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PubMed1995

Problems of focus group methods in cross-cultural research: a case study of beliefs about sudden infant death syndrome.

Over the past decade there has been increasing interest in using focus group methods in public health research. Focus group discussions have become particularly popular, in part because they are commonly perceived to be a less time-consuming and less expensive way of collecting qualitative data than the more traditional ethnographic methods. However, little attention has been given to methodological issues when the focus group method is applied in cross-cultural settings. This paper discusses a number of these concerns, illustrated through the use of the focus groups to explore mothers' beliefs about sudden infant death syndrome (SIDS) in an ethnically diverse sample in Victoria. We found that some methodological difficulties were related to cultural factors. This has led us to use caution when considering the use of focused group discussions as a research method in cross-cultural contexts. We urge public health researchers to take a critical look at the appropriateness of focus groups before applying this method in cross-cultural public health research.

Adult↗

PubMed1994

Conceptual learning in clinical pastoral education supervisory training: a focus-group research project with recommendations.

Reports on focus group research designed to determine how conceptual skills are developed and integrated into the learning experience of supervisory training in Clinical Pastoral Education. Records actual participants' responses to five basic questions and identifies major underlying ideas gleaned via content analysis. Notes both limitations and strengths of the focus group method of qualitative research and offers recommendations designed to encourage and extend research focused on ways in which conceptual learning in Clinical Pastoral Education Supervisory Training may be achieved.

Administrative Personnel↗

PubMed2000

Using focus groups to seek the views of patients dying from cancer about the care they receive.

PURPOSE: The prime purpose of the study was to investigate whether focus groups were a practical way of seeking the views of dying people and whether the information collected added to that collected by more established methods. DESIGN: A sample frame of Macmillan nurse patients was collated from which three cluster samples were randomly selected to participate in focus groups. The focus groups were structured with an experienced facilitator and recorder to answer three key questions. SETTING AND PARTICIPANTS: Patients of Macmillan nurses in three NHS Trusts in West Yorkshire who were living at home with incurable cancer. They were aware of their condition and were willing to participate. MAIN VARIABLES STUDIED: The three key questions were; what kind of help are you currently receiving? What sort of help do you want? Of the kind of help you are receiving what kind is most important to you? RESULTS: 17 patients participated in three focus groups. Participants were generally fairly able and living with spouses or relatives. They were of varying age with different types and duration of cancer. They were receiving a range of health and social services of varying importance to them. More help was particularly wanted with support for daily living, support from specialist cancer nurses, help getting out and with housework. Macmillan nurses and general practice services were highly rated in some but not all three trust areas. CONCLUSIONS: We propose that focus groups are a practical way of collecting information about dying patients that can complement other sources of information in planning and auditing the provision of care.

Journal Article↗

PubMed2000

A guide to the use of focus groups in health care research: Part 2.

In this paper, the second in a two part series on focus groups, a comprehensive overview of the literature concerning the interviewing process, methodology and analysis is provided. We discuss the characteristics of the moderator and the way in which a focus group is conducted (the who, where, and how of the focus group process), the participants, the process, and the analysis. Nursing staff and allied health professionals, especially those contemplating using focus groups for the first time, will be able to gain an understanding of the conduct of focus groups from this one source. The comprehensive reference list will provide a wealth of primary sources for further reading.

Data Interpretation, Statistical↗

PubMed2001

Focus group on telepharmacy.

The focus group strongly believed that telepharmacy will change the practice of pharmacy and that it is not a matter of if or when but how. Consumers' expectations and the need for efficient health care delivery will drive the use of technology. Pharmacists have considerable lever-age in this technological world because of the money associated with the use of medications. Telepharmacy holds great promise for the profession and should result in greater visibility of pharmacists and enhanced patient access to their services.

Costs and Cost Analysis↗

PubMed1996

Using focus group interviews to understand school meal choices.

Focus groups were used to examine adolescents' participation in school nutrition programs, their opinions about the meals served in these programs, and their suggestions for improving the meals. A pilot and four focus group interviews were conducted with ninth grade students in five geographically distinct regions of Florida. Male students and those from rural areas were more likely to participate in school meal programs than were females and those from suburban and urban areas. Students expressed intense dislike and distrust of school meals. School meals were criticized for taste, appearance, small serving sizes, and cost. Students overwhelmingly favored commercial food vendors serving lunch at school. Suggestions for improving school meals included improving the taste and appearance of food, offering a wider variety of foods, serving more fresh fruit and vegetables, lowering the price, increasing the serving sizes, teaching food service workers how to cook, and offering more condiments.

Adolescent↗

PubMed1995

[Focus group interview as a qualitative research method].

Focus group research is a qualitative method with interesting properties. It is performed by planned discussion and interview with a small group of people conducted by a moderator. The participants are sampled from the study population. The aim is to obtain knowledge of the participant's considerations and ideas on a specific topic. The method is feasible in illuminating the variation of viewpoints held in a population. It is used as a single source of data or in combination with other methods. As the method provides data in a social context it is used as an alternative to individual interviews, when appropriate, or in the initial development of a questionnaire. The focused interviews is feasible in methodological triangulation or when other methods are suboptimal. Focus group interviews is considered to be of value in health research.

Focus Groups↗

PubMed2006

Focus group research and "the patient's view".

A clear emphasis on the patient's view is discernible in the health services research literature of the past decades. Such a switch to patients' perspectives has been greatly facilitated by a wider acceptance and use of qualitative methods. In particular, focus groups are often used to uncover the range and depth of experiences of health services users and chronically ill individuals. Although this method contributes to a better understanding of patients' perspectives and practices, a number of analytical considerations have been overlooked. The aim of this paper is to consider how to conceptualise and analyse interactions in focus group research. We argue that focus groups are social spaces in which participants co-construct the "patient's view" by sharing, contesting and acquiring knowledge. Focus groups conducted with home care patients in Quebec, Canada (on antibiotic intravenous therapy, parenteral nutrition, peritoneal dialysis and oxygen therapy) are used to illustrate three interactive processes at work in focus groups: (1) establishing oneself as experienced and knowledgeable; (2) establishing oneself as in search of information and advice; and (3) validating or challenging one another's knowledge claims. We develop an analytical template focused on the subtle dynamics underpinning the various and at times competing claims of patients. This template acknowledges the processes through which participants attribute authority to the claims of others, including the focus group moderator. We find that focus group research does not derive epistemological authority simply from the identity of its participants. Rather, an emerging consensus about what constitutes the patient's view is the result of context-dependent social interactions that need to be scrutinised.

Adult↗

PubMed2005

Interaction in cyberspace: an online focus group.

AIM: This paper reports a study that explored whether active engagement and group interaction could be captured in an online environment. BACKGROUND: Focus groups have become a common means of capitalizing on group interaction to collect rich responses to questions posed. Whilst their use is well established in the repertoire of qualitative researchers, with changing technology there is the opportunity to use a computer program that facilitates online engagement and interaction to bring together a group of people to explore issues, attitudes and perceptions. METHOD: Using a qualitative descriptive method and purposive sampling, 38 Australian Enrolled Nurses participated in an online focus group. WebCT, a program that facilitates online engagement and interaction, was used to enable participants to interact from any computer, from any location, at any time. FINDINGS: The experience of conducting an online focus group was a positive one. Advantages such as cost savings and convenience for both researcher and participants were identified. This study demonstrated that participants could be actively engaged over a 2-month period and that group interaction could be achieved to collect richly detailed research data. CONCLUSION: Whilst online focus groups may not be suitable in every situation, the potential exists to capitalize on technology to bring together a group of people separated by distance in an online environment that encourages interactive discussion.

Focus Groups↗

PubMed1994

Focus group responses of potential participants in a nutrition education program for individuals with limited literacy skills.

OBJECTIVE: To obtain information to direct the design and development of a nutrition intervention program targeted at a low-literacy audience. SUBJECTS: Thirty-nine female and two male clients of the Expanded Food and Nutrition Education Program (EFNEP) participated in five focus-group discussions. The focus groups included 23 African American, 9 white, 4 Southeast Asian, 1 American Indian, 2 Hispanic American, and 2 Middle Eastern EFNEP participants. DESIGN: All focus groups were moderated and co-moderated by University of Minnesota staff members. The focus groups were tape-recorded and transcribed. A written report was generated based on the independent evaluation of two staff members. RESULTS: We learned that EFNEP participants thought they would be motivated to change their eating habits for health concerns, including weight loss, and to help their families develop healthful eating habits. They mentioned several barriers to making changes, including extra time and money needed to purchase and prepare healthful foods, food preferences of family members, lack of interest and skills in cooking, and insufficient knowledge about which foods are healthful. Participants shared ideas for program content and delivery. CONCLUSIONS: Clients with limited literacy skills have valuable opinions and insights that program developers targeting this hard-to-reach group should hear. The EFNEP participants wanted simple, practical, and relevant information about what foods to eat and how to prepare them. They considered lectures an ineffective way to receive nutrition information, and they expressed a preference for hands-on activities that were enjoyable and allowed participants to share ideas and experiences.

Black or African American↗

PubMed1988

Focus groups--some suggestions.

In this article, the use of focus groups in health information campaigns is discussed from a mass communication theory point of view. The authors argue that information campaigning to a large degree is suffering from a "we-know-best" type of professionalism, and that the defining of the audience, its perception of health related concepts and its needs is often done with a lack of sensitivity and empathy. Focus group discussions could be used to help the health campaigner to define relevant target groups and to test how concepts and messages are received, perceived, interpreted, understood and accepted. Focus groups can be used to help formulate concepts and arguments, to reveal counterarguments that are triggered by the campaign arguments, and to test whole information campaign units.

Communication↗

PubMed1987

Focus group interview: an underutilized research technique for improving theory and practice in health education.

The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of-the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, literature describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this technique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; applicability of marketing research to understanding and influencing consumer behavior, despite notable distinctions between educational initiatives and marketing; and need for professional preparation faculty to consider increasing emphasis on qualitative research methods.

Adolescent↗

PubMed1999

Focus group interviews in health-care research.

The focus group interview allows researchers to obtain data about participants' feelings and opinions on a particular topic. Careful consideration must be given to the size of the group, the participants' backgrounds, the venue and the choice of moderator. It is not always appropriate to generalise the findings of focus group interviews on to a larger population.

Focus Groups↗

PubMed1997

Guidelines for dyspepsia management in general practice using focus groups.

BACKGROUND: There is a paucity of published guidelines on managing dyspepsia in general practice. Existing guidelines emphasize the role of investigations and drugs rather than management approaches. Focus groups are a means of uncovering the way in which the participants think and work in the pragmatic-setting, and have not previously been formally used in creating guidelines. AIM: To develop guidelines for the management of dyspepsia and to assess the use of focus groups of general practitioners (GPs) in order to do so. METHOD: Initial evidence-based guidelines were proposed by a group of four GPs with an audit facilitator, and used for discussion in three focus groups using a standard format. An anthropological analysis of the proceedings led to modifications of the original guidelines, based on knowledge, perceptions and attitudes. The study was set in three distinct locations involving 30 GPs. The outcome measures consisted of feedback, categorized by types of responses, from the analysis of the focus groups and the creation of guidelines. RESULTS: The resulting guidelines were patient centred and based on the principles of good consultation. They encompassed patients' fears and doctors' clinical uncertainties, and allowed flexibility in the individual patient's management. The focus group methodology exposed a substantial number of GPs to guideline development, and had the added benefits of dissemination, peer review and educational challenge. CONCLUSION: It was possible to develop guidelines for dyspepsia using focus groups. The methodology had the added benefits of ownership, peer review, exposure of educational gaps and locality factors, and dissemination of good practice. It included steps from evidence review to implementation strategies. The development of this technique could lead to a strategy towards the creation and application of evidence-based and professionally acceptable clinical guidelines and practice on a locality basis nationally.

Dyspepsia↗

PubMed1999

The attitudes of Australian GPs to evidence-based medicine: a focus group study.

BACKGROUND: Over the last 6 years there has been an exponential increase in the publication of medical literature on evidence-based medicine. In Australia, as in many other parts of the world, there have been calls for an increase in the practice of evidence-based medicine. In general practice, two major themes of criticism have been the lack of relevant research evidence in primary care and the failure of evidence-based medicine to take into account the complexity of the consultation. OBJECTIVE: We aimed to explore the attitudes of Australian GPs to evidence-based medicine. METHODS: We conducted a qualitative study using evidence-based guidelines as a model to explore attitudes within focus group interviews. Focus group data were analysed using grounded theory methodology. The study was set in the Australian cities Melbourne, Adelaide and Darwin. The subjects were 27 GPs in five focus groups. RESULTS: Data were used to generate a model illustrating factors affecting the consideration and use of evidence within consultations. Prior beliefs and experience had a strong influence on decision-making. Overall, the GPs had a positive attitude to evidence-based medicine and stated that this could be a helpful strategy for meeting their information needs. These needs arose during the consultation and were frequently generated by patients. The evidence-based approach was regarded as particularly useful when patients required validation of their management or had specific queries. However, the GPs also expressed some concerns, such as the application of evidence from clinical trials to individuals, and the appropriateness of using research evidence with certain patients. They also feared a move away from the 'art of medicine'. None of the GPs expressed a need for critical appraisal skills. CONCLUSIONS: The Australian GPs in this study had mixed views about the increasing profile of evidence-based medicine, and the use of this paradigm in practice. Acceptability was more likely to be influenced by relevance to general practice and local contextual and patient factors than by the strength, or critical quality of the evidence.

Adult↗

PubMedDate not supplied

Focus groups and vulnerable populations. Insight into client strengths and needs in complex community health care environments.

Focus groups are a useful qualitative research technique to assist in interpreting quantitative community assessment data. Data obtained from focus groups can provide sociological and psychological insights into the perceptions of population subgroups and suggest answers to the "why" questions raised by descriptive data about such issues as teen pregnancy, poverty, immunization levels, or lifestyle-related morbidity and mortality. Application of these insights can lead to the better use of community strengths and the creation of community-specific responses to barriers to health care. Focus groups work well for involving hard-to-reach members of a community in program development, planning, and evaluation. They may be more effective than face-to-face interviews and questionnaires because people often have not thought about how they feel and tend not to form opinions in isolation (1). The information sought through the use of focus groups is not randomly distributed in the population. Thus, groups are not randomly selected, and data are not gathered with the intent to generalize to all populations.

Adult↗

PubMed1990

The role of focus groups in health education for cervical cancer among minority women.

Focus groups were used in the development of community-based public health education designed to reduce mortality from cervical cancer among black women in Forsyth County, North Carolina. The educational goals of this National Cancer Institute (NCI) funded project were to increase the proportion of black women, age 18 and older, who obtain Pap smears on a regular basis and return for followup care when necessary. A series of four focus groups were conducted to help develop the conceptual basis for designing educational messages and materials. The groups were led by a black, female professional focus group moderator, and explored a variety of health-related topics ranging from general, ordinary concerns of daily living to knowledge and attitudes about cancer screening. The group discussions suggested that health is regarded as very important to the target population, particularly when related to family functioning. Regarding the Pap smear, most women knew about the test, but had little awareness of its role in the early detection of cervical cancer. Fear and fatalism were clearly the dominant, top-of-mind reactions to cancer, and there was little differentiation among sites or types of cancer. Despite the overall pessimism, the groups agreed that early diagnosis and treatment provide the best hope for good outcomes with cancer.

Black or African American↗

PubMed2005

Prostate cancer screening perceptions, knowledge and behaviors among African American men: focus group findings.

The purpose of the study was to explore, using focus groups, the knowledge, perceptions, attitudes, and behavior of African American men concerning prostate cancer and screening for the disease using the prostate specific antigen and the digital rectal examination. Twelve focus groups (n=104) were conducted among African American men 40 years of age and older, residing in three counties in the metropolitan area of Baltimore, Maryland. The results of the study show various barriers to screening among the target population, which include limited knowledge about the disease, lack of access to screening services, embarrassment and fear of a positive diagnosis. Additional barriers reported were distrust of medical professionals and the government, reluctance to talk about sex-related health problems, complacency about the possibility of having the disease, and belief that prostate cancer is related to sexual behavior. Positive beliefs, hope, and familiarity with the disease were enabling factors for prostate cancer screening. The focus groups served to open doors to communities from the research and medicine world, and heightened awareness of prostate cancer.

Adult↗