Focus Group Resource Guide

DEPARTMENT OF FAMILY MEDICINE FOCUS GROUP RESOURCE GUIDE

WHAT ARE FOCUS GROUPS?

Focus groups are defined as "carefully planned series of discussions designed to obtain perceptions on a defined area of interest in a permissive, nonthreatening environment.” (Krueger & Casey, 2009) Some key points about focus groups: Focus groups are a way to get information about attitudes, beliefs, feelings and emotional reactions. Focus groups can also help you generate new ideas. Focus groups allow you to get both individual and interactive opinions (how your subjects react to one another; and they allow you to record both words and nonverbal behaviors. You can also learn about the language your participants use to describe your topic of interest. Focus groups can be used for program development OR to evaluate an existing program or intervention. With focus groups, there are no right or wrong answers – all ideas and opinions are important. Focus groups are LESS useful us eful for learning information about sensitive topics where people may feel uncomfortable sharing in a group setting, or if you want detailed and in depth responses from people. Focus group logistics: Focus groups are conducted in a relaxed and quiet setting and are usually done with 4 to12 subjects at a time (ideal is 6 to10 participants). Interviewer asks up to 12 open-ended questions with follow-ups ("probes") for clarification if necessary. 10 or fewer questions are ideal. Each focus group session lasts no longer than 1½ hours. Participants are purposefully selected. Consider conducting multiple groups on the same topic but with different participants to allow for groups to be homogeneous (e.g. age, race/ethnicity, gender) For a brief overview to help you determine when it is appropriate to use focus groups, see: http://www.extension.iastate.edu/Publications/PM1969A.pdf

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Developed by Kate Cronin, MPH Senior Research Specialist Department of Family Medicine

DEVELOPING A TOPIC/INTERVIEW GUIDE

Dr. Betty Kramer, from UW-Madison ‟s School of Social Work has a comprehensive guide to focus group fundamentals, including designing a topic guide. Please review her excellent work located here: http://videos.med.wisc.edu/videos/10479 At this site, you may view a video of her presentation about focus groups and find her slides and a detailed handout with resources. Copies of the presentation and handouts are also available from DFM by contacting the Research Program Assistant in Room 3820. General considerations for developing a topic/interview guide: Always use open ended questions; avoid questions that can be answered yes or no. No more than 10-12 questions

Flow from general to specific o Consider appropriate probes (questions to elicit more specific information) Consider ways to engage all participants o “are there other ways of looking at this?” “who else has an idea?” “let me see if I‟m understanding you…(paraphrase a comment) “am I getting this right?” Avoid using “why” questions – instead use what or how Use “think back” questions – take people back to an experience, don‟t ask about    

the future Sample topic guides are also available from DFM by contacting the Research Program Assistant in Room 3820. SUBMITTING AN IRB APPLICATION

Before conducting any focus groups, it is necessary to obtain approval from the University of Wisconsin IRB in order to conduct human subjects research. More information about UW‟s IRBs and their submission process may be found here:

http://www.grad.wisc.edu/research/hrpp/irblinks.html Please note: The IRB will want to see recruitment materials, a topic guide and consent forms as part of the review process, which means these will need to be finalized before submitting an application to the IRB.

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RECRUITING FOCUS GROUP PARTICIPANTS P r e -t a r g e t t h e g e n er a l c h a r ac t e r i s t i c s y o u w a n t y o u r s u b j e c t s t o h a v e. Unlike the

classic quantitatively based "random sample," you are not looking for a 'broad mix of infinite numbers of variables.' Rather, your study necessitates pre-targeting subjects with certain characteristics . H o m o g e n e o u s s a m p l es . This is critical for focus groups to be successful!

Develop your recruiting materials with these characteristics in mind. For example, if you are looking for African American women between the ages of 25-50 who currently have school aged children – make sure that your flyers state this, and post them in areas where you are likely to reach your desired population. Make sure your recruiting materials are positive – try using phrases like “Tell us what you think!” or “Share your thought with us!” FOCUS GROUP LOGISTICS

SELECTING A FACILITATOR It is best to identify a facilitator that is similar to the focus group participants in age, ethnicity and gender. In cases of great differences in demographic characteristic, a researcher needs to consider either a) letting someone of a similar background to the subjects conduct the interview; or b) at the very least, having someone of a similar background serve as assistant moderator. (Fern, 2001) LOCATION Your goal is to provide a familiar, safe, comfortable setting that will allow for lively discussions. Select a location that is familiar and accessible (consider transportation issues) for your participants. Above all, the location should be quiet enough to allow your recording devices to pick up all of the conversations and should not be located where you may be subject to interruptions such as non participants entering and exiting or loud speaker announcements interrupting your discussion. Consider providing food and childcare. It is not recommend allowing participants to bring their children unless you want the children to be a part of your data collection. Having children in the room is not conducive to discussion - it is simply too distracting.

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FINANCIAL CONSIDERATIONS (PAYMENT TO PARTICIPANTS, PAYMENT TO FACILITATOR) Focus group participants are typically compensated for their time. Payment amounts are usually ~$25 per person and can also include cab fare, bus voucher or parking validation. Subject reimbursement can be in the form of gift cards, or subjects can receive a check. Please refer to the following link regarding the process for establishing a UW checking account. http://www.bussvc.wisc.edu/acct/instructions/capp7.html If the focus group facilitator is not a UW or DFM employee, they can be paid using the Payment to Individual mechanism. The facilitator will need to provide a valid SSN and a signed W-9 to submit with the Payment to Individual paperwork. Agreement on hourly rate should be made in advance. AUDIO RECORDING GROUPS It is critically important to record your focus groups. You will need to inform the participants that they are being recorded and this will also be outlined in your consent form. Assistant moderator(s) should still take notes, especially to record non verbal information, but the recording and subsequent transcripts ARE your data. DFM digital recording devices can be obtained from the Research Program Assistant in Room 3820. Small digital recorders may also be checked out from the Digital Media Center on campus. Contact them at: Biotechnology Center 425 Henry Mall https://dmc.wisc.edu/audiorecorders.php TRANSCRIPTION SERVICES Transcription of focus group recordings is done most efficiently by companies designed to provide this service. Available services: GMR Transcription Services, Inc. www.gmrtranscription.com

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Upload your digital files to their website. Transcription documents are typically returned in less than a week. DFM research groups who have used GMR found them to be fast, affordable and accurate. ANALYSIS OF FOCUS GROUP DATA

The following site gives some good tips on analyzing focus group data: (http://www.utexas.edu/academic/ctl/assessment/iar/programs/report/focus Analysis.php). An excerpt from this site follows: Berkowitz (1997) suggests considering six questions when coding and analyzing qualitative data: What common themes emerge in responses about specific topics? How do these patterns (or lack thereof) help to illuminate the broader central question(s)? Are there deviations from these patterns? If so, are there any factors that might explain these deviations? How are participants' environments or past experiences related to their behavior and attitudes? What interesting stories emerge from the responses? How do they help illuminate the central question(s)? Do any of these patterns suggest that additional data may be needed? Do any of the central questions need to be revised? Are the patterns that emerge similar to the findings of other studies on the same topic? If not, what might explain these discrepancies? Coding Focus Group Data What is coding? Coding is simply parsing speech into categories that enable you to organize large amounts of text and to discover patterns that would be difficult to detect by just listening to a tape or reading a transcript. If you decide to code your data, Bogdan and Biklin (1998) provide common types of coding categories, but emphasize that your central questions shape your coding scheme. Setting/Context codes provide background information on the setting, topic, or

subjects. Defining the situation codes categorize the world view of respondents and how

they see themselves in relation to a setting or your topic. 6/29/11


Respondent perspective codes capture how respondents define a particular

aspect of a setting. These perspectives may be summed up in phrases they use, such as, "Say what you mean, but don't say it mean." Respondents' ways of thinking about people and objects codes capture how they categorize and view each other, outsiders, and objects. For example, a dean at a private school may categorize students: "There are crackerjack kids and there are junk kids." Process codes categorize sequences of events and changes over times. Activity codes identify recurring informal and formal types of behavior. Event codes, in contrast, are directed at infrequent or unique happenings in the setting or lives of respondents. Strategy codes relate to ways people accomplish things, such as how instructors maintain students' attention during lectures. Relationship and social structure codes tell you about alliances, friendships, and adversaries as well as about more formally defined relations such as social roles. Method codes identify your research approaches, procedures, dilemmas, and breakthroughs. Conduct your initial coding by generating numerous category codes as you read responses, labeling data that are related without worrying about the variety of categories. Write notes to yourself, listing ideas or diagramming relationships you notice, and watch for special vocabulary that respondents use because it often indicates an important topic. Because codes are not always mutually exclusive, a piece of text might be assigned several codes. Last, use focused coding to eliminate, combine, or subdivide coding categories, and look for repeating ideas and larger themes that connect codes. Repeating ideas are the same idea expressed by different respondents or across focus groups, while a theme is a larger topic that organizes or connects a group of repeating ideas. Try to limit final codes to between 30 and 50. After you have developed coding categories, make a list that assigns each code an abbreviation and description. Software programs can help with coding focus group data, understanding conceptual relationships, or counting key words. They facilitate systematic, efficient coding and complex analyses. Three popular software packages for qualitative coding and data analysis are Atlas.ti and NVivo7 and XSight. HOWEVER:

Be selective when using computer software packages in qualitative analysis: A

great proliferation of software packages that can be used to aid analysis of qualitative data has been developed in recent years. Most of these packages were reviewed by Weitzman and Miles (1995), who grouped them into six types: word processors, word retrievers, textbase managers, code-and-retrieve programs, code-based theory builders, and conceptual network builders. All have strengths and weaknesses. 6/29/11


Weitzman and Miles suggested that when selecting a given package, researchers should think about the amount, types, and sources of data to be analyzed and the types of analyses that will be performed. Two caveats are in order. First, computer software packages for qualitative data analysis essentially aid in the manipulation of relevant segments of text. While helpful in marking, coding, and moving data segments more quickly and efficiently than can be done manually, the software cannot determine meaningful categories for coding and analysis or define salient themes or factors. In qualitative analysis, as seen above, concepts must take precedence over mechanics: the analytic underpinnings of the procedures must still be supplied by the analyst. Software packages cannot and should not be used as a way of evading the hard intellectual labor of qualitative ana lysis. Second, since it takes time and resources to become adept in utilizing a given software package and learning its peculiarities, researchers may want to consider whether the scope of their project, or their ongoing needs, truly warrant the investment. (Berkowitz S., 1997) Other useful tools when analyzing your focus group data Use visual devices to organize and guide your study Matrices, concept maps, flow charts, or diagrams to illustrate relationships or themes may be helpful. Visual devices can aid critical thinking, confirmation of themes, or consideration of new relationships or explanations. Have more than one person review your transcripts for coding and themes. At least one other person should review your transcripts. This can be your assistant moderator or another person familiar with your research. Fresh eyes may identify new codes and themes. A third person is also helpful, but more than that and it becomes too complicated.

References & Resources:

Barbour, R., (2007). Doing Focus Groups. Thousand Oaks, CA: Sage Publications. Beck, C. T. (2003). “Initiation into qualitative data analysis.” Journal of Nursing Education, 42 (5), 231-234.

Dereshiwsky, M. (1999). He-said-she-said: Focus group interviewing: Part one. http://jan.ucc.nau.edu/~mid/edr725/class/interviewing/focus1/reading4-2-1.html . Arizona State University. 6/29/11


Dereshiwsky, M. (1999). Ways and means: Focus group interviewing: Part two. http://jan.ucc.nau.edu/~mid/edr725/class/interviewing/focus2/reading4-3-1.html . Arizona State University.

Edmunds, H. (1999). The focus group research handbook. Chicago, IL: NTC Business Books. Fern, E.F. (2001). Advanced focus group research. Thousand Oaks, CA: Sage Publications. Freeman, T. (2006). Methodological issues in nursing research: „Best pracitce‟ in focus group research: Making sense of different views. Journal of Advanced Nursing, 56 , 491497. Greenbaum, T.L. (1998). The handbook for focus group research (2nd Ed). Thousand Oaks, CA: Sage. Greenbaum, T. L. (2000). Moderating focus groups: A practical guide for group facilitation. Thousand Oaks, CA: Sage Publications. Grudens-Schuck, N., Lundy Allen, B., & Larson, K. (2004). Focus Group Fundamentals. Ames, IO: IowaState University Extension. http://www.extension.iastate.edu/Publications/PM1969B.pdf Ivanhoff, S.D., & Hultberg, J. (2006). Understanding the multiple realities of everyday life: Basic assumptions in focus group methodology. Scandinavian Journal of Occupational Therapy, 13, 125-132. Instructional Assessment Resources, The University of Texas at Austin, 2007 http://www.utexas.edu/academic/ctl/assessment/iar/programs/report/focus-Analysis.php Kidd, P.S., & Parshall, M.B. (2000). Getting the focus and the group: enhancing analytical rigor in focus group research. Qualitative Health Research, 10 , 293-308. Krueger, R.A., & Casey, M.A. (2009). Focus groups: A practical guide for applied research (4th Ed.).Thousand Oaks, CA: Sage Publications. Larson, K.N., Grudens-Schuck, N., & Lundy Allen, B. (2004). Can you call it a focus group? Ames, IO: Iowa State University Extension. http://www.extension.iastate.edu/Publications/PM1969A.pdf Leech, N. L., & Onwuegbuzie, A. J. (2007). An array of qualitative data analysis tools: A call for data analysis triangulation. School Psychology Quarterly, 22 (4), 4447-584. 6/29/11


Lofland, J. & Lofland, L. H. (1995). Analyzing Social Settings: A Guide to Qualitative Observation and Analysis. Belmont, CA: Wadsworth. Morgan, D.L. (Ed.) (1993). Successful focus groups: Advancing the state of the art. Newbury Park, CA: Sage. Owen, S. (2001). Methodological issues in nursing research: The practical, methodological and ethical dilemmas of conducting focus group with vulnerable clients. Journal of Advanced Nursing, 3,6 652-658. Patton, M.Q. (1990). Qualitative evaluation and research methods (2nd ed.). Newbury Park, CA: Sage. Teufel-Shone NI, Williams S. Focus groups in small communities. Prev Chronic Dis 2010;7(3). http://www.cdc.gov/pcd/issues/2010/may/09_0164.htm Weitzman, E.A., and Miles, M.B. (1995). A Software Sourcebook: Computer Programs for Qualitative Data Analysis. Thousand Oaks, CA: Sage.

BOOKS AND OTHER RESOURCES AVAILABLE AT DFM: (ROOM 3803)

Krueger, R.A., & Casey, M.A. (2009). Focus groups: A practical guide for applied th research (4th Ed.).Thousand Oaks, CA: Sage Publications. 4 ED. Morgan D.L. and Krueger, R.A. Focus Group Kit Vols 1-6 Morgan DL. Vol. 1 The Focus Group Guidebook 1998 Thousand Oaks, CA: Sage Publications. Morgan DL. Vol. 2 Planning Focus Groups 1998 Thousand Oaks, CA: Sage Publications Krueger RL Vol. 3 Developing Questions for Focus Groups 1998 Thousand Oaks, CA: Sage Publications. Krueger RL Vol. 4 Moderating Focus Groups 1998 Thousand Oaks, CA: Sage Publications. Krueger RL, King JA Vol. 5 Involving Community Members in Focus Groups 1998 Thousand Oaks, CA: Sage Publications. Krueger, R.A. Vol. 6 Analyzing and Reporting Focus Group Results 1998 Thousand Oaks, CA: Sage Publications. Crabtree, BF and Miller WL. Doing Qualitative Research Second Ed. 1999 Sage Publications Stewart, M, et.al. Tools for Primary Care Research vol 2 1992 Sage Publications. 6/29/11


Focus Group Resource Guide

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