Behaviour is slippery. What we say we do is not always what we actually do, whether we’re talking about diet, exercise, or healthcare practices. It’s not that we’re lying; it’s simply that we tend to shift our responses to please the person who’s asking, or we simply forget, or we’re too embarrassed to explain the truth of the matter.
The use of ethnographic studies in medical market research is an attempt to overcome the behavioural blind spots that can occur when using surveys, or interviews which require subjects to answer questions about their behaviour. Ethnographic research recognises that behaviour can only be understood when it is observed, within the context in which it occurs.
Consider someone who has recently been diagnosed with COPD. They have been issued with an inhaler and told to try it out to see how they get on with it. In an interview situation, they may report that they’re taking the medication regularly and that it’s having a positive effect on their health.
An ethnographic study may take the form of a home video diary and a series of interviews. This data, collected in a familiar environment, may expose ‘inconsistent truths’ about the way the medication is taken, and its effects. Perhaps the way the inhaler is being used is problematic, or use is sporadic. Maybe the user is still coming to terms with the diagnosis and can’t bring themselves to admit to their family that they need an inhaler.
Ethnographic studies are being used successfully in medical device design, patient experience studies, and in modelling the active engagement of patients in their own healthcare. Ethnography provides a detailed understanding of:
Ethnography is particularly important as a methodology at moments where a culture is changing. Across much of the globe the patient is no longer a passive recipient of ‘medical cures’ administered by doctors. Digital access to information has shifted this relationship. The patient can now assert their individual needs by requesting an alternative treatment to that prescribed to them, for example, and provide research to back up their request.
As a result of greater patient engagement, medical device providers are now looking for a clearer understanding of the needs of patients. Understanding patient behaviour ethnographically allows for innovative design opportunities that can enhance the experience of users.
As a medical market research provider, ethnography has always been important to the work of LDA Research. Prior to the pandemic this would largely take the form of written or audio diaries, or workshops involving role play, to access the day-to-day experiences of our participants.
Since Covid, however, the use of digital technologies in the home has been normalised to a far greater extent. Most of us are now used to Zoom or Teams meetings, and we use FaceTime to chat to friends, or for doctor’s appointments. There is now much less of a technological barrier to the use of video diaries, in fact many participants are far happier filming their lives rather than writing about them.
The use of video technology within the hospital environment is also changing. Clinicians increasingly use video for training, so filming procedures is now part of normal practice and is generally accepted. The life and culture of the hospital is also more accessible to the general public. Film crews are allowed access under strict guidelines; for example, surgeons at Addenbrooke’s Hospital and Royal Papworth Hospital were filmed performing operations for a documentary aired on BBC2 in November 2021.
LDA Research is increasingly using a range of ethnographic methods for clients. Recent research for a wound care company, follows patients and surgeons through orthopaedic hip and knee surgery. This uses videos of the operation, as well as patient diaries, photos, blogs and follow up interviews.
LDA was set up by Lucy Doorbar in 2011. We’re a small, core team working alongside a global network of trusted associates. We carry out quantitative research for medical and pharmaceutical clients, medical comms agencies, health market research agencies, management consultants and advertising agencies.