Using a scenario-based hybrid approach to understand participant health behavior

Res Social Adm Pharm. 2021 Dec;17(12):2070-2074. doi: 10.1016/j.sapharm.2021.02.020. Epub 2021 Mar 4.


Background: Qualitative and mixed methods approaches are commonly used to understand participants' interactions with real-world settings and can help health services researchers to obtain realistic details about patients' health behaviors. However, interviews do not easily capture data about how patients perform health-related behaviors that are not part of their daily routine. A scenario-based approach is one method that can be used prospectively to explore how patients make decisions about their health-related behaviors. This approach is comprised of a set of small tailored probable circumstances with equally plausible situations, and are presented as narrative descriptions. To understand how older adults, a group at high-risk for OTC misuse, select over-the-counter (OTC) medication qualitative methods can be used.

Objectives: This study describes a scenario-based hybrid approach that included a simulation exercise and a situational interview to understand how older adults first select and then take OTC medication.

Methods: The scenario-based hybrid approach consisted of 1) a simulation exercise to emulate participants' real-world experiences as they selected a medication in a store, followed by 2) a situational interview to capture how participants intended to take the medication they selected. Video recordings captured interview data as well as participants' body language, navigation patterns, and other nuanced data that would not have been captured in audio recordings.

Results/conclusion: The scenario-based hybrid approach not only yielded detailed information about behavior, but also allowed investigators to discern participants' decision-making, influences, and the rationales they use when selecting and taking OTC medications. Studies aiming to capture participants' behavior in naturalistic situations can use these techniques to draw inferences from direct and indirect visual references that may not be captured otherwise. In this study, the goal was to understand how older adult participants select and take OTC medications. This approach allowed the research team to expediently recreate situations in which participants would purchase an OTC medication, a task that may not occur frequently and thus may not be amenable to participant observation or accurately recalled using retrospective interviewing.

Keywords: Community pharmacy; Older adult; Over the counter medication; Simulation exercise; Situational interview.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Consumer Behavior
  • Health Behavior*
  • Humans
  • Nonprescription Drugs*
  • Retrospective Studies


  • Nonprescription Drugs