Qualitative research and implementation science: Informing the acceptability and implementation of a trial of a conditional cash transfer intervention designed to reduce drug use and HIV risk

HIV risk remains high among Cambodian female entertainment and sex workers, driven by amphetamine-type substance use and sexual risk. Conditional cash transfer is an evidence-based approach to reduce stimulant use and optimize HIV/AIDS prevention, but questions remain regarding implementation in resource-limited settings. We conducted formative qualitative research to enhance acceptability of a conditional cash transfer intervention aimed at reducing amphetamine-type substance use and HIV risk among female entertainment/sex workers and inform implementation as part of a large cluster randomized trial. We conducted in-depth interviews with 30 female entertainment/sex workers. Interviews were digitally recorded and conducted and transcribed in Khmer. English transcripts were read for emerging themes and an initial coding scheme was developed. Data were coded using open and axial coding to clarify and consolidate initial themes. While most participants expressed enthusiasm for the intervention, financial and transportation issues emerged as key barriers to participation. The proposed incentive of USD$1 per screen was regarded as unacceptable and participants identified a need for transportation assistance. Participants also expressed concerns about directly observed urine specimen collection. Finally, while most participants found the 4-week aftercare program acceptable, the need for enjoyable as well as educational content was emphasized. Revisions to the protocol taking these data into account were made to optimize the acceptability of the intervention and the implementation of the trial. Findings identified key concerns and preferences that were taken into account in the final trial protocol. In particular, financial and transportation issues were identified as critical barriers to participation, with the potential to impact both intervention uptake and trial feasibility. Results demonstrate the value of formative qualitative research for clinical trial planning and implementation, particularly in settings where little is known about acceptability of interventions or willingness to participate

Farmer surveys in Cambodia and Vietnam: cassava planting material use and exchange at national level with 4 district-level case studies

The data includes national surveys of 15 districts in Vietnam and 16 districts in Cambodia, with 15 responses by district. Districts were selected based on high cassava production density and expert input from local government officials. National surveys covered the following themes: (a) respondent information, (b) seed use overview, and (c) field and household data. In addition to the aforementioned categories, the subnational surveys collected data on (d) quality, (e) affordability/profitability, and (f) information sources

Raising the Stakes: Cassava Seed Networks at Multiple Scales in Cambodia and Vietnam

Cassava is one of the most important annual crops in Southeast Asia, and faces increasing seed borne pest and disease pressures. Despite this, cassava seed systems have received scant research attention. In a first analysis of Vietnamese and Cambodian cassava seed systems, we characterized existing cassava seed systems in 2016–2017 through a farmer survey based approach at both national and community scales, with particular focus on identifying seed system actors, planting material management, exchange mechanisms, geographies, and variety use, and performed a network analysis of detected seed movement at the provincial level. Despite their status as self-organized “informal” networks, the cassava seed systems used by farmers in Vietnam and Cambodia are complex, connected over multiple scales, and include links between geographically distant sites. Cassava planting material was exchanged through farmer seed systems, in which re-use of farm-saved supply and community-level exchanges dominated. At the national level, use of self-saved seed occurred in 47 and 64% of seed use cases in Cambodia and Vietnam, respectively. Movement within communes was prevalent, with 82 and 78% of seed provided to others being exchanged between family and acquaintances within the commune in Cambodia and Vietnam, respectively. Yet, meaningful proportions of seed flows, mediated mostly by traders, also formed inter-provincial and international exchange networks, with 20% of Cambodia's seed acquisitions imported from abroad, especially neighboring Vietnam and Thailand. Dedicated seed traders and local cassava collection points played important roles in the planting material distribution network at particular sites. Sales of planting material were important means of both acquiring and providing seed in both countries, and commercial sale was more prevalent in high-intensity than in low-intensity production sites. Considerable variability existed in local seed networks, depending on the intensity of production and integration with trader networks. Adapted innovations are needed to upgrade cassava seed systems in the face of emerging pests and diseases, taking into account and building on the strengths of the existing systems; including their social nature and ability to quickly and efficiently distribute planting materials at the regional level

Farmer surveys in Cambodia and Vietnam: cassava planting material use and exchange at national level with 4 district-level case studies

The data includes national surveys of 15 districts in Vietnam and 16 districts in Cambodia, with 15 responses by district. Districts were selected based on high cassava production density and expert input from local government officials. National surveys covered the following themes: (a) respondent information, (b) seed use overview, and (c) field and household data. In addition to the aforementioned categories, the subnational surveys collected data on (d) quality, (e) affordability/profitability, and (f) information sources