A focus group is a particular technique in qualitative research. In order to do a focus group interview a group of individuals is gathered in function of their specific profile or characteristics to explore a limited number of “focused questions” (Sofaer,1999). Groups are generally homogenous on a or several criteria relevant to the focus of the discussion.
“In essence, a focus group is a small (usually 6-12 people) group brought together to discuss a particular issue (..) under the direction of a facilitator who has a list of topics to discuss” (Green and Thorogood, 2009, p. 111).
Focus groups are group semi-structured interviews used for the purpose of collecting information focused on a specific subject or area of concern, for exploration and discovery, in-depth understanding of a problem as it is experienced in context, to assess needs, preferences, attitudes and interests related (in the context of KCE research) to health and health care issues.
It differs from individual semi-structured interviews, as the interaction component is used to bring out insights and understandings in ways which questionnaire items or individual questions may not be able to do. The interaction between the moderator and the group, as well as the interaction between group members, may result in more in-depth information, and to elicit differing perspectives related to carefully designed questions. Focus groups are thus not to be considered as a pragmatic time saving substitute for individual semi-structured interviews (e.g. if for any reason the planning does not allow for individual interviews), as the methodological groundings of both techniques differ.
A focus group is not synonymous to ‘group interview’: For a focus group, people are recruited specifically to participate in a research protocol, using a certain method. It is a group interview in the sense that it gathers data simultaneously from different participants (Green and Thorogood, 2009) However it differs from a group interview in the importance that is attached to the interaction among participants. Participants might change their perspective during the focus group interview because of this interaction. In a group interview the interaction between participants is limited, and occurs mainly between interviewer and interviewees.
Figure 4 – Interaction patterns in a group interview versus focus group interview
Depending on sampling strategy and aims, group interviews can take several forms, e.g. consensus panel, focus group, natural group or community interview (Coreil 2005 cited by Green and Thorogood, 2009).
Focus groups can be used as a single research strategy, as well as in combination with other methods in a multi-method research strategy.
The principal feature of focus group interviews is interaction between participants. Kitzinger (2006, p. 22) highlights that this particularity could be used to:
The benefits from focus groups highlighted are:
The limitations of focus groups are related to the limitations of group interviews:
Since focus group interviews are a collective data collection technique requiring direct person-to-person contact (several people have to come together at the same moment and in the same place) a careful planning of all activities and related tasks is necessary.
The data collection by focus group could vary according to (Cohen et al, 2008):
During the preparation of the focus group interviews a set of topics or questions is developed and takes the form of a topic list or questionnaire. For the general principles, see here
A focus group interview is in most cases a structured group process structured by means of an agenda to keep the group focused and on track. A focus-group should be experienced as free-flowing and relatively unstructured, but in reality, the moderator must follow a pre-planned script of specific issues and set goals for the type of information to be gathered. An introduction of up to 15 minutes should be carefully planned, as well as a good opening question. In order to keep the time schedule, as several people are going to participate and answer to the questions, it is important to foresee a maximum duration for each question.
The use of a well designed guide is helpful to compare information from one group to another as it is expected to have more than one focus group for a given topic.
For general issues on sampling, see “Sampling issues in qualitative research: who and how many?”
The starting point for selecting participants for focus groups is to identify the unit of analysis. Is the unit of analysis “individuals for their personal opinions/experience/expertise”, or is it “individuals because they represent organizational perspectives”? It has a major impact on the people invited to the focus group interview and therefore it should be clearly described.
The sample of focus groups will consist of groups of people, instead of individuals. People who are invited to take part need to have an interest in the subject.
Ideally groups have to be internally homogenous on criteria relevant to the topic but externally heterogeneous between groups. Homogeneity in the group capitalizes on people’s shared experiences (Kitzinger, 2006).
It is best to select people who do not know one another, but have similar relationships with the topic being investigated (although it could in practice be difficult for particular topics). Selecting participants who are similar may help them to share ideas more freely and develop an in-depth analysis of a topic (homogeneous groups).
Sometimes, heterogeneous groups can be used after the primary analysis of homogeneous focus groups has started. Heterogeneous groups are used to “confront” diverging opinions. In general terms, heterogeneous groups are composed of representatives of all relevant stakeholders.
In this case, the researcher has to pay attention to potential power differences or inequalities between participants. This may prevent some people from talking freely during the discussion and by consequence prevent the collection of rich data (Kitzinger, 2006).
In the Belgian context, focus group interviews can be carried out with French-speaking or Dutch-speaking and even German-speaking, participants. It is advisable to conduct unilingual groups: it is easier and richer for facilitators and participants. For heterogeneous groups, like stakeholders samples, it could be difficult to separate people in groups according to their mother tongue. In this particular case, it is important that participants express themselves in their mother tongue and to be sure that every participant understands the other language. The moderator has to be thus perfectly bilingual.
A group of six to twelve people is sufficient for a focus group. The ideal size for a focus group is eight to ten respondents. In general, the smaller the group, the more manageable it is. From experience, a group of 6‑8 participants allows enough time for discussion and is easier to manage. Where the purpose is to generate in-depth expression from participants, a smaller group size may be preferable in combination with carrying out more focus groups to attain saturation.
In order to make sure that a group counts enough participants, it is advisable to recruit 25% more people than required (Green and Thorogood, 2009). If too few participants turn up, one should foresee an additional focus group to substitute for the low attendance.
The number of focus group interviews needed depends on the aims and available resources . It is almost impossible to give clear standardized guidelines on the number of focus groups needed.
It is methodologically important for both approaches to conduct at least two focus groups by ‘type of people’. Using only one focus group to arrive at conclusions is risky since the opinions expressed may have had more to do with the group dynamics (i.e. persuasive skills of one or two members) than a true sampling of the opinions of the population that the group represents. Even the preset number of two focus groups is generally too limited to make in-depth analyses, especially if the topics discussed are rather “broad” or general (see also paragraph analysis on continuous comparative method). Having two homogeneous groups that provide different results suggests that more information is necessary (data saturation is not reached). One rule of thumb is to conduct focus groups until they no longer provide any new information on the topic discussed.
3.1.3.8 Human resources necessary
Three people (from the research team) could chair the focus group interview:
As focus group have to be transcribed afterwards. It is also useful to engage the services of an audio typist.
For general principles see “How to run the data collection?”.
In the case of focus groups, once the group of respondents is gathered for the discussion, the moderator should give a brief introduction to set everybody at ease[1]. More concretely, the moderator should:
The Moderator will then begin the focus group interview by asking an ‘icebreaker question’ to facilitate the discussion in the group. Afterwards, he/she will come to the focus of the discussion.
Immediately after the focus group a debriefing has to be foreseen with the moderators/facilitators. The debriefing part is an essential step for the analysis. The debriefing exercise is best supported by a template of dimensions, upon which the moderator/facilitator team needs to comment (example in Appendix).
The facilitators should review the notes taken during the focus group and have a first assessment of clarity and understanding.
They should discuss, compare and record observations or impressions about the group not readily apparent from the notes.
Discuss and record any insights or ideas emerging during the interviews while they are still fresh in the mind.
See also part “How to run the data collection? ”
The length of the focus group should be between 1 and 3 hours.
Allow sufficient time at the beginning to welcome participants, give them an introduction and let them introduce themselves. This part should not take excessive time (about 10 minutes).
Data are collected through different sources: audio or video-taping can be considered. When focus group interviews are recorded, the equipment should be of good quality and easy to use (check batteries and microphone). For larger groups, it may be necessary to use two tape recorders or multi-channel equipment, strategically placed to maximize the probability of recording contributions from all participants.
“Field notes” are an essential part during data collection. They capture all of the essential “non-verbal” information during the focus group interview.
Information has to be collected in an unbiased manner (avoid to filter out information as pre-interpreting it as unimportant, especially in the first focus groups).
The context of statements made during focus groups should be documented (important for giving meaning to the statements in the phase of analysis).
Try to capture nonverbal behavior of group participants (nonverbal reactions of other participants after a participant statement may indicate consensus or disagreement).
For issues on analysis, see “How to analyse the data?”.
In the particular case of focus groups, separate analyses have to be performed on data gathered “within-focus group” and continuously compared “between focus group”. This is also an iterative process.
It is important that statements be understood in the context which they were made. Nonverbal communication observed during the interview can also be very informative.
For reporting, see part “How to report qualitative research findings”
Note that findings are reported by focus group as unit of analysis and not by person.
See section part “How to evaluate qualitative research?”
Vermeire et al propose a checklist specific to critical appraise the quality of focus groups in health care research articles in primary healthcare (Vermeire et al, 2002).