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Article Critique 1

Article Critique 1

Stephanie Sandoval

Department of Health Science and Human Ecology, California State University San Bernardino

HSCI 6260: Health Education Planning and Evaluation

Dr. Mshigeni, MPA, MPH, PhD

February 25, 2023

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Article Critique 1
Introduction
In the article, “Ethnographic Process Evaluation: Piloting an HIV Prevention Intervention
Program Among Injection Drug Users”, the author described a systematic ethnographic method
used during a study to evaluate the factors that facilitate or inhibit injection drug use. Although
there have been many HIV intervention programs in the past, few have been able to quantify
documentation that ensure cultural relevance. That is why they launched a new Pilot HIV
Intervention Program specifically aiming to use network-oriented peer outreach interventions.
Social influence plays a major role because immediate community (family, friends, coworkers,
etc.) can help promote risk reduction within their networks. However, it is not always likely that
social networks will be supportive of these interventions so that is why the piloting stage of this
program so important. It will ensure that any barrier encountered are identified in the early stages
and the plan can be modified to counteract those issues.

Methodology
This intervention program utilized the STEP Project and social influence theory to train Injection
Drug Users (IDUs) to promote HIV prevention among their drug networks. The STEP method
was an effective communication tool that trains individuals on how to use effective language and
skills to talk about harm reduction. STEP stands for: (S) “Stand up and be Positive”, (T)“Talk
with Respect” (E)“Evaluate the Situation, and (P) “Put a Plan into action”. Additionally, this
entire study was designed to as a controlled Phase II Efficacy Trial where participants were
randomly designated to be either in an experimental condition, they were exposed to the STEP
intervention, or they were in an equal-attention control condition. The STEP trainings were
broken up into six sessions; these sessions were then tested and revised through 5 cohorts of
pilots within the same year (2003-2004). There were significant changes to the structure and
intervention method that varied between cohort. These changes were all based on the evaluations
and feedback they got from the participants.
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Article Critique 1
Results
The findings of the study were interesting because it was condensed to reflect the tapes, notes of
training sessions, fieldwork and interviews in the communities, and in-depth interviews. These
findings were translated into actions: (1) “Getting Clean” vs. “Harm Reduction” stated that many
drug users expressed that getting clean and harm reduction was the same thing. Harm reduction
philosophies could instead be integrated into their lives to help them get clean. (2) Partner vs.
Network Member stated that many participates were confused about the word “peer mentor”;
they interpreted with too broadly or too narrowly. The program had to adjust their language. (3)
“Stay positive” vs. “Sometimes you gotta go hard” emphasized the importance of having
conversations about safe drug use by first acknowledging positive steps they were taking already.
(4) The communication skills taught were changed from active listening to talking with respect
and incorporating the “stay positive” skill.

Process Evaluation
The process evaluation process included the utilization of the systematic ethnographic methods.
As mentioned previously, the data collected was a culmination of interviews, note-taking,
observations, etc. Thus, it was essential that all this information be used during the evaluation.
Another thing to note was that the evaluation took places the moment the development of the
session material was initiated, to the facilitator’s execution of the session material, to the
participants’ reaction to the material and the interactions they had, to the participants’ ability to
communicate this material with their peers. It was vital that the participants were able to
effectively process the information and disseminate it to their networks and demonstrated risk
reduction behaviors. Also, during each STEP training session at least on ethnographer was
present to observe and during break they would take the time to get feedback from the
participants; they helped build a level of trust and respect.
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Article Critique 1
Two (2) thing I liked about the article
This article was very stimulating and interesting to read. The two things that I liked the most
about this article were the findings mainly because they were very well translated into actions.
For example, the first one that stood out to me was the fact that the program brought in “harm
reduction educators” who had graduated from previous intervention programs to share their
experiences. That actively engages the current group because they have a space to ask questions
and learn more about sharing harm reduction messages to their communities. Another thing I
liked was the “stand up and be positive” messaging because it truly highlighted on the benefits of
having a positive attitude towards life.

Two (2) things I did not like about the article

Although this article had many great points and it touched on topics that were very interesting to
me the study did have limitations. One of the things I did not like about the article was the sheer
volume of the data collection. Most of the information was translated in paragraph form, so it is
not very feasible to analyze data thoroughly, especially if the project is time sensitive. The
second thing I thought was controversial was the data collection method. Most of it was in
interview or note-taking formula. Often it is hard to get good data in real time.