Methods for think-aloud interviews in health-related resource-use research: the PECUNIA RUM instrument

Area of Science:

• Health Economics
• Qualitative Research Methods

Background:

• The think-aloud (TA) approach offers insights into cognitive processes and respondent perspectives.
• Its application in resource-use measurement (RUM) instrument development is currently limited, with scarce methodological guidance.
• This paper aims to address this gap by transparently detailing TA methods for RUM in health economics.

Purpose of the Study:

• To describe a standardized, multi-national, ten-step process for conducting think-aloud (TA) interviews.
• To enhance methodological transparency in the development of resource-use measurement (RUM) instruments.
• To reduce the knowledge gap concerning the application of qualitative research methods in health economics.

Main Methods:

• Iterative development of TA interview methods by a multinational working group of health economists and qualitative experts.
• Conducting TA interviews in four countries to refine the methodology.
• Outlining a ten-step process divided into pre-interview, during-interview, and post-interview phases.

Main Results:

• A detailed ten-step process for conducting multi-national TA interviews for RUM instrument development (PECUNIA RUM instrument).
• The process covers pre-interview (translation, recruitment, training), during-interview (setting, opening, instrument completion, questioning, closing), and post-interview (transcription, analysis, trustworthiness) stages.

Conclusions:

• This manuscript provides a transparent, step-by-step guide for implementing multi-national TA interviews in RUM development.
• Adoption of this methodology increases transparency and reduces the knowledge gap in using qualitative methods within health economics research.