Focus Groups in Health Focus Groups in Health Education Practice:Education Practice:An IntroductionAn Introduction

Ric Underhile, Ph.D., LLPCRic Underhile, Ph.D., LLPCGrand Rapids Community CollegeGrand Rapids Community College

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A presentation for the American College Health Association29 April 2013

What we’re going to doWhat we’re going to do

Review the Review the various traditions various traditions of qualitative inquiryof qualitative inquiry

Discuss the Discuss the characteristics of rigor characteristics of rigor expected from expected from qualitative inquiryqualitative inquiry

Consider the Consider the step-by-step process step-by-step process for for administering focus groupsadministering focus groups

Discuss strategies for Discuss strategies for analyzing qualitative dataanalyzing qualitative data

View an View an exampleexample

Ask and Ask and respond to questions respond to questions and commentsand comments

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Some notes about this Some notes about this presentationpresentation

Influenced by the work of Patricia Fabiano, Ph.D. Influenced by the work of Patricia Fabiano, Ph.D. and Linda Lederman, Ph.D.and Linda Lederman, Ph.D.

Focus Groups: Top Ten Misperceptions Threatening Focus Groups: Top Ten Misperceptions Threatening Quality in Student Affairs Assessment (Fabiano & Quality in Student Affairs Assessment (Fabiano & Underhile, Sponsored Session; ACPA/NASPA Joint Underhile, Sponsored Session; ACPA/NASPA Joint Meeting, Orlando FL, April 2007)Meeting, Orlando FL, April 2007)

My own experiences during my graduate trainingMy own experiences during my graduate training

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Five traditionsFive traditions

BiographyBiographyThe study of a single individual and his or her The study of a single individual and his or her experiencesexperiences

A single parent who relocates and strives to raise A single parent who relocates and strives to raise their child in a new towntheir child in a new town

PhenomenologyPhenomenologyA study that describes the meaning of experiences of A study that describes the meaning of experiences of a phenomenon shared by several individualsa phenomenon shared by several individuals

How a group of runners adjust to the recent death of How a group of runners adjust to the recent death of one of their friendsone of their friends

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See, Qualitative Inquiry and Research Design: Choosing Among Five Traditions by John W. Creswell for excellent further reading.

Five traditionsFive traditions

Grounded TheoryGrounded TheoryThe collection of interview data, field work, constant The collection of interview data, field work, constant comparison of information and final development of a comparison of information and final development of a context-specific theorycontext-specific theory

The process of engaging in career development The process of engaging in career development experienced by community college studentsexperienced by community college students

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Five traditionsFive traditions

EthnographyEthnographyThe study of an intact social or cultural group over a The study of an intact social or cultural group over a period of time. This tradition requires the researcher period of time. This tradition requires the researcher to deeply invest in the field.to deeply invest in the field.

Following a cohort of peer health educators throughout Following a cohort of peer health educators throughout the academic year in an effort to chronicle their the academic year in an effort to chronicle their personal and academic growthpersonal and academic growth

Case StudyCase StudyThe study of a “bounded system” with the focus being The study of a “bounded system” with the focus being either the case or an issue expressed by the caseeither the case or an issue expressed by the case

How a university team of administrative leaders How a university team of administrative leaders addressed the student development needs of their addressed the student development needs of their student populationstudent population

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Rigor in qualitative Rigor in qualitative inquiryinquiry

CredibilityCredibilityFindings are believable and convincing.Findings are believable and convincing.

TransferabilityTransferabilityThe findings could realistically apply to other The findings could realistically apply to other situations that are similar to the one being studied.situations that are similar to the one being studied.

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Rigor in qualitative Rigor in qualitative inquiryinquiry

DependabilityDependabilityWithin reason, the findings seem similar to those of Within reason, the findings seem similar to those of other studies.other studies.

ConfirmabilityConfirmabilityThe process and product could be audited by a third The process and product could be audited by a third party with findings being the same.party with findings being the same.

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Characteristics of a “good” Characteristics of a “good” qualitative studyqualitative study

1.1. Multiple forms of data are gathered and analyzed. Multiple forms of data are gathered and analyzed. The “data set” is The “data set” is visually summarized visually summarized (creativity (creativity without gimmickry is encouraged!).without gimmickry is encouraged!).

2.2. The study is framed within the appropriate tradition.The study is framed within the appropriate tradition.

3.3. The researcher begins with The researcher begins with a single focus a single focus (not a (not a causal or comparative approach).causal or comparative approach).

4.4. The study provides a The study provides a detaileddetailed description of the description of the method, enough so that it could be replicated method, enough so that it could be replicated (approach this as you would if you were writing a (approach this as you would if you were writing a screenplay).screenplay).

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Characteristics of a “good” Characteristics of a “good” qualitative studyqualitative study

5.5. The writing is persuasive (i.e., verisimilitude).The writing is persuasive (i.e., verisimilitude).

6.6. Analyses are Analyses are layered.layered.

7.7. The writing is rich with detail and brings the story The writing is rich with detail and brings the story to life.to life.

8.8. The assumptions and characteristics of qualitative The assumptions and characteristics of qualitative inquiry are kept intact (e.g., evolving design, inquiry are kept intact (e.g., evolving design, presentation of multiple perspectives, the full presentation of multiple perspectives, the full engagement of the researcher is present, engagement of the researcher is present, trustworthinesstrustworthiness, etc.), etc.)

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Steps to facilitating focus Steps to facilitating focus groupsgroups

Define the Define the purposepurpose

Develop an interview guideDevelop an interview guide

Train facilitators and, if necessary, scribesTrain facilitators and, if necessary, scribes

Recruit and select participantsRecruit and select participants

Plan and manage Plan and manage logisticslogistics

Conduct focus groups (typically 2-4, until Conduct focus groups (typically 2-4, until saturationsaturation is is reached)reached)

Analyze dataAnalyze data

Report resultsReport results1111

Skills necessary for Skills necessary for facilitating focus groupsfacilitating focus groups

The researcher hasThe researcher hasA clear sense of purposeA clear sense of purpose

An innate ability to express An innate ability to express sustained curiositysustained curiosity, while , while managing time effectivelymanaging time effectively

Professional training in group facilitationProfessional training in group facilitation

Adhered to institutional or organizational standards Adhered to institutional or organizational standards of of human subject participant protocolhuman subject participant protocol

AA budget budget for room rental, honorarium for facilitators for room rental, honorarium for facilitators and/or scribes, transportation, child care, and/or scribes, transportation, child care, refreshments, incentives, etc.refreshments, incentives, etc.

A A realistic time table realistic time table for assembling, analyzing, and for assembling, analyzing, and reviewing datareviewing data

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An exampleAn example

Purpose:Purpose:This case study seeks to discover if the college This case study seeks to discover if the college community under study has the capacity and level of community under study has the capacity and level of readiness to establish and sustain a coordinated readiness to establish and sustain a coordinated school health program (CSHP). The secondary school health program (CSHP). The secondary purpose is to explicate what shifts and or changes, if purpose is to explicate what shifts and or changes, if any, need to occur to successfully implement and any, need to occur to successfully implement and sustain a CSHP in the college.sustain a CSHP in the college.

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An exampleAn example

Six questionsSix questions

Each focus group lasted approximately one hour.Each focus group lasted approximately one hour.

Participants were found and invited via email, Participants were found and invited via email, telephone calls, classroom announcements, and telephone calls, classroom announcements, and face-to-face communication.face-to-face communication.

Each participant was provided a written description Each participant was provided a written description of the project and an informed consent form.of the project and an informed consent form.

Focus groups were audiotaped.Focus groups were audiotaped.

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An exampleAn example

Research participants were provided copies of Research participants were provided copies of transcripts for verification.transcripts for verification.

Audiotapes were analyzed for words or phrases Audiotapes were analyzed for words or phrases that implicitly or explicitly reflected key concepts that implicitly or explicitly reflected key concepts of the research.of the research.

While some experts recommend transcribing only While some experts recommend transcribing only key responses, I transcribed the audiotapes key responses, I transcribed the audiotapes verbatim.verbatim.

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Data Data analysisanalysis

“It is a messy, ambiguous, “It is a messy, ambiguous, and time-consuming, and time-consuming, creative, and fascinating creative, and fascinating process. It does not process. It does not proceed in a linear fashion; proceed in a linear fashion; it is not neat.”it is not neat.”

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Marshall & Rossman, 1999.

Data analysisData analysis

Open codingOpen coding

Interview data were then color-coded.Interview data were then color-coded.

Color-coded text was then cut (with scissors) and Color-coded text was then cut (with scissors) and divided into stacks that corresponded to divided into stacks that corresponded to predetermined themes.predetermined themes.

Each statement was then re-coded to determine Each statement was then re-coded to determine whether it indicated a need or strength.whether it indicated a need or strength.

A complex matrix was then created with themes A complex matrix was then created with themes creating rows and columns and then each cell was creating rows and columns and then each cell was divided into strengths and weaknesses.divided into strengths and weaknesses.

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Matrix example Matrix example (excerpt)(excerpt)

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Authorization & Funding

Communication & Linkages

Personnel & Organizational Placement

Resources

Health Education

Physical Education

Health Services

LessonsLessons

The research question determines method. It is The research question determines method. It is bad practice to choose a method before the bad practice to choose a method before the research question(s) is determined.research question(s) is determined.

Plan, plan, plan!Plan, plan, plan!

Prepare your audience to embrace and understand Prepare your audience to embrace and understand both your method and findings.both your method and findings.

Questions and discussionQuestions and discussion

for more discussion or additional questionsfor more discussion or additional questionsrunderhile@grcc.edurunderhile@grcc.edu

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