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Methodology Matters-V
"Methodology Matters" is the title of a series of intermittently appearing articles on methodology. Other
articles on such topics as Confidena Intervals are planned. Suggestions from readers of additional topics they
would like to ste covered here arc welcome. Please send all such suggestions to the Editor-in-Chief.
Focus Groups
RICHARD A. POWELL and HELEN issues, rather than to enumerate their preva-
M. SINGLE lence. Qualitative methods permit development
of concepts that enable researchers to compre-
Department of Mental Health. University of Excter, hend social phenomena in "naturalistic" rather
Wonford House Hospital, Exeter, UK than experimental settings and accord impor-
tance to the meanings, views and experiences of
respondents. While quantitative methods result
Comsporrdemr should bt addrtascd to: Mr Richard A. PoweIl, Department of Mental Health, University of ktcr,
Wonford House Hospital, Drydcn Road. Exctcr EX2 SAF, UK. Tel. 0139243640; Fax 0 1 3 9 2 - 4 i ) W ; E-mail:
R.A.Powen@exetcr.aC.uk.
500 R.A. Powell and H. M.Single
actions, beliefs, perceptions and attitudes" [I]. asmiations require clarification, elaboration or
This information can be used to identify poten- "salvaging".
tial areas of enquiry or to clarify subject matter
In this respect, a focus group can be employed
that, by its nature, eludes other research instru-
either prior to, concurrently with, or after a
ments. The "focus" underpinning the discus-
quantitative study, or separately to explore
sions is anything that engages the focus group in
complex phenomena not amenable to quantita-
a collective activity, "such as viewing a film,
tive research.
examining a single health education message or
simply debating a particular set of questions"
[21. ORGANISING A FOCUS GROUP
The focus group dates back to the 1920s,when
Group membership and recruitment
it was used as a market research technique.
Today, the focus group has evolved into a data A focus group is composed of individuals with
collection technique that is employed commonly shared key characteristics pertinent to the study
in a range of settings throughout the social and comprises between six and 10 participants
sciences. Examples include investigating experi- who are strangers to each other. In this way, not
ences of childbirth, developing consensus guide- only are participants not inhibited by or defer-
lines for general practice in medicine, evaluating ential to intra-group differences (such as occupa-
a school sexuality education programme and tional seniority among health care
determining the decision-making process behind professionals), but the anonymity engenders an
the search for health care. atmosphere that encourages honest airing of
what could be critical personal views and
Anticipating subject loss, a researcher gener- note-taker, who can document important
ally over-recruits participants by approximately aspects of the group's interaction, such as
25%. It is desirable to "reward" participants expressive body-language of participants, that
with a small incentive -ideally a non-monetary in the absence of a filmed record of the session
one - if only as a gesture of gratitude for the would go unrecorded. The moderator works to a
time committed to the group and as an means of non-prescriptive, semi-structured interview
minimizing subject attrition. schedule and usually will supplement the pre-
pared questions with sub-questions that enable
researchers to clarify a topic or explore partici-
Number, duration and scheduling of sessions
pants' answers in greater detail. The five or six
The desirable number of focus group sessions questions selected for the discussion guide must
depends upon the nature and complexity of the be open-ended, phrased clearly and simply and
subject under investigation and the use for which must draw upon concrete examples to illustrate a
the data generated by the focus group arc to be topic. Where appropriate, the questions should
employed. From one to 10 sessions are generally be sequenced from less to more sensitive ques-
suBcient for most studies, since at some juncture tions. The moderator should also be receptive to
the group's discussion will simply replicate relevant issues raised by participants that have
existing data, making further sessions unneces- not been anticipated in the discussion guide, and
sary. A focus group session lasts approximately should encourage equal participation of all those
90-120minutes (the length of the session is in the group, ensuring that discussion proceeds
usually determined by the complexity of the accordingly.
subject under investigation or the number of Moderators also must be sensitive to, and be
I Number of
rnciwlts
no parhal yes
low w low
FIGURE 1. A comparison of the focus group with the indepth intemcw and the nominal group technique.
structured or unstructured interview guide. being addressed, without conversing with the
Respondents are given considerable liberty in other participants. When requested, participants
their responses and in discussing areas not raised declare their responses and these comments are
by the researcher. As is the case with the semi- recorded on a flipchart by the group facilitator.
structured focus group, the indepth interview After review and discussion of the contents of
enables researchers to gather detailed attitudinal each recorded comment, the group ranks the list
and experiential information from respondents, of comments from the most important to the
and this information is elicited by supplementing least important or acceptable. This initial rank-
the broad, open-ended, exploratory questions ing is recorded, then discussed and this is
with pertinent, gently probing subquestions. followed by a second private ranking of the
listed items. These data comprise the research-
er's core set of information [I I].
Nominal group technique
The nominal group technique, or expert panel,
as it is sometimes called, is an impersonal,
qualitative group method in which "exchange By comparison with the indepth interview,
and interaction between group members is more focus group discussion may be comparatively
controlled than in focus groups" [lo]. The superficial, generating only "surface" informa-
nominal group is similar in size to a focus tion on individual respondents. It is argued -
group, and is used to determine the extent to though this is disputed by others given the use of
which experts agree about a given issue. In this focus groups to investigate attitudes to and
methodology, a facilitator presents the question experiences of intimate sexual health issues -
or problem on which the group's views are that the collective nature of the focus group is
required. The participants list on paper their less appropriate as an investigative tool for the
feelings and experiences connected with the issue disclosure of personal, sensitive information.
R. A. Powell and H. M. Single
Similarly, doubts exist about the extent to which practical guide with an empharis on the topic of
both the moderator and the "group effect" agemg. Research Report No. 90-3, Population
influena individual participation in a focus Studies Centre, University of Michigan,
group discussion. Michigan, 1990.
A comparative advantage of the focus group,
Kreuger R A, Focus groups: a practical guide
however, is its ability to enable researchers to
for applied resemch. Sage Publications Inc.,
identify quickly the full range of perspectives
London, 1988.
held by the respondents. Moreover, the interac-
tional, synergistic nature of the focus group Morgan D L, Focus groups as qualitative
allows participants to clarify or expand upon resemch. Sage Publications Inc., London, 1988.
their contributions to the discussion in the light
Morgan D L (Ed.), Successful focus groups:
of points raised by other participants, thus
advancing the state of the art. Sage Publications
expanding on contributions that might be left
Inc., California, 1993.
underdeveloped in an in-depth interview.
Unlike the focus group, which draws upon Acknorrledgementg The authors u p = their grati-
spontaneous rather than carefully considered tude to Dr Keith Lloyd, Ms Elspcth Mathie and Dr
responses, the nominal group technique is a Andrew Thompson for comments on an earlier draft
directed method. Like the focus group, though of this work. Any remaining errors arc the responsi-
bity of the authors.
not to the same extent, participants' contribu-
tions may be influenced by the "group effect".
However, the focus group is flexible enough to REFERENCES
be sensitive to the personal agenda of partici- Carcy M A, Introduction. QualHealth Res 1995;