At this point, we do not likely need to convince you that if you are aiming to develop and introduce an MPT product, incorporating end-user research into the process is a good idea, especially if you want it to have a positive public health impact. We at the IMPT Secretariat are delighted that end-user research has become an increased focus in the contraception, HIV prevention, and global health spaces. It is now critical that enthusiasm for end-user research in these fields is applied effectively – that is, employs the right methods with the right stakeholders during the right stages, asks questions that fill knowledge gaps rather than ‘reinvent the wheel,’ and otherwise addresses past challenges experienced with this type of research.
Recently, the IMPT Secretariat asked leading experts to think through with us the various complex dimensions of applying end-user research for MPT development and introduction, and several key themes emerged:
1. Prevention is difficult.
When someone has a disease, their motivations for treatment are entirely different than those motivations that impact a prevention product. For prevention, people are looking years and years ahead to when they might actually see the consequence of the behavior that’s about to occur right now. And that’s just really hard for a human being to think through with clarity.” – Kate M Guthrie, PhD (Alpert Medical School of Brown University and The Miriam Hospital)
Researchers need to better understand the facilitators and barriers to an end-user’s motivation to engage in prevention to promote health in general. MPTs pose an even more unique challenge in this research context because they involve multiple types of prevention and their target users are younger women and adolescent girls, who may be less receptive to the concept of prevention than older women, depending upon their context.
2. Theoretical products are difficult.
"One of the biggest challenges is that we don’t have an MPT in hand so we have to rely on analogous products or hypotheticals – but the actual experience of a product really matters.” – Amy Lin, MBA, MA (USAID Center for Accelerating Innovation and Impact, CII)
We cannot know for sure what end-users will think about MPTs given that, other than male and female condoms, no other MPT is commercially available (yet). Experts emphasize that the actual experience of trying out a product often shapes and even changes what those users think about that product. Recent research has aimed to mitigate this challenge through use of placebos to understand product type preference and acceptability, but as Amy Lin’s quote above suggests, there is still much to learn about predicting uptake and use for theoretical products.
3. There are more people to think about than just the end-user.
“It’s important to look at the whole journey of the woman and who her touchpoints and influencers are. For us, there might be multiple end users – it first could be the woman who gets the injection, but it could also be, in a different way, the provider giving the injection.” – Anabel Gomez, MBA (AVAC)
A woman or adolescent girl and her sexual health do not exist in a vacuum. There are many other people who may influence whether (or not) she will accept, be able to access, or consistently use an MPT product who must be thoughtfully engaged – from policymakers, to procurers, to providers, to sexual partners, to community leaders, among others.
4. There are a lot of different approaches to choose from.
“We need to figure out how to apply our best methods to understand end-user motivations and behavior – some of that will be in the more rapid, immersive HCD setting – to identify creative responses to end-user needs, and some of that through traditional behavioral and social science methods – to understand and evaluate how these solutions work for different end-user groups.” – Betsy Tolley, PhD * (FHI 360)
Traditional academic social-behavioral research and market research methods such as human-centered design (HCD) offer diverse pathways to understanding how to develop and deliver an impactful MPT product. While there are clear similarities between approaches, one may lend itself better to early stage product ideation and design, while another may be best suited alongside clinical testing, and another still to develop a product introduction strategy. It is important to think critically about which methods and which implementers can best answer the questions at hand along every stage of this process.
This content was originally presented during a webinar discussion on 12 December 2017 entitled ‘Driving Impactful End-User Research for More Insightful MPT Development,’ hosted by the IMPT Secretariat. For more information about this topic and to hear more of what panelists Kate Guthrie, Amy Lin, Anabel Gomez, and Betsy Tolley discussed, listen to the full webinar recording here.
*Read this report by Dr. Betsy Tolley under a contract with the IMPT, which presents learnings and reflections on traditional socio-behavioral research (SBR) and human-centered design (HCD) as applied to the global health context - specifically in biomedical prevention for sexual and reproductive health.