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Using Focus Groups with Children and Young People. Dr Faith Gibson, Lecturer in Children’s Cancer Nursing Research Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London. Learning outcomes….

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Using focus groups with children and young people l.jpg

Using Focus Groups with Children and Young People

Dr Faith Gibson, Lecturer in Children’s Cancer Nursing Research

Institute of Child Health and Great Ormond Street Hospital

for Children NHS Trust, London

Learning outcomes l.jpg
Learning outcomes…

  • To be able to describe the advantages and disadvantages of using focus groups.

  • To be able to describe the steps taken when planning and running a focus group.

  • To be able to highlight the particular techniques used when working with children and young people in focus groups.

  • To be able to outline the ethical issues involving children and young people in focus groups.

  • To summarize approaches to analysis and reporting of focus group data.

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Overview of the Session (90 minutes)

  • Activity-ice breaker

  • Presentation – Theory and practice of focus groups

  • Activity

  • Presentation – Running a focus group

  • Closing comments

My experience your experience l.jpg

Identifying dimensions of the role of the CNS

Exploring the role of nurses in day care

Identifying competencies of general and specialist nurses

Exploring fatigue with teenagers

Listening to children and young peoples views of their cancer experience

Exploring experiences with young people during the diagnostic period

My experience….your experience????

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A focus group is…….

  • A carefully planned discussion

  • Designed to obtain perceptions

  • On a defined area of interest

  • In a permissive non-threatening environment

  • Conducted with approximately 7-10 people

  • By a skilled interviewer

  • To share ideas and perceptions

  • In which group members influence each other by responding to ideas and comments in the discussion

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The story behind their use……

  • Origins traced back to 1920’s

  • Used then to develop survey instruments

  • Developed in response to general dissatisfaction with interviews

  • Became popular and developed strongly as a research technique for market research

  • Adopted for party political research

  • Well established as a mainstream method across all fields of social and educational research

  • In health care seen increase in use in last 10 years

Characteristics l.jpg

  • Involve people: small enough to share insights, large enough to provide diversity

  • Conducted in a series: to detect patterns and trends across groups

  • Composed of people who are similar: defined by the study

  • Used to produce research data: differs from other group interactions

  • Make use of qualitative data: participants influence each other like in real life as opposed to interviews

  • Have a focussed discussion: carefully predetermined and sequenced

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Some common myths….

  • Cheap and quick

  • Require moderators with highly developed professional skills

  • Must consist of strangers

  • Not used to discuss sensitive topics

  • Tend to produce conformity

  • Are a more natural means of collecting data

  • Should not be used for decision making

  • Must be validated by other methods

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Why focus groups with children/young people

  • Create a safer peer environment

  • Replicate the type of small group setting similar to the classroom

  • May help to re-dress the power imbalance

  • May be encouraged to give their opinions when they hear others

  • Memory may be jogged by others contributions

  • Acknowledges participants as experts

  • Greater involvement in the research process

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Where to start…….

  • Framing your research question

  • Detailing outcomes of the research

  • Agreeing sample and setting

  • Deciding approaches to data collection

  • Identifying data analysis techniques

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Early planning process….

  • Number of sessions: practical and substantive issues considered

  • Time and place: knowledge of participants to increase uptake

  • Style and format: standardise for coverage and analysis

  • Recording tools: tape, video, group activities, note taking

  • Analysis: most challenging aspect where less has been written

  • Pilot: process and questions

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Working within an ethical framework

  • Duties

  • Rights

  • Benefits/harm

  • Risk of distress

  • Risks to children from participating- benefits to children in the future

  • Respect for privacy and confidentiality, use of quotes

  • Trust

  • Understanding

  • Keeping children safe

Refer to checklists, e.g. NCB,


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Group composition factors

  • Age dictates size of group, average 5-8

  • Participants in a group should be within two-year age span

  • Used with children over 6 years

  • Single-sex/mixed sex

  • Known/unknown

  • Homogenous/heterogeneous

  • Last 45 mins-90 mins

  • Research question will influence many factors

Location seating l.jpg

  • Familiarity balanced against suitability

  • Noise levels and distractions

  • Seating arrangements, floor, seated in circle with moderator, with/without table

  • Eye contact

  • Choice of seating

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The Moderator

  • Make the group feel comfortable and at ease

  • Set themselves apart from other authority figures

  • Matching moderator to the group

  • Allowing participants to influence the agenda

  • Keep discussions focused on the topic

  • Ensure all participants have an opportunity to contribute

  • Remain mindful of non-verbal signs and fatigue/boredom

  • Be aware of/note group dynamics

  • Enhance the clarity of participants contributions

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Introducing the group

  • Standard statement

  • Format and nature of the group discussion

  • Confidentiality, what this means

  • Ground rules

  • Recording, tape/video

  • Role of assistant moderator

  • The opening topic, sequencing questions

  • Discussion

  • Ending the discussion

  • Summary, concluding for the group and the individual

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Conducting the discussion..

  • Flexibility or structure

  • Probing

  • Noting non-verbal language

  • Creating space for everyone to contribute

  • Addressing dominant participants

  • Drawing out reticent participants

  • Avoiding simultaneous dialogue

  • Value interactions, recognise cannot follow every point raised

  • Exploring emerging issues, diversity of view

  • Challenging social norms and apparent consensus

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Using activities

  • Ice-breaker

  • Age-specific activities, designed for the purpose

    • Brainstorming

    • Sentence completion

    • Visual prompts

    • Vignettes

    • Fantasy wishes

    • And…………

  • Emphasise participation

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Transcript, tape, notes, observation based

Revise decision if necessary

Diagram of seating arrangements

De-brief immediately after and take notes

Organize data


Review tapes, transcripts, and notes look for emerging themes and develop coding categories

Construct overview grid

Making group comparisons

Reliability and members check

Analysing data

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Threats to quality…….

  • Clarity of purpose

  • Appropriate environment

  • Sufficient resources

  • Appropriate participants

  • Recruitment and scheduling of sessions

  • Skilful moderator

  • Effective questions

  • Careful data handling

  • Systematic and verifiable analysis

  • Appropriate presentation

  • Honouring the participant and the method

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Ensuring quality and reporting back

  • Detail participants and the context in which views were given

  • True representation of findings

  • Face validity

  • Convergent validity: confirmed by future behaviours, experiences or events?

  • Feedback, written, user forum, conferences, publication

  • Influencing practice

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In summary…….

  • Preparation and planning ensures success

  • Not to be taken on as an easy option

  • Research question influences methods

  • Group composition, format, etc all need considerable thought

  • Rigour at all stages is crucial

  • And……………

  • Valuable approach to gathering valid and reliable data directly with children and young people