Learn about the use of focus and discussion groups to engage and/or collect data with patients, the public, and research participants. CHI's Lunchtime Learning is open to all researchers, decision-makers, clinicians, patients and members of the public who want to learn more about the theory and practice of meaningful, inclusive, and safe patient and public engagement. Following this session, attendees should be able to: - Describe differences between focus groups and discussion groups; - Determine when each approach is appropriate to use; and - Assess challenges and needs for planning effective focus and discussion groups.

1. PRACTICAL ENGAGEMENT:
FOCUS & DISCUSSION GROUPS
Ogai Sherzoi & Alexie Touchette | December 9th, 2020
CHI Patient Engagement Lunchtime Learning Series (2020-2021)

3. • Describe differences between focus
groups and discussion groups;
• Determine when each approach is
appropriate to use; and
• Assess challenges and needs for planning
effective focus and discussion groups.
Learning Objectives

4. Poll Question #1

5. Focus Groups

6. • Focus groups are participatory methods of
collecting data in qualitative research
• There are different types of focus groups:
1. Single focus group
2. Two-way focus group
3. Dueling moderator focus group
4. Respondent focus group
5. Mini-focus groups
6. Online focus groups
What are Focus Groups?

7. • Suggested to have between 6-12
participants
• Smaller groups for controversial or
emotionally charged topics
• Usually last 1-2 hours
• Participants are asked 3-5 research
questions
Focus Group Format

8. Useful for:
1. Developing or introducing a new program or
service
2. Getting answers to specific research question
that you otherwise could not obtain from
written surveys
3. Obtaining in-depth and diverse perspectives,
opinions, and thoughts of
patients/caregivers/community members
Focus Groups

9. Poll Question #2

10. Discussion Groups

11. • Used as part of patient engagement activity
(partners, not participants)
• Small groups consisting of 5-10 individuals
• Individuals in the group focus on one research
decision
• Patient partners also are encouraged to be
actively involved as co-facilitators
What are Discussion Groups?

12. Useful for:
1. Identification of public opinion and discussion
around research decisions
2. Providing an opportunity for voices traditionally
less heard in health research
3. Insightful information for evaluation of health
research
4. Using previously analyzed data to generate
alternative interpretations
Discussion Groups

13. Focus vs. Discussion Groups
Focus Groups
• Research
participants
provide input
and/or answer
research questions
Discussion Groups
• Patient partners
(research
partners/co-
researchers, etc.),
provide input around
research decisions
Doria et al., Research Involvement & Engagement, 2018

14. Focus vs. Discussion Groups
Focus Groups
• Common to record
audio/video and
transcribe into
narrative data
Discussion Groups
• Group member’s
feedback is
collected for
research design and
decision-making
purposes and NOT
part of data
collection

16. True or False

17. Advantages:
1. Cost effective
2. Opportunity to reflect and react to the
viewpoints of other group members
3. Stimulate further in-depth conversation
Focus & Discussion Groups

18. Advantages:
4. Chance to ask follow-up questions, which can
lead to producing more information
5. Offers flexibility for probing—
facilitator/moderators can ask for clarification
and or diverse opinions
Focus & Discussion Groups

19. Limitations:
1. Individuals may not feel comfortable sharing
their stories and experiences in a group
setting
2. Important to have a skilled
moderator/facilitator
3. Some members may feel pressured to agree
with opinion of others
Focus & Discussion Groups

20. • Choose a space that is accessible, inclusive,
and safe (emotionally, culturally, physically,
spiritually) to all members
• Moderator/facilitator is responsible to create
agenda
Implementation

21. Group is structured as:
Welcome all members/nametags/house
keeping items/principles of working together
Icebreaker activity—be purposeful in the ice
breaker activity you choose
Confidentiality
Goals and objectives
Implementation

22. Content
Questions
Summarize what you have heard (member
checking)
Closing
Implementation

23. • Listing, choosing, ranking, prioritizing
• Keep in mind the age group
• Any stage of focus or discussion groups
Activity-Oriented Questions

24. Free Listing:
• Participants or partners list out and produce
a list
• Example: list of solutions to problems; ways to
manage pain; issues that need interventions;
and so on
• In discussion groups, partners can create a list
of research priorities
Activity-Oriented Questions

25. Rating:
• Rank a list of terms according to specified
dimensions
• Example: most likely to least likely; most
accessibly to least accessibility; and so on
• Helps to prioritize
Activity-Oriented Questions

26. Pile Sorting:
• Group together items that have similarities
and differences from others. Typically done
with cards or paper, can also be done with
objects (photographs, etc.).
• Example: looking for themes
Activity-Oriented Questions

27. Choosing Among Alternatives:
• Popular technique—various alternatives are
offered and partners/participants discuss
advantages and disadvantages and select
one (two…three…four...) that is most
appropriate.
Activity-Oriented Questions

28. Storytelling:
• Invite participants/partners to tell a story—
narrative around topic of interest or
experiential knowledge and way to inform
research design
Activity-Oriented Questions

29. Moderator/Facilitator’s response:
1. Allow space for the individual feeling
strong emotions to regain composure
by sitting quietly and waiting.
2. Important to be empathetic by stating
something like “it’s been very hard on
you” and “Are you ok to continue?”
Emotions & Mindful Responses

30. 3. If the individual no longer wants to
participate, we can ask if they would
like to call their supports.
4. Also important to give participants
counselling resources ahead of time in
case they need supports
Emotions & Mindful Responses

31. Disengaged:
Do an energizer activity
Ask members to do more of the sharing
Fatigue :
Breaks
Energizer
Lighter topics
Stretching
Addressing Behaviours

32. Being on the phone/distracted
Important to not assume and be open-
minded when interpreting behaviours.
Is the behaviour directing to others and
limits participation of the group members?
Addressing Behaviours

33. Create a checklist of all the items you will
need to moderate the focus group/ facilitate
the discussion group.
 What is not said is maybe just as important
as what is sad.
Tips

34. Make sure you stick to the timeline that was
given to the participants. Individuals may
have other commitments.
Be mindful that we are inclusive and
welcoming members from diverse
backgrounds and experiences.
Tips

35. Important to record what participants say
word for words. If summarizing check back
with the group to make sure you captured
what they intend to say.
Using name tags allows you to call
participants by their names, which helps
them feel recognized and more comfortable.
Tips

36. Ensuring that everyone get a chance to share
their voice; not just one members dominating
the discussion.
 Important to not over-direct the focus group
as we want to be mindful that we are not
bringing our own views into play.
Tips

38. What are they?
• Semi-structured online group discussions
• Participants respond to pre-determined
questions and other’s comments
• At any time, not necessarily only when others
are participating
Asynchronous Online Focus Groups

39. How can they be used?
Study example: Engage Canadians with limited
mobility to create an online toolkit for individuals
who use mobility devices during the winter.
Asynchronous Online Focus Groups

40. Overview of Methods
• 5 separate week-long
online focus groups (BC,
MB, ON, QC*, NS)
• Recruitment through
posters and email
advertisements major
organizations, universities,
and mobility aid vendors
*All materials translated in French

41. Eligibility:
• Mobility aid users (e.g. canes, walkers, scooters,
wheelchairs);
• 19 years of age or older;
• Able to access the Internet; and
• Willing to spend a minimum of 30 minutes daily
(for the entire week) answering questions and
responding to comments
Overview of Methods

42. • Secure website was
created using
WordPress.com
• Pre-determined
question posted each
day (total 7 days)
• 3 discussion
facilitators*
Overview of Methods

43. • Honorarium mailed to
participants
• Individual access
cancelled, cleared,
prepared for next
group
Overview of Methods

44. Recruitment Results
n= 8
Total number of
participants: 24
n= 6
n= 5
n= 2
n= 3

45. 1. Convenience of
participation through
flexibility of schedules and
availability
Advantages

46. 1. Convenience of
participation through
flexibility of schedules and
availability
2. Efficacy & cost
Advantages

47. 1. Convenience of
participation through
flexibility of schedules and
availability
2. Efficacy & cost
3. Inclusion of geographically
distributed participants
Advantages

48. 1. Convenience of
participation through
flexibility of schedules and
availability
2. Efficacy & cost
3. Inclusion of geographically
distributed participants
4. Allowed time & space for
reflection
Advantages

49. 5. Allows Inclusion of More Voices
Advantages

50. 5. Allows Inclusion of More Voices
Advantages

51. 5. Allows Inclusion of More Voices
Advantages

52. 5. Allows Inclusion of More Voices
6. Encourages Peer Problem-Solving
Advantages

53. 5. Allows Inclusion of More Voices
6. Encourages Peer Problem-Solving
7. Anonymity
Advantages

54. 1. Lack of Face-to-Face Interaction
Disadvantages

55. 1. Lack of Face-to-Face Interaction
2. Accessibility & Inclusivity
Disadvantages

56. 1. Lack of Face-to-Face Interaction
2. Accessibility & Inclusivity
3. Technology Problems
Disadvantages
Freepik.com

57. Key Takeaway
The method selected must match the
research objectives and population.

58. Key Takeaway
Asynchronous online focus group method
provides another option.