research instrument for observation

Observation

Observation, as the name implies, is a way of collecting data through observing. This data collection method is classified as a participatory study, because the researcher has to immerse herself in the setting where her respondents are, while taking notes and/or recording. Observation data collection method may involve watching, listening, reading, touching, and recording behavior and characteristics of phenomena.

Observation as a data collection method can be structured or unstructured. In structured or systematic observation, data collection is conducted using specific variables and according to a pre-defined schedule. Unstructured observation, on the other hand, is conducted in an open and free manner in a sense that there would be no pre-determined variables or objectives.

Moreover, this data collection method can be divided into overt or covert categories. In overt observation research subjects are aware that they are being observed. In covert observation, on the other hand, the observer is concealed and sample group members are not aware that they are being observed. Covert observation is considered to be more effective because in this case sample group members are likely to behave naturally with positive implications on the authenticity of research findings.

Advantages of observation data collection method include direct access to research phenomena, high levels of flexibility in terms of application and generating a permanent record of phenomena to be referred to later. At the same time, this method is disadvantaged with longer time requirements, high levels of observer bias, and impact of observer on primary data, in a way that presence of observer may influence the behaviour of sample group elements.

It is important to note that observation data collection method may be associated with certain ethical issues. As it is discussed further below in greater details, fully informed consent of research participant(s) is one of the basic ethical considerations to be adhered to by researchers. At the same time, the behaviour of sample group members may change with negative implications on the level of research validity if they are notified about the presence of the observer.

This delicate matter needs to be addressed by consulting with dissertation supervisor, and commencing the primary data collection process only after ethical aspects of the issue have been approved by the supervisor.

My e-book,  The Ultimate Guide to Writing a Dissertation in Business Studies: a step by step assistance  offers practical assistance to complete a dissertation with minimum or no stress. The e-book covers all stages of writing a dissertation starting from the selection to the research area to submitting the completed version of the work within the deadline.

John Dudovskiy

Qualitative Research: Observation

• Getting Started
• Focus Groups
• Observation
• Case Studies
• Data Collection
• Cleaning Text
• Analysis Tools
• Institutional Review

Participant Observation

Photo: https://slideplayer.com/slide/4599875/

Field Guide

• Participant Observation Field Guide

What is an observation?

A way to gather data by watching people, events, or noting physical characteristics in their natural setting. Observations can be overt (subjects know they are being observed) or covert (do not know they are being watched).

• Researcher becomes a participant in the culture or context being observed.
• Requires researcher to be accepted as part of culture being observed in order for success

Direct Observation

• Researcher strives to be as unobtrusive as possible so as not to bias the observations; more detached.
• Technology can be useful (i.e video, audiorecording).

Indirect Observation

• Results of an interaction, process or behavior are observed (for example, measuring the amount of plate waste left by students in a school cafeteria to determine whether a new food is acceptable to them).

Suggested Readings and Film

• Born into Brothels . (2004) Oscar winning documentary, an example of participatory observation, portrays the life of children born to prostitutes in Calcutta. New York-based photographer Zana Briski gave cameras to the children of prostitutes and taught them photography
• Davies, J. P., & Spencer, D. (2010).  Emotions in the field: The psychology and anthropology of fieldwork experience . Stanford, CA: Stanford University Press.
• DeWalt, K. M., & DeWalt, B. R. (2011).  Participant observation : A guide for fieldworkers .   Lanham, Md: Rowman & Littlefield.
• Reinharz, S. (2011).  Observing the observer: Understanding our selves in field research . NY: Oxford University Press.
• Schensul, J. J., & LeCompte, M. D. (2013).  Essential ethnographic methods: A mixed methods approach . Lanham, MD: AltaMira Press.
• Skinner, J. (2012).  The interview: An ethnographic approach . NY: Berg.
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Non-Experimental Research

32 Observational Research

Learning objectives.

• List the various types of observational research methods and distinguish between each.
• Describe the strengths and weakness of each observational research method. 

What Is Observational Research?

The term observational research is used to refer to several different types of non-experimental studies in which behavior is systematically observed and recorded. The goal of observational research is to describe a variable or set of variables. More generally, the goal is to obtain a snapshot of specific characteristics of an individual, group, or setting. As described previously, observational research is non-experimental because nothing is manipulated or controlled, and as such we cannot arrive at causal conclusions using this approach. The data that are collected in observational research studies are often qualitative in nature but they may also be quantitative or both (mixed-methods). There are several different types of observational methods that will be described below.

Naturalistic Observation

Naturalistic observation  is an observational method that involves observing people’s behavior in the environment in which it typically occurs. Thus naturalistic observation is a type of field research (as opposed to a type of laboratory research). Jane Goodall’s famous research on chimpanzees is a classic example of naturalistic observation. Dr.  Goodall spent three decades observing chimpanzees in their natural environment in East Africa. She examined such things as chimpanzee’s social structure, mating patterns, gender roles, family structure, and care of offspring by observing them in the wild. However, naturalistic observation  could more simply involve observing shoppers in a grocery store, children on a school playground, or psychiatric inpatients in their wards. Researchers engaged in naturalistic observation usually make their observations as unobtrusively as possible so that participants are not aware that they are being studied. Such an approach is called disguised naturalistic observation .  Ethically, this method is considered to be acceptable if the participants remain anonymous and the behavior occurs in a public setting where people would not normally have an expectation of privacy. Grocery shoppers putting items into their shopping carts, for example, are engaged in public behavior that is easily observable by store employees and other shoppers. For this reason, most researchers would consider it ethically acceptable to observe them for a study. On the other hand, one of the arguments against the ethicality of the naturalistic observation of “bathroom behavior” discussed earlier in the book is that people have a reasonable expectation of privacy even in a public restroom and that this expectation was violated. 

In cases where it is not ethical or practical to conduct disguised naturalistic observation, researchers can conduct  undisguised naturalistic observation where the participants are made aware of the researcher presence and monitoring of their behavior. However, one concern with undisguised naturalistic observation is  reactivity. Reactivity refers to when a measure changes participants’ behavior. In the case of undisguised naturalistic observation, the concern with reactivity is that when people know they are being observed and studied, they may act differently than they normally would. This type of reactivity is known as the Hawthorne effect . For instance, you may act much differently in a bar if you know that someone is observing you and recording your behaviors and this would invalidate the study. So disguised observation is less reactive and therefore can have higher validity because people are not aware that their behaviors are being observed and recorded. However, we now know that people often become used to being observed and with time they begin to behave naturally in the researcher’s presence. In other words, over time people habituate to being observed. Think about reality shows like Big Brother or Survivor where people are constantly being observed and recorded. While they may be on their best behavior at first, in a fairly short amount of time they are flirting, having sex, wearing next to nothing, screaming at each other, and occasionally behaving in ways that are embarrassing.

Participant Observation

Another approach to data collection in observational research is participant observation. In  participant observation , researchers become active participants in the group or situation they are studying. Participant observation is very similar to naturalistic observation in that it involves observing people’s behavior in the environment in which it typically occurs. As with naturalistic observation, the data that are collected can include interviews (usually unstructured), notes based on their observations and interactions, documents, photographs, and other artifacts. The only difference between naturalistic observation and participant observation is that researchers engaged in participant observation become active members of the group or situations they are studying. The basic rationale for participant observation is that there may be important information that is only accessible to, or can be interpreted only by, someone who is an active participant in the group or situation. Like naturalistic observation, participant observation can be either disguised or undisguised. In disguised participant observation , the researchers pretend to be members of the social group they are observing and conceal their true identity as researchers.

In a famous example of disguised participant observation, Leon Festinger and his colleagues infiltrated a doomsday cult known as the Seekers, whose members believed that the apocalypse would occur on December 21, 1954. Interested in studying how members of the group would cope psychologically when the prophecy inevitably failed, they carefully recorded the events and reactions of the cult members in the days before and after the supposed end of the world. Unsurprisingly, the cult members did not give up their belief but instead convinced themselves that it was their faith and efforts that saved the world from destruction. Festinger and his colleagues later published a book about this experience, which they used to illustrate the theory of cognitive dissonance (Festinger, Riecken, & Schachter, 1956) [1] .

In contrast with undisguised participant observation ,  the researchers become a part of the group they are studying and they disclose their true identity as researchers to the group under investigation. Once again there are important ethical issues to consider with disguised participant observation.  First no informed consent can be obtained and second deception is being used. The researcher is deceiving the participants by intentionally withholding information about their motivations for being a part of the social group they are studying. But sometimes disguised participation is the only way to access a protective group (like a cult). Further, disguised participant observation is less prone to reactivity than undisguised participant observation. 

Rosenhan’s study (1973) [2]   of the experience of people in a psychiatric ward would be considered disguised participant observation because Rosenhan and his pseudopatients were admitted into psychiatric hospitals on the pretense of being patients so that they could observe the way that psychiatric patients are treated by staff. The staff and other patients were unaware of their true identities as researchers.

Another example of participant observation comes from a study by sociologist Amy Wilkins on a university-based religious organization that emphasized how happy its members were (Wilkins, 2008) [3] . Wilkins spent 12 months attending and participating in the group’s meetings and social events, and she interviewed several group members. In her study, Wilkins identified several ways in which the group “enforced” happiness—for example, by continually talking about happiness, discouraging the expression of negative emotions, and using happiness as a way to distinguish themselves from other groups.

One of the primary benefits of participant observation is that the researchers are in a much better position to understand the viewpoint and experiences of the people they are studying when they are a part of the social group. The primary limitation with this approach is that the mere presence of the observer could affect the behavior of the people being observed. While this is also a concern with naturalistic observation, additional concerns arise when researchers become active members of the social group they are studying because that they may change the social dynamics and/or influence the behavior of the people they are studying. Similarly, if the researcher acts as a participant observer there can be concerns with biases resulting from developing relationships with the participants. Concretely, the researcher may become less objective resulting in more experimenter bias.

Structured Observation

Another observational method is structured observation . Here the investigator makes careful observations of one or more specific behaviors in a particular setting that is more structured than the settings used in naturalistic or participant observation. Often the setting in which the observations are made is not the natural setting. Instead, the researcher may observe people in the laboratory environment. Alternatively, the researcher may observe people in a natural setting (like a classroom setting) that they have structured some way, for instance by introducing some specific task participants are to engage in or by introducing a specific social situation or manipulation.

Structured observation is very similar to naturalistic observation and participant observation in that in all three cases researchers are observing naturally occurring behavior; however, the emphasis in structured observation is on gathering quantitative rather than qualitative data. Researchers using this approach are interested in a limited set of behaviors. This allows them to quantify the behaviors they are observing. In other words, structured observation is less global than naturalistic or participant observation because the researcher engaged in structured observations is interested in a small number of specific behaviors. Therefore, rather than recording everything that happens, the researcher only focuses on very specific behaviors of interest.

Researchers Robert Levine and Ara Norenzayan used structured observation to study differences in the “pace of life” across countries (Levine & Norenzayan, 1999) [4] . One of their measures involved observing pedestrians in a large city to see how long it took them to walk 60 feet. They found that people in some countries walked reliably faster than people in other countries. For example, people in Canada and Sweden covered 60 feet in just under 13 seconds on average, while people in Brazil and Romania took close to 17 seconds. When structured observation  takes place in the complex and even chaotic “real world,” the questions of when, where, and under what conditions the observations will be made, and who exactly will be observed are important to consider. Levine and Norenzayan described their sampling process as follows:

“Male and female walking speed over a distance of 60 feet was measured in at least two locations in main downtown areas in each city. Measurements were taken during main business hours on clear summer days. All locations were flat, unobstructed, had broad sidewalks, and were sufficiently uncrowded to allow pedestrians to move at potentially maximum speeds. To control for the effects of socializing, only pedestrians walking alone were used. Children, individuals with obvious physical handicaps, and window-shoppers were not timed. Thirty-five men and 35 women were timed in most cities.” (p. 186).

Precise specification of the sampling process in this way makes data collection manageable for the observers, and it also provides some control over important extraneous variables. For example, by making their observations on clear summer days in all countries, Levine and Norenzayan controlled for effects of the weather on people’s walking speeds.  In Levine and Norenzayan’s study, measurement was relatively straightforward. They simply measured out a 60-foot distance along a city sidewalk and then used a stopwatch to time participants as they walked over that distance.

As another example, researchers Robert Kraut and Robert Johnston wanted to study bowlers’ reactions to their shots, both when they were facing the pins and then when they turned toward their companions (Kraut & Johnston, 1979) [5] . But what “reactions” should they observe? Based on previous research and their own pilot testing, Kraut and Johnston created a list of reactions that included “closed smile,” “open smile,” “laugh,” “neutral face,” “look down,” “look away,” and “face cover” (covering one’s face with one’s hands). The observers committed this list to memory and then practiced by coding the reactions of bowlers who had been videotaped. During the actual study, the observers spoke into an audio recorder, describing the reactions they observed. Among the most interesting results of this study was that bowlers rarely smiled while they still faced the pins. They were much more likely to smile after they turned toward their companions, suggesting that smiling is not purely an expression of happiness but also a form of social communication.

In yet another example (this one in a laboratory environment), Dov Cohen and his colleagues had observers rate the emotional reactions of participants who had just been deliberately bumped and insulted by a confederate after they dropped off a completed questionnaire at the end of a hallway. The confederate was posing as someone who worked in the same building and who was frustrated by having to close a file drawer twice in order to permit the participants to walk past them (first to drop off the questionnaire at the end of the hallway and once again on their way back to the room where they believed the study they signed up for was taking place). The two observers were positioned at different ends of the hallway so that they could read the participants’ body language and hear anything they might say. Interestingly, the researchers hypothesized that participants from the southern United States, which is one of several places in the world that has a “culture of honor,” would react with more aggression than participants from the northern United States, a prediction that was in fact supported by the observational data (Cohen, Nisbett, Bowdle, & Schwarz, 1996) [6] .

When the observations require a judgment on the part of the observers—as in the studies by Kraut and Johnston and Cohen and his colleagues—a process referred to as   coding is typically required . Coding generally requires clearly defining a set of target behaviors. The observers then categorize participants individually in terms of which behavior they have engaged in and the number of times they engaged in each behavior. The observers might even record the duration of each behavior. The target behaviors must be defined in such a way that guides different observers to code them in the same way. This difficulty with coding illustrates the issue of interrater reliability, as mentioned in Chapter 4. Researchers are expected to demonstrate the interrater reliability of their coding procedure by having multiple raters code the same behaviors independently and then showing that the different observers are in close agreement. Kraut and Johnston, for example, video recorded a subset of their participants’ reactions and had two observers independently code them. The two observers showed that they agreed on the reactions that were exhibited 97% of the time, indicating good interrater reliability.

One of the primary benefits of structured observation is that it is far more efficient than naturalistic and participant observation. Since the researchers are focused on specific behaviors this reduces time and expense. Also, often times the environment is structured to encourage the behaviors of interest which again means that researchers do not have to invest as much time in waiting for the behaviors of interest to naturally occur. Finally, researchers using this approach can clearly exert greater control over the environment. However, when researchers exert more control over the environment it may make the environment less natural which decreases external validity. It is less clear for instance whether structured observations made in a laboratory environment will generalize to a real world environment. Furthermore, since researchers engaged in structured observation are often not disguised there may be more concerns with reactivity.

Case Studies

A  case study   is an in-depth examination of an individual. Sometimes case studies are also completed on social units (e.g., a cult) and events (e.g., a natural disaster). Most commonly in psychology, however, case studies provide a detailed description and analysis of an individual. Often the individual has a rare or unusual condition or disorder or has damage to a specific region of the brain.

Like many observational research methods, case studies tend to be more qualitative in nature. Case study methods involve an in-depth, and often a longitudinal examination of an individual. Depending on the focus of the case study, individuals may or may not be observed in their natural setting. If the natural setting is not what is of interest, then the individual may be brought into a therapist’s office or a researcher’s lab for study. Also, the bulk of the case study report will focus on in-depth descriptions of the person rather than on statistical analyses. With that said some quantitative data may also be included in the write-up of a case study. For instance, an individual’s depression score may be compared to normative scores or their score before and after treatment may be compared. As with other qualitative methods, a variety of different methods and tools can be used to collect information on the case. For instance, interviews, naturalistic observation, structured observation, psychological testing (e.g., IQ test), and/or physiological measurements (e.g., brain scans) may be used to collect information on the individual.

HM is one of the most notorious case studies in psychology. HM suffered from intractable and very severe epilepsy. A surgeon localized HM’s epilepsy to his medial temporal lobe and in 1953 he removed large sections of his hippocampus in an attempt to stop the seizures. The treatment was a success, in that it resolved his epilepsy and his IQ and personality were unaffected. However, the doctors soon realized that HM exhibited a strange form of amnesia, called anterograde amnesia. HM was able to carry out a conversation and he could remember short strings of letters, digits, and words. Basically, his short term memory was preserved. However, HM could not commit new events to memory. He lost the ability to transfer information from his short-term memory to his long term memory, something memory researchers call consolidation. So while he could carry on a conversation with someone, he would completely forget the conversation after it ended. This was an extremely important case study for memory researchers because it suggested that there’s a dissociation between short-term memory and long-term memory, it suggested that these were two different abilities sub-served by different areas of the brain. It also suggested that the temporal lobes are particularly important for consolidating new information (i.e., for transferring information from short-term memory to long-term memory).

The history of psychology is filled with influential cases studies, such as Sigmund Freud’s description of “Anna O.” (see Note 6.1 “The Case of “Anna O.””) and John Watson and Rosalie Rayner’s description of Little Albert (Watson & Rayner, 1920) [7] , who allegedly learned to fear a white rat—along with other furry objects—when the researchers repeatedly made a loud noise every time the rat approached him.

The Case of “Anna O.”

Sigmund Freud used the case of a young woman he called “Anna O.” to illustrate many principles of his theory of psychoanalysis (Freud, 1961) [8] . (Her real name was Bertha Pappenheim, and she was an early feminist who went on to make important contributions to the field of social work.) Anna had come to Freud’s colleague Josef Breuer around 1880 with a variety of odd physical and psychological symptoms. One of them was that for several weeks she was unable to drink any fluids. According to Freud,

She would take up the glass of water that she longed for, but as soon as it touched her lips she would push it away like someone suffering from hydrophobia.…She lived only on fruit, such as melons, etc., so as to lessen her tormenting thirst. (p. 9)

But according to Freud, a breakthrough came one day while Anna was under hypnosis.

[S]he grumbled about her English “lady-companion,” whom she did not care for, and went on to describe, with every sign of disgust, how she had once gone into this lady’s room and how her little dog—horrid creature!—had drunk out of a glass there. The patient had said nothing, as she had wanted to be polite. After giving further energetic expression to the anger she had held back, she asked for something to drink, drank a large quantity of water without any difficulty, and awoke from her hypnosis with the glass at her lips; and thereupon the disturbance vanished, never to return. (p.9)

Freud’s interpretation was that Anna had repressed the memory of this incident along with the emotion that it triggered and that this was what had caused her inability to drink. Furthermore, he believed that her recollection of the incident, along with her expression of the emotion she had repressed, caused the symptom to go away.

As an illustration of Freud’s theory, the case study of Anna O. is quite effective. As evidence for the theory, however, it is essentially worthless. The description provides no way of knowing whether Anna had really repressed the memory of the dog drinking from the glass, whether this repression had caused her inability to drink, or whether recalling this “trauma” relieved the symptom. It is also unclear from this case study how typical or atypical Anna’s experience was.

Case studies are useful because they provide a level of detailed analysis not found in many other research methods and greater insights may be gained from this more detailed analysis. As a result of the case study, the researcher may gain a sharpened understanding of what might become important to look at more extensively in future more controlled research. Case studies are also often the only way to study rare conditions because it may be impossible to find a large enough sample of individuals with the condition to use quantitative methods. Although at first glance a case study of a rare individual might seem to tell us little about ourselves, they often do provide insights into normal behavior. The case of HM provided important insights into the role of the hippocampus in memory consolidation.

However, it is important to note that while case studies can provide insights into certain areas and variables to study, and can be useful in helping develop theories, they should never be used as evidence for theories. In other words, case studies can be used as inspiration to formulate theories and hypotheses, but those hypotheses and theories then need to be formally tested using more rigorous quantitative methods. The reason case studies shouldn’t be used to provide support for theories is that they suffer from problems with both internal and external validity. Case studies lack the proper controls that true experiments contain. As such, they suffer from problems with internal validity, so they cannot be used to determine causation. For instance, during HM’s surgery, the surgeon may have accidentally lesioned another area of HM’s brain (a possibility suggested by the dissection of HM’s brain following his death) and that lesion may have contributed to his inability to consolidate new information. The fact is, with case studies we cannot rule out these sorts of alternative explanations. So, as with all observational methods, case studies do not permit determination of causation. In addition, because case studies are often of a single individual, and typically an abnormal individual, researchers cannot generalize their conclusions to other individuals. Recall that with most research designs there is a trade-off between internal and external validity. With case studies, however, there are problems with both internal validity and external validity. So there are limits both to the ability to determine causation and to generalize the results. A final limitation of case studies is that ample opportunity exists for the theoretical biases of the researcher to color or bias the case description. Indeed, there have been accusations that the woman who studied HM destroyed a lot of her data that were not published and she has been called into question for destroying contradictory data that didn’t support her theory about how memories are consolidated. There is a fascinating New York Times article that describes some of the controversies that ensued after HM’s death and analysis of his brain that can be found at: https://www.nytimes.com/2016/08/07/magazine/the-brain-that-couldnt-remember.html?_r=0

Archival Research

Another approach that is often considered observational research involves analyzing archival data that have already been collected for some other purpose. An example is a study by Brett Pelham and his colleagues on “implicit egotism”—the tendency for people to prefer people, places, and things that are similar to themselves (Pelham, Carvallo, & Jones, 2005) [9] . In one study, they examined Social Security records to show that women with the names Virginia, Georgia, Louise, and Florence were especially likely to have moved to the states of Virginia, Georgia, Louisiana, and Florida, respectively.

As with naturalistic observation, measurement can be more or less straightforward when working with archival data. For example, counting the number of people named Virginia who live in various states based on Social Security records is relatively straightforward. But consider a study by Christopher Peterson and his colleagues on the relationship between optimism and health using data that had been collected many years before for a study on adult development (Peterson, Seligman, & Vaillant, 1988) [10] . In the 1940s, healthy male college students had completed an open-ended questionnaire about difficult wartime experiences. In the late 1980s, Peterson and his colleagues reviewed the men’s questionnaire responses to obtain a measure of explanatory style—their habitual ways of explaining bad events that happen to them. More pessimistic people tend to blame themselves and expect long-term negative consequences that affect many aspects of their lives, while more optimistic people tend to blame outside forces and expect limited negative consequences. To obtain a measure of explanatory style for each participant, the researchers used a procedure in which all negative events mentioned in the questionnaire responses, and any causal explanations for them were identified and written on index cards. These were given to a separate group of raters who rated each explanation in terms of three separate dimensions of optimism-pessimism. These ratings were then averaged to produce an explanatory style score for each participant. The researchers then assessed the statistical relationship between the men’s explanatory style as undergraduate students and archival measures of their health at approximately 60 years of age. The primary result was that the more optimistic the men were as undergraduate students, the healthier they were as older men. Pearson’s  r  was +.25.

This method is an example of  content analysis —a family of systematic approaches to measurement using complex archival data. Just as structured observation requires specifying the behaviors of interest and then noting them as they occur, content analysis requires specifying keywords, phrases, or ideas and then finding all occurrences of them in the data. These occurrences can then be counted, timed (e.g., the amount of time devoted to entertainment topics on the nightly news show), or analyzed in a variety of other ways.

Media Attributions

• What happens when you remove the hippocampus? – Sam Kean by TED-Ed licensed under a standard YouTube License
• Pappenheim 1882  by unknown is in the  Public Domain .
• Festinger, L., Riecken, H., & Schachter, S. (1956). When prophecy fails: A social and psychological study of a modern group that predicted the destruction of the world. University of Minnesota Press. ↵
• Rosenhan, D. L. (1973). On being sane in insane places. Science, 179 , 250–258. ↵
• Wilkins, A. (2008). “Happier than Non-Christians”: Collective emotions and symbolic boundaries among evangelical Christians. Social Psychology Quarterly, 71 , 281–301. ↵
• Levine, R. V., & Norenzayan, A. (1999). The pace of life in 31 countries. Journal of Cross-Cultural Psychology, 30 , 178–205. ↵
• Kraut, R. E., & Johnston, R. E. (1979). Social and emotional messages of smiling: An ethological approach. Journal of Personality and Social Psychology, 37 , 1539–1553. ↵
• Cohen, D., Nisbett, R. E., Bowdle, B. F., & Schwarz, N. (1996). Insult, aggression, and the southern culture of honor: An "experimental ethnography." Journal of Personality and Social Psychology, 70 (5), 945-960. ↵
• Watson, J. B., & Rayner, R. (1920). Conditioned emotional reactions. Journal of Experimental Psychology, 3 , 1–14. ↵
• Freud, S. (1961).  Five lectures on psycho-analysis . New York, NY: Norton. ↵
• Pelham, B. W., Carvallo, M., & Jones, J. T. (2005). Implicit egotism. Current Directions in Psychological Science, 14 , 106–110. ↵
• Peterson, C., Seligman, M. E. P., & Vaillant, G. E. (1988). Pessimistic explanatory style is a risk factor for physical illness: A thirty-five year longitudinal study. Journal of Personality and Social Psychology, 55 , 23–27. ↵

Research that is non-experimental because it focuses on recording systemic observations of behavior in a natural or laboratory setting without manipulating anything.

An observational method that involves observing people’s behavior in the environment in which it typically occurs.

When researchers engage in naturalistic observation by making their observations as unobtrusively as possible so that participants are not aware that they are being studied.

Where the participants are made aware of the researcher presence and monitoring of their behavior.

Refers to when a measure changes participants’ behavior.

In the case of undisguised naturalistic observation, it is a type of reactivity when people know they are being observed and studied, they may act differently than they normally would.

Researchers become active participants in the group or situation they are studying.

Researchers pretend to be members of the social group they are observing and conceal their true identity as researchers.

Researchers become a part of the group they are studying and they disclose their true identity as researchers to the group under investigation.

When a researcher makes careful observations of one or more specific behaviors in a particular setting that is more structured than the settings used in naturalistic or participant observation.

A part of structured observation whereby the observers use a clearly defined set of guidelines to "code" behaviors—assigning specific behaviors they are observing to a category—and count the number of times or the duration that the behavior occurs.

An in-depth examination of an individual.

A family of systematic approaches to measurement using qualitative methods to analyze complex archival data.

Research Methods in Psychology Copyright © 2019 by Rajiv S. Jhangiani, I-Chant A. Chiang, Carrie Cuttler, & Dana C. Leighton is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Research Methodologies: Research Instruments

• Research Methodology Basics
• Research Instruments
• Types of Research Methodologies

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Types of Research Instruments

A research instrument is a tool you will use to help you collect, measure and analyze the data you use as part of your research.  The choice of research instrument will usually be yours to make as the researcher and will be whichever best suits your methodology. 

There are many different research instruments you can use in collecting data for your research:

• Interviews  (either as a group or one-on-one). You can carry out interviews in many different ways. For example, your interview can be structured, semi-structured, or unstructured. The difference between them is how formal the set of questions is that is asked of the interviewee. In a group interview, you may choose to ask the interviewees to give you their opinions or perceptions on certain topics.
• Surveys  (online or in-person). In survey research, you are posing questions in which you ask for a response from the person taking the survey. You may wish to have either free-answer questions such as essay style questions, or you may wish to use closed questions such as multiple choice. You may even wish to make the survey a mixture of both.
• Focus Groups.  Similar to the group interview above, you may wish to ask a focus group to discuss a particular topic or opinion while you make a note of the answers given.
• Observations.  This is a good research instrument to use if you are looking into human behaviors. Different ways of researching this include studying the spontaneous behavior of participants in their everyday life, or something more structured. A structured observation is research conducted at a set time and place where researchers observe behavior as planned and agreed upon with participants.

These are the most common ways of carrying out research, but it is really dependent on your needs as a researcher and what approach you think is best to take. It is also possible to combine a number of research instruments if this is necessary and appropriate in answering your research problem.

Data Collection

How to Collect Data for Your Research   This article covers different ways of collecting data in preparation for writing a thesis.

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What is a Research Instrument?

• By DiscoverPhDs
• October 9, 2020

The term research instrument refers to any tool that you may use to collect or obtain data, measure data and analyse data that is relevant to the subject of your research.

Research instruments are often used in the fields of social sciences and health sciences. These tools can also be found within education that relates to patients, staff, teachers and students.

The format of a research instrument may consist of questionnaires, surveys, interviews, checklists or simple tests. The choice of which specific research instrument tool to use will be decided on the by the researcher. It will also be strongly related to the actual methods that will be used in the specific study.

What Makes a Good Research Instrument?

A good research instrument is one that has been validated and has proven reliability. It should be one that can collect data in a way that’s appropriate to the research question being asked.

The research instrument must be able to assist in answering the research aims , objectives and research questions, as well as prove or disprove the hypothesis of the study.

It should not have any bias in the way that data is collect and it should be clear as to how the research instrument should be used appropriately.

What are the Different Types of Interview Research Instruments?

The general format of an interview is where the interviewer asks the interviewee to answer a set of questions which are normally asked and answered verbally. There are several different types of interview research instruments that may exist.

• A structural interview may be used in which there are a specific number of questions that are formally asked of the interviewee and their responses recorded using a systematic and standard methodology.
• An unstructured interview on the other hand may still be based on the same general theme of questions but here the person asking the questions (the interviewer) may change the order the questions are asked in and the specific way in which they’re asked.
• A focus interview is one in which the interviewer will adapt their line or content of questioning based on the responses from the interviewee.
• A focus group interview is one in which a group of volunteers or interviewees are asked questions to understand their opinion or thoughts on a specific subject.
• A non-directive interview is one in which there are no specific questions agreed upon but instead the format is open-ended and more reactionary in the discussion between interviewer and interviewee.

What are the Different Types of Observation Research Instruments?

An observation research instrument is one in which a researcher makes observations and records of the behaviour of individuals. There are several different types.

Structured observations occur when the study is performed at a predetermined location and time, in which the volunteers or study participants are observed used standardised methods.

Naturalistic observations are focused on volunteers or participants being in more natural environments in which their reactions and behaviour are also more natural or spontaneous.

A participant observation occurs when the person conducting the research actively becomes part of the group of volunteers or participants that he or she is researching.

Final Comments

The types of research instruments will depend on the format of the research study being performed: qualitative, quantitative or a mixed methodology. You may for example utilise questionnaires when a study is more qualitative or use a scoring scale in more quantitative studies.

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Home » Observational Research – Methods and Guide

Observational Research – Methods and Guide

Table of Contents

Observational Research

Definition:

Observational research is a type of research method where the researcher observes and records the behavior of individuals or groups in their natural environment. In other words, the researcher does not intervene or manipulate any variables but simply observes and describes what is happening.

Observation

Observation is the process of collecting and recording data by observing and noting events, behaviors, or phenomena in a systematic and objective manner. It is a fundamental method used in research, scientific inquiry, and everyday life to gain an understanding of the world around us.

Types of Observational Research

Observational research can be categorized into different types based on the level of control and the degree of involvement of the researcher in the study. Some of the common types of observational research are:

Naturalistic Observation

In naturalistic observation, the researcher observes and records the behavior of individuals or groups in their natural environment without any interference or manipulation of variables.

Controlled Observation

In controlled observation, the researcher controls the environment in which the observation is taking place. This type of observation is often used in laboratory settings.

Participant Observation

In participant observation, the researcher becomes an active participant in the group or situation being observed. The researcher may interact with the individuals being observed and gather data on their behavior, attitudes, and experiences.

Structured Observation

In structured observation, the researcher defines a set of behaviors or events to be observed and records their occurrence.

Unstructured Observation

In unstructured observation, the researcher observes and records any behaviors or events that occur without predetermined categories.

Cross-Sectional Observation

In cross-sectional observation, the researcher observes and records the behavior of different individuals or groups at a single point in time.

Longitudinal Observation

In longitudinal observation, the researcher observes and records the behavior of the same individuals or groups over an extended period of time.

Data Collection Methods

Observational research uses various data collection methods to gather information about the behaviors and experiences of individuals or groups being observed. Some common data collection methods used in observational research include:

Field Notes

This method involves recording detailed notes of the observed behavior, events, and interactions. These notes are usually written in real-time during the observation process.

Audio and Video Recordings

Audio and video recordings can be used to capture the observed behavior and interactions. These recordings can be later analyzed to extract relevant information.

Surveys and Questionnaires

Surveys and questionnaires can be used to gather additional information from the individuals or groups being observed. This method can be used to validate or supplement the observational data.

Time Sampling

This method involves taking a snapshot of the observed behavior at pre-determined time intervals. This method helps to identify the frequency and duration of the observed behavior.

Event Sampling

This method involves recording specific events or behaviors that are of interest to the researcher. This method helps to provide detailed information about specific behaviors or events.

Checklists and Rating Scales

Checklists and rating scales can be used to record the occurrence and frequency of specific behaviors or events. This method helps to simplify and standardize the data collection process.

Observational Data Analysis Methods

Observational Data Analysis Methods are:

Descriptive Statistics

This method involves using statistical techniques such as frequency distributions, means, and standard deviations to summarize the observed behaviors, events, or interactions.

Qualitative Analysis

Qualitative analysis involves identifying patterns and themes in the observed behaviors or interactions. This analysis can be done manually or with the help of software tools.

Content Analysis

Content analysis involves categorizing and counting the occurrences of specific behaviors or events. This analysis can be done manually or with the help of software tools.

Time-series Analysis

Time-series analysis involves analyzing the changes in behavior or interactions over time. This analysis can help identify trends and patterns in the observed data.

Inter-observer Reliability Analysis

Inter-observer reliability analysis involves comparing the observations made by multiple observers to ensure the consistency and reliability of the data.

Multivariate Analysis

Multivariate analysis involves analyzing multiple variables simultaneously to identify the relationships between the observed behaviors, events, or interactions.

Event Coding

This method involves coding observed behaviors or events into specific categories and then analyzing the frequency and duration of each category.

Cluster Analysis

Cluster analysis involves grouping similar behaviors or events into clusters based on their characteristics or patterns.

Latent Class Analysis

Latent class analysis involves identifying subgroups of individuals or groups based on their observed behaviors or interactions.

Social network Analysis

Social network analysis involves mapping the social relationships and interactions between individuals or groups based on their observed behaviors.

The choice of data analysis method depends on the research question, the type of data collected, and the available resources. Researchers should choose the appropriate method that best fits their research question and objectives. It is also important to ensure the validity and reliability of the data analysis by using appropriate statistical tests and measures.

Applications of Observational Research

Observational research is a versatile research method that can be used in a variety of fields to explore and understand human behavior, attitudes, and preferences. Here are some common applications of observational research:

• Psychology : Observational research is commonly used in psychology to study human behavior in natural settings. This can include observing children at play to understand their social development or observing people’s reactions to stress to better understand how stress affects behavior.
• Marketing : Observational research is used in marketing to understand consumer behavior and preferences. This can include observing shoppers in stores to understand how they make purchase decisions or observing how people interact with advertisements to determine their effectiveness.
• Education : Observational research is used in education to study teaching and learning in natural settings. This can include observing classrooms to understand how teachers interact with students or observing students to understand how they learn.
• Anthropology : Observational research is commonly used in anthropology to understand cultural practices and beliefs. This can include observing people’s daily routines to understand their culture or observing rituals and ceremonies to better understand their significance.
• Healthcare : Observational research is used in healthcare to understand patient behavior and preferences. This can include observing patients in hospitals to understand how they interact with healthcare professionals or observing patients with chronic illnesses to better understand their daily routines and needs.
• Sociology : Observational research is used in sociology to understand social interactions and relationships. This can include observing people in public spaces to understand how they interact with others or observing groups to understand how they function.
• Ecology : Observational research is used in ecology to understand the behavior and interactions of animals and plants in their natural habitats. This can include observing animal behavior to understand their social structures or observing plant growth to understand their response to environmental factors.
• Criminology : Observational research is used in criminology to understand criminal behavior and the factors that contribute to it. This can include observing criminal activity in a particular area to identify patterns or observing the behavior of inmates to understand their experience in the criminal justice system.

Observational Research Examples

Here are some real-time observational research examples:

• A researcher observes and records the behaviors of a group of children on a playground to study their social interactions and play patterns.
• A researcher observes the buying behaviors of customers in a retail store to study the impact of store layout and product placement on purchase decisions.
• A researcher observes the behavior of drivers at a busy intersection to study the effectiveness of traffic signs and signals.
• A researcher observes the behavior of patients in a hospital to study the impact of staff communication and interaction on patient satisfaction and recovery.
• A researcher observes the behavior of employees in a workplace to study the impact of the work environment on productivity and job satisfaction.
• A researcher observes the behavior of shoppers in a mall to study the impact of music and lighting on consumer behavior.
• A researcher observes the behavior of animals in their natural habitat to study their social and feeding behaviors.
• A researcher observes the behavior of students in a classroom to study the effectiveness of teaching methods and student engagement.
• A researcher observes the behavior of pedestrians and cyclists on a city street to study the impact of infrastructure and traffic regulations on safety.

How to Conduct Observational Research

Here are some general steps for conducting Observational Research:

• Define the Research Question: Determine the research question and objectives to guide the observational research study. The research question should be specific, clear, and relevant to the area of study.
• Choose the appropriate observational method: Choose the appropriate observational method based on the research question, the type of data required, and the available resources.
• Plan the observation: Plan the observation by selecting the observation location, duration, and sampling technique. Identify the population or sample to be observed and the characteristics to be recorded.
• Train observers: Train the observers on the observational method, data collection tools, and techniques. Ensure that the observers understand the research question and objectives and can accurately record the observed behaviors or events.
• Conduct the observation : Conduct the observation by recording the observed behaviors or events using the data collection tools and techniques. Ensure that the observation is conducted in a consistent and unbiased manner.
• Analyze the data: Analyze the observed data using appropriate data analysis methods such as descriptive statistics, qualitative analysis, or content analysis. Validate the data by checking the inter-observer reliability and conducting statistical tests.
• Interpret the results: Interpret the results by answering the research question and objectives. Identify the patterns, trends, or relationships in the observed data and draw conclusions based on the analysis.
• Report the findings: Report the findings in a clear and concise manner, using appropriate visual aids and tables. Discuss the implications of the results and the limitations of the study.

When to use Observational Research

Here are some situations where observational research can be useful:

• Exploratory Research: Observational research can be used in exploratory studies to gain insights into new phenomena or areas of interest.
• Hypothesis Generation: Observational research can be used to generate hypotheses about the relationships between variables, which can be tested using experimental research.
• Naturalistic Settings: Observational research is useful in naturalistic settings where it is difficult or unethical to manipulate the environment or variables.
• Human Behavior: Observational research is useful in studying human behavior, such as social interactions, decision-making, and communication patterns.
• Animal Behavior: Observational research is useful in studying animal behavior in their natural habitats, such as social and feeding behaviors.
• Longitudinal Studies: Observational research can be used in longitudinal studies to observe changes in behavior over time.
• Ethical Considerations: Observational research can be used in situations where manipulating the environment or variables would be unethical or impractical.

Purpose of Observational Research

Observational research is a method of collecting and analyzing data by observing individuals or phenomena in their natural settings, without manipulating them in any way. The purpose of observational research is to gain insights into human behavior, attitudes, and preferences, as well as to identify patterns, trends, and relationships that may exist between variables.

The primary purpose of observational research is to generate hypotheses that can be tested through more rigorous experimental methods. By observing behavior and identifying patterns, researchers can develop a better understanding of the factors that influence human behavior, and use this knowledge to design experiments that test specific hypotheses.

Observational research is also used to generate descriptive data about a population or phenomenon. For example, an observational study of shoppers in a grocery store might reveal that women are more likely than men to buy organic produce. This type of information can be useful for marketers or policy-makers who want to understand consumer preferences and behavior.

In addition, observational research can be used to monitor changes over time. By observing behavior at different points in time, researchers can identify trends and changes that may be indicative of broader social or cultural shifts.

Overall, the purpose of observational research is to provide insights into human behavior and to generate hypotheses that can be tested through further research.

Advantages of Observational Research

There are several advantages to using observational research in different fields, including:

• Naturalistic observation: Observational research allows researchers to observe behavior in a naturalistic setting, which means that people are observed in their natural environment without the constraints of a laboratory. This helps to ensure that the behavior observed is more representative of the real-world situation.
• Unobtrusive : Observational research is often unobtrusive, which means that the researcher does not interfere with the behavior being observed. This can reduce the likelihood of the research being affected by the observer’s presence or the Hawthorne effect, where people modify their behavior when they know they are being observed.
• Cost-effective : Observational research can be less expensive than other research methods, such as experiments or surveys. Researchers do not need to recruit participants or pay for expensive equipment, making it a more cost-effective research method.
• Flexibility: Observational research is a flexible research method that can be used in a variety of settings and for a range of research questions. Observational research can be used to generate hypotheses, to collect data on behavior, or to monitor changes over time.
• Rich data : Observational research provides rich data that can be analyzed to identify patterns and relationships between variables. It can also provide context for behaviors, helping to explain why people behave in a certain way.
• Validity : Observational research can provide high levels of validity, meaning that the results accurately reflect the behavior being studied. This is because the behavior is being observed in a natural setting without interference from the researcher.

Disadvantages of Observational Research

While observational research has many advantages, it also has some limitations and disadvantages. Here are some of the disadvantages of observational research:

• Observer bias: Observational research is prone to observer bias, which is when the observer’s own beliefs and assumptions affect the way they interpret and record behavior. This can lead to inaccurate or unreliable data.
• Limited generalizability: The behavior observed in a specific setting may not be representative of the behavior in other settings. This can limit the generalizability of the findings from observational research.
• Difficulty in establishing causality: Observational research is often correlational, which means that it identifies relationships between variables but does not establish causality. This can make it difficult to determine if a particular behavior is causing an outcome or if the relationship is due to other factors.
• Ethical concerns: Observational research can raise ethical concerns if the participants being observed are unaware that they are being observed or if the observations invade their privacy.
• Time-consuming: Observational research can be time-consuming, especially if the behavior being observed is infrequent or occurs over a long period of time. This can make it difficult to collect enough data to draw valid conclusions.
• Difficulty in measuring internal processes: Observational research may not be effective in measuring internal processes, such as thoughts, feelings, and attitudes. This can limit the ability to understand the reasons behind behavior.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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6.5 Observational Research

Learning objectives.

• List the various types of observational research methods and distinguish between each
• Describe the strengths and weakness of each observational research method. 

What Is Observational Research?

The term observational research is used to refer to several different types of non-experimental studies in which behavior is systematically observed and recorded. The goal of observational research is to describe a variable or set of variables. More generally, the goal is to obtain a snapshot of specific characteristics of an individual, group, or setting. As described previously, observational research is non-experimental because nothing is manipulated or controlled, and as such we cannot arrive at causal conclusions using this approach. The data that are collected in observational research studies are often qualitative in nature but they may also be quantitative or both (mixed-methods). There are several different types of observational research designs that will be described below.

Naturalistic Observation

Naturalistic observation  is an observational method that involves observing people’s behavior in the environment in which it typically occurs. Thus naturalistic observation is a type of field research (as opposed to a type of laboratory research). Jane Goodall’s famous research on chimpanzees is a classic example of naturalistic observation. Dr.  Goodall spent three decades observing chimpanzees in their natural environment in East Africa. She examined such things as chimpanzee’s social structure, mating patterns, gender roles, family structure, and care of offspring by observing them in the wild. However, naturalistic observation  could more simply involve observing shoppers in a grocery store, children on a school playground, or psychiatric inpatients in their wards. Researchers engaged in naturalistic observation usually make their observations as unobtrusively as possible so that participants are not aware that they are being studied. Such an approach is called disguised naturalistic observation.  Ethically, this method is considered to be acceptable if the participants remain anonymous and the behavior occurs in a public setting where people would not normally have an expectation of privacy. Grocery shoppers putting items into their shopping carts, for example, are engaged in public behavior that is easily observable by store employees and other shoppers. For this reason, most researchers would consider it ethically acceptable to observe them for a study. On the other hand, one of the arguments against the ethicality of the naturalistic observation of “bathroom behavior” discussed earlier in the book is that people have a reasonable expectation of privacy even in a public restroom and that this expectation was violated. 

In cases where it is not ethical or practical to conduct disguised naturalistic observation, researchers can conduct  undisguised naturalistic observation where the participants are made aware of the researcher presence and monitoring of their behavior. However, one concern with undisguised naturalistic observation is  reactivity. Reactivity  refers to when a measure changes participants’ behavior. In the case of undisguised naturalistic observation, the concern with reactivity is that when people know they are being observed and studied, they may act differently than they normally would. For instance, you may act much differently in a bar if you know that someone is observing you and recording your behaviors and this would invalidate the study. So disguised observation is less reactive and therefore can have higher validity because people are not aware that their behaviors are being observed and recorded. However, we now know that people often become used to being observed and with time they begin to behave naturally in the researcher’s presence. In other words, over time people habituate to being observed. Think about reality shows like Big Brother or Survivor where people are constantly being observed and recorded. While they may be on their best behavior at first, in a fairly short amount of time they are, flirting, having sex, wearing next to nothing, screaming at each other, and at times acting like complete fools in front of the entire nation.

Participant Observation

Another approach to data collection in observational research is participant observation. In  participant observation , researchers become active participants in the group or situation they are studying. Participant observation is very similar to naturalistic observation in that it involves observing people’s behavior in the environment in which it typically occurs. As with naturalistic observation, the data that is collected can include interviews (usually unstructured), notes based on their observations and interactions, documents, photographs, and other artifacts. The only difference between naturalistic observation and participant observation is that researchers engaged in participant observation become active members of the group or situations they are studying. The basic rationale for participant observation is that there may be important information that is only accessible to, or can be interpreted only by, someone who is an active participant in the group or situation. Like naturalistic observation, participant observation can be either disguised or undisguised. In disguised participant observation, the researchers pretend to be members of the social group they are observing and conceal their true identity as researchers. In contrast with undisguised participant observation,  the researchers become a part of the group they are studying and they disclose their true identity as researchers to the group under investigation. Once again there are important ethical issues to consider with disguised participant observation.  First no informed consent can be obtained and second passive deception is being used. The researcher is passively deceiving the participants by intentionally withholding information about their motivations for being a part of the social group they are studying. But sometimes disguised participation is the only way to access a protective group (like a cult). Further,  disguised participant observation is less prone to reactivity than undisguised participant observation. 

Rosenhan’s study (1973) [1]   of the experience of people in a psychiatric ward would be considered disguised participant observation because Rosenhan and his pseudopatients were admitted into psychiatric hospitals on the pretense of being patients so that they could observe the way that psychiatric patients are treated by staff. The staff and other patients were unaware of their true identities as researchers.

Another example of participant observation comes from a study by sociologist Amy Wilkins (published in  Social Psychology Quarterly ) on a university-based religious organization that emphasized how happy its members were (Wilkins, 2008) [2] . Wilkins spent 12 months attending and participating in the group’s meetings and social events, and she interviewed several group members. In her study, Wilkins identified several ways in which the group “enforced” happiness—for example, by continually talking about happiness, discouraging the expression of negative emotions, and using happiness as a way to distinguish themselves from other groups.

One of the primary benefits of participant observation is that the researcher is in a much better position to understand the viewpoint and experiences of the people they are studying when they are apart of the social group. The primary limitation with this approach is that the mere presence of the observer could affect the behavior of the people being observed. While this is also a concern with naturalistic observation when researchers because active members of the social group they are studying, additional concerns arise that they may change the social dynamics and/or influence the behavior of the people they are studying. Similarly, if the researcher acts as a participant observer there can be concerns with biases resulting from developing relationships with the participants. Concretely, the researcher may become less objective resulting in more experimenter bias.

Structured Observation

Another observational method is structured observation. Here the investigator makes careful observations of one or more specific behaviors in a particular setting that is more structured than the settings used in naturalistic and participant observation. Often the setting in which the observations are made is not the natural setting, rather the researcher may observe people in the laboratory environment. Alternatively, the researcher may observe people in a natural setting (like a classroom setting) that they have structured some way, for instance by introducing some specific task participants are to engage in or by introducing a specific social situation or manipulation. Structured observation is very similar to naturalistic observation and participant observation in that in all cases researchers are observing naturally occurring behavior, however, the emphasis in structured observation is on gathering quantitative rather than qualitative data. Researchers using this approach are interested in a limited set of behaviors. This allows them to quantify the behaviors they are observing. In other words, structured observation is less global than naturalistic and participant observation because the researcher engaged in structured observations is interested in a small number of specific behaviors. Therefore, rather than recording everything that happens, the researcher only focuses on very specific behaviors of interest.

Structured observation is very similar to naturalistic observation and participant observation in that in all cases researchers are observing naturally occurring behavior, however, the emphasis in structured observation is on gathering quantitative rather than qualitative data. Researchers using this approach are interested in a limited set of behaviors. This allows them to quantify the behaviors they are observing. In other words, structured observation is less global than naturalistic and participant observation because the researcher engaged in structured observations is interested in a small number of specific behaviors. Therefore, rather than recording everything that happens, the researcher only focuses on very specific behaviors of interest.

Researchers Robert Levine and Ara Norenzayan used structured observation to study differences in the “pace of life” across countries (Levine & Norenzayan, 1999) [3] . One of their measures involved observing pedestrians in a large city to see how long it took them to walk 60 feet. They found that people in some countries walked reliably faster than people in other countries. For example, people in Canada and Sweden covered 60 feet in just under 13 seconds on average, while people in Brazil and Romania took close to 17 seconds. When structured observation  takes place in the complex and even chaotic “real world,” the questions of when, where, and under what conditions the observations will be made, and who exactly will be observed are important to consider. Levine and Norenzayan described their sampling process as follows:

“Male and female walking speed over a distance of 60 feet was measured in at least two locations in main downtown areas in each city. Measurements were taken during main business hours on clear summer days. All locations were flat, unobstructed, had broad sidewalks, and were sufficiently uncrowded to allow pedestrians to move at potentially maximum speeds. To control for the effects of socializing, only pedestrians walking alone were used. Children, individuals with obvious physical handicaps, and window-shoppers were not timed. Thirty-five men and 35 women were timed in most cities.” (p. 186).  Precise specification of the sampling process in this way makes data collection manageable for the observers, and it also provides some control over important extraneous variables. For example, by making their observations on clear summer days in all countries, Levine and Norenzayan controlled for effects of the weather on people’s walking speeds.  In Levine and Norenzayan’s study, measurement was relatively straightforward. They simply measured out a 60-foot distance along a city sidewalk and then used a stopwatch to time participants as they walked over that distance.

As another example, researchers Robert Kraut and Robert Johnston wanted to study bowlers’ reactions to their shots, both when they were facing the pins and then when they turned toward their companions (Kraut & Johnston, 1979) [4] . But what “reactions” should they observe? Based on previous research and their own pilot testing, Kraut and Johnston created a list of reactions that included “closed smile,” “open smile,” “laugh,” “neutral face,” “look down,” “look away,” and “face cover” (covering one’s face with one’s hands). The observers committed this list to memory and then practiced by coding the reactions of bowlers who had been videotaped. During the actual study, the observers spoke into an audio recorder, describing the reactions they observed. Among the most interesting results of this study was that bowlers rarely smiled while they still faced the pins. They were much more likely to smile after they turned toward their companions, suggesting that smiling is not purely an expression of happiness but also a form of social communication.

When the observations require a judgment on the part of the observers—as in Kraut and Johnston’s study—this process is often described as  coding . Coding generally requires clearly defining a set of target behaviors. The observers then categorize participants individually in terms of which behavior they have engaged in and the number of times they engaged in each behavior. The observers might even record the duration of each behavior. The target behaviors must be defined in such a way that different observers code them in the same way. This difficulty with coding is the issue of interrater reliability, as mentioned in Chapter 4. Researchers are expected to demonstrate the interrater reliability of their coding procedure by having multiple raters code the same behaviors independently and then showing that the different observers are in close agreement. Kraut and Johnston, for example, video recorded a subset of their participants’ reactions and had two observers independently code them. The two observers showed that they agreed on the reactions that were exhibited 97% of the time, indicating good interrater reliability.

One of the primary benefits of structured observation is that it is far more efficient than naturalistic and participant observation. Since the researchers are focused on specific behaviors this reduces time and expense. Also, often times the environment is structured to encourage the behaviors of interested which again means that researchers do not have to invest as much time in waiting for the behaviors of interest to naturally occur. Finally, researchers using this approach can clearly exert greater control over the environment. However, when researchers exert more control over the environment it may make the environment less natural which decreases external validity. It is less clear for instance whether structured observations made in a laboratory environment will generalize to a real world environment. Furthermore, since researchers engaged in structured observation are often not disguised there may be more concerns with reactivity.

Case Studies

A  case study  is an in-depth examination of an individual. Sometimes case studies are also completed on social units (e.g., a cult) and events (e.g., a natural disaster). Most commonly in psychology, however, case studies provide a detailed description and analysis of an individual. Often the individual has a rare or unusual condition or disorder or has damage to a specific region of the brain.

Like many observational research methods, case studies tend to be more qualitative in nature. Case study methods involve an in-depth, and often a longitudinal examination of an individual. Depending on the focus of the case study, individuals may or may not be observed in their natural setting. If the natural setting is not what is of interest, then the individual may be brought into a therapist’s office or a researcher’s lab for study. Also, the bulk of the case study report will focus on in-depth descriptions of the person rather than on statistical analyses. With that said some quantitative data may also be included in the write-up of a case study. For instance, an individuals’ depression score may be compared to normative scores or their score before and after treatment may be compared. As with other qualitative methods, a variety of different methods and tools can be used to collect information on the case. For instance, interviews, naturalistic observation, structured observation, psychological testing (e.g., IQ test), and/or physiological measurements (e.g., brain scans) may be used to collect information on the individual.

HM is one of the most notorious case studies in psychology. HM suffered from intractable and very severe epilepsy. A surgeon localized HM’s epilepsy to his medial temporal lobe and in 1953 he removed large sections of his hippocampus in an attempt to stop the seizures. The treatment was a success, in that it resolved his epilepsy and his IQ and personality were unaffected. However, the doctors soon realized that HM exhibited a strange form of amnesia, called anterograde amnesia. HM was able to carry out a conversation and he could remember short strings of letters, digits, and words. Basically, his short term memory was preserved. However, HM could not commit new events to memory. He lost the ability to transfer information from his short-term memory to his long term memory, something memory researchers call consolidation. So while he could carry on a conversation with someone, he would completely forget the conversation after it ended. This was an extremely important case study for memory researchers because it suggested that there’s a dissociation between short-term memory and long-term memory, it suggested that these were two different abilities sub-served by different areas of the brain. It also suggested that the temporal lobes are particularly important for consolidating new information (i.e., for transferring information from short-term memory to long-term memory).

www.youtube.com/watch?v=KkaXNvzE4pk

The history of psychology is filled with influential cases studies, such as Sigmund Freud’s description of “Anna O.” (see Note 6.1 “The Case of “Anna O.””) and John Watson and Rosalie Rayner’s description of Little Albert (Watson & Rayner, 1920) [5] , who learned to fear a white rat—along with other furry objects—when the researchers made a loud noise while he was playing with the rat.

The Case of “Anna O.”

Sigmund Freud used the case of a young woman he called “Anna O.” to illustrate many principles of his theory of psychoanalysis (Freud, 1961) [6] . (Her real name was Bertha Pappenheim, and she was an early feminist who went on to make important contributions to the field of social work.) Anna had come to Freud’s colleague Josef Breuer around 1880 with a variety of odd physical and psychological symptoms. One of them was that for several weeks she was unable to drink any fluids. According to Freud,

She would take up the glass of water that she longed for, but as soon as it touched her lips she would push it away like someone suffering from hydrophobia.…She lived only on fruit, such as melons, etc., so as to lessen her tormenting thirst. (p. 9)

But according to Freud, a breakthrough came one day while Anna was under hypnosis.

[S]he grumbled about her English “lady-companion,” whom she did not care for, and went on to describe, with every sign of disgust, how she had once gone into this lady’s room and how her little dog—horrid creature!—had drunk out of a glass there. The patient had said nothing, as she had wanted to be polite. After giving further energetic expression to the anger she had held back, she asked for something to drink, drank a large quantity of water without any difficulty, and awoke from her hypnosis with the glass at her lips; and thereupon the disturbance vanished, never to return. (p.9)

Freud’s interpretation was that Anna had repressed the memory of this incident along with the emotion that it triggered and that this was what had caused her inability to drink. Furthermore, her recollection of the incident, along with her expression of the emotion she had repressed, caused the symptom to go away.

As an illustration of Freud’s theory, the case study of Anna O. is quite effective. As evidence for the theory, however, it is essentially worthless. The description provides no way of knowing whether Anna had really repressed the memory of the dog drinking from the glass, whether this repression had caused her inability to drink, or whether recalling this “trauma” relieved the symptom. It is also unclear from this case study how typical or atypical Anna’s experience was.

Figure 10.1 Anna O. “Anna O.” was the subject of a famous case study used by Freud to illustrate the principles of psychoanalysis. Source: http://en.wikipedia.org/wiki/File:Pappenheim_1882.jpg

Case studies are useful because they provide a level of detailed analysis not found in many other research methods and greater insights may be gained from this more detailed analysis. As a result of the case study, the researcher may gain a sharpened understanding of what might become important to look at more extensively in future more controlled research. Case studies are also often the only way to study rare conditions because it may be impossible to find a large enough sample to individuals with the condition to use quantitative methods. Although at first glance a case study of a rare individual might seem to tell us little about ourselves, they often do provide insights into normal behavior. The case of HM provided important insights into the role of the hippocampus in memory consolidation. However, it is important to note that while case studies can provide insights into certain areas and variables to study, and can be useful in helping develop theories, they should never be used as evidence for theories. In other words, case studies can be used as inspiration to formulate theories and hypotheses, but those hypotheses and theories then need to be formally tested using more rigorous quantitative methods.

The reason case studies shouldn’t be used to provide support for theories is that they suffer from problems with internal and external validity. Case studies lack the proper controls that true experiments contain. As such they suffer from problems with internal validity, so they cannot be used to determine causation. For instance, during HM’s surgery, the surgeon may have accidentally lesioned another area of HM’s brain (indeed questioning into the possibility of a separate brain lesion began after HM’s death and dissection of his brain) and that lesion may have contributed to his inability to consolidate new information. The fact is, with case studies we cannot rule out these sorts of alternative explanations. So as with all observational methods case studies do not permit determination of causation. In addition, because case studies are often of a single individual, and typically a very abnormal individual, researchers cannot generalize their conclusions to other individuals. Recall that with most research designs there is a trade-off between internal and external validity, with case studies, however, there are problems with both internal validity and external validity. So there are limits both to the ability to determine causation and to generalize the results. A final limitation of case studies is that ample opportunity exists for the theoretical biases of the researcher to color or bias the case description. Indeed, there have been accusations that the woman who studied HM destroyed a lot of her data that were not published and she has been called into question for destroying contradictory data that didn’t support her theory about how memories are consolidated. There is a fascinating New York Times article that describes some of the controversies that ensued after HM’s death and analysis of his brain that can be found at: https://www.nytimes.com/2016/08/07/magazine/the-brain-that-couldnt-remember.html?_r=0

Archival Research

Another approach that is often considered observational research is the use of  archival research  which involves analyzing data that have already been collected for some other purpose. An example is a study by Brett Pelham and his colleagues on “implicit egotism”—the tendency for people to prefer people, places, and things that are similar to themselves (Pelham, Carvallo, & Jones, 2005) [7] . In one study, they examined Social Security records to show that women with the names Virginia, Georgia, Louise, and Florence were especially likely to have moved to the states of Virginia, Georgia, Louisiana, and Florida, respectively.

As with naturalistic observation, measurement can be more or less straightforward when working with archival data. For example, counting the number of people named Virginia who live in various states based on Social Security records is relatively straightforward. But consider a study by Christopher Peterson and his colleagues on the relationship between optimism and health using data that had been collected many years before for a study on adult development (Peterson, Seligman, & Vaillant, 1988) [8] . In the 1940s, healthy male college students had completed an open-ended questionnaire about difficult wartime experiences. In the late 1980s, Peterson and his colleagues reviewed the men’s questionnaire responses to obtain a measure of explanatory style—their habitual ways of explaining bad events that happen to them. More pessimistic people tend to blame themselves and expect long-term negative consequences that affect many aspects of their lives, while more optimistic people tend to blame outside forces and expect limited negative consequences. To obtain a measure of explanatory style for each participant, the researchers used a procedure in which all negative events mentioned in the questionnaire responses, and any causal explanations for them were identified and written on index cards. These were given to a separate group of raters who rated each explanation in terms of three separate dimensions of optimism-pessimism. These ratings were then averaged to produce an explanatory style score for each participant. The researchers then assessed the statistical relationship between the men’s explanatory style as undergraduate students and archival measures of their health at approximately 60 years of age. The primary result was that the more optimistic the men were as undergraduate students, the healthier they were as older men. Pearson’s  r  was +.25.

This method is an example of  content analysis —a family of systematic approaches to measurement using complex archival data. Just as structured observation requires specifying the behaviors of interest and then noting them as they occur, content analysis requires specifying keywords, phrases, or ideas and then finding all occurrences of them in the data. These occurrences can then be counted, timed (e.g., the amount of time devoted to entertainment topics on the nightly news show), or analyzed in a variety of other ways.

Key Takeaways

• There are several different approaches to observational research including naturalistic observation, participant observation, structured observation, case studies, and archival research.
• Naturalistic observation is used to observe people in their natural setting, participant observation involves becoming an active member of the group being observed, structured observation involves coding a small number of behaviors in a quantitative manner, case studies are typically used to collect in-depth information on a single individual, and archival research involves analysing existing data.
• Describe one problem related to internal validity.
• Describe one problem related to external validity.
• Generate one hypothesis suggested by the case study that might be interesting to test in a systematic single-subject or group study.
• Rosenhan, D. L. (1973). On being sane in insane places. Science, 179 , 250–258. ↵
• Wilkins, A. (2008). “Happier than Non-Christians”: Collective emotions and symbolic boundaries among evangelical Christians. Social Psychology Quarterly, 71 , 281–301. ↵
• Levine, R. V., & Norenzayan, A. (1999). The pace of life in 31 countries. Journal of Cross-Cultural Psychology, 30 , 178–205. ↵
• Kraut, R. E., & Johnston, R. E. (1979). Social and emotional messages of smiling: An ethological approach. Journal of Personality and Social Psychology, 37 , 1539–1553. ↵
• Watson, J. B., & Rayner, R. (1920). Conditioned emotional reactions. Journal of Experimental Psychology, 3 , 1–14. ↵
• Freud, S. (1961).  Five lectures on psycho-analysis . New York, NY: Norton. ↵
• Pelham, B. W., Carvallo, M., & Jones, J. T. (2005). Implicit egotism. Current Directions in Psychological Science, 14 , 106–110. ↵
• Peterson, C., Seligman, M. E. P., & Vaillant, G. E. (1988). Pessimistic explanatory style is a risk factor for physical illness: A thirty-five year longitudinal study. Journal of Personality and Social Psychology, 55 , 23–27. ↵

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• v.6(2); 2018 Jun 27

Observe Before You Leap: Why Observation Provides Critical Insights for Formative Research and Intervention Design That You'll Never Get From Focus Groups, Interviews, or KAP Surveys

Steven a. harvey.

a Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Associated Data

Four case studies show how observation can uncover issues critical to making a health intervention succeed or, sometimes, reveal reasons why it is likely to fail. Observation can be particularly valuable for interventions that depend on mechanical or clinical skills; service delivery processes; effects of the built environment; and habitual tasks that practitioners find difficult to articulate.

Formative research is essential to designing both study instruments and interventions in global health. While formative research may employ many qualitative methods, focus group discussions and in-depth interviews are the most common. Observation is less common but can generate insights unlikely to emerge from any other method. This article presents 4 case studies in which observation revealed critical insights: corralling domestic poultry to reduce childhood diarrhea, promoting insecticide-treated bed nets (ITNs) to prevent malaria, evaluating skilled birth attendant competency to manage life-threatening obstetric and neonatal complications, and assessing community health worker (CHW) ability to use malaria rapid diagnostic tests (RDTs). Observation of Zambian CHWs to design malaria RDT training materials revealed a need for training on how to take finger-stick blood samples, a procedure second nature to many health workers but one that few CHWs had ever performed. In Lima, Peru, study participants reported keeping their birds corralled “all the time,” but observers frequently found them loose, a difference potentially explained by an alternative interpretation of the phrase “all the time” to mean “all the time (except at some specific seemingly obvious times).” In the Peruvian Amazon, observation revealed a potential limitation of bed net efficacy due to the built environment: In houses constructed on stilts, many people sleep directly on the floor, allowing mosquitoes to bite from below through gaps in the floorboards. Observation forms and checklists from each case study are included as supplemental files; these may serve as models for designing new observation guides. The case studies illustrate the value of observation to clearly understanding clinical practices and skills, details about how people carry out certain tasks, routine behaviors people would most likely not think to describe in an interview, and environmental barriers that must be overcome if an intervention is to succeed. Observation provides a way to triangulate for social desirability bias and to measure details that interview or focus group participants are unlikely to recognize, remember, or be able to describe with precision.

INTRODUCTION

Let's play a quick game of word association: If I say “formative research,” what's the first word or phrase that comes to mind? Some of you, thinking of purpose, might say that formative research is what you do before designing a behavior change campaign. Others, thinking of methods, might say “focus groups.” Both would be wrong. Well, at least partially wrong.

Formative research is important to the design of behavior change campaigns, but it serves many other purposes as well. It is essential to developing research instruments and global health interventions of many kinds. 1 – 4 It can provide the basis for assessing clinical practice, determining how to measure intervention outcomes, planning quality improvement initiatives, and understanding many other aspects of global health programming. 5 – 14 As medical anthropologist Margaret Bentley explains 15 :

The purpose [of formative research] is to provide input into the design of a research study or intervention, including the identification of target populations and appropriate recruitment, retention or consent strategies, development of assessment or evaluation measures, and refinement of intervention components. Formative research allows community participation in the design of research and program protocols, which leads to greater community acceptance.

So formative research is about much more than just behavior change interventions.

Now, what about methods? If you want to do formative research, how should you go about it? Formative research can incorporate many methods, both qualitative and quantitative. Focus groups tend to be the most common, perhaps because they are most familiar. Interviews and knowledge, attitude, and practice (KAP) surveys are also popular. However, as you've probably gathered by now, I'm going to argue that those methods are often insufficient. If you're doing formative research, you should also consider observation.

If you're doing formative research, you should consider observation.

Researchers seem more hesitant about observation than other methods, perhaps because they don't know how to do it, consider it too labor-intensive or costly, feel uncomfortable with the idea of watching other people, or worry about reactivity—the phenomenon where those being observed change their behavior due to the observer's presence. 16 – 18 But observation can generate insights you won't get using any other method. And those insights can often prove critical.

In this article, I present 4 case studies on different global health topics, from corralling domestic poultry to measuring the competency of skilled birth attendants (SBAs). 19 – 21 These examples illustrate some of the scenarios in which observation—both structured and unstructured—can be useful, and they highlight the types of insights it can provide. In each case study, observation yielded critical information that would have been difficult or impossible to obtain any other way. For each case study, I provide a brief description of the research and the context from which it was drawn, then focus more extensively on the observational methods used and the unique insights they generated. Complete descriptions of the original research can be found elsewhere. 22 – 28 I've provided the observation instruments used for each case study as supplemental files.

Ethics Review

The research cited in case studies #1 and #2 was reviewed and approved by the Institutional Review Board of the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, USA, and by the Ethics Committee of the Asociación Benéfica PRISMA in Lima, Peru. The research cited in case study #3 was reviewed for compliance with the ethics guidelines of the Quality Assurance Project funded by the United States Agency for International Development and approved by Ministry of Health ethics committees or their equivalent in each study country. The research cited in case study #4 received ethics approval from the World Health Organization Special Programme for Research and Training in Tropical Diseases (WHO/TDR) and by the Tropical Disease Research Centre Ethics Committee – Ndola, Zambia.

CASE STUDY #1: CORRALLING DOMESTIC POULTRY TO REDUCE CHILDHOOD DIARRHEA IN LIMA, PERU

Campylobacter jejuni is a common bacterial contributor to diarrheal disease worldwide. 23 , 29 – 31 The bacteria is found almost universally in the intestinal tracts of chickens and can be transmitted to humans from contact with chicken feces or consumption of undercooked chicken. 23 , 32 – 36 In the shanty town outside Lima, Peru, where this study took place, the link between C. jejuni in domestic poultry and childhood diarrhea has been established for decades and confirmed repeatedly. 23 , 32 , 37

Study Context and Observation Methods

The observations described here took place as formative research for a trial to test whether corralling free-range chickens and other domestic poultry would reduce Campylobacter- associated diarrhea by minimizing contact between children and birds. 23 The research team recruited 12 local families raising domestic poultry, built corrals for the poultry at each household, and asked each family to test the corral for 8 weeks. A study team member made weekly visits to each household to complete a 19-item structured observation form ( Supplement 1 ) with space to record variables such as number of birds present; number inside and outside each corral; visual evidence that birds might have been outside the corral recently (e.g., feathers or bird droppings in the yard or inside the house); interaction, if any, between birds and children; cleanliness and structural soundness of each corral; and presence and cleanliness of food and water. The weekly visits were carried out at preselected random times during daylight hours Monday–Saturday. Participants were not notified of visits in advance. This unannounced random schedule made it possible to observe the natural state of each household and corral on different days of the week and at different times of day. In addition, the project sociologist made 3–4 random semi-structured spot checks per household over the 8-week period (30 total across the 12 participating households) noting whether, at the moment of arrival, birds were corralled, children were interacting with birds, birds had adequate food and water, and corrals were in good condition. The sociologist took unstructured notes on anything he judged relevant to feasibility or acceptability of corralling.

Critical Findings

Extent of corralling.

In interviews, participants stated that they kept their birds corralled “all the time.” However, observers found birds loose during 13% of observation visits and 33% of spot checks. Asked about this difference, participants clarified that they let the birds out at certain times such as while cleaning the corrals or to give them time to play ( recrearse )—an activity owners considered essential to their birds' well-being.

Why did participants say they kept their birds corralled all the time when they really didn't? One possible reason is courtesy bias: The project had built them corrals, and so participants may have felt they would disappoint us or seem ungrateful by admitting they didn't always use them. Another possible reason is that they meant something different than we did by “all the time.” Participants took for granted that—like themselves—everyone would understand the need to let birds loose at certain times for practical or health reasons, a “fact” seemingly so obvious as to be unworthy of mention. “All the time” really meant “all the time except at certain (presumably obvious) specific times.” Had we relied solely on interviews (reported behavior), we might never have known that birds were sometimes loose or might never have thought to ask why. Triangulation between what people told us and what we observed revealed critical information about why the intervention might not work.

Participants took for granted that—like themselves—everyone would understand the need to let birds loose at certain times for practical or health reasons, a “fact” seemingly so obvious as to be unworthy of mention.

Sufficient Food and Water

For the local population, one advantage of raising loose poultry was that the birds could find their own food and water. With a corral, the household needed to provide a constant supply of food and water and maintain hygienic conditions. As shown in Figure 1 , both structured observations and spot checks revealed that over the 8-week surveillance only 46% of corrals had food and only 43% had water. Further, corral floors were often wet after birds overturned their water dishes, and food was often rotting. In earlier interviews, participants had expressed concern that corralling would be unhealthy for their birds. Observations made clear that a corralling intervention might validate these concerns unless participants received training on how to keep corrals clean and corralled birds healthy. The data also showed that corralling took more time and effort since someone had to clean the corrals regularly and ensure availability of food and water.

Percentage of Domestic Poultry Corrals Containing Food or Water During Weekly Random Observations, Lima, Peru (N=122 Observations)

Contact Between Poultry and Children

The primary objective of corralling was to break the Campylobacter transmission cycle by separating birds from children. Observations demonstrated that children took a keen interest in the new corrals, often swinging on the doors, sticking their fingers through the mesh, or entering to play with the birds. Attempts to childproof corrals with latches or convince parents to keep children away were largely ineffective: Observers continued to encounter children inside. Parents explained that this was natural and appropriate: They wanted their children to grow up around animals. Children as young as 3 were assigned to collect eggs every day. Instead of isolating children from C. jejuni , observations suggested that corralling actually concentrated exposure. This may help explain the finding from a later study that rates of Campylobacter -associated diarrhea among children under 6 were 2 to 7 times higher in corralling households than non-corralling households with the same number of chickens. 38 Without observation, we might have missed the child-bird contact.

Handling of Poultry Manure

One contributor to child Campylobacter exposure not revealed in interviews was household handling of chicken manure. With manure now concentrated in a smaller space, poultry-raising households began to collect it to use as fertilizer. Observers documented that manure removed from coops was often stored in tin cans or buckets outside the coop within easy reach of children. Uncovered storage also allowed the wind to scatter dried manure around the outside of the living area, thus increasing potential contact.

Contrast Between Human and Bird Habitation

Though not part of formal data collection, observers also noted the contrast between human and animal living space. Residents of this area had settled outside Lima as squatters, often after fleeing rural terrorism in the 1980s. Most worked as casual laborers, domestic servants, or textile piece-workers earning the equivalent of $4.00 to $5.00 per day. Many lived in houses cobbled together from discarded materials, often scavenged from construction sites or garbage dumps. Corrals, though built as cheaply as possible, were made from new material at an average cost of $60.00 per household. Figure 2 shows a project-constructed corral to the left with the human habitation in the center. After receiving their corrals, more than 1 participant joked that their birds now enjoyed a higher standard of living than the human members of the family. Documenting this contrast offered a perspective beyond that likely to be achieved through interviews or focus groups alone.

Contrast Between Human and Animal Living Spaces Documented Through Observation, Las Pampas de San Juan de Miraflores, Peru

Project-constructed poultry corral (left foreground) vs. human habitation (center background). Project participants sometimes joked that the birds in the project enjoyed a better standard of living than the people. © 1999 Steven Harvey.

CASE STUDY #2: BED NETS FOR MALARIA PREVENTION IN THE PERUVIAN AMAZON

Malaria was virtually eliminated from the Peruvian Amazon during the 1970s and 1980s but began to reappear sporadically in the mid-1990s, culminating in an epidemic outbreak in 1997. 39 In response that year, the Peruvian Ministry of Health began distributing ITNs to affected communities. This case study involves observations carried out to evaluate the social acceptability of ITNs and to assess their potential efficacy based on human behavior during the peak biting hours of local malaria-transmitting mosquitoes.

The study took place in 1 peri-urban community and 3 rural villages, all within 30 km of Iquitos, the Peruvian Amazon's largest city. Over 9 months, 4 observers carried out 1 dusk-to-dawn observation in each of 60 households. Upon arrival, the observer used a structured form ( Supplement 2 ) to collect information about the number, ages, and relationships of household occupants; the number and types of sleeping spaces; and the number and types of bed nets. The observer then took unstructured notes at 5-minute intervals throughout the night, recording the location and activities of each household member. Most households consisted of a wooden platform on stilts raised about 2 meters off the ground and covered with a thatched roof. These structures had few rooms or interior dividers, so observers could follow most household activities from a single vantage point. 17 , 40

Net Use During Peak Biting Hours

A key concern about ITN effectiveness in the Americas is whether people are likely to be inside a net during the hours when local malaria-transmitting mosquitoes bite. Observation allowed us to systematically document net use. As shown in Figure 3 , people began to enter their nets for the night as early as 7:00 p.m., but only about half the population was inside a net by 8:30 p.m. and slightly less than 80% by 9:30 p.m., the peak biting hour for Anopheles darlingi , the Amazon's most important malaria vector. 42 This suggests that ITNs might be somewhat effective, but not as effective as in Africa where principal vector species feed later at night. Rather than observing all night, we might have simply asked people what time each member of the household went to bed the previous night, but in a setting where few people had watches or clocks, it would have been hard for them to respond with much precision. Social desirability bias might also have affected people's reports about their own behavior: At the time, the Ministry of Health was running a campaign encouraging people to enter their nets at dusk—a practice unlikely to be feasible in an area near the equator where the sun sets around 6:30 p.m. throughout the year.

Percentage of the Population in Bed by Half-Hour (N=60 Observations) Compared With Anopheles darlingi Feeding Behavior, a Department of Loreto, Peru

a Data on mosquito feeding behavior come from Vittor (2003). 41

Multiple Entries and Exits

One unanticipated finding was the number of times people enter and exit ITNs during the night. 43 Each time the net is lifted, mosquitoes have an opportunity to enter. Parents who share nets with children may spend considerable time outside the net unprotected after their children have gone to sleep. The Table shows an example of a single sleeping space occupied by a 23-year-old mother and her 2-year-old son. The net was lifted a total of 20 times between 7:00 p.m. and 6:30 a.m. The mother spent 195 minutes outside the net between the first time she entered with her son at 7:00 p.m. and the time both of them got out of bed at 6:30 the next morning.

Observational Bed Net Entry and Exit Data From a Single Sleeping Space With 2 Occupants, a 23-Year-Old Mother and Her 2-Year-Old Son, Peruvian Amazon

An unanticipated finding from an observational study of bed net use was the number of times people enter and exit their bed nets during the night—as many as 20 times for 1 mother with a young son.

Additional Potential Risk Factors

Observations revealed other phenomena that would have been difficult to capture with interviews or focus groups. For instance, observers took detailed notes on sleeping spaces in participating households. These notes revealed that many people slept directly on cane flooring rather than on a bed. The flooring had gaps between the cane staves. Since many houses were built on stilts, this meant mosquitoes could enter the sleeping space from below. A net alone could not provide adequate protection in this setting: An effective malaria prevention intervention would need to help at-risk individuals find a way to protect themselves from below as well as from above. Observers also documented other practices that might increase exposure risk: attending evening church services during peak biting hours, bathing after dark, running small home-based stores where community members came to buy food or basic necessities in the evening hours, and other nighttime activities such as hunting, fishing, or charcoal production. While study participants reported some of these activities during interviews, direct observation allowed the study team to document them more systematically.

CASE STUDY #3: ASSESSING THE COMPETENCY OF SKILLED BIRTH ATTENDANTS IN 7 COUNTRIES

About 90% of the 300,000–350,000 annual maternal deaths worldwide are caused by 5 common obstetric complications: postpartum hemorrhage, pregnancy-induced hypertension, obstructed labor, perinatal sepsis, and postabortion complications. 44 , 45 Risk for experiencing one of these life-threatening complications cannot be reliably predicted in advance, but most can be treated successfully if the woman experiencing them has access to basic or comprehensive essential obstetric care delivered by an SBA. For this reason, the World Health Organization (WHO) recommends that all pregnant women be assisted by an SBA during labor and delivery. 46 Several international organizations have defined the competencies necessary to manage these complications. The observations described below were carried out as part of developing a method to assess these competencies among practicing SBAs in low- and middle-income countries.

Testing a clinician's competency to manage a complication according to standards requires assessing not only abstract knowledge but also physical or manual ability. Knowledge can be measured using a written exam, but the only way to assess manual skill is by watching someone perform a task to see whether she or he does it correctly. Assessing skills on actual patients, however, is problematic. Ethically, an observer qualified to evaluate clinical competency would need to stop observing and intervene before allowing an insufficiently skilled provider to endanger a patient's life or well-being. Moreover, even common obstetric complications are relatively rare. This makes it impossible to assess the skill of more than a handful of providers using actual patients.

While knowledge can be measured using a written exam, the only way to assess manual skill is by watching someone perform a task.

The observations discussed here were designed to test SBA competency at performing 4 critical procedures. The first 3 procedures—active management of the third stage of labor (AMTSL), manual removal of the placenta, and bimanual uterine compression—are performed to prevent or control postpartum hemorrhage in a mother who has just given birth. The fourth, neonatal resuscitation with an Ambu bag, is used to treat neonatal asphyxia. The project, eventually carried out in Benin, Ecuador, Jamaica, Kenya, Nicaragua, Rwanda, and Tanzania, used expert obstetrician/gynecologists and pediatricians from host countries as observers. SBAs being assessed performed each procedure on an anatomical model (Gaumard S500 Advanced Childbirth Simulator and Simulaids Sani-Baby CPR mannequin or Gaumard S320 Newborn Airway Trainer); observers assessed competency using a structured step-by-step checklist ( Supplement 3 ). 27 , 28

Correct hand position and movement are essential to successfully performing all 4 tasks. Controlled cord traction, an elective component of AMTSL, requires exerting a gentle downward pull on the umbilical cord with one hand while using the other to prevent uterine inversion by applying counter-traction just above the pubic bone. 47 In case of retained placenta, manual removal requires inserting the hand through the vaginal canal and using a gentle lateral motion to detach the placenta intact, leaving no fragments that could provoke continued bleeding or cause sepsis. Figure 4 shows an expert observer demonstrating manual removal with the Gaumard Advanced Childbirth Simulator. The open abdominal cavity allows the observer to assess the technique of the SBA being observed. Some SBAs might be able to describe these or similar procedures, but even a precise detailed description would not necessarily indicate ability to perform them.

Demonstration of the Correct Hand Position for Manual Removal of a Retained Placenta on an Anatomical Model

© 2006 Steven Harvey

Observations across the 7 study countries revealed the following:

• Though AMTSL is commonly included in national standards for managing uncomplicated delivery, most SBAs did not know how to perform controlled cord traction.
• Similarly, most SBAs could not demonstrate the correct hand positions for carrying out the manual removal of a retained placenta. Although bimanual uterine compression is a relatively simple procedure requiring no instruments or equipment, virtually no SBA was familiar with it.

Neonatal Resuscitation With an Ambu Bag: Correct vs. Incorrect Positioning

Left: Correct positioning of mask, bag, and newborn's head to achieve a good seal, with bag perpendicular to the newborn's body. © 2006 Steven Harvey.

Right: Incorrect positioning, with bag parallel with the newborn's body, making it more difficult to achieve a good seal. © 2002 Steven Harvey.

Using checklists adapted to each country's norms, observation also enabled the study team to assess whether SBAs followed prescribed infection prevention guidelines including handwashing, gloving, and post-procedure decontamination. Participating SBAs were provided with all necessary supplies and equipment. At the beginning of each assessment, the observer instructed each participant to “begin by preparing yourself, the equipment, and the patient,” then noted if the SBA proceeded in accordance with norms. At the end, the observer similarly instructed each participant to “please tell me what more you would do or ask someone else to do once you have finished the procedure.”

It's tempting to classify this research as summative since its initial objective was to assess existing health worker skills. But it was also formative , because the results helped shape interventions: In the short term, observers offered feedback and retraining to each participant, and sometimes—when many participants had a particular weakness in common—to the entire group. In the longer term, findings have influenced training programs and assessment methods in participating countries and around the globe.

CASE STUDY #4: ASSESSING CHW ABILITY TO USE MALARIA RAPID DIAGNOSTIC TESTS IN ZAMBIA

For decades leading up to the early 2000s, malaria in sub-Saharan Africa was diagnosed presumptively: Anyone with a fever was presumed to have malaria and treated with antimalarials. This practice developed because the supply of both microscopes and trained microscopists was too limited to diagnose more than a tiny fraction of febrile patients. In addition, first-line antimalarial drugs were cheap and adverse effects negligible, so presumptive treatment involved minimal cost and risk. After introduction of artemisinin combination therapy as first-line treatment for malaria starting around 2004, WHO recommended parasite-based diagnosis first for adults and older children, then for all suspected cases of malaria regardless of age. 48 Malaria rapid diagnostic tests (RDTs) make parasite-based diagnosis possible even at health facilities with no laboratory, microscope, or microscopist. In many areas, however, febrile patients seek treatment at the community level without ever visiting a health facility. The observations described in this case study were carried out to determine whether volunteer community health workers (CHWs) could use RDTs safely and accurately and, if so, what sort of training materials they needed.

Based on focus group discussions with Zambian CHWs, the study team designed a job aid and brief training curriculum. We used structured observation to pilot test these materials. Study team members observed 79 CHWs prepare 3 RDTs each and recorded the results on a 16-item checklist ( Supplement 4 ). 24 , 25

• Malaria RDTs require using a sterile lancet to draw a finger-stick blood sample, a procedure that is second nature to many professional health workers. Due to concerns about HIV and other blood-borne diseases, however, most African CHWs were prohibited from taking finger-stick blood samples. The Zambian Medical Council authorized the practice for this study, but few participating CHWs had ever taken a sample or used a lancet. During training, observers noticed that instead of drawing blood with a quick stab—the preferred approach—many CHWs set the point of the lancet on the patient's fingertip, then pushed it into the skin. Participants explained they were doing this for fear that stabbing would cause the patients too much pain, but the effect was just the opposite: Pushing was more painful. In addition, it often produced too little blood, thus necessitating a second, third, or even fourth finger prick. Observing this made clear that CHWs needed specific training on proper lancet technique. The study team subsequently developed a training module demonstrating how to extract sufficient blood with a single prick. Improved CHW technique reduced patient discomfort and increased testing quality.
• Watching CHWs transfer blood from fingertip to test cassette yielded a similar revelation. The project RDT came packaged with a loop-shaped blood transfer device designed to collect a 5 μl film of blood across the width of the loop. CHWs did the finger prick with the ball of the patient's finger facing up, then tried to collect the drop from above. This often conveyed too little blood to the test cassette even after multiple tries. Noting this, an experienced observer suggested pricking the finger, rotating the patient's hand 180°, then collecting the drop from underneath with the ball of the finger facing down. In most cases, this made it possible to collect and transfer the precise volume of blood required on the first attempt.
• A key concern related to blood safety was correct disposal of the blood-contaminated lancet. To minimize danger to patients, CHWs, and the community, the research team distributed sharps boxes to all participating CHWs and instructed them to deposit the used lancet into the sharps box immediately after pricking the patient's finger. Setting down the used lancet prior to disposal heightens risk of finger-stick injuries. Observers noticed that positioning the sharps box appropriately made immediate disposal convenient: For a right-handed CHW, this meant placing the sharps box on the right side of the work space, and vice versa for a left-handed CHW. Placing the box on the opposite side of the CHW's dominant hand forced the CHW to reach across both his or her own body and that of the patient. This made handling the used lancet more risky and immediate disposal more difficult.

Malaria Rapid Diagnostic Test Job Aid

A job aid for community health workers lists at the top all supplies and equipment that the worker needs to assemble prior to conducting a rapid diagnostic test for malaria.

• Watching CHWs provide services from home led to another observational finding: Many CHW homes lack electricity and thus have poor-quality artificial lighting. This fact can affect the accuracy of test interpretation when RDTs are prepared inside, especially after dusk or during inclement weather. The RDT's positive test line—indicating that a patient is infected with malaria—can often be quite faint. With inadequate artificial lighting inside and insufficient natural light outside, a CHW could easily misread a faint positive result as negative, thus leaving an infected patient untreated. Realizing this led to added emphasis during training that positive lines are sometimes quite faint and that CHWs should read results in the brightest light possible to avoid missing a faint positive.

Observation produced novel insights in the case studies just described, but how do you decide when observation might be valuable or even essential for your intervention or study? To answer this, it's useful to think in terms of categories of events or processes. Among others, these might include mechanical skills, health service delivery processes, effects of the built environment, and habitual practices that people would have difficulty articulating, sometimes known as “tacit knowledge.” 49 , 50

Observation can produce novel insights, but how do you decide when it might be valuable or even essential for your intervention or study?

Mechanical Skills

The SBA and RDT case studies both illustrate the value of observation to understanding mechanical skills, including critical details such as the correct hand position needed to effectively carry out a lifesaving obstetric or neonatal intervention. Manual removal of a retained placenta or resuscitation of an asphyxiated newborn are two examples. Although lancet technique, sharps box position, or collecting blood with the fingertip facing up or down might seem like minute details when preparing an RDT, they can make the difference between effective, efficient, safe practices and practices that lead to incorrect results or endanger the patient, the health worker, or the community. Observation in these cases is critical not only to diagnose lapses but also to identify interventions that can address them. Observation thus led to additional practical training for SBAs and to development of specific training modules and revised job aid illustrations for malaria RDTs. Beyond their specific substantive findings, these two studies highlight the value of observation to understanding both health worker and community behavior.

Sequential Processes

Many public health interventions involve sequential processes: Not only must each step be performed properly, it must also be performed in the proper order. Again, the RDT case study offers an illustrative example: The study team identified 16 discrete steps necessary to correctly prepare and interpret the test; performing them in the wrong order (e.g., opening the sterile lancet before cleaning the finger with an alcohol swab) or the wrong way (depositing the blood drop where the buffer solution is supposed to go) could compromise test accuracy or patient or health worker safety. The observation checklist ( Supplement 4 ) enabled the team to determine the proportion of health workers who completed all steps correctly, identify specific steps where health workers had problems, and modify training to address the problems observed. Greenland et al. used a similar approach in Zambia to determine what proportion of caregivers of young children with diarrhea could prepare oral rehydration solution correctly. 51 Hurley et al. used a combination of structured and unstructured observations to track the flow of pregnant women through antenatal care in Mali and better understand why many completed their visits without receiving intermittent preventive treatment for malaria in pregnancy (IPTp) or received it without any information about the purpose of IPTp. 52 Hermida et al. found observation to be more accurate than patient exit interviews or medical record review for assessing facility-based provider adherence to standards of care for acute lower respiratory infection, diarrheal disease, and family planning counseling. 53 For this reason, observation is often a key component of quality improvement research. 53 , 54 In sum, observation can be an invaluable tool for documenting the necessary steps in a process, identifying where breakdowns occur, and thus pinpointing where intervention is needed. This type of analysis can be useful at the household, community, and health facility levels.

Understanding the Built Environment

The built environment—and sometimes its relationship to the natural environment—can significantly affect disease risk, health service delivery, and the feasibility of health interventions. The Campylobacter study setting consists of dusty desert hills where water is scarce and rain nonexistent (natural environment). Since the poorest people live at the top of those hills with neither wells nor piped water (built environment), many families struggle to provide water for themselves. Water for corralled birds becomes, at best, a secondary priority. Observing the difficulty of obtaining water helped study team members better understand owners' concerns about the effect of corralling on birds' health. Wind (natural environment) combined with open storage of concentrated chicken manure cleaned from the corrals (built environment) turned out to be one form of continued contact between humans and Campylobacter despite corralling.

The built environment was likewise a critical aspect of the bed net study. The structure of a typical bed in the study setting—no mattress and gaps between the wooden or bamboo slats that allowed mosquitoes to bite from underneath—might never have occurred to public health practitioners, most of whom presumably sleep in beds with mattresses. Even had it occurred to them, they would not have been able to collect systematic data on bed configurations without observation. Thus, observation revealed one potential limitation of bed net efficacy in the study setting. This, in turn, revealed a necessary component of any improvement intervention: figure out how to block the gaps between flooring that allowed mosquitoes to enter.

Systematically observing the built environment can be revealing in many settings. By documenting patient flow at health centers and hospitals, maternal health researchers from the Quality Assurance Project helped explain why women arriving with an obstetric complication might encounter significant, sometimes life-threatening, delays before seeing a clinician. 55 – 58 Observing both the size of rooms in a house and their use for multiple purposes (sleeping at night, running a small retail shop during the day) helped explain why some households in Ghana were reluctant to permanently install bed nets over their sleeping spaces and why, in some cases, residents preferred conical nets to rectangular. 59 Observing the dim lighting in CHWs' houses helped explain why CHWs might miss weak positive RDT results and why training programs needed to emphasize the importance of reading test results under bright light. 25 Many U.S. researchers have used observation to study the relationships between built environment, physical activity, available food choices, and chronic diseases such as obesity and diabetes. 60 – 63 As with the discussion of sequential processes above, it is worth reiterating that observations related to the built and natural environments can be useful at the household, community, and health facility levels.

Habitual Practices and Tacit Knowledge

In any setting, people perform a variety of routine activities, the procedures for which they learned at some point in the past, committed to memory, and carry out automatically, almost as if by instinct. Because these activities are habitual, those who perform them often have difficulty articulating the step-by-step process and even come to think of that process as self-evident. Collecting a finger-stick blood sample is a case in point. A health care provider who has done it many times considers it second nature and wonders why a novice finds it so difficult. Observation reveals that the process involves numerous steps: assemble all the supplies before starting, swab the fingertip with alcohol, wait for it to dry, massage the finger to work the blood up into the fingertip, open the sterile lancet, puncture the fingertip with a quick stab, orient the fingertip with the blood drop in the optimum position for the particular blood collection device being used, etc. The experienced provider has internalized all this and performs it without needing to think. The novice may fail to massage the finger, stab too timidly and thus extract too little blood, or orient the fingertip in a less than optimal position and thus collect too little blood, or too much. Observing both expert and novice helps distinguish the differences and thus determine what training the novice requires.

People who perform habitual activities often have difficulty articulating the step-by-step process and even come to think of that process as self-evident.

The Campylobacter study provides additional examples: Interview or focus group participants might fail to mention the many points of contact between children and birds either because they knew the intervention was meant to separate the two (courtesy bias) or because the types of contact were so commonplace as to seem unworthy of mention. Observing children play with birds, feed and water them, collect eggs, and clean corrals provides tangible evidence that those designing public health interventions should take into account both human nature (children like to play with animals) and economic and cultural practices (even a very young child may be assigned household chores; parents may view learning to raise animals as a key life skill). Cumulative findings from these observations contributed to a conclusion that the intervention was unlikely to succeed, a conclusion confirmed by subsequent research demonstrating that corralling, instead of decreasing risk of Campylobacter -associated diarrhea in children, actually doubled it. 38

The bed net study also provides examples: Absent observation, as noted above, public health practitioners might not have thought to ask about bed design. Conversely, mentioning bed design—an aspect of daily existence so routine as to pass virtually unperceived—might never have occurred to a member of the at-risk population. Had interviewers thought to ask, net occupants might also have mentioned that they enter and exit their nets more than once per night, but it is unlikely that they could have reported very precisely the number of entries and exits, the amount of time the net was lifted, or the amount of time different occupants spend outside the net. Observation made it possible to quantify this phenomenon much more systematically. 43

After validating the method, Gittelsohn used structured mealtime observations to estimate differences in caloric and micronutrient intake between men, women, and children in lowland south-central Nepal. 64 – 66 It is unlikely that parents would have been able to provide such detailed information about intra-household food allocation. Bentley et al. used structured observation during formative research to document child feeding practices prior to a nutritional intervention to improve infant growth and development in Andhra Pradesh, India. 10 Brummell used observation to discover tacit knowledge related to the prognosis of patients suffering cardiac arrest and whether to attempt resuscitation in 2 UK hospital emergency departments. 67 Huot and Laliberte Rudman, who used participant observation to learn about the daily routines of refugees in Canada, explain why observation can be so important for understanding habitual phenomena 68 :

The tacit nature of daily occupation can make the details involved in participation difficult to verbalize because respondents may not have reflected upon their occupational engagement in such detail, or may assume that such “minutia” may not be relevant for research.

This statement could be extended to many areas of health at individual, household, community, and facility levels. Often observation, used together with more common methods like interviews or focus groups, is the only way to make such tacit knowledge explicit.

Triangulating Observation Data With Data From Other Methods

In both the case studies described here and many of the examples cited, researchers used observation together with other methods to achieve a more complete picture of a setting, practice, or intervention. Using observation to triangulate information gathered from interviews or focus group discussions can bring to light differences between what people say they do (reported behavior) and what people actually do (observed behavior). In some cases, this may reveal social desirability bias: People over- or under-report a particular behavior because it violates what they perceive to be social norms. Hygiene studies, for instance, have often found that people over-report handwashing at critical times; observation shows much lower levels. 69 , 70

Using observation to triangulate information from interviews or focus group discussions can bring to light differences between what people say they do and what they actually do.

There is no Peruvian data on reported ITN use that we can compare to the case study #2 observation. But there is at least a plausible basis for comparison in Ghana: Nighttime observation of net use in Northern and Upper West Regions found that only 17% of the population used a net at any time during the night. 71 In a malaria indicator survey of the same 2 districts, 51% and 54% of the population reported sleeping under a net. 72 The numbers are not directly comparable for many reasons, so these differences should be interpreted with caution. The observation study is based on a small purposive sample, the survey on a population-based representative sample; the data were collected in different years and at different times of year. But the wide gap suggests a considerable difference between reported and actual net use. Also, for the observation sample, we know when each individual entered and exited his or her net and how long individuals spent protected versus unprotected. All we know from the survey is that the individual reported sleeping under the net at some point during the night—we have no idea for how long.

Triangulation may also reveal that a word, phrase, or concept means something different to participants than to the researcher. The possibility, in the Campylobacter study, that participants who reported keeping their birds in the corral “all the time,” really meant “all the time except for certain specific seemingly obvious times” is one example. Had we employed only interviews in that study, we would likely have concluded—incorrectly—that birds were never loose. Had we employed only observation, we would likely have concluded that birds were loose 20% of the time—more accurate, but not the whole story. Only the combination revealed the differences in meaning and their conflicting unspoken assumptions.

Observation and Reactivity

A key objection to observation is that it leads to reactivity: Those under observation may change their behavior because they know they are being observed. However, this problem is not unique to observation: People also change their behavior when they are being studied in other ways. Survey and interview respondents may answer questions based on what they think society (social desirability bias) or the interviewer (courtesy bias) expect of them. Observer expectancy effect refers to how an observer can shape behavior—deliberately or subconsciously—by providing subtle nonverbal cues such as slight changes in facial expression. The Hawthorne effect was named for a study in which factory workers from both intervention and control groups became more productive because they knew that researchers were testing possible interventions (such as better lighting) to improve productivity. More detailed definitions are beyond the scope of this article but can be found in many social science references. 73 – 76

In one example of reactivity, P.V. Ram and colleagues found evidence of a 35% increase in handwashing when an observer was present compared with when there was no observer and handwashing was detected by a motion sensor hidden within a bar of soap.7 77 But while reactivity often does occur, researchers can measure and adjust for it. 17 Reactivity also diminishes with time: The longer amount of time or the greater number of times people are observed, the less likely they are to react to an observer's presence. 78 – 80 Ram's study concluded that their findings “call into question the validity of structured observation details because it appears that a majority of participating caregivers substantially altered their behavior in the presence of an observer.” But the study included only 1 observation per household. Had Ram's team observed each household multiple times and waited until household members became accustomed to the observer's presence, their results might have been different.

Ram and her colleagues have a point that in some cases a less invasive technological method might be preferable to observation. For example, studies exploring household use of cleaner cookstoves to reduce indoor air pollution often use temperature sensors (called stove use monitors or SUMs) to track which stove is being used when and for how long. 81 , 82 At least one recent study reports that combining observation and SUMs data provides a more accurate picture than SUMs data alone. 83

Moreover, reactivity is often unrelated to the focus behavior. In the bed net study, we identified 339 instances of reactivity across 60 observations using the broadest possible definition: any interaction whatsoever between the observer and any member of the observed household. Of these 339 instances, only 2 were directly related to the behavior of interest: protecting against mosquito bites. 17 In a similar way, John Schnelle and colleagues found that observations did not change provider treatment of nursing home residents in the United Kingdom. 84

Another way to control reactivity is through unannounced spot checks similar to those we used in case study #1. Nazmul Chaudhury and colleagues used this method to chronicle the degree of health worker and teacher absenteeism in health facilities and primary schools in Bangladesh, Ecuador, India, Indonesia, Peru, and Uganda. 85 In his classic article about nighttime observations among the Samukundi Abelam, Richard Scaglion describes how he used spot checks to document time allocation within this Papua New Guinea ethnic group. 86 Scaglion admits, however, that he was not always able to maintain the element of spontaneity that spot check observations are meant to provide:

… it is not easy for an anthropologist in the field to come upon an Abelam unawares. Since I did not want to record “greeting anthropologist” as a frequent activity when people were first observed, I often had to reconstruct what they were doing immediately before I arrived.

In sum, observation can be an essential tool in formative research. As a stand-alone method, it can measure phenomena not measurable by any other method. In combination with interviews or focus groups, it can suggest questions to be posed through these other methods. It can also triangulate findings from other methods, reveal potential differences between reported and observed behavior, and thus help assess social desirability bias. Given these benefits, observation—either alone or in combination with other methods—is something both investigators and program managers should consider when undertaking formative research.

Supplementary Material

Acknowledgments.

I am grateful to Marianne Henry for her help with literature review and manuscript preparation. I wish to thank the editor and editorial staff of GHSP as well as the 3 anonymous reviewers, all of whose comments considerably strengthened this manuscript. I also wish to thank the many participants in the 4 studies described here for their time, patience, and willingness to participate. Finally, I am grateful for the comments and suggestions of the many students with whom I have discussed these concepts in formative research classes over nearly a decade and to Drs. Elli Leontsini and Peter Winch for inviting me to do so.

Peer Reviewed

Competing Interests: None declared.

Funding: Funding for case study #1 was provided by the Thrasher Research Fund (award 02813-1). Funding for case study #2 was provided by the US Agency for International Development (USAID) under Grant Number 527G001000070. Case study #3 was supported by the Quality Assurance Project under contracts number HRN-C-00-96-90013 and GPH-C-00-02-00004-00 with the United States Agency for International Development (USAID). Funding for case study #4 was provided by the Australian Agency for International Development (AusAID), the WHO Special Programme for Research and Training in Tropical Diseases (TDR), and the United States Agency for International Development (USAID) under the Quality Assurance and Workforce Development Project at University Research Co., LLC (contract number GPH-C-00-02-00004-00). Conclusions and opinions are the sole responsibility of the author and do not necessarily reflect the views or policies of the funders.

First Published Online: May 23, 2018

Cite this article as: Harvey SA. Observe before you leap: why observation provides critical insights for formative research and intervention design that you'll never get from focus groups, Interviews, or KAP Surveys. Glob Health Sci Pract. 2018;6(2):299-316. https://doi.org/10.9745/GHSP-D-17-00328