Breaking down barriers to conducting qualitative research in China

In this article, we explore how qualitative healthcare market research has changed in China as a result of COVID-19, including expectations for the future given the recent surge in cases and the country’s zero cases ambition, with strict lockdowns being enforced when new cases emerge. In preparing this article, we collaborated with Brandy Lau, Managing Partner of QualWorld Asia, an independent qualitative fieldwork provider, who offers her perspective on how the fieldwork agency has adapted to new ways of working with Healthcare Professionals (HCPs) and her predictions for what further changes may occur.

Changing methods of conducting research
Traditionally, qualitative healthcare market research in China has been conducted using face-to-face interviews with respondents primarily recruited from Tier 1 and Tier 2 cities (and focused primarily on Level 3 hospitals). Not only are face-to-face interviews perceived as more culturally appropriate, but there are also a multitude of other benefits, for example, the ability to infer conversational tone more clearly, easy observation of body language, the ability to interact with research materials (for example, handling of devices) and many more.

However, when COVID restrictions prohibited travel and in-person interactions, market research had to adapt. Consequently, during the past two years, many projects have been run virtually with interviews taking place on web-based platforms, such as Zoom or China-based Tencent. These online interviews have actually proven to be highly successful and boast a number of advantages over traditional methods:

• Respondents who traditionally may not have been able to get to a central location (a venue used to host market research focus groups, face-to-face or in-depth interviews) can now participate, such as those living in tier 3 and 4 cities. In addition, our pharmaceutical clients also hear a more balanced and 360° perspective covering all potential stakeholders
• Conducting research remotely gives HCPs greater flexibility to take part without impacting on their daily duties, which was especially important during the height of the pandemic
• Patients who suffer from physical or cognitive difficulties can participate without the stress of traveling to a central location and from the comfort of their own environment
• Similarly, patients dealing with sensitive or life-changing conditions can contribute to research in a safe and familiar place, at a time that is convenient to them
• Virtual interviews are more widely accessible to interested clients, who can observe interviews live without having to travel
• Moderators do not have to travel to face-to-face interviews, allowing more interviews to be conducted and cost for travel to be saved (which also speeds up fieldwork)

Following are two case studies where Research Partnership and QualWorld collaborated together to conduct virtual research targeting harder-to-reach patients and HCPs across China.

Case study 1: Reaching vulnerable patients and caregivers
Prior to the COVID-19 pandemic reaching patients diagnosed with any cognitive impairment was extremely challenging, yet crucial to understand the experience of the patient and the perspective of their loved ones. In a study fielded during the pandemic, we sought to understand the needs of patients diagnosed with Alzheimer’s disease alongside the needs of their caregivers, the objective being to identify inflection points where a pharmaceutical company could offer improved support to these patients on their journey.

Alzheimer’s disease is a complex disorder with many components of daily life impacted. The research required an approach that would allow us to explore the patient journey in detail from all angles. We opted for qualitative interviews conducted via a web-sharing platform (Zoom) followed by an online mobile diary task to capture ‘in-the-moment’ needs of daily life. This allowed patients to participate in an environment they felt comfortable in, at a time of their choosing and with their caregiver present if preferred. Key benefits of the virtual interviews:
1. Respondent-friendly methodology with improved response rate and greater engagement
2. Greater efficiency due to a shorter timeline and more interviews being conducted each day
3. Digital methodologies allowed greater user generated content (e.g. self-filming using own mobile) which provided improved insights that can be used as stimulus during the Zoom interview.

Conducting the research using these methods allowed us to provide our client with an in-depth understanding of how Alzheimer’s disease impacts patients and their loved ones on a daily basis.

Case study 2: Ensuring all voices are heard – Targeting procurement managers from
Tier 1 – 3 cities
Our client, a pharmaceutical company, tasked us with conducting a mixed-methodology approach whereby the focus was to speak to procurement managers to assess the opportunity for introducing a new product to a crowded market.

As mentioned, prior to the COVID-19 pandemic, it was normal to hold qualitative interviews in China face-to-face as a cultural preference. As a result, our targets for research tended to be from Tier 1 and Tier 2 cities. However, during COVID, we chose to conduct the research via telephone interviews (using Tencent in order to share materials/complete exercises). In this scenario our client was keen to explore the feasibility of broadening the scope to also reach procurement managers working in tier 3 and 4 cities. In the past, whilst this could have been accommodated, it would have had both cost and time implications.

Our research showed that we could broaden the scope to provide our client with rich insights. This allowed for directional comparisons to be made between cities, whilst still adhering to tight timelines. As a result, we were able to confirm the extent of opportunity to launch a new product in China, whilst also commenting on how this differed across tiers. This enabled our client to take a step back and align on who the most appropriate targets were, which offered maximum opportunity to enhance their asset.

Ensuring virtual interviews are a success
At Research Partnership, we have conducted over 130 qualitative projects in China. Working with QualWorld has enabled us to comprise a list of top tips to ensure virtual research projects run smoothly:

• Choosing the ‘right platform’ is very important. It has to be user-friendly to maximize engagement. Tencent is well known and widely accepted by Chinese doctors – more than 90% of doctors have no issues accessing or using the platform. This allows them to easily be interviewed during work breaks or at their workplace.
• Internet speed is another key factor to ensure interview success. Hospital Wi-Fi can sometimes interrupt the interview connection (with background noise also being a problem). Therefore, for studies that require a review of materials such as concept and message testing, it is important to ensure respondents are well-informed so that interviews can be planned ideally outside of the working day.
• Incentive payments still require a chain for auditing purposes. WeChat transfer and electronic records are regularly used and documented.
• Online recruitment – Wenjuan xin (a function of the WeChat platform) has proven to be successful instead of calling HCPs directly.
• Rapport is more critical than ever when interviews are conducted in a virtual environment. Interviews need to be set up in such a way that the moderator has time at the start to ease the respondent in gradually and to build a bond to ensure maximum insights.
• Chinese respondents may appear shy and are often more conservative, therefore expectations need to be adjusted since webcams are usually declined by HCPs.

The future market research environment in China
Although there are a number of benefits offered by conducting interviews remotely, it is important to bear in mind that remote interviews cannot completely replace face-to-face interviews. Whilst device testing, detailed concept, message, campaign research, and group/duo interviews to name a few, can all be conducted both virtually and face-to-face, in some settings face-to-face interviews are recommended, providing an improved interview flow and seamless performance.

Nevertheless, virtual methods of conducting research in China look set to stay and can complement more traditional methods. In specific research situations (especially those examples outlined in the case studies provided) virtual methods can elevate the research insights. The COVID-19 pandemic is still an ongoing issue in many markets, and it has undoubtedly changed the future direction of research. Although we anticipate face-to-face interactions to continue to open up, there is certainly a place for virtual interviews which will continue to evolve and increase. Our pharmaceutical clients can be assured the experience of Research Partnership and fieldwork providers such as QualWorld will guarantee objectives are met using virtual methodologies and offer new advantages to research. Our innovative approaches means we are always looking to adapt to new changes and can guarantee client satisfaction on each project.

Infographic: China critical #MRX success factors.

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