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FOCUS GROUP FACILITATION MANUAL

Production of this manual has been made possible through funding from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the view of the

Public Health Agency of Canada

La production du manuel a été rendue possible grâce au financement de l’Agence de la santé publique du Canada. Les points du vue exprimés ne reflètent pas nécessairement ceux de

l’Agence de la santé publique du Canada

MNICSP – July 2014 2 | P a g e

Table of content

Introduction ………………………………………………………………..…….… 4

Focus group

1. What is a focus group? ……………………………………………………… 52. Characteristics of a good focus group ……………………………….. 53. Qualities of a good facilitator ………………………………………….… 64. Role of the Facilitator ………………………………………………………… 65. Role of the assistant of facilitator ……………………………………… 6

Planning focus group ……………………………………………………………… 8Conducting focus group …………………………………………………………. 9Challenges ……………………………………………………………………………… 11Ground rules ………………………………………………………………………….. 13Using Probes and Asking Clarifying Questions ……………………….. 14Focus group introduction script ……………………………………………… 15Checklist sample ……………………………………………………………………. 16Debriefing Guide …………………………………………………………………… 18


Introduction

“Mobilizing Newcomers and Immigrants to Cancer Screening Programs” (MNICS) project is a Public Health Agency of Canada’s project proposing to develop and deliver an evidence based cancer prevention and screening awareness and service delivery model targeted to newcomers and immigrants under/never screened populations.

We are going to apply focus group methodology to understand what the barriers are of accessing cancer screening services, knowledge about cancer prevention and cancer screening, and how to engage under/never screened population through an educational model culturally adapted.

This manual has been developing to help peer health educators to become a skilled facilitators as well as planning and leading focus groups.

This is a practical guide that supports peer health educators on working with focus groups and communities.


Focus Group

What is a focus group?

A focus group interview is an interview with a small group of people on a specific topic (Patton, 2002).

Focus groups are typically semi-structured to allow participants to discuss their perceptions and experiences with others in the group.

Generally small to allow all participants enough time to talk and deal with topics in-depth (not possible through a survey).

Collects in-depth information from a group of people who represent the population of interest

Sometimes groups are audio taped and/or notes recorded by hand to ensure all opinions/input are captured

Characteristics of a good focus group

Trained facilitator/moderator comfortable leading group discussion Paid participants meet certain criteria

Several opinions gathered within short time periods

8-12 participants One to two hours in length 8-15 questions asked


Qualities of a good facilitator

Doesn’t need to be an expert on the topic Builds a relationship with the participants Doesn’t react or influence the participants Aware of reactions and facial expressions Facilitates discussion without going off topic Keeps participants focused A good listener - listens to understand Is a facilitator not a participant Intuits (can sense) and/or expect situations

Role of the Facilitator

Register participants Engage in casual conversation before start Explain purpose of focus group Explain ‘ground’ rules Listen using eye contact/facial expression Ask extra questions if needed (use probes) Summarize the focus group session Thank participants Review focus group results with assistant after participants leave

Role of the assistant of facilitator

Hand out and collect consent forms Help participants with consent forms Responsible for audio equipment (tapes) Take detailed notes during discussion Distribute incentives to participants at end Review focus group results with facilitator after participants leave



Review Material

Be Ready

Focus Group

Meeting

Post Meeting Debriefin

g

Be prepared for focus group

Planning Focus Group

1. Determine the times, dates and locations of the focus groupsRemember that these people are going out of their way already in giving up their time to assist youChoose a time, location and venue that are likely to be attractive and appealing for participants

2. Invite focus group participants Contact possible participants by phone. Explain to them the purpose of this meeting and how is working

Call participants at least one week before the planned date. Introduce yourself and your role in the project. Explain to them the purpose of the project and their

participation. Explain to them how focus groups are going to be done Highlight the importance of his/her participation Explain that the participation is voluntary and the

confidentiality will be kept it. Call participants 2 days before the planned focus group to remind

them date, time and location.

3. Review the questionnaire Understand the question and what the question is certainly asking

4. Translate necessary documents Informed Consent Ground rules Questions Educational material

Conducting Focus Group


1. Preparation: Call participants 2 days before the planned date to remind their

participation Check the checklist Organize the boxes Agree who is going to facilitate and who is going to be the assistant

2. Focus Group meeting: Set up the room: - The room is comfortable (temperature, lighting, and Privacy) - Seating allows participants to see and interact which each other


- Organize welcome desk (informed consent forms, pens, happy face stickers, markers, participant name tags, clip boards, participants sign sheet) - Organize refreshment table Focus group work: - Greet each participant and start the session

- Start recording the discussion - Thanking the group for their time - Follow the script - Start the questions, use probing questions - The assistant takes notes: notes should summarize the key points being made by the participants - Encourage participation - Keep the session on time - Closure: Summarize the key points made, repeat what actions will be taken as a result of their feedback, thank the group for their time and input - Give the participants the incentive for their participation and let them sign the record sheet

Clean up: Organize the room as it was found Debriefing: This is a short discussion about the data collected during the

focus group, how was your impression of the focus group (describing the setting, the participants, the mood of the focus group), and your reflections and insights

• The co-facilitator is going to do a writing report based on the recorded information

3. Post focus group meeting: Discuss how the focus group meeting was: Overall mood of discussion Reports participant’s wordsMain ideas and collected informationDifferences among different focus groupsHow we could improveWhat phrase(s) we could include as a quote(s)


Challenges

1. How to make participants feel comfortable and safe

Smile Introduce yourself Use eye contact Be warm and welcoming Share information about room and building Use participant names when speaking to them


2. How to draw out quiet participants

Use pre-session time to identify quiet/shy participants

Use tent cards to seat them across from facilitator to maximize eye contact

Allow more time for them to think before they speak Encourage them to answer questions using eye

contact and calling on them by name

3. How to control dominant participants

Listen and observe participants in the pre-session to identify dominant personalities

Seat them beside facilitator so you can use body language to hold them back

Avoid eye contact with them when asking questions Use suggested phrases to respectfully interrupt them so you can move on

4. How to deal with too many people talking at the same time

Use judgment to determine you need to take back control of the group Ask participants to speak one at a time so everyone

has a chance to be heard Turn lights off and on quickly to get attention If necessary, announce a five minute break and that

they will change seats when they come back

5. How to deal with people who disagree with each other

Remind participants about the ‘ground’ rules


Listen to their answer then remind them that everyone’s opinion counts and is important

Acknowledge their emotion/idea/thought (whatever reaction), explain that it is okay to disagree, thank them for sharing and offer to speak to them about it at the end

6. How to get all questions asked within time limit

Acknowledge time constraints at the beginning of the session Keep answers on topic as much as possible Remind them when time is almost done for each question – use reminder

to get quieter people to participant Limit discussions that go off topic

7. What to do if no one answers the question

Try asking the question differently Come back to it later if it is a sensitive topic for people

Participants might be tired of talking about the topic Wait for a bit and give participants time to think

Ground Rules

It helps to provide a safe and trusting atmosphere where participants can share both positive and challenging thoughts and ideas.

1. Listen & respond to each other carefully and kindly

Listen while others are speaking

Make eye contact when speaking to others


All cell phones or other distractions are turned off and out of site

2. Treat each other with respect

Be open and honest

Think before you speak

One person speaks at a time

Give everyone a chance to speak

Be supportive and avoid judgment

3. Actively participate

There are no right or wrong answers

Everyone’s opinion is important

Everyone’s ideas, experiences, and opinions are valuable

Ask for clarification if you are not sure about the question

Using Probes and Asking Clarifying QuestionsPurpose:

To help clarify and understand what a participant has said To help get more detailed information from the participant, giving them more time to think

Examples of Probes: “Please tell me (more) about that…” “Could you explain what you mean by…?” “Can you tell me something else about…?” “Would you explain further?” “Would you give me an example of what you mean?” “Is there anything else?” “Please describe what you mean.” “Does anyone see it differently?”

Example of a Probe you would not use: “So you are telling me that… Right?”


Keeping Them Talking: Interrupt as little as possible If you need to follow-up by using a probe, make a mental note and ask them about it when they

finish speaking

Probing In, Not Finishing Their Thought: Show the participant that you are there to listen, interrupting may influence their answer and if

they answer the questions you are asking

Seeing Things from Their Perspective Using probes for clarification helps to gather good information and avoid making assumptions

Avoid Making Assumptions: Clarifying questions and probes gives the participant clues as to how much detail you would like

in their answers Keep questions short and to the point, this way you will get more detail from the participant and

keep you from making assumptions

The Participant is the Expert: Using probes to clarify reinforces the fact that the participant has expert knowledge based on

their direct experiences with the topic

Good Probing is Not Leading: When you ask a leading question it reflects your opinion/assumption about a topic Example: “Don’t you think…” –this question shows that you have an opinion. It does not show

you are there to learn from them.

Phase 1 Focus Group Introduction Script

Order of Welcome:– Welcome – Overview of the topic – why you are here– Review guidelines or ground rules – Opening question (ice breaker)

Good (evening/afternoon), and welcome to our session tonight. Thank you to everyone for agreeing to be part of the “Mobilizing Newcomers and Immigrants to Cancer Screening Programs” project and for taking the time to join our discussion about cancer screening barriers.

My name is _________________ and assisting me is ___________________, and we are here on behalf of ___________________. We want to learn about what our community knows about cancer screening and what they would like to know. You were selected because you all belong to the _______________ community living in _____________ and we want to learn about cancer screening barriers specific to the _________________ community.


We are particularly interested in your views because we want to develop an educational model to motivate people to get screened that meets our cultural needs.

We basically want to know what you know about cancer and what issues prevent you from accessing cancer screening programs. Today we will also ask your thoughts and opinions about what you know about accessing cancer screening programs.

While you may have different points of view, there are no wrong answers. Please feel free to share your point of view even if it differs from what others have said. Keep in mind that we’re just as interested in negative comments as positive comments, and at times the negative comments can be the most helpful.

Before we begin, let me suggest some things that will make our discussion more productive. Please feel free to speak up, but only one person should talk at a time. We’re tape recording the session because we don’t want to miss any of your valuable comments. We’ll be on a first-name basis only. We will not use any names in our reports, nor will there be any names attached to comments. You may be assured of confidentiality.

My role here is to ask questions and listen. I won’t be participating in the conversation, but I want you to feel free to talk with one another. I’ll be asking ______ (#) questions, and I’ll be moving the discussion from one question to the next. There is a tendency in these discussions for some people to talk a lot and some people not to say much. But it is important for us to hear from each of you tonight because you have different experiences. So if one of you is sharing a lot, I may ask you to let others talk. And if you are not saying much, I may ask your opinion. We’ve placed name cards on the table in front of you to help us remember each other’s names.

Let’s begin. Let’s find out some more about each other by going around the table. Tell us a few words that describe you. _______________, let’s start with you.

Check List (sample)Item Check

General Laptop

Projector

Voice Recorder

AAA Batteries

USB presentation

Camera

ICS posters

Banner - ICS

Registration Participant Information sheet

Participant name tags


Participant consent form – Translated

Participant consent form – English

Clip boards (6)

Pens

Markers

Stickers ( to recognize people who do not sign the picture consent)

Focus group Masking tape

Meeting ground rules

Focus groups questions – English

Focus group questions – Translated

Envelope – Consent forms

Envelope – Focus group material

Paper

Thank you cards (12)

Evaluation forms – English

Evaluation forms - Translated

Ending Record sheet for incentives (for example: bus tickets and/or gift certificates)

Debriefing Debriefing guide sheet

Food Water bottles

Coffee

Juice boxes

Granola bars

Fruit

Plastic flowers

Vase

Plates

Cutlery

Napkins


Paper towels

Tablecloth (7)

Information Breast Cancer

Colorectal cancer

Cervical cancer

Glass stand (2)

Plastic card holders /cards

Arabic/Spanish breast cancer screening

Debriefing Guide

1. What were the most important themes or ideas discussed?

2. How did these differ from what we expected?

3. What points need to be included in the report?


4. What quotes should be remembered and possibly included in the report?

5. Were there any unexpected or anticipated feelings?

6. Should we do anything differently for the next meeting?


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