Focus Group Setting Research Articles

Engaging Stakeholders to Inform Clinical Practice Guidelines That Address Multiple Chronic Conditions.

Having more than one chronic condition is common and is associated with greater health care utilization, higher medication burden and complexity of treatment. However, clinical practice guidelines (CPGs) do not routinely address the balance between harms and benefits of treatments for people with multiple chronic conditions (MCCs). To partner with the Kaiser Permanente Integrated Cardiovascular Health (ICVH) program to engage multiple stakeholders in a mixed-methods approach in order to: 1) identify two high-priority clinical questions related to MCCs, and 2) understand patients' and family caregivers' perceptions of meaningful outcomes to inform benefit/harm assessments for these two high-priority questions. These clinical questions and outcomes will be used to inform CPG recommendations for people with MCCs. DESIGNAND PARTICIPANTS: The ICVH program provided 130 topics rank-ordered by the potential for finding evidence that would change clinical recommendations regarding the topic. We used a modified Delphi method to identify and reword topics into questions relevant to people with MCCs. We used two sets of focus groups (n = 27) to elicit patient and caregiver perspectives on two important research questions and relevant patient-important outcomes on benefit/harm balance for people with MCCs. Co-investigators, patients and caregivers identified "optimal blood pressure goals" and "diabetes medication management" as important clinical topics for CPGs related to people with MCCs. Stakeholders identified a list of relevant outcomes to be addressed in future CPG development including 1) physical function and energy, 2) emotional health and well-being, 3) avoidance of treatment burden, side effects and risks, 4) interaction with providers and health care system, and 5) prevention of adverse long-term health outcomes. Through the application of a mixed-methods process, we identified the questions regarding optimal blood pressure goals and diabetes medication management, along with related patient-centered outcomes, to inform novel evidence syntheses for those with MCCs. This study provides the lessons learned and a generalizable process for CPG developers to engage patient and caregivers in priority-setting for the translation of evidence into future CPGs. Ultimately, engaging patient and stakeholders around MCCs could improve the relevance of CPGs for the care of people with MCCs.

Comparing focus groups and individual interviews: findings from a randomized study

Qualitative researchers often have to decide whether to collect data using focus groups or individual interviews. We systematically compare these two methods on their ability to generate two types of information: unique items in a brainstorming task and personally sensitive disclosures. Our study sample consisted of 350 African-American men living in Durham, North Carolina. Participants were randomized into either a focus group arm or individual interview arm, and were asked the same open-ended questions about their health-care seeking behavior. For the item-generating task, we compared data at two levels of analysis – the event and the individual. At the event level, focus groups and individual interviews generated similar numbers of unique items in a free-listing task. When compared on a per-person basis, however, individual interviews were more effective at generating a broad range of items. We also compared the number of data collection events in which personal, sensitive information was disclosed. We found that several types of sensitive and personal disclosures were more likely in a focus group setting, and that some sensitive themes only occurred in the focus group context. No sensitive themes emerged exclusively, or more often in, an individual interview context. Researchers may use these findings to help align their choice of qualitative data collection method with research objectives.

Understanding the functions and operations of data monitoring committees: Survey and focus group findings.

The use of data monitoring committees in the conduct of clinical trials has increased and evolved, but there is a lack of published information on when data monitoring committees are needed and utilized, the acceptable range of data monitoring committee practices, and appropriate qualifications of data monitoring committee members. To gain a better understanding of data monitoring committee operations and areas for improvement, the Clinical Trials Transformation Initiative conducted a survey and set of focus groups. A total of 143 respondents completed the online survey: 76 data monitoring committee members, 52 sponsors involved with organization of data monitoring committees, and 15 statistical data analysis center representatives. There were 42 focus group participants, including data monitoring committee members; patients and/or patient advocate data monitoring committee members; institutional review board and US Food and Drug Administration representatives; industry, government, and non-profit sponsors; and statistical data analysis center representatives. Participants indicated that the primary responsibility of a data monitoring committee is to be an independent advisory body representing the interests of trial participants by assessing the risk and benefit ratio in ongoing trials. They noted that data monitoring committees must have access to unmasked data in order to perform this role. No clear consensus emerged regarding specific criteria for requiring a data monitoring committee for a given trial, and some participants felt data monitoring committees may be overused. Respondents offered suggestions for the data monitoring committee charter and communications with sponsors, institutional review boards, and regulators. Overall, data monitoring committee members reported that they are able to function independently and their recommendations are almost always accepted by the sponsor. Participants indicated that there are no standards or guidelines pertaining to qualifications of data monitoring committee members. Furthermore, only 8% (6/72) of data monitoring committee member survey respondents received any formal training, and 94% (68/72) were not aware of any training programs. Findings from the survey and focus groups provide a better understanding of contemporary data monitoring committee operations and insights regarding challenges and best practices. Overall, it was clear that increased training will be needed to prepare the next generation of qualified data monitoring committee members to meet the growing demand. These findings can be used by Clinical Trials Transformation Initiative and others to develop recommendations and tools to improve data monitoring committee operations and the overall quality of trial oversight.

Resilience for the Anthropocene? Shedding light on the forgotten temporalities shaping post-crisis management in the FrenchSud Ouest

Building on a set of semi-structured interviews, focus groups and participant observations conducted in the South West region of France in the aftermath of two windstorms (Martin in 1999 and Klaus in 2009) and the collapse of the natural gas industry, this paper explores how different temporal dynamics and rhythms interact in the shaping of post-crisis responses in the wider context of the Anthropocene. By so doing, it argues that resilience proponents and critics have articulated a wider biopolitics of speed in which accelerated futures and explicated time have both become the focal temporal realms in which it is possible to (re)think and enact political change. Finally, it is argued that resilience is detracting our attention from important enquiries about temporal relations and processes such as rhythms, which have the capacity to transcend classical rationality and axiology for reimagining what it means to be together, in a different human–non-human nexus that is fit for the Anthropocene.

‘I don’t want my parents’ respect going down the drain’: South Asian, Muslim young women negotiating family and physical activity

ABSTRACTYoung women’s relationship with physical activity has been explored extensively, yet the focus is often upon young women who are White. This paper considers South Asian, Muslim young women’s experiences of physical activity and how these are influenced by family. A ‘middle ground’ feminist approach is used, drawing upon the work of Hill Collins [(2000). Black feminist thought: Knowledge, consciousness, and the politics of empowerment. London: Routledge] and Hamzeh [(2012). Pedagogies of deveiling: Muslim girls and the hijab discourse (critical construction). Charlotte, NC: Information Age Publishing]. Data were generated with 13 young women using participatory approaches in focus group settings, and individual interviews. This research highlights how the young women’s families can both enable and challenge opportunities and involvement in physical activity. The paper discusses how gender and religion intersect with family and wider community to influence experiences in multiple, diverse and fluid ways. The young women’s narratives suggest that experiences are not determined solely by these influences; rather, they emerge as active agents negotiating different contextual challenges in their quest to be physically active.

Aging at home with telecare in Spain. A dicourse analysis

Caring for the elderly is turning to forms of community care and home care. Telecare is one of those emergent modalities of caring. This article will explore the meanings that older people give to the experience of staying at home in later life by using telecare. Discourse analysis is used to examine a set of focus groups and interviews with telecare users from different cities of Catalonia (Spain). The outcomes include three interpretative repertoires that we called: "Aging at home", "normal aging" and "unsafe aging". For each repertoire we examine how the permanence of older people in their homes is accounted, and which role telecare plays in such experience.

User-centered design of multi-gene sequencing panel reports for clinicians

The objective of this study was to develop a high-fidelity prototype for delivering multi-gene sequencing panel (GS) reports to clinicians that simulates the user experience of a final application. The delivery and use of GS reports can occur within complex and high-paced healthcare environments. We employ a user-centered software design approach in a focus group setting in order to facilitate gathering rich contextual information from a diverse group of stakeholders potentially impacted by the delivery of GS reports relevant to two precision medicine programs at the University of Maryland Medical Center. Responses from focus group sessions were transcribed, coded and analyzed by two team members. Notification mechanisms and information resources preferred by participants from our first phase of focus groups were incorporated into scenarios and the design of a software prototype for delivering GS reports. The goal of our second phase of focus group, to gain input on the prototype software design, was accomplished through conducting task walkthroughs with GS reporting scenarios. Preferences for notification, content and consultation from genetics specialists appeared to depend upon familiarity with scenarios for ordering and delivering GS reports. Despite familiarity with some aspects of the scenarios we proposed, many of our participants agreed that they would likely seek consultation from a genetics specialist after viewing the test reports. In addition, participants offered design and content recommendations. Findings illustrated a need to support customized notification approaches, user-specific information, and access to genetics specialists with GS reports. These design principles can be incorporated into software applications that deliver GS reports. Our user-centered approach to conduct this assessment and the specific input we received from clinicians may also be relevant to others working on similar projects.

Eliciting Students' Understanding of a Local Socioscientific Issue Through the Use of Critical Response Pedagogies

This study introduces a critical response pedagogy (CRP), an arts-based critical technique to facilitate meaningful dialogue in focus group settings, to secondary school science education students to engage them in discussion about sediment and chemical load in their local river basin community. Using a holistic single case design, twenty-two 11th and 12th graders (15 male and 7 female) from an environment ethics course participated in focus group interviews. The analysis of the data was made via case-by-case analysis individually performed by each researcher to identify themes, then across the cases using the long table (classic) method. The following themes were identified: (1) aroused curiosity, (2) human impact and responsibility, (3) triggering memories, (4) feeling connected to the Minnesota River, (5) outside of the captured area, (6) use of the image, (7) social impacts, (8) economy, and (9) ecological impacts. The findings indicated that student’s characterization and description of the rivers is mixed although they have similar observations and experiences. In addition, using a critical response protocol created a dialogical environment where students were comfortable engaging in a conversation about a local controversial issue. Thus, the conversation shifted toward critical analysis of an issue rather than an under informed debate about perspectives. This study showed that critical response pedagogy is a non-threatening way to gauge students’ knowledge and understanding of issues and identify possible misconceptions or knowledge gaps which would be useful in designing instruction.

Teacher Belief in a Focus Group: A Respecification Study

This paper investigates teacher belief as a social practice in a focus group setting with three second language teachers by utilizing a discursive psychology (DP) approach (Edwards, 1997; Edwards & Potter, 2005). By adopting an empirically based emic perspective (i.e., how the participants display their understandings through their own contributions), we aim to respecify individual psychological states as an embodied interactional activity and study what members achieve through their interaction, particularly in their disagreement and teasing sequences. The findings show how teacher belief is a socially co-constructed phenomenon that not only evolves through interaction but stands as a foundational concept upon which participants build and display their teacher competence within the focus group setting. We thereby provide a new methodological means of investigation and new methods to focus on when examining teacher belief, as well as to show the procedure of what members do in a teacher belief focus group session. We conclude by summarizing our findings and addressing some implications for further work on teacher belief.

Communication Challenges: A Qualitative Look at the Relationship Between Pediatric Hospitalists and Primary Care Providers

ObjectivePrimary care providers (PCPs) and hospitalists endorse the importance of effective communication yet studies illustrate critical communication problems between these 2 provider types. Our objective was to develop deeper insight into the dimensions of and underlying reasons for communication issues and determine ways to improve communication and remove barriers by eliciting the perspectives of pediatric PCPs and hospitalists. MethodsUsing qualitative methods, 2 sets of focus groups were held: 1) mix of local PCPs serving diverse populations, and 2) hospitalists from a free-standing, pediatric institution. The open-ended, semistructured question guides included questions about communication experiences, patient care responsibilities, and suggestions for improvement. Using inductive thematic analysis, investigators coded the transcripts, and resolved differences through consensus. ResultsSix PCP (n = 27) and 3 hospitalist (n = 15) focus groups were held. Fifty-six percent of PCPs and 14% of hospitalists had been practicing for >10 years. Five major themes were identified: problematic aspects of communication, perceptions of provider roles, push-pull, postdischarge responsibilities/care, and proposed solutions. Aspects of communication included specific problem areas with verbal and written communication. Perceptions of provider roles highlighted the issue of PCPs feeling devalued. Push-pull described conflicting expectations about a counterpart's role and responsibilities. Postdischarge responsibilities/care addressed unclear responsibilities related to patient follow-up. Proposed solutions were suggested for ways to improve communication. ConclusionsDeficiencies in communication hinder successful collaboration and can cause tension between providers in inpatient and outpatient settings. Understanding specific issues that contribute to poor communication like perceptions about provider roles is critical to improving relationships and facilitating combined efforts to improve patient care.

Black Identities Inside Advertising: Race Inequality, Code Switching, and Stereotype Threat

ABSTRACtThis article explores Black identities within the U.S. advertising industry—an atmosphere charged by a history of discrimination against, and continuing underrepresentation of, African American practitioners. Drawing on theories of code switching and stereotype threat, the author interprets data from a set of focus groups with Black interns working at agencies in New York City and argues that their supposed race-based affiliations conceal deeper anxieties of cultural belonging marked by fissures of class and language that trigger self-monitoring and thus undermine retention and advancement in the advertising field. Furthermore, the author contends that the added psychological burden of stereotype threat makes Black interns wary of seeking out help from other more established Black employees—for fear of being seen as preferring their own race—thus placing them at a career development disadvantage vis-à-vis Whites, who have no qualms about affiliating with and mentoring other Whites. The author then offers some strategies for closing the White–Black labor gap in advertising ranging from agency reform from within to clients exerting structural pressure from without and concludes with a call for communication scholars to move beyond the text and critique race representation at the point of production.

Qualitative Measures of Wildlife Value Orientations with a Diverse Population in New York City

ABSTRACTThis article reports on the development and implementation of a qualitative methodology to measure wildlife value orientations (WVOs) in a focus group setting, with the ultimate goal of developing a technique to help with cross-cultural assessments of WVOs. Information provided by such assessments can assist conservation organizations in understanding and meeting the needs of an increasingly diverse population. The technique was administered to Latino and Chinese-American audiences in New York City. Focus group participants were shown a series of photographs depicting wildlife and human–wildlife interactions, and asked to individually evaluate each photograph and discuss their reactions. Results revealed this methodology to be effective in eliciting WVOs. Four WVO types recognized from previous literature were identified across the groups based on participant comments. This article concludes with suggestions on how to improve this methodology for future use and adapt it for applications in other settings.

ADHD in college: A qualitative analysis.

Attention-deficit/hyperactivity disorder (ADHD) affects many adults and is particularly impairing for emerging adults enrolled in college. Research has shown substantial academic impairment for these individuals. However, research on ADHD impairment has largely been quantitative and focused on children. Therefore, the current study employed Interpretative Phenomenological Analysis to explore the lived experience of college students with ADHD with the following two research questions: (1) What is it like to be a college student with ADHD? and (2) What resources are utilized by college students with ADHD? Thirty-six college students with ADHD were interviewed in focus group settings. Our participants reported a complex and mixed experience living with ADHD in college and varied use of treatments and other accommodations. Specifically, three Constructs emerged in the current study: Consequences of Diagnosis, Impairment, and Treatment Management. Implications for professionals working with these students and future directions for researchers are discussed.

Description of Unified English Braille Implementation in Canada

Unified English Braille (UEB) is used for the transcription of literary and technical texts in Canada. Professionals in Canada have been closely involved in the process of developing and adopting UEB for many years. In 2004, the Canadian Braille Authority (CBA) voted to explore potential implications of adopting UEB. The CBA teaching and learning committee received funding from Human Resources and Skills Development, Canada, for research that examined the use of UEB by braille-reading technical experts. Carried out by members of the CBA teaching and learning committee, the research was not intended to be a comparison of use of UEB and the Nemeth Braille Code for Mathematics and Science Notation, but, rather, it was an attempt to determine if UEB was a useful code for representing mathematics, science, and computer science. The researchers asked the technical experts to explore samples in UEB and to discuss their findings in a focus-group setting, and the results were published in the Journal of Visual Impairment & Blindness (Holbrook & MacCuspie, 2010). Stakeholders considered these findings, along with the results of consultations conducted across Canada, to make the decision about the adoption of UEB for use in literary and technical texts. In 2010, CBA--now known as Braille Literacy Canada (BLC)--voted to adopt UEB for literary and technical texts in Canada. In 2012, British Columbia hosted a three-day UEB Summit with 32 Canadian delegates for the purpose of discussing UEB implementation in Canada. EVALUATION OF UEB In Canada, education is a provincial matter, and braille production is overseen by the Canadian Association of Educational Resource Centres for Alternate Format Materials (CAER), which has representatives from all the major educational braille producers across Canada that produce materials for students in kindergarten through Grade 12, as well as those in postsecondary educational environments. For a few years prior to the official adoption of UEB in Canada, CAER explored how UEB might simplify teaching and learning of mathematics and better integrate technology that would make it easier to translate print materials into braille (forward translation) and braille materials into print (back translation). In early 2013, CAER created a subcommittee to develop a national implementation plan for the transition to UEB in education. The outcome was an agreement that all CAER members should move forward together with the transition to UEB in order to ensure that resource centers could continue to share resources with each other, thus saving time and money and allowing students to easily move from province to province. It was agreed that each province would develop its own plan based on local needs and resources, but that the overarching transition for all provinces would be mostly completed by September 2017. CAER members communicated this plan through a panel presentation at the Seeing Beyond the Horizon Conference in Halifax in May 2014. DEVELOPMENT OF A GRADED APPROACH FOR TRANSITION The Provincial Resource Centre for the Visually Impaired (PRCVI) in British Columbia, under the management of the first author of this commentary, Christopher Marshall, decided to take a graded approach to the introduction of UEB. It considered factors such as the number of students currently learning braille, available human and monetary resources, and the training requirements of teachers of students with visual impairments and transcribers. The plan for British Columbia spans five years: it began in 2013 with the development of resources for the first cohort of students in kindergarten through grade 3. In the first year, year PRCVI disseminated information to school district administrators, conducted a series of face-to-face and online training sessions in UEB, and transcribers and teachers of students with visual impairments were encouraged to update their own braille qualifications. …

Review of the cultural safety of a national Indigenous point-of-care testing program for diabetes management.

In Australia, Aboriginal and Torres Strait Islander people have approximately three-fold higher rates of diabetes than non-Indigenous Australians. Point-of-care testing, where pathology tests are conducted close to the patient, with results available during the patient consultation, can potentially deliver several benefits for both the Indigenous client and the health professional team involved in their care. Currently, point-of-care testing for diabetes management is being conducted in over 180 Aboriginal and Torres Strait Islander Medical Services as part of a national program called Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS). The cultural safety of the Program was reviewed by sourcing the views of the QAAMS Indigenous Leaders Team in a focus group setting and by surveying the point-of-care testing operators enrolled in QAAMS, via an electronic questionnaire. The current study confirms that QAAMS remains a culturally safe program that fills a permanent and positive niche within the Indigenous health sector. The study demonstrates that QAAMS provides a convenient and accessible 'one-stop' pathology service for Indigenous clients with diabetes and empowers Aboriginal Health Workers to have a direct role in the care of their diabetes clients.

On the responsibility to engage: non-Indigenous peoples in settler states

Many non-Indigenous peoples in settler societies describe themselves as concerned with the legacies of colonialism and wish to become more engaged with that history and with Indigenous peoples. Paradoxically, however, many do not understand what that engagement might entail, how they could do it or whether, indeed, it is their place to do so. In this research, we survey findings from three sets of focus groups with non-Indigenous peoples in Canada conducted over a two-year period and intersecting with the Truth and Reconciliation Commission process that has nearly concluded there. The goal was to see what ‘emergent’ discourses of reconciliation are at play in reflective conversations between non-Aboriginal Canadians. Some strong but complex themes arise from this research, in particular a mode of ‘delegation’ and another, of ‘embodiment’. These are expressed in different rhetorical styles and speak to variations in the geography, history and identity of the participants and their communities. A broad but tentative conclusion is that for reconciliation the politics of the local matter. We explore this finding with one eye toward policy innovations and as part of a broad comparative inquiry into non-Indigenous peoples' ideas of engagement and responsibility in settler colonial states.

The two fold role of pre-service teachers: their perceptions towards bilingualism in their future practices

The aim of this study was to explore the perceptions of a group of pre-service teachers towards bilingualism and its role in their teaching practices. The participants came from two public universities whoparticipated in a set of focus groups. Their responses were validated with theoretical elements. In order to gain deeper understanding of data gathered the Grounded Theory methodology was used in the analysis of it. Findings evidence that the participants’ perceptions of bilingualism let them conceive themselves as having a twofold role in their future practices. This is sustained in two subcategories, the first: To be a bilingual master and the second: To be a bicultural reader.

Measuring the value of theatre for Tyneside audiences

What values do theatre and dance hold for audience members? And how do these values differ between subsidised, amateur, and commercial performance? This paper addresses these questions through a survey of over 1800 spectators for theatre and dance in Tyneside in northeastern England, as well as a parallel set of focus groups, in the spring of 2014. These methods, which are designed for comprehensiveness and comparability, are being used across Europe by the Project on European Theatre Systems, a working group of theatre sociologists. Our research showed two sets of values which performances achieved; one was a common measure of performance quality, while the other described the values particular to subsidised work. This allows us to articulate both the general value of the arts and the particular values which subsidy (attempts to) facilitate. This has implications for both understandings of cultural value and for cultural policy, as the distinction between the two groups was not clean. We also found that amateur theatre participated in the same value system, but with an increased emphasis on loyalty and community cohesion. The paper concludes a methodological reflection on the use of quantitative methods in theatre studies.

Supporting Adolescent Daughters as They Come of Age: Latina Mothers’ Reflections and Recommendations

The current project describes themes emerging from a set of focus groups with 20 Latina mothers (aged 25 to over 45) who reflected on the transition to adulthood for their daughters. As community stakeholders residing in a large city in the Southern USA, these mothers shared their perspectives and advice on supporting adolescent girls during the transition to adulthood. Qualitative coding revealed four key aspects of the transition that were important to these mothers: ethnic identity, involvement of others, communication with daughters, and individual personality characteristics. We discuss their reflections with regard to the development of more culturally relevant programs for Latina girls coming of age within the USA context.

University Students’ Reflections on Representations in Genetics and Stereochemistry Revealed by a Focus Group Approach

Genetics and organic chemistry are areas of science that students regard as difficult to learn. Part of this difficulty is derived from the disciplines having representations as part of their discourses. In order to optimally support students’ meaning-making, teachers need to use representations to structure the meaning-making experience in thoughtful ways that consider the variation in students’ prior knowledge. Using a focus group setting, we explored 43 university students’ reasoning on representations in introductory chemistry and genetics courses. Our analysis of eight focus group discussions revealed how students can construct somewhat bewildered relations with disciplinary-specific representations. The students stated that they preferred familiar representations, but without asserting the meaning-making affordances of those representations. Also, the students were highly aware of the affordances of certain representations, but nonetheless chose not to use those representations in their problem solving. We suggest that an effective representation is one that, to some degree, is familiar to the students, but at the same time is challenging and not too closely related to “the usual one”. The focus group discussions led the students to become more aware of their own and others ways of interpreting different representations. Furthermore, feedback from the students’ focus group discussions enhanced the teachers’ awareness of the students’ prior knowledge and limitations in students’ representational literacy. Consequently, we posit that a focus group setting can be used in a university context to promote both student meaning-making and teacher professional development in a fruitful way.