Chapter 14: Focus groups

What are focus groups?

Focus groups are convened to discuss an issue of mutual concern. The purpose of a focus group is to explore the experiences, understandings, opinions or motivations of research participants.¹ While individual interviews explore the experiences of (usually) one participant (see Chapter 13), focus groups are conducted with three or more people who share an experience or concern. The conversation between participants in a focus group is mediated and facilitated by the researcher. Focus groups can be used when little is known about the participants or a topic (an exploratory process), when testing new ideas (e.g. acceptability of a program or intervention) or when undertaking an evaluation of a service or product.

The focus of the discussion is on the interaction between participants in the group; some participants may have similar experiences or views, while others have different experiences. The group dynamic is important and therefore it is important that participants lead the discussion and are encouraged to talk through their similarities and differences, so that the researcher might gain a well-rounded perspective and account of the topic. A group might be homogeneous, get along well and share similar experiences. Or the group might be heterogeneous and have differing opinions and experiences. Participants might know each other because they have been recruited from the same program or community, or they could be total strangers. All these elements contribute to the focus of discussion, and to the group dynamic; that is, the interactivity of the focus group.

How many focus group members should there be?

Ideally, a focus group should include 6–10 participants² and the conversation should be moderated by the researcher, using a focus group discussion guide. However, the number of participants may vary according to the topic and the number of participants able to be recruited. The data collected from focus groups tends to differ from interview data because people respond and compare their own experiences with those of others in the group. Therefore, the number and composition of group members influence the data gathered.

Having too many people in a group means that discussion can become chaotic and it is unlikely that everyone in the group will have a say. Having too few people means that there may not be sufficient interaction to enable to capture a group perspective. Focus groups have been conducted with as few as two people: in a focus group conducted by one of the authors of this chapter, several participants had been invited, but only two attended. Since participants were difficult to recruit from the target population, it was not feasible to cancel the focus group. The topic was recovery after percutaneous coronary intervention (a cardiac procedure). The focus group discussion developed into an intimate conversation between two older men about their challenges in physical recovery and the psychological effects of not being able to fulfil a traditional male role. The small group size was serendipitous, in that the researcher may not have been able to collect such rich data had the group been larger.³

The researcher(s)

It is common to have two researchers present in a focus group. One facilitates the group, while the other observes and records the session, and takes notes about who said what, body language and other observable information that contributes to the context of the data being collected. The observer should be as unobtrusive as possible and not participate in the group discussion. Similar to interviews, focus groups are audio-recorded so the conversation can be transcribed for analysis.  The researcher is encouraged to build rapport with focus group participants, which is aided by having a friendly and approachable manner. The focus group method enables the facilitator to probe ideas as they arise and to check their understanding of participants’ responses. This active facilitation enhances the robustness of the data collected. The quality of the data collected will depend greatly on how effective the researcher is at facilitating the group, and thus good interpersonal skills are essential. Conducting effective focus group discussions comes with practice and experience.

How long should a focus group be?

There are no strict rules about how long a focus group should be. Different groups will likely run for different amounts of time because this depends on the research question/s and the types of group members. For example, a group of people who know each other and have a common experience may need no longer than 45 minutes, whereas a group of strangers with different experiences may need up to 2 hours. Additionally, the number of people in the focus group will affect the amount of time needed. A focus group discussion with 6 participants may likely be shorter than a focus group with 12 participants.

Designing the focus group guide

Before the commencement of a focus group, the researchers need to develop a focus group discussion guide, which is similar to an interview guide. Both aim to explore the experiences, understandings, opinions and motivations of participants. If the study’s research methods include interviews and focus groups, the questions will be very similar. The difference is that the focus group discussion guide does not typically ask questions to elicit individual storytelling, but rather to ask questions to invite discussion of shared experiences, in which participants confirm or contrast each others’ views. If focus groups are the sole data collection method, the researcher may consult existing literature, speak to experts, including people with lived experience about the focus of the research, and draw on their knowledge so that the topics and questions can be mapped to the research question/s.

The focus group guide should be developed well in advance of commencing data collection. This provides time for the facilitator and the observer to explore together the language and clarity of questions, the order and flow of the guide, and whether the instructions for participants are clear and comprehensive. To facilitate free-flowing responses, it is important to use open-ended questions that encourage participants to be expansive in their responses. Examples of open-ended question formats include those that start with ‘who’, ‘how’ ‘tell me more about’ and ‘where’.

Pilot interview/s enable the researchers to test the interview guide. However, they are often not conducted because it can be difficult to recruit enough relevant participants. Instead, focus group questions might be reviewed by other members of the research team for clarity and comprehensiveness. The study design will determine the number of questions asked and the extent of the focus group guide. The target population may also determine the extent of the focus group guide; for example, clinicians who are time-poor may need shorter focus groups while patient populations may be interested in exploring their experiences in detail and at length.

Following is a template that can be adapted for the introduction of a focus group. Table 14.1 offers example questions for a focus group discussion guide.

Focus group introduction

‘Hi everyone. My name is [insert name] and I’m from [insert organisation]. I am conducting [describe study]. Thank you for agreeing to be part of this focus group today. You were invited to participate in this focus group because [include reason]. Today we would like to discuss [outline topics]. We anticipate that the session will go for approximately [insert expected time].

Before we get started, I’d like to explain how we would like to structure the discussion.

1. We would like to hear from everyone present. This may mean that I will call on you by name to respond to a question. I may also indicate to you when it’s time to wrap up your thoughts so we can move on to another person or topic.

2. Feel free to respond directly to each other. I’m here to facilitate the discussion, but you are encouraged to respond to the other participants in this group.

3. We are recording the session today. This will ensure that we capture everything discussed. Your names will not be used in the reporting of this data and we will be using pseudonyms or codes instead when writing up results.

4. Please be respectful of what other participants share. Due to the nature of focus groups, we cannot ensure confidentiality, but we do ask that you do not repeat what is discussed in this group to people who were not present. You should feel free to not answer a question if you don’t feel comfortable answering.

Do you have any questions before we begin?”

Table 14.1. Focus group guide: Example questions for a descriptive study

An earlier variation of this table has appeared in the Supplementary material for the article Why do students plagiarise? Informing higher education teaching and learning policy and practice.⁴

Setting up the focus group

In the past, most focus groups were conducted in person. Emerging technologies have enabled the conduct of focus groups online, using teleconferencing and videoconferencing platforms. While it is more challenging to conduct a focus group online – primarily because participants’ body language is often not seen – it can be a very useful method of collecting data. The benefits include low cost, greater access to participants in different locations and time efficiencies.⁵ Participants who are less inclined to participate verbally are able to use ‘chat’ functions to contribute their comments. Whether the focus group is face-to-face or online, the facilitator will need to help participants feel as comfortable as possible and encourage discussion.

Focus group activities

Focus groups may incorporate activities in addition to, or to aid discussion; for example, sorting and ranking activities to prioritise topics for discussion in the focus group; or a River of Life⁶ activity (see Chapter 18).

Considerations for the conduct of focus groups

Confidentiality should be addressed explicitly; for example, using the Chatham House rule, which sets out expectations about repeating what is said in a meeting without revealing the identities of who said it or other participants.⁷ It is advisable to provide each participant with an explanatory statement to read, which states that confidentiality is essential to the focus group discussions.

Expectations need to be communicated in advance. Many of the tips for interviews in Chapter 13 apply also to focus groups, but it is important to communicate the researchers’ and the group’s expectations upfront. Some, but not all, of the expectations of focus groups are included in Table 14.2. The facilitator should explain these expectations before the focus group starts. Table 14.3 provides examples of studies using focus groups for data collection.

Table 14.2. Dos and don’ts of conducting focus groups

Power imbalances. When setting up a focus group, the facilitator should pay strict attention to how homogenous the group needs to be concerning the topic, and how possible power imbalances might affect the data collection. For example, if the research question seeks to understand why drug administration errors occur in hospitals, it would not be a good idea to have doctors, nurses and pharmacists in the same group. Why? Because they might not feel comfortable expressing views in front of the very people they have seen make errors. Instead, you could run three separate groups: one with doctors, one with nurses and another with pharmacists. Conducting separate group discussions helps to avoid the chance that a powerful group might dominate the discussion and enables each group member to express their views openly.

Participant identity. The facilitator should invite participants to introduce themselves to other group members, to encourage familiarity; name tags can help participants remember each other’s names. The researchers will need to maintain a list of participants and any necessary demographic details.

Risk. The possibility of distress or harm occurring must always be considered in a focus group. Participants may become distressed because sensitive topics are being discussed, and there is always a risk that some participants might overshare their experiences. The facilitator will need to judge when to stop the discussion if it becomes clear that one or more participants are distressed.⁸ Researchers should have a clear protocol developed that provides advice about how to handle distress.

After the focus group

Once the discussion is concluded, participants should be thanked for their time and contributions. Explain how participants might contact the researcher if they have any questions or would like to provide the facilitator with follow-up information. If the focus group has covered sensitive topics or any participants have become distressed during the discussion, make sure that you spend some time privately with the participant to provide appropriate referrals and follow-up (see Section 6). Referrals and follow-up are usually described in the protocol addressing distress.

Data analysis is discussed in Section 4, but it is important to know what to do immediately after each focus group is completed. Download (or upload) the recording from the audio-recording device to ensure it is saved in a secure location that can only be accessed by people on the research team (see Chapter 34). The recording should be transcribed; that is, reproduced verbatim, for data coding and analysis. The transcription of data is an important step in the analysis process, and it is important to note that this is a highly time-consuming task. Transcribing a 60-minute focus group discussion can take up to 10 hours.

Table 14.3. Examples of focus groups

Summary

Focus groups and (individual interviews) are the most common data collection techniques in qualitative research. The success of a focus group depends on the group composition and the effectiveness of the facilitator. It is important to formulate open-ended focus group questions that are understandable and easy for participants to engage with. Setting up the focus group discussion guide, rules and other considerations will enhance the experience of the focus group for the participant and the researchers, as well as the quality of the data collected.

References

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