1. Begin with the End in Mind
Now let’s start talking about the actual research process. We’ll start with the beginning – the planning phase.
We approach the planning phase much like the process of mapping a research study to the program/policy context – we start with thinking about how the results will be used.
Session 2

2. Session Objectives
Understand the value of a communication plan in improving the use of research results
Understand the importance of stakeholders in the research and research use processes
Introduce the Stakeholder Analysis Matrix
Establish the criteria for meaningful research questions

3. Who Will Use Study Results?
Developing a communication plan
Ensures communication activities are budgeted
Identifies key audience – decision maker and other consumers of information
Identifies appropriate communication method for each audience
We start by determining who will use the study results. We do this through developing a communication plan. A communication plan has multiple purposes. First, with a communication plan, you ensure that communication activities are incorporated into study activities and budgets. Often we see this area of the study process either not included in the budget at all or being very much under-budgeted. As researchers, we often feel that this is the work of someone else, that our job ends with the completion of a final report. This is not sufficient.
Second, a communication plan allows you to identify primary and secondary consumers of the study findings. You can identify the primary audience (users) among key decision makers who are in the MOH, or who are donors or national-level policy makers. Secondary consumers may be program managers at the province, district, or even facility levels. Providers also are secondary consumers of information oftentimes, as they are the ones affected most by changes in the delivery of health services.
Last, the communication plan identifies appropriate communication methods for each audience.

4. Developing a Communication Plan
Different stakeholder audiences
Have different perspectives
Need/want different information
Need information at different levels of complexity
Have different intensities of interest
We need to consider communicating information differently to different audiences because different stakeholders:
Have different perspectives
Need/want different information
Need information at different levels of complexity
Have different intensities of interest

5. Communication Plan – 4 Questions
1. What are the objectives of the communication strategy? 2. Who are the target audiences? 3. What are appropriate channels of communication? 4. How will you assess information use?
There are four essential questions to consider when developing a communication plan.
Right now, we will discuss the first two. We will address questions 3–4 later in the training.

6. Developing a Communication Strategy
What are the objectives of the communication strategy?
Multiple research questions often included in a study
Identify key potential findings and align them with appropriate target audiences
Essentially, we want stakeholders to use the information for decision making. Although this is the goal, remember that different stakeholders have different information needs because they make decisions at both policy and program levels. As such, multiple research questions are often included in a study, which in turn results in a variety of communication objectives. The next step in the communication strategy is to align the study objectives with the appropriate target audiences.

7. 2. Who Are the Target Audiences?
Decision maker
Primary stakeholders affected
Secondary stakeholders affected
Here you see a graphic of how to segment the different audiences of your communication strategy. The graphic is a bull’s-eye. The center (the yellow circle) represents your target audience.
The turquoise circle represents the primary stakeholders who will be affected by any kind of change, decision, or action enacted by the decision maker.
The light blue circle represents the secondary stakeholders – those who also will be affected by any change, decision, or action, but not as immediately as the primary stakeholder group.

8. Role of Stakeholders in the Research Process
We’ve just talked about stakeholders and their importance in the communication process. Let’s take some time to talk about their roles in the broader decision-making context.

9. What Is a Stakeholder?
Any person or group with a particular interest or ‘stake’ in your research
Providers / Implementers
Policy makers
Program managers
Partners
Funding agencies
Beneficiaries
Professional associations
A stakeholder is anyone who has a “stake” or interest in your program. We often think of policy makers, funding agencies, and even implementers or providers at the community and facility levels as stakeholders. However, we do not often think of beneficiaries as stakeholders. The people that our programs and services strive to serve make decisions about seeking services and continuing to seek care. It is vital to consider these various stakeholders when designing and implementing research.

10. Context of Decision Making
Information/data
Stake-holders
Decisions
Let’s look at stakeholders’ roles in the context of decision making. To make a decision, three elements are critical.
Data – This is the area with which we are most comfortable. As researchers, it is our job to generate new information.
Decisions – These are the decisions that will be made based on the research results. Generally speaking, research leads to three types of decisions:
Disseminate results – Strength of results are not sufficient for action – More research needed
Disseminate results – AND take policy or program action – Make a change
Disseminate results – Do not make a change
Involvement of stakeholders – As we discussed, these are the decision makers and those affected by the study results.
The point of this graphic is to show that ALL three elements are equally important. Without all of these components, you will either fail to make a decision or fail to make an evidence-based decision. 10

11. Involving Stakeholders Throughout the Research Process
Relevance of data
Ownership of data
Appropriate dissemination of data
Use of data
Involving stakeholders throughout the research process increases the understanding of the process, which in turn leads to:
Relevance of data – increased opportunities to discuss and identify key programmatic questions and concerns result in an increased relevance of data to program needs.
Ownership of data – when stakeholders are sufficiently involved in the decision-making context, ownership of data is built so that when data-informed decisions are made, the necessary buy-in exists to move the decision forward.
Use of data – by linking data users (the decision makers) and data producers (the researchers), the information cycle is strengthened and the value of data to program improvement becomes clear.

12. Implications of Expanded Stakeholder Involvement
Additional actors in the research process can:
Increase timelines
Add complexity to the process
Increase study cost
While the value of additional stakeholders in the research process is clear, it is also important to discuss possible challenges involved in expanding your study team.
Additional people and steps in the process can make the study timeline longer, add complexity to an already complex process, and increase the overall cost of the study. It is important to balance the contributions of stakeholders with the resources and timeframe available to conduct the work.

13. When to Involve Stakeholders in Research Activities
Study planning
Study question development
Protocol development
Data collection
Data interpretation & recommendation development
Dissemination
Assessing effects
As we have just established, involving stakeholders is critical to the research process, but you also need to be conscious of how many extra players are involved.
In the next few slides, we will discuss where in the research process you can expand the involvement of stakeholders. The bullets above indicate the specific phases of the research process where you can improve stakeholder involvement.
NOTE to facilitator: Read slide.
Let’s discuss the first phase – study planning.

14. How to Involve Stakeholders?
Study planning
Stakeholder analysis
Communication plan development
Study question development
Protocol development
Data collection
Data interpretation & recommendation development
Dissemination
Assessing effects
The first thing to do is conduct an analysis of stakeholders; the second thing is to begin developing your communication plan.

15. Stakeholder Analysis Matrix
Name of Stakeholder Organization (and specific individual)
Stakeholder Description
Potential Role in Activity and Use of Results
Level of Knowledge of Research Topic
Level of Commitment to Topic (positive and negative)
Constraints to Participate in Activity
When to Involve
Gov’t sector
Political sector
Commercial sector
NGO sector
Civil society
Donors
Here you see a Stakeholder Analysis tool developed by MEASURE Evaluation. This tool can help you to identify stakeholders that can affect and influence your research activity. The tool also helps you to home in on the most important stakeholders. Let me walk you through the Stakeholder Analysis Matrix.
The 1st column is for the name of the stakeholder. In this column, you include the stakeholders at different levels of the health field (national, regional, private, public, governmental, nongovernmental, civil society, donors, etc.). Be sure to include the name of the organization and a specific individual’s title.
The 2nd column is for the stakeholder description. Here you include an overview of the organization’s purpose and primary scope of work.
The 3rd column is for the stakeholder’s potential role or vested interest in the research or application of the findings.
The 4th column is for the level of knowledge of the stakeholder about the research topic. You can identify specific areas of a stakeholder’s expertise or knowledge relevant to the research topic, or specific lack thereof.
The 5th column is for the assumed level of commitment to the topic being investigated. Indicate if the stakeholder supports or opposes potential outcomes of the research activity, and why.
The 6th column is for the possible constraints that may limit the stakeholder from participating in the activity.
The 7th and last column is to detail the specific times/activities to involve the stakeholder in the research process.

16. Stakeholder Analysis Matrix
Name of Stakeholder Organization (and specific individual if required)
Stakeholder Description
Potential Role in Research Activity and Use of Results
Level of Knowledge of Research Topic
Level of Commitment to Research Topic (positive and negative)
Constraints to Participate in Research Activity
When to Involve
Div. of Maternal and Child Health, MOH
MCH service delivery
Primary audience; access to sites; service guideline revision
High, extensive
Strongly supports scale-up of PMTCT services
Busy schedule; Need 4-week lead time to participate in meetings
Study planning, question development, data collection, interpretation, dissemination & use
Let’s look at an example. Here you see a Stakeholder Analysis Matrix that was done in preparation for a study that was evaluating PMTCT services. The research question was “Are HIV-positive women and their babies being counseled, tested, and treated for HIV?”
NOTE to facilitator: Read the slide and discuss the inputs into each column.

17. How to Involve Stakeholders?
Study planning
Stakeholder analysis
Communication plan development
Research question development
Protocol development
Data collection
Data interpretation & recommendation development
Dissemination
Assessing effects
During the study planning period, you can also involve stakeholders in the development of the communication plan, as we discussed earlier.
NOTE to facilitator: Click twice to reveal animation on slide (change in font color).
Now let’s talk about how to involve stakeholders in the development of your primary and secondary research questions, so that the questions respond directly to their information needs.

18. Formulating Meaningful Research Questions

19. Identifying, Assessing, Refining, and Prioritizing Questions
Initial Question
Refined Question
Final Question
Through discussions with key stakeholders, you can refine your primary and secondary research questions. Stakeholder involvement allows you to hear directly from the end users of your data what they want to know. If you don’t involve stakeholders in refining your research questions, you can overlook a whole domain of questions that are critical to program implementers and policy makers.
When you start to develop your initial research questions, you should discuss them with stakeholders if they are:
Important to the local health context.
Priority. Is this a priority in terms of decision making? Are these data needed to answer a question with which decision makers are currently struggling, or is this more of a ‘nice to know’ rather than a ‘need to know’ issue?
Actionable. Once we have data on this issue, will the recommendations be actionable? Or will implementing the changes be prohibitively expensive? Alternatively, is there some sort of political, cultural, or ideological resistance to this issue?
Data gap. When engaging in discussions with stakeholders, also consider whether any data already exist on this issue, or if a study addressing the issue may be underway already.
Answerable. Last, always consider whether the question is answerable. Is there a methodology that can be used to produce good data on this topic within a reasonable time period and with reasonable cost?
It is during this phase that it is recommended you convene a research advisory group with the core group of stakeholders and priority audiences. This group can help not only with question formulation and refinement but also to guide you through the entire research process.
Important
Priority
Actionable
Data gap
Not already underway
Answerable
Method available
Reasonable time period

20. Criteria for Meaningful Research Questions
Important: Could the answer to the question lead to a policy or program change that would have a large effect on the population in question?
Priority: Does the question address a current and pertinent issue?
Actionable: Can the results of the research be used to identify clear policy or program recommendations?
Answerable: Are data available, or can data be collected, to address the question?
Let’s consider in detail the issues involved when formulating meaningful research questions.
Important – Is the research question important in terms of public health concerns? What is the potential public health impact resulting from the use of data?
Priority – Is the research question a priority locally? Internationally? (Sometimes there is a difference between international and local priorities.)
Actionable – Do the expected results have a direct programmatic and/or policy application?
Answerable – Is the research question answerable, given available methodological approaches, cost, and time considerations?

21. Let’s Look at an Example
Research topic: Number of children borne by a woman (parity) & contraceptive use
Research problem: Do women with few (or no) children have a lower demand for family planning?
Research question: How does contraceptive use vary by number of existing children among married women?
Hypothesis: Low parity married women will have lower contraceptive prevalence rates.
Let’s take an example.
NOTE to facilitator: Read the slide. Then lead the group in a discussion based on whether or not the research question is a meaningful one that will result in useful data. Apply the parameters of: important, priority, actionable, and answerable.
Direct the discussion to the context in which you are giving this training. Alternatively, you can substitute an example that is more relevant to the group attending the training.

22. Key Messages
Identify your target audiences and how you will communicate your research findings
Involve stakeholders throughout the process, not just at the beginning and the end; this facilitates uptake of results
Develop research questions that fill an information gap so that your research is linked to program/policy development and improvement

23. Formulating Meaningful Research Questions & Identifying Stakeholders
Small Group Activity 2:
Formulating Meaningful Research Questions & Identifying Stakeholders
Now let’s do a group exercise to practice formulating meaningful research questions and identifying stakeholders.
NOTE to facilitator: Have the group refer to the Small Group Activity 2 – DIRECTIONS handout. Hand out the Exercises 2, 3 WORKSHEETS. Read the directions together. Ensure that the directions are clear to the group. Assign one research question to each small group. Give the group 1 hour for this exercise. Refer the groups to the Exercise 2 Worksheet to record their answers.

24. Small Group Activity 2: Instructions
Select a reporter to record the group work on flip chart paper and report back to the plenary. Locate Exercise 2 worksheet.
Develop a hypothesis for the research question assigned to your group. The hypothesis is the provisional theory guiding the research (see Exercise 2 worksheet – part 1).
Identify the primary program or policy implication for the research question assigned to your group. The program implication will be the action undertaken if the hypothesis is supported by the data.
Assuming the hypothesis is correct, what additional questions need to be answered to implement the recommendation of the study effectively?
Assuming the hypothesis is not correct, what additional information would help to interpret the results?
Considering where the research falls in the program-policy continuum, what stakeholders need to be involved in the research activity? Use the Stakeholder Analysis Matrix to guide this discussion (see Exercise 2 worksheet – part 2). When filling out the stakeholder analysis, complete only columns 1–3 (stakeholder name, description, and role).
NOTE to facilitator: Read slide.

25. Small Group Activity 2: Report Back
Each group has 10 minutes to discuss what they found challenging when developing research questions and identifying stakeholders, and how they overcame these challenges.
NOTE to facilitator: Give each group approximately 10 minutes to report back to the larger group. If you have more than 4 groups, you will need to reduce the report back time. The report back should take no longer than a total of 45 minutes.

26. MEASURE Evaluation is funded by the U.S. Agency for
International Development and is implemented by the
Carolina Population Center at the University of North
Carolina at Chapel Hill in partnership with Futures Group
International, ICF Macro, John Snow, Inc., Management
Sciences for Health, and Tulane University. The views
expressed in this presentation do not necessarily reflect
the views of USAID or the United States Government.