By Andrew A. Fisher
Publication by means of Fisher, Andrew A., Foreit, James R.
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Extra resources for Designing HIV Aids Intervention Studies: An Operations Research Handbook
Previous research on patient adherence found that poor adherence usually occurs because patients are either not receiving adequate information, are not receiving counseling support to use the information they do receive, or are experiencing severe side effects that are not adequately addressed by providers. These findings suggest several strategies for reducing adherence problems. First, information materials such as brochures, pamphlets, and a video could be developed and given to all new ARV patients to explain the need for strict adherence to ARV regimens.
Researchers, for example, begin to understand more fully the day-to-day administrative concerns of managers, the service delivery problems NGOs face, and the social, economic, psychological, and health concerns that PLHA confront every day. This increased understanding can help sharpen the focus of a study on those aspects of a program problem that could be changed. Administrators begin to appreciate the need to identify and define program problems on the basis of accurate data. They begin to view research as an important tool for decision making and as an ongoing process to which they can contribute.
But a study with high internal validity may not have high external validity. External validity refers to the extent to which the results of a study can be generalized to other settings or groups. For example, if a certain intervention is successful in reducing unsafe sexual behavior in Uganda, will the same intervention have the same results in Brazil? 46 Will an intervention that was effective with heterosexuals also be effective with homosexuals? If the answer is “yes,” the study is said to have high external validity, that is, the study results can be generalized to other settings and other populations.