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Kitzinger, J (2005) FOCUS GROUP RESEARCH: using group dynamics to explore perceptions, experiences and understandings Holloway I. (ed.) (2005) Qualitative Research in Health Care Maidenhead: Open University Press pp.56-6 ISBN 0-335-21293-x Focus group research is a very popular method across many academic disciplines and for professional practitioners, particularly within health research. Focus groups offer a very valuable alternative, or supplement, to other data collection techniques such as individual interviews, or participant observation. But what exactly is a focus group? Under what circumstances are they appropriate? What practical issues should be considered when running group discussions? How should they be analysed? This chapter offers a basic introduction to some core issues in focus group research and highlights the rich potential of this data collection technique. An introduction to the principles of focus group research What are focus groups? Focus groups are group discussions organised to explore a particular set of issues. The group is focused in the sense that it involves some kind of collective activity – such as debating a particular set of questions, reflecting on common experiences or examining a single health education campaign. There is a strong tradition of various forms of ‘group work’ within health services research. The term ‘focus group’ is often used (and sometimes misused) for a wide variety of such work, and other terms are sometimes employed interchangeably. This can lead to extensive confusion. Before talking in depth about the type of work that can be defined as focus group research, it is therefore important to mention the other terms the reader may have encountered. Some researchers talk of ‘nominal groups’ – groups specially convened by the researcher often for the purpose of ranking exercises with respect to (most frequently consumer/patient) concerns or priorities. Others use ‘consensus’ groups ‘- often set up by professional bodies in order to carry out specific tasks- or ‘expert panels’ – which bring together acknowledged experts or sometimes ‘opinion leaders’, who can be relied upon to bring to the discussion an in-depth knowledge of practice development, policy considerations or the research literature. ‘Delphi groups’ build on this idea of harnessing existing expertise, but seek to combine ‘expert panel’ discussions with other research methods – most commonly involving experts in responding to the results of a survey or postal questionnaire. In fact any of these groups could be, but are not necessarily, examples of ‘focus group research’. ‘Focus group research’ is a generic term for any research which studies how groups of people talk about an issue. Indeed, a defining feature of focus group research is using the interaction between research participants to generate data and giving attention to that interaction as part of the analysis. A focus group is ‘a research encounter which aims to generate discussion on a particular topic or range of topics, with the emphasis being on interaction between participants’ (Kitzinger, 1994a: 103) Using this definition it is clear, for example, that a nominal group could be treated as a focus group – but not if the researcher simply comes away with the final outcome of the ranking exercise as the ‘findings’. She or he would also have to consider how the group members debated the ranking exercise and came to their ‘consensus’ (A process which is often far more revealing than the final outcome). Similarly any of the other sessions, such as the ‘expert panel’ might also be treated as a ‘focus group’, again as long as the researcher was not only interested in the final assertion of ‘advice’, but in the processes through which the participants debated the issues. The key issue in focus group research is to treat the interaction in the group (the exchange of ideas and experiences, use of rhetoric or anecdotes, shifts in agreement and disagreement) as an integral part of the data. Apart from this there are no other golden rule which define focus groups. Focus groups can involve different group compositions (including strangers or friends, ‘lay people’ or professionals) and diverse group tasks (including brainstorming, ranking exercises or attempting to reach a consensus). Indeed, the creative use of focus groups could include developing – where appropriate - hybrids of the various group types on offer and using focus groups in multi-method studies as well as refining stand-alone group methods to address a wider range of issues. When is it appropriate to use focus groups? Focus groups are ideal for exploring people’s talk, experiences, opinions, beliefs, wishes and concerns. The method is particularly useful for allowing participants to generate their own questions, frames and concepts and to pursue their own priorities on their own terms, in their own vocabulary. Group work also helps researchers tap into the many different forms of communication that people use in day-to-day interaction - including jokes, anecdotes, teasing, and arguing. Gaining access to such variety of communication is useful because people's knowledge and attitudes are not entirely encapsulated in reasoned responses to direct questions. Everyday forms of communication may tell us as much, if not more, about what people know or experience. In this sense focus groups reach the parts that other methods cannot reach: revealing dimensions of understanding that often remain untapped by more conventional data collection techniques. Focus groups also enable researchers to examine people’s different perspectives as they operate within a social network. Crucially, group work explores how accounts are articulated, censured, opposed, and changed through social interaction and how this relates to peer communication and group norms. Indeed, depending on the researcher’s theoretical approach, focus group data can go further and challenge the notion that opinions are attributes of subjects at all rather than utterances produced in specific situations (see Myers and Macnaghten, 1999). Focus groups are often used to explore in depth the form of people’s talk, or thoughts, or experiences, about an issue from a variety of practical or theoretical perspectives Focus groups can be used, for example, for: The development or evaluation of a health education campaign The improvement of health services provision or outreach In-depth exploration of the experience of a diagnosis, diseases or treatment Examination of professional identities and role or responses to institutional changes (e.g. Barbour, 1999) Analysis of the role of the mass media or broader cultural representations in shaping understandings of a disease (or profession, or stigmatised group) (e.g. Miller et al., 1998) Gaining insights into broad public understandings of and responses to, issues such as biomedical ethics, new biotechnologies, health services, health policies or health inequalities. Some people worry that group work may be inappropriate for very sensitive topics such as sexually transmitted diseases or bereavement, but this is not necessarily true. Sometime people may be more willing to talk openly about issues when in a group of people with similar experiences than they would be in a one to one interview (Farquahar and Das, 1999; Kitzinger and Farquhar, 1999). In fact I have yet to see a research question where focus groups in some form would not be relevant, even if other data collection techniques are also used. However, when considering whether or not to use focus groups, it is worth thinking through what they offer compared to other data collection techniques, and what they might offer in combination with other data collection techniques. Comparing focus groups to other qualitative data collection techniques Focus group research is different from individual interviews because research participants talk to the researcher as a group, and most importantly, discuss the issues with one another. Focus groups differ from observation or ethnographic work because instead of observing spontaneous action and interaction in a natural setting the focus group is usually convened by the researcher (albeit often involving naturally occurring groups on their home territory) and the researchers prompts and focuses the discussion around a particular issue. . Interviews may be more effective for tapping into individual biographies. Observation may be more appropriate for documenting social roles and formal organisations. Focus groups, however, are invaluable for examining how knowledge, ideas, story telling, self-presentation and linguistic exchanges operate within a given cultural context around specific topics – and this can include the narratives people tell about their own lives, and their experiences of social roles and formal organisations. Comparing focus groups to quantitative data collection techniques Focus groups are also very different from quantitative methods such as survey questionnaires because it is a qualitative technique – with all that implies about the quality of the data. Whereas large-scale surveys aim for representativeness, qualitative work may try to reflect the range of experience or opinion, whereas surveys aim for breadth, qualitative work aim for depth. In general, large-scale questionnaires are more appropriate for obtaining quantitative information and explaining how many people ‘hold’ a certain (pre-defined) ‘opinion’. However, focus groups are better for exploring how points of view are constructed and expressed. Thus, for example, while surveys repeatedly identify gaps between health knowledge and health behaviour, only qualitative methods, such as focus groups, can actually fill these gaps and explain why these occur. Even these generalisations, however, should not be treated as if they were cast in stone and combining different data collection techniques into a single project can be highly productive. No one data collection technique is inherently ‘better’ than another. It depends on the aims of the research question and on how each technique is employed in practice. Often it may also be useful to combine methods Combining focus groups with other research methods Focus groups can be combined with in-depth ethnographic work or with interviews, Researchers have found, for example, that ethnographic work may help them develop more sensitive focus groups (Baker and Hinton, 1999) or that interviews combined with focus groups gain access to different aspects of people’s experience (Michell, 1999). You cannot assume that people are more ‘honest’ in interviews or in groups, but they may talk in different ways or reveal different aspects of their experience. (Baker and Hinton, 1999; Michell, 1999) Focus groups can also be combined with questionnaires. This may be simply that focus group participants complete questionnaires before and/or after the session. This can help provide basic background information, and may offer participants opportunities to say things they would rather not reveal in the group, or to reflect on the experience of participating in the group afterwards. The questionnaire need not strictly be a ‘quantitative’ method if it includes open-ended questions and the analysis of responses is qualitative. Focus groups can also be used in combination with more traditional large-scale surveys. Focus groups are often used to help design or interpret a major survey project. At the outset of such research, group work can be employed to help construct questionnaires: developing an understanding of key issues and refining the phrasing of specific questions. (Kitzinger, 1994; O'Brien 1993). Focus groups can also provide fertile ground for eliciting anecdotal material and are therefore ideal ‘seed beds’ for ‘germinating’ vignettes for use in questionnaires. Focus groups are often useful in the latter stage of predominantly quantitative projects. They can help to tease out the reasons for surprising or anomalous findings and to explain the occurrence of ‘outliers’ identified – but not explained – by quantitative approaches, such as scattergrams or ‘box and whisker plots’ (Barbour, in press). Sometimes group work cannot only complement data collected via other methods, but may actually challenge how such data are interpreted. My own study of public understandings of AIDS, for example, demonstrates how focus groups can suggest different ways of interpreting survey findings through revealing the ‘readings’, ‘facts’ and value systems that inform respondents’ answers to survey questions (see Kitzinger, 1994b). What theoretical or political research perspectives are implied by the choice of focus groups as a data collection technique? Focus groups can be used from a wide variety of theoretical perspectives with very different analytical tools. They are a data collection technique not an epistemological or ontological straightjacket. The group discussion may be analysed from a straightforward positivist approaches, or approaches using phenomenology (see chapter x, this volume), narrative analysis (chapter x) discourse or conversation analysis. They can also be used in very different types of research, framed by contrasting political agenda. Focus groups are used in traditional top-down research (and, indeed, are very popular within commercial marketing). However, they have also proved very fruitful in ‘client centred’, action research or feminist research. (Wilkinson, 1999). Focus group methods are popular with those concerned to 'empower' research participants because the participants can become an active part of the analysis process. Indeed, if the research brings together people for the purposes of the research, group participants may actually develop particular perspectives as a consequence of talking with other people who have similar experiences. For example, group dynamics can allow for a shift from personal self-blaming psychological explanations (I'm stupid not to have understood what the doctor was telling me'; 'I should have been stronger - I should have asked the right questions,') to the exploration of structural solutions ('If we've all felt confused about what we've been told maybe having a leaflet would help or what about being able to take away a tape-recording of the consultation?') Some researchers have also noted that group discussions can generate more critical comments than interviews (Watts and Ebbutt 1987). For example, Geis and his colleagues, in their study of the lovers of people with AIDS, found that there were more angry comments about the medical community in the group discussions than in the individual interviews: ' ... perhaps the synergism of the group "kept the anger going" and allowed each participant to reinforce another's vented feelings of frustration and rage...' (Geis et el., S 1986). Using a method which facilitates the expression of criticism and the exploration of different types of solutions is invaluable if one is seeking to improve services. Such a method is especially appropriate when working with particular disempowered 'patient' populations who are often reluctant to give negative feedback or may feel that any problems result from their own inadequacies. After childbirth, for example, many women may be grateful to have a health baby, and be unwilling to make criticisms of how they were treated when interviewed one-to-one, but may be more able to make constructive suggestions for improvements when involved in a group discussion (DiMatteo Met al., 1993). There is, however, nothing inherent about focus group work that will automatically make it ‘empowering’ – researchers have to think through the entire context of the research design, implementation, analysis and presentation to achieve this (Baker and Hinton, 1999) Planning a focus group study The size of the group A group, for the purposes of focus group research, could be three people or fifteen people. The smaller number, however, offers minimal opportunities for lively group interaction, and the larger number can have the same effect and leave very little time for individuals to contribute. A group between the size of four and eight is usually ideal. Often, however, it is necessary to over-recruit, as not everyone may be able to turn up on the day. Group composition Most researchers recommend aiming for some homogeneity within each group in order to capitalise on people's shared experiences. However, it can also be advantageous to bring together a diverse group (e.g. from a range of professions) in order to maximise exploration of different perspectives within a group setting. However, it is important to be aware of how hierarchy within the group may affect the data e.g. a nursing auxiliary is likely to be inhibited by the presence of a consultant from the same hospital. Related to the above issue is the question of whether or not to work with people who already know each other. Market research texts tend to insist on focus groups being held with strangers in order to avoid both the ‘polluting’ and ‘inhibiting’ effect of existing relations between group members. However, many social science researchers prefer to work with pre-existing groups: people who are already acquainted through living, working, or socialising together. These are, after all, the networks in which people might normally discuss (or evade) the sorts of issues likely to be raised in the research session and the ‘naturally-occurring’ group is one of the most important contexts in which ideas are formed and decisions made. By using pre-existing groups, one is able to observe fragments of interactions which approximate to naturally occurring data (such as might have been collected by participant observation). An additional advantage is that friends and colleagues can relate each other's comments to actual incidents in their shared daily lives. They may challenge each other on contradictions between what they profess to believe and how they actually behave (e.g. 'how about that time you didn't use a glove while taking blood from a patient?'). Pre-existing groups are not, however, a pre-requisite for successful focus group research. Indeed, many projects bring together people who might not otherwise meet. Studies into the experience of living in a particular tower block, having a particular illness, or winning the lottery, might involve people who are virtual strangers. Even in a study where it has been possible to recruit pre-existing groups, the researcher might want to intervene to bring together other participants who do not know each other and whose voices and common experiences might otherwise be muted or entirely excluded from the research. In some cases, too, researchers deliberately opt to observe the talk generated by strangers or set up one-off groups to ensure that participants will talk without fear of making revelations to members of their own social circle. If pre-existing groups are chosen then consideration should be given to the types of networks used. For example, an investigation into school sex education programmes, could access the same 16-year-old boy through a variety of networks. He could participate in a focus group with his parents and sister; with a selection of his school friends or he could become involved in the research via a support group for gay teenagers. Each type of group may give a different perspective on this same young man’s views and experiences. Whether or not ‘naturally occurring’ groups are used it would be naïve to assume that group data are by definition 'natural' in the sense that such interactions would have occurred without the group being convened for this purpose. Rather than assuming that sessions inevitably reflect everyday interactions (although sometimes they will), the group should be used to encourage people to engage with one another, formulate their ideas and draw out the cognitive structures that previously have not been articulated. It is important to consider the appropriateness of group work for different study populations and to think about how to overcome potential difficulties. Group work can facilitate collecting information from people who cannot read or write. The 'safety in numbers' factor may also encourage the participation of those who are wary of an interviewer or who are anxious about talking (Lederman L. 1983). However, group work can compound difficulties in communication if each person has a different disability. In the study assessing residential care for the elderly, I conducted a focus group which included one person who had impaired hearing, another with senile dementia and a third with partial paralysis affecting her speech. This severely restricted interaction between research participants and confirmed some of the staff's predictions about the limitations of group work with this population. However, such problems could be resolved by thinking more carefully about the composition of the group and sometimes group participants could help to translate for each other. It should also be noted that some of the old people who might have been unable to sustain a one-to-one interview were able to take part in the group, contributing intermittently. Even some residents whom staff had suggested should be excluded from the research because they were 'unresponsive' eventually responded to the lively conversations generated by their co-residents and were able to contribute their point of view. Considerations of communication difficulties should not rule out group work, but must be considered as a factor. The number and range of groups The number of groups conducted can consist of anything between just a couple of groups to over fifty groups, depending on the aims of the project and the resources available. Most studies involve just a few groups (between six and fifteen). Although it may be possible to work with a representative sample of a small population, most focus group studies therefore use a theoretical sampling model whereby participants are selected to reflect a range of the total study population or to test particular hypothesise. If you are examining people’s views on AIDS you might wish to include people who have tested HIV positive and those who have tested HIV negative; if exploring experiences of breast cancer you might wish to talk with women at different stages of their treatment, and include a group of men with breast cancer. If working with nurses you might wish to run groups with nurses at different points in the hierarchy. It is also important to reflect demographic diversity. Imaginative sampling is crucial. Most people now recognise age, class or ethnicity as important variables. However, it is also worth considering other variables. For example, when exploring women's experiences of maternity care or cervical smears it may be advisable explicitly to include groups of lesbians or women who were sexually abused as children (Kitzinger, 1990) Location of the focus group session It helps to hold focus group sessions in a place easily accessible to potential participants (and familiar to them). However sometimes it helps to run sessions outside people’s institutional setting (away from their place of work or institution) so that they can talk more freely (and be away from interruptions or observation). The room should be comfortable, quiet (for recording purposes) and comfortable to facilitate a relaxed atmosphere. It’ll be all right on the night…or will it? There is often an element of unpredictability to focus group research. However carefully you plan, you may confront problems such as that the room you were planning to use has been double booked or a loud disco is being held next door or advance sickness, transport or child care problems can mean some people do not turn up. You can try to mitigate against some of these factors by researching your venue and making contingency plans. It is wise, for example, to over-recruit for the session to allow for non-attendance. It helps if you can organise transport or childcare. Alternatively sometimes you may also find people are participating in the group whom you had not invited (someone may bring along a partner, mother-in-law or child), or you included by mistake. I have had the experience of facing a group of young men (contacted for me by an agency) who believed they were there to discuss football hooliganism. In fact I wanted them to discuss child sexual abuse! In this situation it was important that I not simply proceed with my agenda, although in the event the participants decided they would be prepared to discuss my topic of concern – with very interesting results. On another occasion I mistakenly included a short-term resident of a hospital unit for the elderly in a group discussion with long-term residents. In fact this proved invaluable – the resident who was soon due to return home – prompted far more critical discussion in this group than in the groups composed entirely of longer-term residents who adopted a more resigned and institutionalised attitude. Do not worry if the focus group composition is not quite what you expect. Go ahead anyway (as long as there are no ethical problems) and reflect on this in your analysis and writing up. Preparing material for the session Documentation you will need to prepare in advance of running a focus group includes (a) the letter of invitation to participants, including a (very brief) outline of your research and what they can expect from the session and (b) guidelines for yourself (or the session facilitator) outlining some questions you would like the group to address. In addition some researchers like to take along some group materials, prompts, games or exercises. This can be as simple as a flip chart and pens, some newspaper headlines, a taking along an object. For example Lai-fong Chiu and Deborah Knight took a speculum along to their focus group discussions about cervical smears and encouraged women to pass it around and comment on it. In another group, run a woman spontaneously passed round her breast prosthesis, against generating fascinating data (see Wilkinson, 1999). More structured exercises can include presenting the group with a series of statements on large cards. The group members are asked collectively to sort these cards into different piles depending on, for example, their degree of agreement or disagreement with that point of view or the importance they assign to that particular aspect of service. For example, I have used such cards to explore public understandings of HIV transmission (placing statements about 'types' of people into different risk categories), old people's experiences of residential care (assigning degrees of importance to different statements about the quality of their care) and midwives' views of their professional responsibilities (placing a series of statements about midwives' roles along an agree-disagree continuum). Such exercises encourage participants to concentrate on one another (rather than on the group facilitator) and force them to explain their different perspectives. The final layout of the cards is less important than the discussion that it generates. For further discussion of this technique see Kitzinger, 1990. Researchers may also use such exercises as a way of checking out their own assessment of what has emerged from the group. In this case it is best to take along a series of blank cards and only fill them out toward the end of the session, using statements generated during the course of the discussion. Reflecting on some ethical issues As with all research it is important to consider the ethics of what you are doing. For example: have research participants given you their informed consent and will the information they give you be treated with respect and confidentiality? Group work poses more challenges than individual interviews because gatekeepers may have not passed on information and, unlike interviewees, focus group participants cannot be given an absolute guarantee that confidences shared in the group will be respected. Another issue is that group members may voice opinions that are upsetting to other participants (e.g. in one group I ran, the suggestion that incest survivors should be sterilised because they were deemed to be ‘unfit parents’). A related problem is that participants may actually provide each other with misinformation during the course of the group, information that may be implicitly legitimised by the presence of the researcher. It is inappropriate simply to walk away from a group after having silently listened to people convincing each other that HIV can be transmitted by casual contact or that anal intercourse is safer than vaginal intercourse. In such cases the researcher has a responsibility to provide accurate information. Such ethical issues can be addressed through attempting to set ground rules prior to the session, and through debriefing and supplying literature after the session. During the course of the session itself it may very occasionally be necessary to intervene. (For a more extensive discussion see Kitzinger and Farquhar, 1999). Running the session Sessions should be relaxed: refreshments and sitting round in a circle will help to establish the right atmosphere. Sessions may last around one or two hours (or extend into a whole afternoon or a series of meetings). The facilitator should explain that the aim of focus groups is to encourage people to talk to each other rather than to address themselves to the researcher. It helps to start by going round the table asking people to state their name (for the tape and for voice recognition). The facilitator may wish to start with group ‘games’ and may wish to take a back seat at first, allowing for a type of 'structured eavesdropping'. Later on in the session, however, the researcher can adopt a more interventionist style: urging debate to continue beyond the stage it might otherwise have ended and encouraging them to discuss the inconsistencies both between participants and within their own thinking. Disagreements within groups can be used to encourage participants to elucidate their point of view and to clarify why they think as they do. Difference between individual one-off interviews have to be analysed by the researchers through armchair theorising; differences between members of focus groups should be explored in situ with the help of the research participants. Recording the discussion Ideally the group’s discussions should be tape-recorded, and some researchers even like to videotape sessions. How you record the session will have a major impact on how and what you can analyse. At the very least it is vital to take careful notes and researchers may find it useful to involve the group in noting key issues on a flip chart. Some researchers would find this record of a session totally inadequate for their purposes and, indeed, insist on a full transcript, even, if a formal conversation analysis is planned, recording every pause and hesitation. Analysis and writing up Analysing focus groups is basically the same as analysing any other qualitative self-report data (see Britten, 1996; Mays & Pope, 1996). At the very least, the researcher draws together and compares discussions of similar themes and examines how these relate to the variables within the sample population. In general it is not appropriate to give percentages in reports of focus group data, and it is important to try to distinguish between individual opinions expressed in spite of the group, and the actual group consensus. As in all qualitative analysis, deviant case analysis is important: attention must be given to minority opinions and examples which do not fit with the researchers overall theory and attention given to silenced voices. The only distinct feature of working with focus group data is the need to indicate the impact of the group dynamic and analyse the sessions in ways that take full advantage of the interaction between research participants. When coding the script of a group discussion it is worth employing special categories for certain types of narrative such as jokes and anecdotes, and types of interaction, such as ‘questions’, 'deferring to the opinion of others', 'censorship' or 'changes of mind'. A focus group research report which is true to its data should also usually include at least some illustrations of the talk between participants, rather than simply presenting isolated quotations taken out of context. They may also want to track how individual voices weave through the broader group discussion. Figure 1 and 2 presents extract from different focus group sessions from two different studies. Obviously, each one is only an extract from a much lengthier discussion and it is taken out of social context. However, what do you think is going on here? What insights does this discussion provide? [INSERT FIG 1 AND FIG 2 NEAR HERE] Fig 1. Extract from a focus group discussion with elderly people in hospital residential care evaluating the service and seeking suggestions for improvements. For ease of reading one participant’s comments, Bessy’s, have been highlighted in bold. Facilitator: If you have any problems or worries who do you talk to? F3: We would talk to the sister I would think, but I’ve never really had any problems, have you? Bessy: Well, just I wanted to go home. F3: Well, we all do, don’t we, but we are here [...] Facilitator: What are the sort of things you miss? [...] Bessy: I have lost all my friends. I’ve been shifted about so much [...] f?: We are friendly, it is up to yourself ... Bessy: The neighbours [at the previous smaller unit] were really great...before we came here, well you can’t make the same neighbourliness in a place like this. f?: Well I think it is up to yourself how you mix with people. Bessy: It is, there is nothing wrong with it really, it’s just eh...it’s hard to get used to [...] Facilitator: I have a few words [on cards] here I would like you to comment on [...] Let me choose one that you brought up earlier, Bessy ... ‘Independence’. Bessy: Yes. Facilitator: That’s important to you then? Bessy: Oh yes...oh yes, very much so. Facilitator: And are there things that make you feel independent? Bessy: [There’s] an unwritten law that you stay here, that, em, your independence, well, I couldn’t say anything more...I like to be independent...but em...yes. [...] Facilitator: Are there things that make you feel that you are not independent...? Bessy: Get out of here...no, no...it’s not a bad place to be in [...] I’m as happy as the rest. It’s just...where dignity is concerned, I don’t know. F2: Well, you never use your dignity now, so much. Figure 2. This discussion took place in a community with very low rates of breastfeeding and involved a group of teenage mothers. All the young mothers in this group used formula milk and talked about breastfeeding as rather disgusting. Samantha presented a rather different attitude (she was also the only member of the group who had not yet given birth). F: There was a woman in the travel agent that was breastfeeding in front of a guy and all that. Samantha: If a guy it going to get thingmy when he sees a women pull her breast out then he is not much a guy is he. F: Listen to you, Samantha! Samantha: But he is not, if he is going to get all flustered and that over a woman feeding a baby. [...] I think I am going to do it [breastfeed]. [...] It was my boyfriend that said about it because he was breastfed F3: Because he wants a better look at your breast more often! [...] F4: What is the point in hurting yourself? F1: You end up bottle-feeding anyway. Samantha: I was told if I breastfeed my baby then my baby might not get asthma Facilitator: Right Samantha: Less chance than there would be if I bottle-fed F3: If it is going to get asthma it is going to get asthma F6: That’s right Facilitator: Can I just ask you why you are maybe going to try breastfeeding? F1: She just wants to be different Samantha: For a better bond. I don’t know. I just read up on it and I was thinking about trying it out because it [breastfeeding] can improve its sight and improve its abilities and all that crap. [Note: We kept in touch with Samantha, in the event she did not breast feed her baby] (See: Henderson, L. et al. 2000) Each of the above extracts could be approached in different ways. There is no definite rule beyond this about how to approach focus group data. Your method of analysis will depend on your theoretical perspective. A conversation analyst – who treats talk as action – will be interested in every intonation and will analyse the (very detailed) transcript as a no more, and no less, than talk. (The quality of the above transcription would be inadequate for that sort of analysis). Discourse analysts will be interested in the discourses employed; researchers coming from other approaches will see the talk as accessing something else (feelings, experiences, attitudes, group norms). Conclusion This chapter has presented the factors to consider when designing or evaluating a focus group study. In particular, it has drawn attention to the overt exploitation and exploration of interactions in focus group discussion. Interaction between participants can be used to achieve seven main aims: Interaction between participants can be used to achieve seven main aims: 1. To highlight the respondents' attitudes, priorities, language and framework of understanding; 2. To encourage research participants to generate and explore their own questions and develop their own analysis of common experiences; 3. To encourage a variety of communication from participants - tapping into a wide range and form of understanding; 4. To help to identify group norms/cultural values; 5. To provide insight into the operation of group social processes in the articulation of knowledge (e.g. through the examination of what information is censured or muted within the group); 6. To encourage open conversation about embarrassing subjects and to permit the expression of criticism 7. Generally to facilitate the expression of ideas and experiences that might be left underdeveloped in an interview and to illuminate the research participants' perspectives through the debate within the group. This chapter is not arguing that group data are either more or less authentic than data collected by other methods; instead it is illustrating how focus group research may be the most appropriate method for researching particular types of question, and it is often a useful component of any project. Focus groups are not an easy option. The data they generate can be as cumbersome as they are rich and complex. Yet the method is basically straightforward and need not be intimidating for either the researcher or the researched. Perhaps the very best way of working out whether or not focus groups might be appropriate in any particular study is to try them out in practice. References Baker, R and Hinton, R (1999) ‘Do focus groups facilitate meaningful participation in social research?’ In Barbour, R & Kitzinger, J (1999) (eds) Developing Focus Group Research: politics, theory and practice, pp79-98 London: Sage. 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