The current study utilized a cross-sectional study design to identify which components of the national ACSM campaigns were most likely to be recalled within the community. A stratified multi-stage random sampling design was used to collect data from 2,400 participants. Stage one involved randomly selecting tehsils (sub-districts) from across Pakistan, while the second stage involved randomly selecting urban union council areas and rural union council areas from each selected tehsil. The total number of localities within each selected union council was collected from the Census Organization of Pakistan. Using systematic random sampling, 43 urban and 74 rural union councils were selected from across five provinces: Punjab, Azad Jammu and Kashmir, Khyber Pakhtunkhwa, Sindh, and Balochistan. For urban union councils, each locality was further divided into nine notional parts (clusters) of equal size. Half of the selected households were randomly assigned to be 'male’ households where only males from the target cohort (18–49 years of age) were interviewed, while the other half were randomly assigned as 'female’ households where only females from the target cohort were interviewed. This approach was undertaken to ensure that an equal number of males and females were sampled, thus addressing concerns that women in Pakistani culture may be under-represented in survey-based research . This process also removed the potential for interviewers to introduce selection bias into the design by arbitrarily deciding which gender to interview in each household.
Next, within each selected notional cluster, every fifth household was targeted until a total of 28 households were surveyed from that cluster. In cases where the respondent category was not available within the selected household, the adjacent household was visited. To identify the survey respondent within each targeted household, all eligible persons, regardless of gender, were listed. Then, depending on whether the household had been pre-selected as a 'female’ or 'male’ household interview, one individual from the list of household members was selected to take the survey instrument using a Kish grid table .
In the case of rural union councils, the area encapsulated within a union council was divided into nine notional parts of equal size and two parts were selected using a systematic sampling method. Each of these notional parts were then further divided into clusters of 150 households after making a transactional walk and having discussions with the relevant councilor/area head/village head. One cluster was then selected at random. The exception to this process was when a village formed a notional part of a union council. In this situation, the village was not broken down into smaller clusters. Within the chosen cluster, every ninth household was selected until a total of 16 households had been surveyed. The sampling methodology was then the same as that used for urban union councils.
Administration of the survey instrument was undertaken by a total of 112 enumerators under the guidance of 16 supervisors. All fieldworkers underwent extensive training, which included a background briefing on the project and its objectives as well as information about the range of ACSM activities that had been undertaken during the preceding programing period. Time was also allocated to 'workshop’ the survey instrument in order to identify potentially ambiguous wording and to ensure that all item skips were clearly understood and that the fieldworkers understood the protocols for employing and recording item probes. All instructions were recorded in an easy to follow fieldworker guide. Finally, mock interviews and in-field pilot testing were undertaken prior to the actual fieldwork.
The survey instrument assessed: (i) sociodemographic background and household information; (ii) recall of the ACSM mass-media and community-based TB campaigns; and (iii) TB knowledge and attitudes. TB knowledge and attitude were examined using three-point Likert scales, whereby 1 = disagree, 2 = neither agree/disagree, and 3 = agree. In line with Behling and Law,  the final version of the questionnaire was translated into the local language and then back translated to ensure equivalence of concepts and scales. Approval for the implementation of the study method and instruments was obtained through the Ethics Committee of the National TB Programme within the Government of Pakistan’s Ministry of IPC National Tuberculosis Control Program (approval number: NTPEC-MC/TBACSM/30/1/13). All participants gave their informed consent prior to completing the survey instrument.