PMH36 Think-aloud interviews in health-related resource-use research: application in the PECUNIA project

Objectives: Individuals may encounter various problems when completing resource-use measurement (RUM) instruments for health economics research purposes, compromising the validity of the responses. These problems are often overlooked during the development stage of RUM instruments, yet they can be mitigated if respondents are involved in the development process. One way to incorporate their perspective is by employing qualitative methods such as the think-aloud (TA) approach. This method allows researchers to gain insight into the thinking processes and experiences of the respondents when completing a RUM instrument. Nevertheless, its use in RUM-related research is limited and little methodological guidance on the use of these methods is available. Therefore, this study describes the protocol for employing TA interviews in the development process of the PECUNIA RUM instrument.

Methods: The protocol for conducting TA interviews was iteratively developed by a multi-national working group of health economists from the PECUNIA consortium. Additional expertise was sought from the literature on qualitative research methods and by consulting persons with experience in qualitative research. The protocol serves to harmonize the TA interviews in four countries (Germany, Netherlands, Austria, and the United Kingdom) by describing a uniform approach. The protocol describes the steps in chronological order including a description of the events before (translation, recruitment, training), during (setting, opening, completing the instrument, open ended questions, closing), and after the interview (transcription, data analysis).

Discussion: As qualitative methods have not been widely used in RUM-related research, this study adds value by increasing transparency in applied qualitative research in the field of health economics. This protocol was developed within the PECUNIA project and aims to harmonize multi-national TA interviews for pilot testing of the PECUNIA RUM instrument. This protocol can also serve as a guide for researchers who want to conduct TA studies in the field of health economics.