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Ethnographies Today

Written by Tom Groves

One of the most potent tools that have been available for years to the market researcher is the ethnography. The term (from the Greek ἔθνος ethnos = folk/people and γράφω grapho = to write) had its origins in the late 19th century as scientists sought way to interpret meanings and behaviors within cultures. By unbiased observing of ordinary activities, within naturally occurring settings, they could draw hypotheses on broad issues: religion, sex, family structure, social hierarchies, and the everyday: preparing food, building shelter, childrearing.  Margaret Mead, with her groundbreaking Coming of Age in Samoa, published in 1928, brought ethnography as a discipline of cultural anthropology into the public eye, and her methods spawned a long line of ethnographic treatises, which examine sub-cultures within societies. Recent examples include Guests of the Sheik: An Ethnography of an Iraqi Village by Elizabeth Warnock Fernea and Helen Thornam’s Ethnography of the Videogame.

Advertisers and marketers quickly learned the value of ethnographic study, whether conducted in the home, the grocery store, or the office. Its value became more apparent when researchers noticed, especially in low involvement packaged goods, a huge gap between respondents “stated” and “observed” behavior.  To cite some examples from my own past, I learned that in focus groups respondents almost always underestimate the number of products they have in any particular category.  Ask a respondent how many kinds of cereal they have at home, a typical answer might be “Three – a healthy brand for my husband and me, one for the kids that’s low in sugar, and a “special treat” cereal” (Lucky Charms and Count Chocula always seemed to be in that category!).  Visit their home, and you’d invariably find six or seven boxes.  I’ve found the same holds true for salad dressing, shampoo, laundry soap and may others.  Consumers tended to “compartmentalize” and give the types of brands- low-fat, ranch, blue cheese, etc. rather than the actual number of products they have on hand.

It’s also human nature to want to appear in the best light in front of their fellow respondents.  I once did a focus group on couponing and I started off asking how often they used coupons.  The first respondent said that she rarely used coupons since money was no object when it came to buying the best for her family.  After that statement, the other respondents were unwilling to volunteer their amount of coupon use.  I was able to bring them around, but it took a bit of coaxing. To get to real truths and real behavior in many categories, a home visit or in-store observation is always in order.

In healthcare research, the danger of “compartmentalization” is ever-present.  In many conditions that we research, respondents in focus groups (and this includes both virtual on-line groups as well as in-person) tend to rationalize the effect of an illness on their lives.  You often hear, “It’s not so bad”, “I can deal with it”, “Hey, it could be worse, it’s not cancer!” While it is true that good moderators can break down natural defense mechanisms and barriers, often the real truths are revealed only when you are able to observe and interview a respondent in his or her home.  To give an example, I did a focus group several years ago with male patients with Type 2 diabetes.  There was a lot of rationalization and compartmentalization going on in the room (the fact that they were males may have had something to do with it).  I often recruit ethnographies from people I interview in focus groups, so I asked one respondent, Bill, if we could come to his house for a follow-up interview.  Mind you, Bill was very clear in the group that he was managing his diabetes and it hadn’t affected his life in any meaningful way.  When we got to Bill’s apartment, he showed us around I asked him if I could look in his fridge where he (I assumed) kept his insulin.

He replied, “Oh, I don’t keep my insulin here!”

“Well, where do you keep it?”

“At my mother’s apartment two blocks away.”

“Why is that?

“I don’t want anyone to know, especially a woman I might invite over, to have ANY idea that I have diabetes.”

Then the floodgates opened and he shared with us how devastating the diagnosis was, how it had affected his relationships, how he had gone from a slim weekend athlete to overweight, out of shape homebody.  He volunteered to take us shopping, and we watched him throw the items in the shopping cart punctuated by the statement  “Now this is what I’m forced to eat.”

Based on my experience with Bill, I now try whenever possible to convince teams of the value of in-home ethnographies.  I’ve done them for MS, psoriasis, thalassemia, OAB, osteoporosis and depression, to name a few.

As Atticus Finch said in To Kill A Mockingbird, “You never really understand a person until you consider things from his point of view… Until you climb inside of his skin and walk around in it.”

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Where creativity thrives

Written by Kristin Volk

One of my biggest passions in life is traveling, especially to places a bit off the beaten path.  Even better if it’s a destination most Americans wouldn’t think of going to, which means a lot of developing countries.  In the past few years, I’ve had the great fortune to experience places like Cuba, Lombok, Cambodia, Tunisia, Yemen, Syria, Tanzania, and Suriname.  I always avoid the tourist areas and the ex-pats, preferring to mingle with the locals, soak up the culture, and learn something new.

One of the things I’ve noticed in all of these places is the incredible display of creativity, innovation, and resourcefulness.  While you can find creativity in varying degrees virtually everywhere, the place where it exists in its purest, most uncensored form is in economically disadvantaged communities, including those in so-called first world countries like the USA.

We’re all born with creative tendencies – all you have to do is watch kids at play to confirm this — but most of us have a lot of it beaten out of us at a young age due to pressures to conform.  We’re told we must color between the lines, dress this way, wear our hair that way, speak this way, and so on.

But economically disadvantaged people, as well as those suffering from political and social oppression, are often struggling with bigger, more pressing issues than simply conforming. They are forced to use their creative skills to figure out how to make do with less, and in many cases, how to survive. Unconstrained by society’s rules and conventions, and driven in some cases by Darwinian forces, their creative freedom and expression are allowed free reign.  When you have nothing to lose, you’re much more willing to take chances and try things you might not otherwise.

Because of the unrelenting hardship people in these places must deal with every single day of their lives, they are forced to be creative in nearly everything they do – how they make a living, how they dress, how they have fun, how they get around, even how they exercise.  Economic realities have created a “survival of the fittest” culture that pushes people to do things differently, hence the incredible expressions of creativity you find in these communities.  If you think about it, it’s really a form of improvisation – making it up as you go along with what you have at hand, and adjusting to the ever-changing conditions around you.  There’s even a colloquial Hindi term in India that gets at this notion – jugaad, which can mean anything from an innovative fix to frugal engineering.

What follows are some examples of the awe-inspiring creativity, innovation, and sheer resourcefulness I’ve had the privilege to witness around the globe.

What a grind!  (Sana’a, Yemen)

When you have fewer resources to draw from, you must be more creative and resourceful with what you do have. This camel in Yemen is a perfect example of this. There is a need here to extract oil from sesame seeds, but no machinery available to do it. They do have plenty of camels, however, and the ingenuity to figure out how to use them to grind the seeds and extract the oil. The camel, whose eyes are covered with blinders (as seen in the inset photo), is tethered to a giant pestle and the seeds are put into a large mortar. The camel then walks in circles for hours, which causes the pestle to crush the seeds. The only maintenance this machine needs is food and water.

Namaste  (Paramaribo, Suriname)

Yoga is often seen as somewhat of a luxury — something people do to relax, de-stress, improve flexibility, and enhance posture. While most people learn to do yoga by going to classes or watching videos, there are many places where people don’t have access to either. But that doesn’t mean they can’t teach themselves, especially if mastering the poses means a much-needed source of income. This highly motivated, creative man has been practicing his moves for years, usually in front of sidewalk cafes, where amazed patrons are more than happy to pay him in appreciation for the impossible ways he contorts his body. For him, yoga is far from a pleasant diversion. It is his livelihood.

Mobile roasted nuts  (Damascus, Syria)

The mammoth covered markets in Damascus are filled with stall after stall selling all sorts of food, clothing, housewares, hardware, and just about anything else you can imagine.  But it costs money to rent a stall, and not everyone can afford to.  This industrious young boy rigged a bicycle with a wood burning stove on it, along with a supply of fuel in the back.  This lets him sell freshly roasted nuts in whatever location represents the best market at any given time.  Not only does he avoid having to rent a stall, he’s not locked into any one location.  And as we all know, location is everything.  Pure genius!

Disadvantaged?  (Sana’a, Yemen)

This young boy was spotted in the old walled city playing marbles using a manhole cover.  In a society used to computers, video games and sophisticated toys, this sight might induce feelings of pity instead of admiration for figuring out a creative way to make do with what he has available.  Imagine the skills he is learning that he’ll be able to apply to other aspects of his life as he gets older.  Not only that, while his counterparts in more “advanced”  areas are getting increasingly obese due to their sedentary lifestyles, he’s getting exercise from this “old school” form of play.  Smart kid!

Who needs a treadmill?  (New York City)

They call themselves the Bartendaz because, as one of them told me, “It’s better to be behind this kind of bar than the other kind.”  Just because you can’t afford to join a gym doesn’t mean you can’t stay fit, and these guys are more fit than any gym rat I’ve ever met. They rely only on calisthenics and pullup bars that can be found in pretty much any playground in Harlem.  Plus, they’ve turned this into a community-wide movement, complete with the slogan, “Health is wealth and movement is medicine.”  Kids are encouraged to join, but only if they keep their grades up and stay in school.  In addition to a creative solution to a lack of gym membership, this gives kids a way to express their own unique individuality through the moves they make on the bar as well as the creative names everyone is given, like “Transformer” and “Honeybee.”

Balancing act  (Lombok, Indonesia)

On the island of Lombok, where many live by fishing or subsistence farming, a car or truck is usually out of the question.  But there is still a need to transport goods from one place to another.  What you see here is one of many ingenious solutions the locals have created.  In this case, a motorbike has been rigged with a wood and metal structure, making it possible to carry what appears to be an impossible amount of cargo.  Just don’t sideswipe him!

Hot breakfast to go  (Sana’a, Yemen)

Street food is another place you see incredible examples of creativity and resourcefulness.  While it’s not unusual to see vendors in developed countries selling all sorts of food from trucks and stands, you’d be hard-pressed to find a huge open vat of boiling oil on a city street in NY.  Not only is this guy smart to sell this popular breakfast pastry – he had a line of people waiting to be served every morning – he’s also gutsy and resourceful to be able to do it with such finesse.

What would the Colonel think? (Paramaribo, Suriname)

In many countries, there is a certain cachet to American brands, and the former Dutch colony of Suriname is one of them. Along the waterfront in Paramaribo, there is fierce competition among the food stall vendors, and any perceived advantage might be enough to give one a competitive advantage over the others. Here you see a creative way one vendor is leveraging the Kentucky Fried Chicken brand to enhance his own chicken offering. We think the Colonel would approve of the entrepreneurial spirit shown by this guy!

Who’s knocking off whom?   (New York City)

Selling bootleg “designer brands” on the streets of NY is a tough way to make a living. The competition is stiff and the cops are everywhere, making it necessary to come up with creative ways to conceal your goods as well as your “catalog.” This clever guy has placed his brochure of fake Louis Vuitton bags inside a copy of the NY Times. But even more interesting is seeing the creative twists that are made on the knockoffs.  In fact, some of the illegal knockoffs are so creative (and wildly successful), that the original, legitimate manufacturers have taken to knocking off the knockoffs!

Riding in style: (Sana’a, Yemen)

Many people in this developing nation can’t afford a car, but that makes it even more important to make a statement with your bike. This notion of creatively customizing your vehicle is seen in every corner of the globe, where people use everything from tinted windows and spinning rims to custom sound systems and fancy paint jobs to put their personal stamp on their mode of transportation.  Resources may be scarce in Yemen, but sheep and creativity are plentiful.  Not only is sheepskin a way to make his seat more comfortable, it’s also a way to make his bike (and him) stand out in a sea of other bikes.  GQ’s got nothing on you, Sir!

People who face economic, political, and social disadvantage have to deal with hardships most of us can only imagine.  But these same circumstances push them to develop a level of creativity, innovation, and resourcefulness that we all can admire and learn from.  For me, they are a constant source of inspiration.

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Shopping a Sales Aid

Written by Connie Esler

Having had some experience in Shopper Marketing, I realized that certain aspects of shopping in retail are like detailing a sales aid.

It may sound odd since shopping and being detailed are such different experiences, not to mention shopping can be more fun than presenting a sales aid….sorry.  However, understanding the similarity of key functional needs of both situations allows that comparison, and putting shopper principles to use could be helpful in providing a more engaging experience for the physician when the sales rep is presenting a sales aid.

There are three functional needs a person has as they experience a shopping environment:

  • Navigation
  • Education
  • Inspiration

Let’s think about a time when you are new to a store.  Navigation is about a retailer supplying clear signage, store layout and good direction that help you easily get around the store and to the product you’re looking for.  Once you’ve found the item, how can the package, category, environment or personnel provide additional information to clarify or support your decision (Education)?  Once you’ve made your selection, you have time to relax, pause and look around to become Inspired by finding something new or unexpected.

Often the shopping experience is not as fun or engaging as it could be because there are barriers in one or more of these “need” areas.  If solutions aren’t created to address the barriers, shoppers may leave the aisle or store and not even get to where they were headed, much less be educated or inspired.  An example of this is the cereal aisle, which in most stores is long, massive and sometimes takes up both sides of the aisle.  Other than a sign above the aisle highlighting “cereal,” there are usually no other points of navigation guiding shoppers to their desired products.

Thus, the shopper is left to their own methods of navigation, and most have learned through experience that cereal is grouped by manufacturer, kids’ cereals are on the bottom shelves, healthier cereals are on the top, and Cheerios are usually found in the middle of the aisle.  People go to the brand they’re looking for, grab it, and leave because nothing else about the aisle is capturing their attention or imagination.  Cereal manufacturers and retailers are letting consumers set their own course rather than helping to improve their experience by;  providing more information to help educate, creating a more engaging aisle through imagery or layout, or making it easier to see what’s new rather than simply reading “new” on the box or relying on the end aisle display.  In the end, any of these changes would translate into more money being spent.

Instead, manufacturers and retailers allow the barriers of little signage, long aisles, and a confusing multitude of flavors to negatively impact shoppers’ experience and shorten their time in the aisle.

So how does this apply to a sales aid?  In grocery shopping, a person thinks about what they want to get or writes a list, then decides which store(s) to visit to accomplish the task.  Reps have to plan out their day and think about what they need to cover with each HCP visit.  When in the store, a person generally wants to be as efficient as possible, to easily navigate through the aisles and find what’s on the list, relying on signage to guide them when the store is new to them.  A sales rep has to navigate through a sales aid to be prepared for the discussion, particularly with a first time call, or move to the right piece of information to make a point or answer a question.

Quickly and easily covering the key points a rep wants to make, the rep can talk about or show something else that furthers the HCP’s knowledge of the drug or device.  Similarly in the grocery aisle, if a shopper easily finds their item, there is time to read the package or gather other information nearby which educates the person on the brand or even other products.

The last functional need is inspiration.  Manufacturers and retailers love it when a shopper finds what is on the list, gets the information needed, and then takes a breath, relaxes and looks around to see what’s new and adds an unexpected item into the cart.  A sales rep feels rewarded when after making an initial point and successfully answering questions, the doctor has a moment to reflect about his or her patients, and is openly inspired by the conversation with a final thought.

If any barriers arise during the detail, for example; the entry into the discussion isn’t as relevant as planned, the sales rep can’t quickly get to information to answer a question, the doctor doesn’t have time to talk or quizzes the rep, the process breaks down and the three functional needs of navigation, education and inspiration will suffer or not be met.  Ideally getting to the point of “inspiration” allows the sales rep and HCP to feel good about what was accomplished.

So the next time you are out shopping, you might observe what is really helpful, or what barriers you come across in your experience, and think about how those things could apply to developing a better sales tool.