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PubMed1994

Food security: what the community wants. Learning through focus groups.

We used focus groups to learn the range of issues threatening food security of low income residents in our community. Five major themes emerged from the discussions: literacy, money, time, mental health and self-esteem, suggesting several approaches that could help ensure food security: 1) education, 2) sharing of resources, 3) coalition building, and 4) advocacy. Education programs have to be practical, allowing for demonstrations and hands-on learning while emphasizing skill building and problem solving. Incorporating a social aspect into learning may compensate for the social isolation and would capitalize on the impressive mutual support we witnessed. Strategies based on self-help and peer assistance may counteract low self-esteem and overcome suspicion of health professionals. A community-wide effort is needed to address the factors contributing to food insecurity. We envision the formation of a coalition of professionals, agencies, and low income people to develop a comprehensive strategy for achieving food security.

Community Health Planning↗
PubMed1997

Focus groups: issues of analysis and interpretation.

Focus groups have become a popular method in nursing research. Their history can be traced back to marketing research methods, but they have also been used in qualitative, ethnographic research. Our study, which used this approach as part of data collection, raised many issues of analysis and interpretation: in particular, the importance of paying attention to the sequence of focus group discussions, the individuals involved, and the social context of the focus group. We conclude that focus groups are not a 'quick and easy' method of collecting data, and that issues of validity and the relationship between focus group data and other data require careful consideration.

Aged↗
PubMed1996

Focus groups.

This paper introduces focus group methodology and discusses its relevance to those researching health care provision. As a qualitative data collection technique, the focus group has advantages over other qualitative methods, such as the in-depth interview and nominal group technique. This paper highlights these advantages after providing guidelines on group composition, the management of group discussion and the process of analysing results.

Data Interpretation, Statistical↗
PubMed2002

'Could you please pass one of those health leaflets along?': exploring health, morality and resistance through focus groups.

This paper derives from research in which focus groups were used as a preliminary method of eliciting peoples' perceptions, attitudes and opinions towards health and health promotion in a Northern British city. However, applying criticisms associated with social constructionist theories (e.g. discourse analysis and rhetorical analysis), some recently emerging work on focus groups (see The challenge and promise of focus groups, in: Barbour, Kitzinger (Eds.), Developing Focus Group Research: Politics, Theory and Practice, Sage, London, 1999, p. 1; Focus Groups in Social Research, Sage, London, 2001) has suggested that their traditional use, as a kind of 'window' onto peoples' attitudes and opinions, misses important dimensions of the way in which these phenomena are actively negotiated and constructed during the course of the focus group. Working on the premise that these observations are particularly pertinent to health issues, this paper draws on data from one focus group in order to provide a detailed working example of the way in which attitudes and opinions towards health issues are actively constructed during the course of interaction. In addition, in accordance with social constructionist theories, attention will be paid to the way in which such construction is inextricably linked to social and moral actions such as the negotiation of blame and allocation of responsibility. Through an analysis of six extracts, the paper ultimately identifies three 'positions' or 'stances', which develop over the course of the focus group, often in opposition to one another. These are: (1) 'positive mental attitude'; (2) 'genes and luck'; and (3) 'resistance'. Each of these positions becomes associated, not only with certain moral values, but also 'attached' to certain people within the group. One of the main aims of this analysis is to illustrate how, through the everyday nature of such debates, health remains an intrinsically moral phenomenon.

Attitude to Health↗
PubMed2000

Using focus group methods with middle school children.

Focus group methods are an effective way to clarify middle school children's perceptions of health and illness. Children between 11 and 14 years of age, who are undergoing the developmental transition from child to adolescent, tend to be reticent when talking with adult strangers. However, they are more relaxed and willing to share perceptions when discussions are held with a group of peers. Conducting focus groups involves developing an interview guide, arranging the meeting place, supporting group building, and encouraging participation by the group members while discouraging domination by influential members. Data analysis begins during the focus group session as issues emerge in the context of group discussions.

Adolescent↗
PubMed2005

Management of chest pain: exploring the views and experiences of chiropractors and medical practitioners in a focus group interview.

BACKGROUND: We report on a multidisciplinary focus group project related to the appropriate care of chiropractic patients who present with chest pain. The prevalence and clinical management, both diagnosis and treatment, of musculoskeletal chest pain in ambulatory medical settings, was explored as the second dimension of the focus group project reported here. METHODS: This project collected observational data from a multidisciplinary focus group composed of both chiropractic and medical professionals. The goals of the focus group were to explore the attitudes and experiences of medical and chiropractic clinicians regarding their patients with chest pain who receive care from both medical and chiropractic providers, to identify important clinical or research questions that may inform the development of 'best practices' for coordinating or managing care of chest pain patients between medical and chiropractic providers, to identify important clinical or research questions regarding the diagnosis and treatment of chest pain of musculoskeletal origin, to explore various methods that might be used to answer those questions, and to discuss the feasibility of conducting or coordinating a multidisciplinary research effort along this line of inquiry. The convenience-sample of five focus group participants included two chiropractors, two medical cardiologists, and one dual-degreed chiropractor/medical physician. The focus group was audiotaped and transcripts were prepared of the focus group interaction. Content analysis of the focus group transcripts were performed to identify key themes and concepts, using categories of narratives. RESULTS: Six key themes emerged from the analysis of the focus group interaction, including issues surrounding (1) Diagnosis; (2) Treatment and prognosis; (3) Chest pain as a chronic, multifactorial, or comorbid condition; (4) Inter-professional coordination of care; (5) Best practices and standardization of care; and (6) Training and education. CONCLUSION: This study carries implications for chiropractic clinical training relative to enhancing diagnostic competencies in chest pain, as well as the need to ascertain and improve those skills, competencies, and standards for referrals and sharing of clinical information that may improve cross-disciplinary coordination of care for chest pain patients.

Journal Article↗
PubMed2003

Report from the CDC. Telephone focus groups: an emerging method in public health research.

BACKGROUND: The focus group is a widely used qualitative method in public health research. Typically, focus groups involve face-to-face interaction, although focus groups have also been conducted via telephone conference calls. METHODS: The indexed medical and social sciences literature was reviewed to assess what is empirically known about the telephone focus group method and how this method has been used to explore health topics. RESULTS: Thirteen studies reported in 16 publications were found that used telephone focus groups. Of the 13 studies, 12 investigated health topics, and none explored any methodological issues. Some health studies used the telephone focus group method exclusively, whereas others used it in conjunction with additional methods. The studies involved a variety of lay and professional populations in six countries and explored a range of topics. Several of the studies included participants from a wide geographic area, such as across the entire United States. Two rationales for using the telephone focus group method were reported: assembling geographically disparate participants and increasing participant anonymity by eliminating visual contact. CONCLUSIONS: Health researchers appear to be the primary users of the telephone focus group method for academic research. The telephone focus group method may be especially useful in health studies involving populations that do not have adequate representation in any single region and studies investigating sensitive topics. Methods studies are needed to compare the group dynamics of telephone and in-person focus groups and determine the most appropriate size and duration for telephone focus groups.

Attitude to Health↗
PubMed2002

The dynamic process of focus groups with migrant farmworkers: the Oregon experience.

Focus groups with culturally diverse populations, and Latino farmworkers in particular, have been used as an effective research method. However, the specifics of planning and implementing focus groups with diverse populations have not been elaborated in the literature. Focus groups were used as part of The Reducing Pesticide Exposure in Minority Families Project to successfully elicit migrant farmworkers' views on pesticide exposure and preferences for educational method. Although attention was paid to cultural and lifestyle considerations in the planning and implementation of our focus groups, recruitment, environmental context, convener, focus group questions, and within-population differences were identified as areas that required ongoing assessment and operational change. Vigilance to the dynamics of the process resulted in more effective focus groups.

Journal Article↗
PubMed1991

Use of focus groups in evaluating nutrition education materials.

Focus groups were used to study public reaction to the nutrition education material, Dietary Guidelines for Americans, US Department of Agriculture bulletin HG232. Respondents were asked to comment specifically on the content and format of bulletin HG232 and to compare it with several other commonly used nutrition education print materials. The focus group discussions were recorded on videotape and the information was analyzed by two independent reviews of the tapes. The focus groups produced good information on perceived usability of a variety of nutrition education print materials and made specific suggestions for improving HG232. Although there are limitations to using focus groups as a data collection technique (data are not quantitative, making data analysis difficult; responses are influenced by group dynamics; and some suggestions made by the group are not appropriate), the richness and innovativeness of the data collected make focus groups a worthwhile evaluation method for nutritionists.

Female↗
PubMed2003

Qualitative research-enhanced understanding of patients' beliefs: results of focus groups with low-income, urban, African American adults with asthma.

BACKGROUND: Qualitative research is an important research methodology for understanding the health beliefs and attitudes of patients. These beliefs and attitudes have been proposed as partial explanations for low adherence to medical therapy and the consequent high burden of morbidity from asthma among low-income urban minorities. OBJECTIVE: The purpose of this study was to explore barriers to adherence to inhaled corticosteroids (ICSs), health beliefs regarding asthma and its treatment, and opinions about providers and clinical research among low-income groups. METHODS: Three focus groups were conducted with 15 low-income, urban, African American adults with persistent asthma. These focus group sessions were audiotaped, transcribed verbatim, and coded by using qualitative analytic techniques. RESULTS: Health beliefs that influenced adherence included patients' reliance on their assessment of asthma control over that of the health provider and concern over the adverse effects of ICS therapy. Adherence was also adversely affected by social obligations and insurers' approval policies and restricted formularies. Although mistrust of the medical establishment was evident, members generally expressed a willingness to participate in nonpharmacologic clinical research and the belief that research was beneficial. However, they had strong preferences for where the research should be conducted. CONCLUSIONS: Although barriers exist to ICS adherence in patient populations, many of these can be addressed during patient-clinician interactions. Qualitative research is an important tool for formulating hypotheses for improving ICS adherence that can then be tested in the future by using quantitative research methods.

Administration, Inhalation↗
PubMed1998

Knowledge of diet and blood pressure among African Americans: use of focus groups for questionnaire development.

Though focus groups are widely used for development of interventions, little is known about their utility in questionnaire construction, particularly for health surveys in a south-eastern African-American population. In this study, focus groups aided in the development of questions, question sub-components, and response options identifying factors that may influence dietary behavior. Information was used for a survey of dietary knowledge, blood pressure knowledge, and measured blood pressure in a church-based, stratified random sample of middle-class African Americans in North Carolina. Each session, conducted in six churches, lasted 1-1 1/2 hours and had four to nine participants; thirty-four individuals participated. Recorded responses were reviewed and summarized by trained personnel. Results indicate that participants had a general understanding of hypertension, its risk factors, and modes of prevention. However, some misconceptions existed regarding blood pressure and sources of sodium. Television was the most common source of health information. Cost and Southern cultural traditions were deemed the major influences on dietary behavior. Many believed stress was strongly related to blood pressure. The focus group process generated useful information for developing questions about nutrition knowledge, blood pressure knowledge, and health attitudes and beliefs of the target population for the epidemiologic survey that followed.

Adult↗
PubMed2000

A guide to the use of focus groups in health care research: Part 1.

Focus group interviewing is becoming a popular research method among nurses as well as allied health professionals. Prior to performing a focus group interview a novice must first search the literature to gain an understanding of the function, uses, preparation, conduct and analysis of this form of methodology. This paper has been compiled in an attempt to synthesise, condense and simplify the information from an extremely wide and varied focus group literature and provide a comprehensive review to assist nurses who are considering utilising this methodology in their research studies. The purpose of this paper was stimulated by one of the author's (MP) own experience learning about focus group methodology before commencing her first focus group.

Bias↗
PubMedDate not supplied

Focus groups: a useful tool for curriculum evaluation.

BACKGROUND AND OBJECTIVES: Focus group interviews have been used extensively in health services program planning, health education, and curriculum planning. However, with the exception of a few reports describing the use of focus groups for a basic science course evaluation and a clerkship's impact on medical students, the potential of focus groups as a tool for curriculum evaluation has not been explored. Focus groups are a valid stand-alone evaluation process, but they are most often used in combination with other quantitative and qualitative methods. Focus groups rely heavily on group interaction, combining elements of individual interviews and participant observation. This article compares the focus group interview with both quantitative and qualitative methods; discusses when to use focus group interviews; outlines a protocol for conducting focus groups, including a comparison of various styles of qualitative data analysis; and offers a case study, in which focus groups evaluated the effectiveness of a pilot preclinical curriculum.

Curriculum↗
PubMed2001

Focus groups as a tool for critical social research in nurse education.

Focus groups are now widely adopted in qualitative health and social research, and have been increasingly used as a data-collection technique in nursing research. The focus group is not a new method, but its uses and procedures have been considerably revised in recent years. The aim of this paper is to present an overview of the focus group as a research tool in social science literature, followed by a more considered discussion on the use of focus groups in contemporary critical social science. It draws on this work to illustrate the potential of focus groups to address some of the political issues in social research, in particular the balance of power between researcher and researched, and the empowerment of under-represented groups. Advantages of the method in connecting the researcher with group perspectives and experiences that may be unexplored by other methods of data collection are discussed, and the 'collective conscience' is put forward as an appropriate resource in data analysis. It argues that the application of focus-group techniques can build on experiences and principles of working with or participating in groups. Focus groups are particularly applicable to research in nurse education, for involving diverse stakeholders in curriculum evaluation and development, and in ongoing appraisals of the student's perceptions of their experience, for which universities have tended to rely on survey approaches and structured questionnaires. The article ends by drawing some conclusions from the health and social research literature to inform nursing education research using focus groups.

Focus Groups↗
PubMed2002

Focus groups in rural Gujarat, India: a modified approach.

Focus groups have become increasingly popular in health research. However, their feasibility depends on the context of such research. Through discussion of focus groups they conducted in rural India, the authors argue that successful focus groups in rural contexts must be culturally sensitive, with a research team that goes beyond the mere technicalities of collecting data. A culturally competent focus group can result when the research team has geographic, political, economic, and sociocultural knowledge related to the research area and its population. With extensive local collaboration, foreign researchers are better able to conduct data collection respectfully. The authors provide recommendations for future studies toward increasing the cultural appropriateness of focus groups in areas such as rural India.

Ethics↗
PubMed1995

A review of 5 existing guidelines for planning focus groups in GP research.

The use of a focus group as a research method has become increasingly common in general practice related studies. Although existing guidelines for planning focus groups are very useful, a review of these guidelines indicate that a few of them are vague and need further elaboration. The authors review five existing guidelines for planning focus groups. These are size, number, duration, format and composition of a focus group. Suggestions have been made to address the uncertainties in these areas when a focus group is used. This paper was a section of manuscript presented at the 2nd International Qualitative Health Research Conference on 11 June 1994, Hershey, Pennsylvania.

Family Practice↗
PubMedDate not supplied

The use of focus group methodology in health disparities research.

Focus group methodology uses focused interviews to obtain information from individuals and interactions among individuals in a small group setting. In this article we share the insights we have gained from using focus group methodology in work with an under-served population of black menopausal women. This methodology holds promise for advancing our understanding of, and ultimately eliminating, health disparities. Included is a discussion of planning and facilitating the focus group, recruiting group members, collecting and analyzing the data and reporting the results. Throughout, we explain how we applied these principles and we conclude by sharing lessons learned from our study on menopause and midlife experiences in Black women.

Black or African American↗