Focus Groups in Health Education Practice: An Introduction

1. Focus Groups in Health Education Practice:An Introduction RicUnderhile, Ph.D., LLPC Grand Rapids Community College A presentation for the American College Health Association 29 April 2013

2. What we’re going to do • Review the various traditions of qualitative inquiry • Discuss the characteristics of rigor expected from qualitative inquiry • Consider the step-by-step process for administering focus groups • Discuss strategies for analyzing qualitative data • View an example • Ask and respond to questions and comments

3. Some notes about this presentation • Influenced by the work of Patricia Fabiano, Ph.D. and Linda Lederman, Ph.D. • Focus Groups: Top Ten Misperceptions Threatening Quality in Student Affairs Assessment (Fabiano & Underhile, Sponsored Session; ACPA/NASPA Joint Meeting, Orlando FL, April 2007) • My own experiences during my graduate training

4. Five traditions • Biography • The study of a single individual and his or her experiences • A single parent who relocates and strives to raise their child in a new town • Phenomenology • A study that describes the meaning of experiences of a phenomenon shared by several individuals • How a group of runners adjust to the recent death of one of their friends See, Qualitative Inquiry and Research Design: Choosing Among Five Traditions by John W. Creswell for excellent further reading.

5. Five traditions • Grounded Theory • The collection of interview data, field work, constant comparison of information and final development of a context-specific theory • The process of engaging in career development experienced by community college students

6. Five traditions • Ethnography • The study of an intact social or cultural group over a period of time. This tradition requires the researcher to deeply invest in the field. • Following a cohort of peer health educators throughout the academic year in an effort to chronicle their personal and academic growth • Case Study • The study of a “bounded system” with the focus being either the case or an issue expressed by the case • How a university team of administrative leaders addressed the student development needs of their student population

7. Rigor in qualitative inquiry • Credibility • Findings are believable and convincing. • Transferability • The findings could realistically apply to other situations that are similar to the one being studied.

8. Rigor in qualitative inquiry • Dependability • Within reason, the findings seem similar to those of other studies. • Confirmability • The process and product could be audited by a third party with findings being the same.

9. Characteristics of a “good” qualitative study • Multiple forms of data are gathered and analyzed. The “data set” is visually summarized (creativity without gimmickry is encouraged!). • The study is framed within the appropriate tradition. • The researcher begins with a single focus (not a causal or comparative approach). • The study provides a detailed description of the method, enough so that it could be replicated (approach this as you would if you were writing a screenplay).

10. Characteristics of a “good” qualitative study • The writing is persuasive (i.e., verisimilitude). • Analyses are layered. • The writing is rich with detail and brings the story to life. • The assumptions and characteristics of qualitative inquiry are kept intact (e.g., evolving design, presentation of multiple perspectives, the full engagement of the researcher is present, trustworthiness, etc.)

11. Steps to facilitating focus groups • Define the purpose • Develop an interview guide • Train facilitators and, if necessary, scribes • Recruit and select participants • Plan and manage logistics • Conduct focus groups (typically 2-4, until saturation is reached) • Analyze data • Report results

12. Skills necessary for facilitating focus groups • The researcher has • A clear sense of purpose • An innate ability to express sustained curiosity, while managing time effectively • Professional training in group facilitation • Adhered to institutional or organizational standards of human subject participant protocol • A budget for room rental, honorarium for facilitators and/or scribes, transportation, child care, refreshments, incentives, etc. • A realistic time table for assembling, analyzing, and reviewing data

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

14. An example • Six questions • Each focus group lasted approximately one hour. • Participants were found and invited via email, telephone calls, classroom announcements, and face-to-face communication. • Each participant was provided a written description of the project and an informed consent form. • Focus groups were audiotaped.

15. An example • Research participants were provided copies of transcripts for verification. • Audiotapes were analyzed for words or phrases that implicitly or explicitly reflected key concepts of the research. • While some experts recommend transcribing only key responses, I transcribed the audiotapes verbatim.

16. Data analysis“It is a messy, ambiguous, and time-consuming, creative, and fascinating process. It does not proceed in a linear fashion; it is not neat.” Marshall & Rossman, 1999.

17. Data analysis • Open coding • Interview data were then color-coded. • Color-coded text was then cut (with scissors) and divided into stacks that corresponded to predetermined themes. • Each statement was then re-coded to determine whether it indicated a need or strength. • A complex matrix was then created with themes creating rows and columns and then each cell was divided into strengths and weaknesses.

18. Matrix example (excerpt)

19. Lessons • The research question determines method. It is bad practice to choose a method before the research question(s) is determined. • Plan, plan, plan! • Prepare your audience to embrace and understand both your method and findings. • Questions and discussion • for more discussion or additional questionsrunderhile@grcc.edu