Focus group

Focus Groups An Executive Summary 2008<nowiki>Insert non-formatted text here

Description: A qualitative research method that collects data from a group of participants that are guided in their discussion by a moderator. The group typically contains 6-10 participants and lasts for one to two hours.

Brief History: From the literature, the first use of group interviews was in the 1920 by social scientists, Emory Bogardus and Walter Thursone to develop survey instruments. During World War II Columbia University faculty Robert Merton and Paul Lazarsfeld used group interviews to assist the government in the development propaganda materials, training manuals and understand social issues. The term “Focus group” replaced “group interviews” as the name of this technique in 1956 when Patricia Kendall and Majorie Fiske published their book “The Focused Interview”. For the following thirty years focus groups were primarily used by market researchers to understand customers while social scientists preferred survey research. Academic interest in focus groups was reignited in the late 1980’s when several books on the topic were published. Over the last twenty years there has been a steady increased interest in balancing quantitative data with qualitative research which has produced growing use of focus groups, especially in the health field.

Principal Use: Focus groups are used by academics, the government, and companies to solicit feedback on key questions.

Structure of Focus Group Technique: 1. Plan the purpose of the focus group 2. Recruit participants 3. Moderate the group 4. Analyze the results 5. Report the findings

Advantages: • A variety of perspectives can captured if participants reflect a wide audience • The interactions between participants can be synergistic • Less time intensive and costly than individual interviews

Shortcomings: • Finding can be influenced by researcher • The quality of the findings are dependent on the participants willingness to interact • Participants will describe how they think they will behave • Challenging to coordinate multiple participants

Examples in Informatics: • Focus groups of general physicians were asked about what influenced their prescribing behavior.

 L Tobin et al.  Influences on the prescribing of new drugs.  Aust Fam Physician.  2008 Jan-  
 Feb;37(1-2):78-81

• Focus groups of home care teams were asked about the use of telecare in COPD management.

 K Horton. The use of telecare for people with chronic obstructive pulmonary disease:   
 Implications for management.  J Nurs Manag. 2008 Mar;16(2):173-180.

• Focus groups of African-American adolescent males were asked about health text messages.

 D Levine et al. SEXINFO: A Sexual Health Text Messaging Service for San Francisco Youth.
 Am J Public Health. 2008 Jan 30.

Resources: • R Krueger et al. The Focus Group Kit. Sage Pulbications. Thousand Oaks, CA. 1999 • A Ramirez et al. Use of focus groups in health research. Scand J Prim Health Care

 Suppl. 1988;1:81-90.

A focus group is a qualitative research technique where the researcher or moderator conducts a group interview to address a specific issue (1). The size of the group is variable, but in general, five to ten participants is considered optimal. The duration of the interview can be an hour or two.

Focus groups originated in response to a need in the mid-twentieth century by advertising companies to determine why (or why not) consumers liked (or disliked) various products and services (2). It was useful to bring consumers together to discuss these products and services, as the interactive nature of the interview allows the researcher to focus as necessary on areas of interest. Once there value was realized, focus groups were no longer limited to marketing, and soon became a cross-discipline research methodology, although their use in academics has been adopted more slowly.

Focus groups are useful for several reasons (1,2,3). First, a group of interviewees can be brought together rapidly and cost-effectively. This is particular important for a health informatics project as continual user feedback during development and deployment is key to a projects success. Second, this informatics project impacts all users in the organization, and therefore having a common forum will help to encourage discussion and sharing of concerns on how the project affects the organization.

As with other research techniques, there are drawbacks (2,3). Most notably, the researcher (or moderator) sacrifices the control of a one-on-one interview for the flexibility of a group interview. This can lead to discussion of extraneous topics, but an effective researcher will be able to quickly refocus the discussion. Another drawback is some interviewees may feel inhibited about bringing up topics where their opinion differs drastically from the group. Combining a group interview with one-on-one interviews can circumvent this drawback.

There are abundant examples of the use of focus groups for informatics projects in published literature. Some select examples include:

• A study where a focus group of nurses was assembled to gather feedback on an “assessment” that was introduced to an EHR (4).
• A study where a group of clinicians was brought together to address a recently implemented EHR and the issue that a “useful clinical overview” was not easily obtained from the system (5).
• A study designed to ascertain the “social and organizational requirements for a decision support system (DSS)” (6).
• A study of clinicians and patients to determine an appropriate alerting technique to track changes in medical knowledge (7).

1. Leedy et al. Practical Research. p146.

2. http://www-tcall.tamu.edu/orp/orp1.htm

3. http://en.wikipedia.org/wiki/Focus_group

4. Gunningberg L, Fogelberg-Dahm M, Ehrenberg A. Nurses' perceptions of feed-back from the electronic patient record for the quality on pressure ulcer care. Stud Health Technol Inform. 2006;122:850.

5. Neve K, Kragh Iversen R, Andersen CK. Is it possible for nurses and doctors to form a useful clinical overview of an EHR? Stud Health Technol Inform. 2006;122:314-9.

6. Dahlstrom O, Thyberg I, Hass U, Skogh T, Timpka T. Designing a decision support system for existing clinical organizational structures: considerations from a rheumatology clinic. J Med Syst. 2006 Oct;30(5):325-31.

7. Hinze A, Buchanan G, Jung D, Adams A. HDLalert - a healthcare DL alerting system: from user needs to implementation. Health Informatics J. 2006 Jun;12(2):121-35.</nowiki>