The social context and impact of a clinical trial: Results from a feasibility study in Soweto, South Africa.
Jonathan Stadler, M. Mntambo, E. Qwana, Sinéad Delany, Jocelyn Moyes, Helen Rees · 2006
TEXT Issues: Cognitive Mapping is used to provide contextual information in the early phases of the projects of town planners and architects. It is not well-known in health research circles, yet is able to yield potentially rich data of considerable subtlety and may inform community entry strategies for clinical field trials. Cognitive mapping reports on how people define the unit of research, who they identify as ‘insiders’ and ‘outsiders’, and important nodal points where people gather. It is a rapid method that requires few resources. Description: Fieldwork was conducted in Orange Farm, South Africa, the site for a Phase III microbicide trial. Informants were drawn from the Orange Farm Community Advisory Group (CAG). Two transect drives were undertaken and thirteen in-depth, semi-structured interviews were conducted with Orange Farm CAG members. Each respondent completed a short and a long sketch map during which the researcher noted the sequence in which different features were sketched. A short structured questionnaire was administered that asked respondents to reflect upon both sketch maps. Respondents then wrote a brief ‘life history’ explaining how they came to live in Orange Farm, what feelings it evoked in them, how they earned a living, and where they lived. Field notes were translated and transcribed and sketch maps scanned. The analysis concentrated on the ‘image-ability’ of landmarks, the frequency of mention of ‘nodes, paths, edges, and districts’. A cognitive map was produced that drew on the interview, mapping and observational data. Conclusion: The cognitive map of Orange Farm revealed the fluidity of the boundaries of Orange Farm and stressed the relationships, and interdependency between sections of the settlement. The CAG members interviewed displayed in-depth knowledge of the physical, social, historical geography of Orange Farm and its historical depth despite its relative youth. The cognitive map has helped to redefine the trial population to incorporate residents of adjacent settlements. The process was also extremely useful in consolidating the CAG for Orange Farm. The report on the cognitive mapping will continue to be useful in interpreting trial findings. Mr Jonathan Stadler Senior Researcher: Reproductive Health And HIV Research Unit, [email protected], tel +27 11 989 9204, fax +27 11 989 9224, PO Bertsham 2013, JOHANNESBURG, 2013, SOUTH AFRICA