Introduction

1. Using synchronous online focus groups with young peopleDr Fiona Fox Qualitative Research Consultant University of Bathf.fox@bath.ac.uk

2. Introduction Aim Practical guide to using online focus groups (OFGs) Background Rationale Process What, why & how Reflections What I learnt

3. Aim: to explore the experiences of young people with chronic skin conditions Why won’t young people take part in focus groups? Centre for Appearance Research

4. Challenges of face to face Focus Groups • Time • Transport • Confidence • Appearance … • (Ginsburg & Link,1989; Wahl, Gjengedal, & Hanestad, 2002)

5. Aim: to explore the experiences of young people with chronic skin conditions What are the alternatives? Why won’t young people take part in focus groups? Centre for Appearance Research

6. Background: Online Focus Groups as an alternative? Online focus groups • Majority of published studies used asynchronous groups (Gaiser 1997; Robson 1999: Ward 1999) • Less synchronous groups reported but are characterised by “dynamism and immediacy”(Stewart et al 1998; O’Connor & Madge 2003; Williams 2003) • Early study explores health perceptions of tobacco use across two cultures (Stewart et al 1998)

7. Aim: to explore the experiences of young people with chronic skin conditions What are the alternatives? Why won’t young people take part in focus groups? Centre for Appearance Research Explored literature

8. Will young people take part in OFGs? • Popularity of internet: “an important social domain and a powerful communication tool” (Pastore, 2002) • Interest: Opportunity to participate online may heighten interest (Tse 1999) • Convenience: Home access is growing: 75% of 9-19 year olds accessed internet from a computer at home • Population biases are declining as access increases (Selwyn and Robson 1998) but exclusivity should still be considered • Confidence: to take part from own home. Perception of anonymity .

9. Aim: to explore the experiences of young people with chronic skin conditions What are the alternatives? Why won’t young people take part in focus groups? Centre for Appearance Research Tried out online focus groups Explored literature

10. Participants & recruitment Participants • 7 x online focus groups: 3 participants in each • 11-18 year olds with psoriasis or vitiligo for 12 months + Recruitment • Skin Organizations advertised study on web sites with direct link to my research web site • Young people read information about study • Registration and consent page • Provide parents email address • I contact them by email with: • - Time & date for OFG • - link to online forum • - unique user name & password

11. Teen Skin website

12. Online forum Web site&online forum hosted by University Environment • Welcome page & ground rules • De-brief page with links • Free of distraction • University logo • Password protected • Piloted with students & supervisors

14. Real time focus groups “in the real time chat of an online focus group, the distinction between replying and sending becomes blurred as the interactivity defies conversational turn-taking” (Mann & Stewart 2000 p.102)

15. Considerations for the Moderator • Decoding synchronous communication • lol • brb • ikr • Understanding emoticons :) :( ;)

16. Lou my exams r dun yipeeeee!!! Bee yay!! Hehe Lou :D Sara wow go Lou lol Lou lol Sara u can enjoy ur hols lol Bee gd 4 u:) Bee still got 3 2 go till imdonew Lou yeh will do! Lol Sara never mind :S Bee !!!!

17. Considerations for the Moderator • Number of participants • Typing speed – the dominant talker • Overlapping conversations • Delayed responses • Silences – how long is too long?

18. ModeratorHow important is your skin in terms of your appearance or the way that you look? • Jo i would definately say that finding other ppl with it helps! • Mark err obviously its never as gd as a level as wen i used treatment btui feel that iv just got used to it, o well i do use that horrible smelling shampoo i forgot bout that i have used it for soo long • Ella my mum was great wen i was worried about it showing on her wedding day but she just said she didnt care cos it was part of me! • Jo skin is everythign for teenagers! evetyone is conscious • Mark errr a lot definately it has knocked my confidence on my appearance • Ella yeah i'mconcious but most people i know know about it • Jo i hate it on my face because everyone can see! ur skin is the thing that everyone sees and you cant change it! • Ella i get worried if it starts spreading to places that u c everyday • Ella like ur face wen its at the front of my scalp • Jo yep ! definately - you always feel conscious and if i c sium1 looking at me iimmedaitely think its about my skin! • Jo yep! i get it round the side but luckily its under hand at the mo due to yucky sticky cream lol :) • Mark yeah i agree wen i had a really bad patch where it was all over my hands and face i was really down about it, i agree el i get that feeling

19. Peer Support • Group cohesion – talked about “us” and “them” • Probed each other and offered support • Social differences, gender, age, status did not seem to be a problem

20. Hannah yeah I see people looking and some people obviously are thinking im glad I don’t have that Tania that wot I tink but my mum always says its just Me! Lol! Nicole but its not r fault Tania nope Hannah i think easy for them to say Tania they aren’t intelligent enuf to no that though! Tania: yeah they don’t reli understand properly Nicole But its not wot we luk like its wots inside Hannah yeah that’s exactly wot my mum says but it’s a bit obvious when someone is blatantly staring Tania: especially on skool trips and ur in the bathroom for ages doing cream Tania yeah but ppl are so shallow Tania like the plastics at my skool! Hannah I go to an all girls school and theres a lot of bitchyness

21. Considerations • Participants cant get online / connection drops • Participants forget to join … send reminders • Time zones complicate arrangements • Cross cultural differences • brb - Participants leave the computer • Privacy? May be other people in the room

22. Ethical Considerations • Digital Divide / equity of access / socio-economic differences: • 88% of middle class children have accessed the internet at home • 61% of working class children have accessed the internet at home (Livingstone & Bober 2005) • 1 in 5 of the young people Catch22 works with has no access to the internet (Catch22, 2010) • Reasonable technical competence required • Consent process • Confidentiality • Distress

23. Reasons for doing FGs online • Convenience: Young people may be unable or unwilling to travel • Interest: synchronous onlinecommunication is popular with young people & the opportunity to participate online may heighten interest (Tse 1999) • Confidence: Young people with appearance related concerns may lack confidence to meet new people (Wahl et al 2002) • Anonymity: increases sense of control & may enhance disclosure (Suzuki & Calzo 2004: Joinson 2001).Participation may be a more pleasant experience for young people.

24. Conclusion • Research: OFGs can: • Provide alternative domain for focus groups • address power dynamics • encourage participation • facilitate dynamic communication • benefits of reduced cost & increased speed • Beyond research situation: OFGs may: • Facilitate networks of peer support • Inclusive for groups with appearance / health related concerns which impede social functioning

25. References • Catch 22 (2010).Young people and the digital divide. Catch 22; Policy & Research • Gaiser, T (1997). Conducting online focus groups; a methodological discussion. Social Science Computer Review, 15 (2), 135-144 • Ginsburg, J.H, & Link, B.G (1989). Feelings of stigmatisation in patients with psoriasis. Journal of American Academy in Dermatology, 20, 53-63 • Joinson A.N (2001) Self-disclosure in computer-mediated communication: the role of self awareness and visual anonymity. European Journal of Social Psychology. 31, 177-92 • Livingstone, S & Bober, M (April 2005) UK Children Go Online. Final report of key project findings. ESRC • O’Connor, H & Madge, C (2003) “Focus Groups in cyberspace”: Using the internet for qualitative research. Qualitative Market Research: An International Journal, 6(2), 133-143 • Robson, K (1999). Employment Experiences of Ulcerative Colitis and Crohn’s Disease Sufferers, Unpublished PhD Thesis, University of Wales, Cardiff • Selwyn, N & Robson, K (1998). Using email as a research tool. Social Research Update, 21. http://www.soc.surrey.ac.uk/sru/sru21.html • Stewart, F., Eckerman, E & Zhou, K (1998). Using the internet in qualitative public health research: A comparison of Chinese and Australian Young Women’s perceptions of tobacco use. Internet Journal of Health Promotion, URL, http://www.monash.edu.au/health/IJHP/1998/12 • Suzuki, L.K & Calzo, J.P (2004) The search for peer advice in cyberspace: An examination of online teen bulletin boards about health and sexuality. Journal of Applied Developmental Psychology, 25. (6) 685-698. • Tse, A.C.B (1999) Conducting electronic focus group discussions among Chinese respondents. Journal of the Market Research Society, 41(407-415) • Wahl, A.K., Gjengedal, E.,& Hanestad, B.R (2002). The bodily suffering of living with severe psoriasis: In-depth interviews with 22 hospitalised patients with psoriasis. Qualitative Health Research, 12(2), 250 - 261 • Ward, K.J (1999). The cyber-ethnographic (re)construction of two feminist online communities. Sociological Research Online, 4(1) available at; www.socresonline.org.uk/socresonline/4/1/ward.html • Williams, M (2003) ‘Virtually Criminal: Deviance and Harm within Online Environments’. Unpublished PhD Thesis, University of Wales, Cardiff.

26. Contact For more information please contact: Fiona Fox f.fox@bath.ac.uk