Using Vignettes to Tap Into Moral Reasoning in Public Health Policy: Practical Advice and Design Principles From a Study on Food Advertising to Children

摘要

In this article, we describe a process for designing and applying vignettes in public health policy research and practice. We developed this methodology for a study on moral reasoning underpinning policy debate on food advertising to children. Using vignettes prompted policy actors who were relatively entrenched in particular ways of speaking professionally about a controversial and ethically challenging issue to converse in a more authentic and reflective way. Vignettes hold benefits and complexities. They can focus attention on moral conflicts, draw out different types of evidence to support moral reasoning, and enable simultaneous consideration of real and ideal worlds. We suggest a process and recommendations on design features for crafting vignettes for public health policy. Vignettes have been identified as a useful device to elicit discussion on beliefs, values, and norms. 1–3 They are short stories based on fictional or fictionalized (hypothetical) scenarios, in which respondents are asked to draw upon their own experience to predict how characters will—or should—behave. 4–7 Vignettes have a long history in social inquiry, including psychology, social work, and health education. Vignettes are useful for several qualitative data collection functions: to set a tone for an encounter by serving as ice-breaker or concluding device (for example, at the opening or closing of an interview or focus group, where shifts between concrete and abstract concepts need to be made), 8 to capture complexity in the operationalization of concepts through their representation of real-world situations, 9 to place potential actions in specific situational contexts, 8 to facilitate expression of personal or subjective experiences and beliefs, 1,2,10 and to analyze judgments in response to moral dilemmas. 8 We outline a process for designing and applying vignettes in public health policy research and practice that we developed for a study on the moral reasoning underpinning policy debate on food advertising to children. Vignettes prompted policy actors, who were relatively entrenched in particular ways of speaking professionally about the issue, to converse in a more authentic and reflective way. First, we describe the issue of food and beverage advertising to children, focusing on how it presents specific challenges for qualitative policy research. Second, we include an in-depth illustrative look at our study methodology. Third, we have included a brief selection of results from the study, focusing on themes that highlight the function of the vignettes. Fourth, we conclude with lessons learned on the practical application of vignettes, from conception to implementation, and how they can serve as a useful tool for public health policy deliberation.