the Research Got Talent Global initiative is coordinated globally by ESOMAR and ESOMAR Foundation and implemented locally by the following market research associations:

About AMSRO

The Association of Market & Social Research Organisations (AMSRO) is the peak body for the market and social research, data and insights industry. AMSRO works in partnership with its company members, plus privacy authorities, business, government and the community to protect and promote the industry and uphold the highest ethical and privacy market and social research standards. Since its establishment in 1989, AMSRO has grown to more than 90 members, who employ over 5,000 people, representing 70% of the industry’s annual (data collection) turnover.  In 2003, AMSRO pioneered its own privacy code for members, which won an Australian Privacy Award in 2009.  www.amsro.com.au

About the ESOMAR Foundation

The ESOMAR Foundation is a charity representing the Market, Social and Opinion Research industry. Our industry has a wealth of knowledge and experience that can be applied to every aspect of society to ensure a more transparent, reliable and sustainable world. The ESOMAR Foundation believes that a fair, just and peaceful society is deserved by all and recognizes the immense promise that the research community offers to those striving to achieve these goals on a global level. The ESOMAR Foundation brings volunteers and resources together to execute projects to help and support charities and NGO’s to achieve their aims. Its aim is to encourage the usage of more insightful and inventive research and increase the overall impact of market research in building a better world.

The science of imagination: how System 3 offers a new way for NGOs to change minds and raise money

I’d like you to start this article by imagining a different world. Imagine the planet, and the society, you’d like to be living in – is it different to the one we inhabit right now? How does it make you feel to picture that new world?

What your mind is doing right now, as it creates the outline of a possible world, is the key to a major scientific breakthrough. A new development in behavioural science is starting to shape how market research will be done in the coming years. This emerging field brings together how people imagine the future, how they empathize with others and how they plan out their choices. All of these processes take place using brain functions separate from the “System 1 and 2” model that is often used to describe immediate decision-making: it has therefore been labelled System 3.

We live in a world where the attitudes and beliefs of the public are in greater focus, and at greater question, than ever before. Five years ago many of us (including me) assumed the arc of human politics and society was bending towards greater compassion, inclusion, equality and understanding. Now we are not so sure.

In some ways, this moment brings new urgency to the role of NGOs in the public conversation. Climate change presents an immediate and obvious priority; many dimensions of inequality have come into sharp clarity in this political environment; an increase in conflict-driven migration has created new tensions in Europe and North America; and the environmental, welfare and development campaigns that have animated global charity work for decades continue to matter just as much.

A personal example: I support a small charity that helps immigration detainees in the UK. AVID provides resources and advice to volunteers who visit asylum applicants and other migrants during the long periods of detention while a decision is made on whether they can stay in the UK. In the last ten years, AVID has faced the tough challenge of unsympathetic public opinion and media narratives. Between the Brexit referendum and recent UK election results, it could feel as if charities like this are fighting a hopeless battle.

If you work in an NGO that campaigns to influence public views, a new tool to change minds might be very useful around now. And if your job is to raise money, you might also be seeking something to strengthen your case. Fortunately, a new area of behavioural science may offer exactly what you need.

Many readers will know of the behavioural science work that has become prominent in recent years. Summarised in Kahneman’s Thinking Fast and Slow and Thaler & Sunstein’s Nudge, the behavioural economics world tells us about human “irrationality”, cognitive biases, and how to influence decisions in-the-moment. Researchers have responded by incorporating implicit testing into their research approaches to understand respondents’ unconscious thinking. New nudges have been designed: anchoring techniques to increase donations and opt-out defaults to change behaviour.

These approaches are good for influencing what people do, but they barely affect what people think or how they feel. Lasting impact requires changing minds, not just behaviour. In the last ten years a new body of scientific research has emerged to fill this gap.

Psychologists have explored prospection, the capability of humans to imagine and plan the future. They have investigated mental simulation, which allows us to think about the alternative outcomes our choices might bring about, and the different worlds we could possibly live in. Neuroscientists have discovered the default mode network, a set of systems in the brain that are activated when our minds are not focused on immediate tasks – for instance when we are daydreaming; or watching TV and absorbing ourselves in the world on-screen. And these processes have been linked to empathy: when we think about how life is for other people, we use the same brain regions that we use for planning our own future.

These research activities are even influencing the latest thinking in artificial intelligence and machine learning: some AI experts are starting to give computers the power of mental stimulation, to help them make better, more human decisions.

Why does this work matter? Because imagination governs how people see, shape, and choose, their future lives. The decisions we make today are motivated by the world we want to live in tomorrow.

On a small scale, this means the products we buy when we visit the supermarket to buy next weekend’s lunch. On a larger scale it translates the choices we each make, into a world that we will all share in the coming decades. The values that we live by are a manifestation of the future we want to be part of. Change how people imagine that future, and you can influence their values today.

Leaders who brought about great changes in society have often started with a call to the imagination. “I have a dream…” said Dr. Martin Luther King Jr. in 1963. “I have cherished the ideal of a democratic and free society in which all people will live together in harmony and with equal opportunities…it is an ideal for which I am prepared to die.” Nelson Mandela’s words during his 1964 trial described an ideal that, at the time, could exist for black South Africans only in the imagination. Emmeline Pankhurst’s speech in Connecticut in 1913 called on the listener to put themselves in the place of – to imagine – the women and men engaged in the political, legal and physical battle for women’s votes in the UK.

So how can you use this new science of imagination? There are three steps you can follow to take advantage of these new discoveries.

About the Author: 

Leigh Caldwell, Founding Partner, Irrational Agency

The science of imagination: 3 steps to follow

In the previous article, I discussed how the imagination of your supporters – also called the “System 3” part of their brain – is the key to changing minds and changing behaviour. If you understand how people perceive the world they live in – which may or may not correspond to reality! – you can influence them, and give yourself the chance to reshape that world.

Here are three steps you can follow to take advantage of these new discoveries.

First, measure how your supporters and your broader audience imagine the world. A new set of research tools are emerging to measure System 3– the brain’s capability for imagining, and the counterpart to the System 1 and 2 distinction explained in Kahneman’s book. By measuring System 3 thinking, you can find out how people think about the world of the future. This might take the form of an “imagination map” (see Figure 1) and is the baseline you are working with.

Figure 1: An example of an imagination map. This would be drawn by measuring an audience’s implicit attitudes towards refugees.

Second, design the world you want them to see. You can create a new imagination map that represents your vision of the future. This is probably different from the way your audience sees things now – that’s only natural, and it gives you a guide to what to do next.

Third, create interventions to redraw your audience’s imagination – to make it more like the world you want to create. Those interventions take one form above all others: stories. Your audience’s imagination is made up of the stories they tell themselves about the future. Your job is to create new stories that are compelling enough to become a part of their internal narrative. Connect the things they already care about to the things you want them to care about, through personal examples, life stories and ideas that they can’t resist; those stories will change their view of the world.

Stories by authors from Harriet Beecher Stowe to George Orwell to Aleksandr Solzhenitsyn have created new understanding in their readers. They led the reader to see the world as their fictional characters did; and on emerging from the world of the novel, to think about reality in a new way. The science of imagination sheds light on how they did that. It shows how a mental model of cause and effect shapes our interpretation of the world, and how stories create new beliefs about causality and change that interpretation.

This new body of scientific work offers a deeper form of understanding of your audiences, supporters and donors. The old style of behavioural economics was about changing people’s behaviour. This new field, sometimes called cognitive economics, is about changing how they think. It offers a powerful set of tools to influence the future via the public’s mind.

Remember that new world you imagined at the beginning of this article? You have the power to create that world. Share your vision, through stories and imagination, and you really can invent the future.

About the Author: 

Leigh Caldwell, Founding Partner, Irrational Agency

Successes of Non Profit Organization to Strengthening the Poor and Marginalized Access to Security Services in Nepal

Nepal indulged into ten years (1996-2006) of insurgency, affected the entire communities of the country that created a sense of insecurity in the mind of people, especially poor, marginalized [including youth and women]. It created widespread poverty, youth unemployment, injustice, inequalities and discrimination (cited in Upreti, 2006). As per Shakya (2008), the major consequences of the conflict on women are the lack of social safety and psychological trauma.

The political transition of the last decade as guided by the Comprehensive Peace Accord (2006) couldn’t bring changes in the insecure mind of people. The frequent political violence and security actions of police further forced these groups of people to stay away from the police and their service. Moreover, the aforementioned groups were frequently denied access to security and justice services. The lack of public knowledge about the security procedure and trust for police along with the role of middlemen in the manipulation and exploitation of poor and vulnerable people further prevented these groups from easily accessing the security services, especially in province no 2, Nepal. People would fear and feel tense in the presence of police.

In the situation above, this article explores how did the interactive formula of community police dialogues and participatory performances contribute to improving the access to security for poor and marginalized in Nepal?

Interventions and Methodologies

From September 2016 to December 2018, a consortium of CSOs led by Janaki Women Awareness Society, a non-profit organization, Nepal implemented Strengthening the Poor and Marginalized Access to Security and Justice project in central southern 4 districts of province no 2, Nepal. The project was implemented in collaboration with Search For Common Ground (SFCG) where the funding was provided by UKAID. The overall aim of the project was to improve access to security and justice of poor and marginalized communities. During the implementation period, 208 participatory interactive dialogues between the citizen [poor, marginalized, youth and women] and police were conducted. Each participatory art-based intervention i.e. football clinics and drama clinics lasted for three days. The follow-up visits with the project participants for the individual as well as group interviews combined to generate the success stories for exploring the changing relationship between police and citizen.  Within the framework of qualitative analysis, the researcher, who had also served as a consortium coordinator for the project, analyzed past security situations in the context of the project site. Then project reports, media evidence and other related reports were also reviewed to reach the conclusion.

Citizen participation in the project and results

During the project, citizen got the opportunity to discuss about their security issues with police, jointly played in a football game with the police officers, performed in a participatory street theater, shared their problems associated with security and justice to police, learned about the work as well as working modality of police, become familiar with the security service obtaining procedures, jointly prepared as well as implemented the security improvement plan with the police in order to upgrade the security situation in the communities. These all actions of the project helped people to overcome their unnecessary thought about the security and justice process of the country. Further on, citizens became aware of their responsibilities to improve the security situation in the communities. Police, on the other hand, also got the opportunity to know the real security issues of the citizen.

The final result of the project showed that interactive dialogues and participatory performances between police and citizen [poor and marginalized people] could establish a mutual relationship between them. The outcome of the project also built a sense of consciousness to the citizen that accessing service from police is easy and police are helpful as well, they learned about the police commitment towards improving the security situation in the communities. They became familiar with the challenges and difficulties police are facing for maintaining a better security situation. People have started seeking the security and legal services in their need by visiting police office without fear and hesitation. This is a tangible success over the objectives of the project.

Participants also responded about the changed behavior of some police personnel. Previously, when women from the rural village used to visit the police office for obtaining security service, the police personnel would often send them back asking them to bring a middleman who knows the application procedure. After the project interventions, whoever from the community went for the security service, police received them in a dignified manner.

Conclusions

The project engaged police, citizen, and CSOs to find a common ground for solving the security-related issues in the community.  The common ground approach of the interventions further led to the collaborative joint actions taken by the police and the public. The participatory nature of the joint actions further promoted the mutual cooperation between police and citizens and opened up opportunities for future collaborations for improving the security situation in the communities. The change in police behavior in treating the security-related service seeker and the initiation of joint actions between police and citizens are the main elements for improving the security situation in communities.

About the implementing organisation:

Janaki Women Awareness Society (JWAS) is a non-profit making non-governmental organization established by a group of women social workers in 1993, at Dhanusha district of Nepal. The formation of a democratic government provided space to the women social workers who were very much disturbed and concerned about the social evils of child marriage, reproductive health and HIV/AIDS, dowry system, domestic violence, conflict-affected people, disables, discrimination against women, youth and marginalized people. To improve people’s lives from the above situations, the group of women social workers decided to work in an organized way and founded JWAS.

References:

Shakya, A. (2008). Impact of Armed Conflict on Women and Children in Nepal. New Delhi:  WISCOMP

Upreti, B.R. (2006). Nepal’s Armed Conflict: Security Implications for Development and  Resource Governance. Kathmandu: NCCR

About the Author: 

Nub Raj Bhandari has focused on issues related to girls’ and women’s rights, education, conflict transformation and social accountability for the past ten years. He is the Program Director at Janaki Women Awareness Society and also a researcher for child marriage and education-related projects. His research focus and commitment are policy-focused and he seeks to transform society by promoting quality education, gender equality, and peacebuilding.

Why Don’t We Talk About This? Why Kenya needs to start talking about mental health

At Be Forward, Africa is our passion. We want to share our passion by bringing to life research and stories from across the continent.

A mental health crisis in Kenya

Africa is facing a mental health crisis. Over the past year, mental health stories have hit the mainstream media headlines, especially in Kenya, the focus of our study.  We wanted to understand what was going on with mental health in Kenya, and to evaluate if the country was indeed facing a crisis.

Research into mental health in Africa has been a neglected priority. Compared to physical diseases, NCDs (Non-Communicable Diseases) have received little research focus; there are still many unknowns where mental health is concerned in Africa.

At Be Forward, we wanted to address this gap and to lay a benchmark for future research by shedding light on mental health in Kenya. How do Kenyans navigate around mental health? What does it mean to them, and how does this impact on their lives? How are changing socio-economic factors impacting on mental health? What impact are global shifts, government, mental health professionals and grassroot advocates having on the mental health agenda?

If the country is facing a crisis, we want to evaluate not only what is being done to address this, but alsogauge if people’s views around mental health were changing (or not). Our research also enables us to identify which challenges and opportunities exist to advancing the mental health agenda in Kenya.

We wanted to primarily understand the average Kenyan’s understanding of mental health. We spoke to members of the general population: men and women, between 20-40 years of age, based in Nairobi, Mombasa and across the Rift Valley, both higher and lower SECs (BC1C2). In order to gather a more comprehensive picture of what was going on in Kenya, we carried out in depth interviews with a range of mental health experts: from radio journalists, to senators, suicidologists to mental health practitioners, as well as recovered mental health patients.

Understanding the stigma around mental health and getting people to open up

We conducted a qualitative general population survey through our online community, providing respondents with a safe and anonymous space in which to explore this sensitive topic. We spoke to more than 80 people either during one-on-ones or in mini groups (3-4 people max). Mini groups were first used to gather general perceptions about mental health; groups were separated by gender, with exception of some deliberate mixed gender groups to allow respondents to exchange and reflect around their mental health experiences. Online research was supplemented by face to face in depth interviews.

We also spoke to people who had recovered from mental health illnesses or had lived an experience with a close family member/friend. For these stories, we used one on ones (face to face or online) to allow them to share their stories privately and in confidence.

To complement the voice of the average Kenyan, we also reached out to numerous stakeholders invested in mental health in Kenya, from policy advisors and politicians, to numerous NGOs or non-profits on the ground. These experts provided us with their knowledge and insight into the mental health landscape in Kenya. In all, 15 stakeholders in Kenya were interviewed. Unanimously, these experts all said the same thing- that there was an urgent need for more research.

Strongly believing that film naturally complements a research report, we produced a short film to accompany the report. This film reflects the title of the report, ‘Why Don’t We Talk About This?’ and illustrates the barriers around mental health and the stigma often faced by those suffering from mental health illness in Kenya. It’s a visual depiction of the current state of mental health in the country.

Whilst our research results are currently qualitative, we are hoping to quantify the hypotheses in 2020 and would value any funding contributions to do so.

Who can benefit from this?

This piece of research provides a robust qualitative baseline that can be used to inform any future research (qualitative and quantitative). This research clearly lays out the population’s thoughts on mental health – a comprehensive ‘U&A’ around the subject. Added to this, our experts have validated and corroborated that the insights uncovered are a true reflection of the current mental health landscape in Kenya.

As far as we know, this is one of the most comprehensive pieces of research that has been undertaken around mental health in Kenya. It’s the first step in a very important journey: that of breaking the silence around mental health in Kenya in order to end the stigma. The research has also recently been used for NGO funding requests.

Help us tell Jackline’s story

In the course of this research we came across many inspiring and tragic mental health stories. One that deeply affected us is that of the death of Jackline Chepngeno, the 14 year old Bomet schoolgirl who tragically took her own life after alleged period shaming by her teacher. Jackline’s story moved us so much, we decided to make a documentary. It’s our first documentary and a huge passion project. We need help to finish it.

If you can spare a little this Christmas, please make a donation on our crowdfunding page. Please help us finish this story!

 

About the Authors: 

Paul Drawbridge, Amélie Truffert and Rhonda Nicholl – Be Forward

Big Data Big Debate: How to handle 5 million plus verbatims in just 2 weeks?

Since the beginning of November 2018 and the start of the Yellow Vest protests, France has experienced a three-fold unprecedented social movement. This mobilisation took place outside any existing organisational framework (i.e. trade unions, political parties or associations). It was also unprecedented in its longevity, as national demonstrations have been held on a weekly basis since Saturday 17th of November 2018, until the European elections in 2019. Last but not least, the multiplicity of channels of expression it used were unknown in France: social networks, the displaying of yellow vests on car windshields, recurring weekly demonstrations, attempts to form a list for the upcoming European elections and so on.

Since the social movement began, it has enjoyed strong public support; it reached 68% in favour ratings in November and December 2018, then dropped to around 58% until the end of January 2019. From February 2019 to present, it stabilised to around 45-48% of support, which is still incredible for a protest that began nine months ago.

Fig. 1

To answer to this protest, President Macron announced in January that a “Grand Débat National” will be held all over the country. A series of town hall-style gatherings were scheduled across France, where citizens could speak to their local mayors about their concerns. During two months, citizens were also allowed to make proposals online at granddebat.fr. Additionally, in March, the government held “regional citizen conferences”, intended to summarise the main findings from the sessions and establish concrete proposals for Macron to consider.

Fig. 2

OpinionWay was in charge of analysing the data collected on the online platform granddebat.fr. Two major challenges were faced. First, we had only two-and-a-half weeks following the end of the debate to deliver the results. Second was the huge volume of data, with more than 70 open-ended questions, 1,363,852 contributions and more than 5 million verbatims written by contributors overall.

The government advertised Grand Débat a lot in order to involve the population and increase contributions. The participation curve was unusual, and a peak was reached again during the last week, which we never notice usually for this kind of online consultation. In the end, more than 500,000 citizens contributed to the website regarding at least one issue, with more than 255,000 respondents to open-ended questionnaires.

Fig. 3

There was no demographics on the questionnaire, so it was a challenge to analyse who the contributors actually were. However, we thought it was a decisive point to understand the data better. The only thing we could use was the postal code. We decided to cross this information with census data in order to create maps and revenue indicators, to verify whether the respondent population matched the general French population, as purchasing power was one of the most important issues for the yellow vests. 

To analyse open-ended questions, regarding to the volume of data and the short period to deliver results, we decided to use AI technology. We used a platform to access software dedicated to text analysis. Developed after several years of research around big data technologies, semantics and machine learning, the platform automatically detects and analyses standard text elements (e.g. person, company, concept, event, organisation, location, etc.), and can also integrate project specific vocabulary.

This solution makes it possible to automatically process large quantities of texts to draw quantitative analyses with a qualitative dimension. It also offers data analysis, segmentation and data visualisation capabilities. Particularly suited to the analysis of open questions resulting from the consultations, which can include a very large number of verbatims, this solution proposes many keys of analysis for the open questions, with a finesse that does not have all the tools of textual analysis.

Semantic enrichment consists of recognising different signifying elements in a text. This involves first detecting named entities, which are proper names or very specific common names. It is then necessary to recognise the concepts, which are phrases of several words having a significant interest. At that stage, human intervention was necessary to decide whether the concept was significant in the context of this analysis or not, and eventually to correct it. Validating renamed identified AI concepts, to make sure they were relevant, was a huge undertaking. After every human intervention, we screened data with AI again to make it more efficient, to eliminate statistical noise and to reduce unclassified verbatims.

Then, for each issue, we tried to summarise the main findings, regarding volume and themes discussed by respondents.

In the end, this mode of analysis was conducted under the constraints of rules enacted by the government, as well as under the protection of a college of guarantors, composed of specialists in public debate and data analysis.

Fig. 4

All the data collected was open-access (and is still) to allow all citizen to make their own analyses, which is not usual in our daily business.

Presentation at ESOMAR FUSION event. Madrid, November 2019

About the Author: 

Bruno Jeanbart, Deputy Managing Director at OpinionWay, France.

 

“For every child, every right” – 20 November – Today we celebrate World Children’s Day!

Around the world, children are showing us their strength and leadership advocating for a more sustainable world for all. Let’s build on advances and re-commit to putting children first. For every child, every right.” UN Secretary-General António Guterres

This year’s celebration marks the anniversary of the United Nations’ adoption of the Convention on the Rights of the Child. We can all play an important part in making World Children’s Day relevant for their societies, communities and nations. We, at the ESOMAR Foundation, want to celebrate this special anniversary by offering our readers and followers a few of the many examples of how solutions have been found and impact has been made on the lives of many children around the world with the help of the skills, knowledge and support of the data, research and insights community.

Reducing Child Mortality – A providers, a mother and a powder

Winner of the Most innovative Not-For-Profit case study of the ESOMAR Foundation Making a Difference Competition 2018. “With deep and nuanced understanding of what was driving oral rehydration salt (ORS) uptake, we developed a radically revised theory of how to increase the use of ORS to treat diarrhea in children. Instead of focusing exclusively on RMPs, programs should create demand for ORS by reframing caregivers’ perception of the treatment. This would help RMPs to bridge their “know-do” gap and prescribe ORS with confidence.” This project was carried out by Surgo Foundation in partnership with the Bill & Melinda Gates Foundation and the Clinton Health Access Initiative

Giving the World’s Children

UN0141031 © UNICEFUN0141031LeMoyne

a Voice: A UNICEF case study

Children represent one of the most vulnerable groups in a society. They also represent a society’s future: future decision-makers, leaders, consumers and employees. Despite the progress achieved in numerous areas, children continue to face high distressing situations across the world.

“For 2017 World’s Children Day, UNICEF’s goal was to give the world’s children a voice. The overarching objective was to see the world through their eyes: to hear their perspectives on the most pressing issues affecting children globally and in their home country, to understand their hopes for the world’s children, to hear what they would change if they were in charge. To put results in perspective, we also wanted to understand their world: who they admire (and are influenced by), whether they feel they are being heard and if so by whom and get their opinion on world leaders’ job at addressing children’s issues.This research is an attempt to give children a voice and make the rest of society aware of what children are concerned about, and what changes they would like to see so their opinions are also taken into account in the decisions being made. It is also a reminder to all to make sure we are talking to the right people.”

This research is the product of the collaboration between UNICEFGrey Advertising (the communications agency for the World’s Children Day) and Kantar’s Lightspeed Research: for the technical aspect of the research project.

Awareness of human trafficking risks among vulnerable children and youth in Ukraine

The survey aimed to define the vulnerability and the level of awareness of human trafficking among nine groups of children and youth in Ukraine. The survey covered children in difficult life circumstances and orphans; children from foster families and family-type homes; children displaced from the conflict zone in the East of Ukraine; children with special needs; homeless children; young people detained in penitentiaries; and youth of vocational schools.

The International Organization for Migration mission in Ukraine (IOM) implements a variety of human trafficking prevention activities. To improve the existing counter-trafficking practice, it conducted specific surveys on a regular basis to identify the most vulnerable and at-risk populations. Taking into consideration the results of the commissioned survey, IOM supported NGO small-grant projects in every oblast of Ukraine focused on targeted awareness increase and prevention work among the identified key vulnerable groups of children and youth with the highest risks of human trafficking. As a result of these projects, more than 63,000 vulnerable children and youth increased their knowledge of various types of human trafficking and basic rules of safe migration and employment.

The research was commissioned by the International Organization for Migration mission in Ukraine and conducted by GfK Ukraine

Driving the Efforts to Prevent “Stunting” in Indonesia

Stunting is the impaired growth and development of children caused by poor nutrition and repeated infection resulting in their height being two standard deviations below the WHO Standards. Indonesia has a higher incidence of stunting among ASEAN Countries …1 in 3 children. Feedback from the National Nutrition Communication Campaign (NNCC), IMA World Health suggests that we are on the right path … “This research program has made a big contribution to our mission …helped us start right. Stunting is no longer invisible. It’s a mainstream issue backed by the government and local communities. We have no doubt that we will see progressive reduction in stunting.

The government of Indonesia has committed to an integrated National Nutrition Communication Campaign (NNCC) for behavior change targeted at individuals, communities and stakeholders to minimize stunting. To this end, IMA World Health was commissioned by MCA Indonesia to design and implement an effective NNCC resulting in behavior change and lower stunting incidence.

Kantar TNS Indonesia conducted the in-depth study for the understanding of knowledge, beliefs, attitudes and behavior related to mother and child nutrition and stunting – to identify the motivators and deterrents to desired behavior, including the role of different influencers and influences to aid integrated communication strategy development covering message and media/touchpoint strategies.

I am one in a million

How Street Invest  and Big Sofa created a remarkable video: ‘I am One in a Million’ from qualitative research findings – with the objective of changing the public perception of Street Children – to humanise them.

The power of this study lies in the shareable and impactful output film.

Through this research, street children have been able to share their own stories, using in their own voice, in a manner which can be shared with those who have the power to change their lives.

* All the street workers involved were trained in Child Protection and informed consent was gained from the young people who participated in the filming.

 

 

Financial Segmentation in Brazil´s base of the pyramid

Plano CDE is a Brazilian social impact business (B Corp) established in 2009 by a group of economists and anthropologists with extensive knowledge in research, consultancy of social projects and public policies for the base of the pyramid. The Organization has the goal of helping to map and understand the needs of beneficiaries of social programs and public policies to subsidize strategies that improve the lives of these families. We partnered with the Center for Microfinances at FGV University to develop this study for J.P Morgan Foundation.

Brazil has a population of 120 million people living on the base of the pyramid, while eighty million have no access to bank accounts (40% of the population). Studies have shown that improvement in financial inclusion has a strong correlation to wellbeing improvement and vulnerability reduction.

Previous qualitative studies have shown the heterogeneity of this vulnerable population on their demands of financial services: the main goal of this research was to measure this diversity. Our primary objective was to develop a segmentation of financial behavior on the base of the pyramid in Brazil in order to subsidize public policies, financial services and financial education programs on offers better suited for the specific needs of different profiles in the population.

The study was divided into four stages: literature review and questionnaire co-creation, face-to-face quantitative survey, ethnographic immersions, and recommendation workshop with stakeholders in the financial ecosystem. The questionnaire was adapted from previous surveys organized by the Brazilian Central Bank, World Bank, and other pre-tested instruments.

Once data was collected, we learned that 57% of the Brazilian base of the pyramid owned bank accounts – but only 7% used them for more than withdrawing their total salary once a month. Payments were made mostly in cash on lottery houses (which, in Brazil, operate as bank correspondents), and digitalization, notwithstanding the universal ownership of smartphones, did not include financial transactions – only 5% ever paid a utility bill online.

Looking at the aggregate data showed a universal distance of lower-income segment to formal financial institutions. Few have access to formal credit, as previous literature on financial inclusion already predicted. Those who save money on the previous 12 months (27% of this population) did it largely at home, in cash and knowledge of financial concepts is also critically low. Only 20% of the sample correctly answered basic interest-related questions. A relevant segment of 27% refused to try to answer these financial education questions, showing a considerable lack of confidence when dealing with numbers, math, and issues related to money.

With these results in hand, our team formulated a clustering analysis called Grade of Membership (GoM). This method allows for a refined clustering, in which individuals are simply assigned to a group, but are given a grade of similarity to others within a group. The result is a definition of “pure profiles” and other mixed profiles. In our survey, we found three pure types of financial behavior.

Three profiles were found, analyzed, and later visited on ethnographic immersions. The qualitative stage allowed us to understand in depth what psychological traits differentiated the groups. The segments were described as follows:

  1. Conservatives (33% of total combining pure and mixed profiles)

Conservatives are usually older (85% are above 50 y.o.), with lower school attendance (84% never finished Elementary school level). Ethnographic data showed Conservatives were mostly worried about having a “good name”, meaning, they will abstain from consumption lest they generate debt.

“It’s better not the have anything than to be in debt”, one of our interviewees explained. More than 71% don’t have bank accounts, and they generally describe a strong distrust of banks. Extra income, for them, would be directed to tangible assets: home improvements, better groceries for the family.

  1. Disorganized (28% of total combining pure and mixed profiles)

Disorganized are families with younger children (1,6 children per household, on average), and didn’t finish high school (83%). Many are in debt, and half of them do not wish to pay their debt. However, what differentiates them the most is the will to consume even when creating new debt (30%, double that of the total population).

“I’m very relaxed with money” is a typical self-description heard on the ethnographic immersions. Their financial decisions are seldom planned – most think it’s not worth thinking too much ahead since emergencies invariably arrive.

  1. Planned (27% of total combining pure and mixed profiles)

This profile has similar education levels as the disorganized, yet they manage to have better financial education and are able to consume and save. “I cannot buy a product made for an upper class” summarizes how Planners deal with their consumption habits: noting what fits their tight budget.

Up to 58% of them were able to save money on the previous year, although commonly at home. The extra income would go to savings accounts – more common in the public, which is 91% bancarized.

These findings were shared in a co-creation workshop including the ecosystem of financial inclusion (Central Bank, major financial institutions, Fintechs, NGOs and Academia). Stakeholders at this meeting recommended solutions for each of the profiles identified. Whilst there was a challenge of finding the Planned profile with current credit scoring algorithms, institutions also needed to learn how to better direct financial literacy solutions to the Disorganized, and more secure payment means to Conservatives. Co-created recommendations can be summarized in the table below

 

Disorganized Planned Conservatives
Drivers Indulgencies, family well-being Build assets Safety and stability
Fears No giving better conditions to their families To lose what they have conquered To default
Relationship to network Highly dependent on their network of friends for credit Individual mindset – will not borrow or lend money Protects the family and depends on working-age children
Why save money To be prepared for small emergencies To conquer new assets To have a less worrying future

 

The results were presented at Brazilian Central Bank Financial Inclusion Conference and other important forums of the theme and subsidized new financial instruments and financial education programs more suited for the different profiles of the base of the pyramid´s population.

 

About the Authors: 

Mauricio de Almeida Prado, Executive Director Plano CDE

 

Safe Village Programs – Preventing Child Trafficking in Rural India

My Choices Foundation is a Hyderabad-based NGO dedicated to ending violence, abuse, and exploitation of women and girls in India. They address two prevalent forms of gender-based violence – domestic violence and child trafficking – through Operation PeaceMaker and Operation Red Alert.

Operation PeaceMaker works in Telangana through thousands of empowered community women, legal teams, programs to empower young girls and encourage men to become allies in ending gender based violence. Operation Red Alert works in rural India to prevent child trafficking through a prevention-based program.

There are between 3 – 20 million commercial sex workers in India. To understand the behaviours we want to end, comprehensive research was required on what drives decisions to:

  • force girls/women into trafficking
  • make men willing to pay for sex

The aim of the research was to understand these contextual factors and the roles of specific emotions and behaviours that enable these decisions. The objective of the research was to apply learnings from cognitive neuroscience and behavioural economics to understand and influence the behaviour of at-risk families and men who buy sex. This reflected a gap in terms of the current understanding of issues.

This research was conducted with the aim of preventing trafficking by sensitising, alerting and empowering at-risk families in source areas, and to stem the demand by changing the behaviour and attitudes of men at destination areas. Key considerations during the research were to ensure that the findings and insights can easily be extrapolated into applicable interventions on the ground.

Our idea of justice is summed up in this: “Pulling drowning people out of a river is compassion. Walking upstream to find the reasons they are falling in, is justice.” My Choices Foundation decided to start with research and commissioned Mumbai-based Final Mile Consulting to conduct this research paper, which won the 2016 ESOMAR Excellence Award.

The first stage of research comprised of field visits to develop an understanding of the context, through direct interactions with at-risk families, stakeholders, migrant workers, influencers and decision making environments.

Due to social stigma attached to the issue, these conversations alone could not reveal the full picture, therefore interviews and discussions were conducted with NGOs, government agencies and stakeholders involved in different aspects of trafficking – prevention, protection and prosecution. Learning from various programs deployed and prior research conducted was also a part of the research methodology and the key output of these stages was a set of hypotheses for understanding and changing behaviour.

This research used EthnoLab™, a FinalMile proprietary research technique that involved a game that simulated the real-world context of the participants to solicit real-world reactions and behaviours. This game was the medium through which context, emotions, and mental models that influence the behaviour of at-risk families and urban clientele were studied. This was followed by an interview session designed to elicit emotions and was a crucial element in gathering insights and information about personal experiences and perceptions of trafficking and purchasing sex.

The main achievement of the research is the development of the Safe Village Program (SVP), designed to help people at all literacy levels in villages understand human trafficking and collectively prevent it from ever occurring in their villages.

Aimed at targeting intervention, Operation Red Alert (ORA) of My Choices Foundation partnered with Quantium Analytics to build a tool based on multiple sets of data to map villages highly prone to trafficking. Using this data, we conduct two-day SVPs in high-risk villages in 8 states in India: Andhra Pradesh, Bihar, Jharkhand, Karnataka, Maharashtra, Telangana, West Bengal and Rajasthan.

To initiate discussions on trafficking amongst children, we created a comic book translated into the vernacular language. To ensure children have retained the message, we scripted a skit on a family experiencing trafficking, which the children re-enact. It is customized to local cultural beliefs and easily resonates with the audience to be more effective.

Members of the village are given the Red Alert helpline (1800 419 8588) which responds to cases of human trafficking. Furthermore, ORA appoints volunteers called Nodal Teachers who watch over vulnerable children and reiterates the message of being alert; and Rakshaks to report urgent cases back to ORA and partnering organizations – thus ensuring the sustainability of the program.

The impact of this research on anti-trafficking NGOs is identifiable through our network of 90+ partnering NGOs which traverses state borders, i.e. a network specialized in its local geographies. In 2019, our first Anti-Trafficking Forum which brought together our NGO partners in India, Bangladesh and Nepal facilitated cooperation amongst organizations committed to ending cross-border trafficking.

Since 2016, ORA has reached over 3,400 SVPs through our research based anti-trafficking program, and we are getting closer to increasing awareness on trafficking to ensure that all children are safe from human trafficking.

About the Authors: 

My Choices Foundation is a Hyderabad-based NGO that works to give women and girls in India the choices to live lives free from violence, abuse and exploitation.