Archive | April, 2012

Conducting focus groups: my PhD experience

22 Apr

Having reflected on my experiences with recruiting participants for focus groups, I shall continue with this thread and share my experiences of conducting the focus groups. In contrast to the recruitment process, I absolutely loved this part. In fact, I was a little bit sad when they were all finished! Obviously I can’t cover everything here, so I will touch upon some of the aspects that were particularly salient for me.

Preparation

Getting the right venue to conduct my focus groups was important. I wanted my participants to feel welcome and comfortable so that discussions would flow with ease. Most of my focus groups were conducted in community centres mainly due to recruiting already formed social groups from the centres. The rooms were clean, warm, and spacious and had comfortable chairs. Having a table was also important for placing name cards on and laying out light refreshments. I made sure I arrived an hour before to be able to arrange the room. Community centres didn’t charge me very much for the use of the room either (anything from £5 – £20). I did do one focus group in a local pub which also worked well. They gave me the function room and even provided the refreshments (free of charge!)

Prior to focus group

I made sure that a bit of time was spent with my participants before the focus group to develop a rapport. I spoke to them about anything but the study at this stage and made sure I included everyone in the conversation. I also provided light refreshments. Although when I say light, I did go way overboard for the first couple. I spent a fortune in M & S on all sorts of food that they didn’t eat! A few biscuits or cakes were all that was needed to go with their tea, coffee and juice. I also brought my own kettle etc. with me.

Also, I made sure that all the paper work was completed prior to the focus group (consent form signed and screening questionnaire completed) so they wouldn’t be forgotten about after. Don’t underestimate the amount of time this all takes. It was an important part of the process so I made sure I didn’t rush it. However, it does add onto participants’ time so I needed to be mindful of that.

 

Participant numbers

I got quite obsessed about having the ‘correct’ of people in each focus group. I thought the more the better. However, I found that not to be the case. The most I had was 8 people and from my experience this was too many. This resulted in a couple of people not saying much at all and some were often interrupted so they weren’t able to finish what they had started to say. Having too many was also difficult for keeping track of who was saying what in my notes. The least amount I had in one group was 3. Although for me it worked out well as they all had lots to say, but it could have also made the discussions a bit stagnant. I found 5 or 6 people were ideal.

Moderating

This was not as easy as the books make it out to be!! My biggest challenge for the first couple was trying to keep quiet! Focus groups are about participant interaction, they are flexible and conversation shouldn’t be forced. Having only a small handful of loosely structured questions (with prompts) helped. However, at the beginning, it was really hard to just to let the conversation flow naturally (even if it did divert from my questions). It wasn’t until I began transcribing that I realised what valuable data this generated (important part of inductive analysis). I also found it difficult not to respond after each person spoke. What this did was to ‘encourage’ my participants to speak to me (rather than each other). When I learned not to do this, they actually rarely looked at me or spoke to me. I like the term Jenny Kitzinger uses: ‘structured eavesdropping’. It’s a difficult thing to do at the beginning, but once I got the hang of it and felt comfortable taking a back seat, it was easy.

Note taking

My advice here is that if you can get someone to take notes, then brilliant! A note taker would have helped my hugely to record the beginning of each person’s sentence (makes transcribing a whole lot easier!). Additionally, the interaction process of participants is an important part of focus group data. A note taker can record the non-verbal language or any specific issues that arise during discussions. All of this is quite difficult to do whilst moderating and things can get missed. However, I managed it and found it much easier after I learned to take a back seat during the discussions. What helped me also was placing name cards in front of each participant and whenever I spoke to them I used their names. On a piece of paper, I also drew the layout of the room and identified where everyone sat. This was helpful for transcribing as I was able to place voices to where they were sitting.

Stimulus material

This was great to stimulate further in-depth discussions about a particular topic. I used newspaper headlines of a Clostridium difficile outbreak as I wanted to explore more in-depth perceptions about media representation. I also found them to be a good tool for encouraging quieter participants to become more involved in the conversation. If you are using something like that – best to laminate them as they can be cleaned between focus groups!

Recording

I recorded all my focus groups using a small Olympus digital voice recorder. Just in case anything went wrong, I also used my phone to record as a backup. However, nothing went wrong ant the digital voice recorder worked perfectly.

Time

I read a lot about how long a focus group should go on for. I was very conscious of not taking advantage of my participants’ time so I said I wouldn’t keep them for longer than an hour. However, I also had to be mindful that the introductions etc. at the beginning were included in that. Overall though, I found 45 minutes generated ample data and was enough time for participants to remain interested and focused. Some did go on for a bit longer but not too much. Also remember that moderating focus groups is very draining so it’s not in your best interest to let them go on for too long! Additionally, transcribing and analysing copious amounts of data would be very time consuming.

Showing appreciation

If it wasn’t for my participants, I simply couldn’t do my study so it was important that I was able to thank my participants. For the members of the public, I gave each person £15 cash (ethically approved). I was able to do this through being awarded a small education grant to help run my focus groups by Ethicon. My healthcare professionals were provided with boxes of chocolates (my funding didn’t stretch to enable them to be given £15 also!).

Post focus group

After my participants had left, I made sure that I had at least an hour to stay in the room and write. I took time to reflect on the session in its entirety and wrote about my perceptions of critical points that had emerged.  Additionally, I wrote about what went well and what didn’t go so well. This also helped me prepare for my next focus group. Reflecting on my focus groups went on for a long time after each one and I found Evernote on my phone invaluable for recording my thoughts as and when they popped into my mind. I also tried to transcribe as quickly as possible because if I had missed anything on my notes, I was able to place voices to responses much easier.

One of the things I would strongly advise is not to try not to do too many in a short space of time. They really are physically and mentally draining. You also need some time to reflect on each one before you embark on the next. Because I stayed in one of the geographical areas for the duration of all my focus groups, just because they were so far away from where I lived, I wasn’t able to spread them out too much so my reflective writing was very helpful.

One final, most important point I will make is to relax and enjoy them because you only get one chance. I felt extremely privileged and humbled that my participants were so willing to give me their time and share their thoughts and personal experiences. I met some wonderful people and generated truely fascinating and some unexpected data. I am now very excited about starting analysis.

I hope you have found my reflections helpful. I don’t proclaim to be an expert in any way, but learning from past experiences certainly helps. Please do leave a comment and share your thoughts and experiences.

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Recruiting healthcare professionals for focus groups: my challenges

22 Apr

OK, so having reflected on my challenges of recruiting members of the public, I shall now share my experiences of recruiting healthcare professionals. Similar to my public focus groups, this was another fairly stressful and frustrating process at the beginning but for different reasons. I used the same two geographical areas as I did for my public focus groups to afford the opportunities to make comparisons. The West of Scotland who had experienced an outbreak was my most challenging area for two reasons. The first major one was that despite the outbreak occurring a number of years ago, the aftermath was still very much apparent. The public inquiry was still on-going and emotions were still very raw. I knew from a moral perspective if nothing else that I had to be careful. For that reason, I did not recruit from a particular healthcare setting. This therefore presented me with challenges around getting enough participants from surrounding areas. The second challenge was that from a clinical and academic perspective I was a stranger in this area. I had worked in the East as an infection prevention practitioner for many years so I was fairly well known there.

Making contact

To identify potential healthcare settings, I simply used the internet. My sample needed to be from a particular area therefore I was limited in who I could approach. Having established potential healthcare settings, I contacted each manager by email. These consisted of two hospitals, 3 GP practices/health centres and 4 care homes. I provided the manager with detailed written information about the study and asked for permission to approach staff and invite them to take part. From this initial contact, two hospitals and one care home agreed to take part. All others responded and declined. It would have been interesting to know why they declined, but ethically I was not able to ask and no-one provided a reason. Of the healthcare settings I contacted in the East, everyone agreed to my request (4 hospitals). I suspect this was because I was known to them (and I think they liked me!).

Gatekeepers

My initial plan was to then contact staff myself through a physical visit, explain the purpose of the study, leave a participant information leaflet with them then wait for them to contact me if they were interested in taking part. Reflecting on my experience with the public in my previous post in terms of waiting for participants to come to me, this made me very nervous! However, all managers suggested that they recruit participants for me. Although there is a lot of literature about the difficulties with using gatekeepers, if I am honest I was just relieved at not having to do this myself! Although some may argue this can result in sampling bias, as the aim of my study was to explore perceptions and experiences rather than locating a ‘truth’, this sampling strategy was acceptable. All that was left for me to do was to agree with each manager a date and time for the focus group to be conducted. They were extremely helpful as they all allowed for the focus groups to be conducted in work time and in the work place which took a lot of pressure off me. Additionally, I was able to conduct the ones in the West within a week so I just took the motorhome down and stayed there for the week!

This whole process was much more time consuming than I had anticipated. It took about 6 weeks before I was able to conduct my first focus group. By the end, I conducted 7 focus groups (3 in the West and 4 in the East). I had hoped for 4 in the West, but due to all other areas declining, this was not possible. However, the data generated was adequate for this part of my study.

So lessons learned for me during this phase:

  • knowing your potential participants makes life much easier (especially if they like you!)
  • using managers as gatekeepers helps hugely (but be aware of potential limitations)
  • my initial contact with the gatekeepers was extremely important – I needed to ensure I ‘sold’ my research to them and for them to see the importance of it. Although it took longer than anticipated, I wasn’t pushy, I didn’t bombard them with numerous emails or give them deadlines as I didn’t want to alienate them from the outset
  • this is an important process which can’t be rushed
  • breathe a big sigh of relief when finished!

I hope this helps anyone who is about to do something similar. I know that I have learned so much from reading other people’s blogs so please do comment here about your experiences with recruiting professionals so that others can benefit from it.

Recruiting the public for focus groups: my challenges

22 Apr

My PhD is a qualitative interpretive study underpinned by weak social constructionism and part of my data collection methods was focus groups. I conducted 15 focus groups in total (8 with the public and 7 with healthcare professionals) from the East and West of Scotland.

To prepare myself, I read lots of literature and research books and felt confident that they would be relatively straightforward. Overall, I really loved doing them. However, it wasn’t all plain sailing. Here I will share some challenges I faced with public recruitment and how I addressed them. Further blogs will follow about other aspects of my focus groups and interviews:

For me, this was the least enjoyable phase and I found it very stressful. In fact, I didn’t enjoy it at all!  I initially planned for purposive sampling so I could include members of the public with a range of demographic characteristics (age gender, education level, occupation etc.). This would be done with the use of a screening questionnaire.

I started with putting up this nice laminated poster in shops, cafes, taxi ranks, GP practices, Dental practices etc. and expected the phone to start ringing pretty much straight away. It didn’t! An important tip here is that if you are using a mobile phone, don’t use your own one. Buy a cheap pay-as-you go one with a number that you’ll never use again. Some of the text messages I received are not repeatable!

So after a week of nothing, I then placed adverts in the local newspapers (all editors were very kind and did this free of charge). A little better response, but not much! Only 4 people came forward. Nowhere near the numbers needed. Next strategy was opportunistic. Chatting to a friend about my frustrations of recruitment, she knew someone who worked in one of the geographical areas I was targeting. A telephone call later, and  snowball sampling from this person led to the recruitment of 6 people for one focus group. Further snowball sampling from the 4 people who responded to the newspaper adverts saw the recruitment of another 5 people. This meant I had enough people for 3 focus groups.

My final strategy was the most effective and I wished I had done this at the beginning – I targeted existing social groups at local community centres (Jenny Kitzinger has written a lot about the effectiveness of this approach). Before their class, I spoke to them, explained the purpose of the study and gave out participant information leaflets. I set up a room in the community centre for the focus groups and asked them to come along after their class if they were interested in taking part. So many people responded to this that I even had to turn some away! I then managed to conduct all my planned focus groups.

So my lesson learned: The public generally don’t not want to take part in research, but they are very busy people.  If you wait for them to come to you, you’ll likely have a long wait. In the end I went to them (ethically approved) and was humbled at the positive response I got. People were genuinely interested in my topic and wanted to share their opinions and experiences. While I didn’t purposively sample in the way I planned, it didn’t matter. I was exploring public perceptions and experiences from two different geographical areas and that’s exactly what I did.

Next I will share my experiences of recruiting healthcare professionals.

Keep going and you’ll get there in the end!  Hearing other people’s experiences and challenges is very helpful – for the next time and for others still to go through this process so please do share yours here. Was your recruitment process straightforward or did you face some difficult challenges?

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