What is a focus-group discussion?
A focus-group discussion is a structured form of group discussion, guided by one person, called a moderator. The discussion can be tape-recorded, or an observer can help the moderator by taking notes of what is said. After some general questions, the discussion focuses on specific topics, for example, relationships, beliefs about HIV/AIDS, access to health services, etc.
How to organize a focus-group discussion
Identify people to invite to the group.
Each focus group should have 6 to 12 participants, plus the group leader (the moderator) and an observer who writes down the main points made by the group. A focus group works best when participants are of the same sex and are of similar ages, educational levels, background, etc. It may only be possible for you to organize a mixed group. If this is the case, remember that some people may not feel so comfortable about expressing their opinions freely. Avoid inviting anyone who is an ‘expert’, such as the local doctor or midwife, or who has a very different status from the rest of the group, as this may also intimidate participants.
The focus-group discussion should be held in a place that is comfortable and free of distractions and interruptions. Participants and the group leader should sit in a circle.
When all the participants have arrived, introduce yourself and the observer, and ask the participants to introduce themselves. You should try to remember their names so you can address them by name during the discussion; if necessary, write their names down or use name tags.
Explain to the group that the purpose of the meeting is to get their ideas and feelings about AIDS, for example. Let them know that the meeting is not an educational lecture, but that you are there to gather their opinions and to learn from them. Tell them that you will not be giving facts or expressing your opinion during the discussion, but that you will be happy to answer questions at the end of the meeting. Emphasize the fact that the participants’ ideas and opinions are very important for the planning of your project, and everyone should express their opinions freely. The rules are that only one person speaks at a time, that all participants address the subject being discussed and that no one is obliged to speak.
Start by asking each person in turn to answer a general question not related to the topic, so that everyone gets used to speaking. For example, “How long have you been a member of this youth group?” Then go on to the questions suggested below. During the session, be sure you stay neutral and do not express your personal opinions or knowledge as this can influence the group. Encourage everyone to participate – don’t allow a few to monopolize the group. If you are encouraging, friendly and relaxed, this will make the group more comfortable and the discussion will be better. Be flexible in letting the group talk, but move them on to the next question before the discussion loses energy or becomes repetitive. The whole discussion should last no longer than one to two hours.
The observer should write down the number of people present, where the discussion takes place, the sex and approximate ages of the participants, and how long the group discussion takes. The participants’ names should not be recorded. The observer should also note down the ‘atmosphere’ of the group –lively or bored, anxious or relaxed, etc. For each question, he/she should write down the main opinions expressed, and the areas of particular sensitivity or strong feeling. It is important to write down the terms and expressions people actually use when talking about sexuality.
To end the meeting, ask the participants one by one if they have any final comments. Examine these comments if they seem interesting or relevant. Ask the group if they have any questions for you; at this point you can freely share with them your own knowledge and experience. Thank the group and repeat that their ideas are valuable and will be used in designing health education materials.
Suggested questions for focus groups
These questions are suggested because they are ‘open questions’ – they can’t be answered with YES or NO, which means they do not have the answers built in, but require group discussion. If you adapt or change any of the questions, be sure you keep them ‘open’.
1. What do you know about this disease called AIDS?
2. What do you think causes AIDS?
3. How do you know if someone has the virus that causes AIDS?
4. How do people get infected?
5. Who is at risk of getting infected with HIV, the virus that causes AIDS?
6. Who is not at risk?
7. In your opinion, how might AIDS affect people in our community, now and in the future?
8. How important do you think AIDS is compared to other problems people face?
9. What can people do to keep from getting infected? How easy or difficult is it to do these things?
10. How would people in this area feel if someone in their family or community were infected with HIV?
11. What or who do you think could be good sources of information about AIDS that people would really listen to? Why?
12. What can young people do to help prevent AIDS in the community?
13. What can young people do to help people and the families of people who are already HIV-infected or have AIDS?
14. What sorts of information/training/materials/other support do you need to prevent people from getting infected with HIV and to support people with AIDS and their families?
The following questions can be answered after you have conducted the focus-group discussion:
Of all the messages coming out of the discussions which, in your opinion, came across most strongly or were most important to the people you spoke with?
What did you learn about the needs for AIDS information?
What did you learn about attitudes towards the sexual behaviour that puts people at risk?
What did you learn about feelings towards people with AIDS and their families?
What do the people you spoke with need from you or the youth group in order to become active in AIDS prevention and/or care?
For some focus-group discussions you may want to get some information on a specific topic. For example, it may be that the frequency with which people have been giving blood in your area has decreased. You may feel it has something to do with the fear of infection with HIV and misinformation. It would be useful to find out what information people have in order to organize a health promotion campaign, which directly answers their questions. The following are some suggested questions to help you find out what people already know and where their fears lie:
Questions about blood donation
1. Why do some people choose to give blood?
2. What are some of the reasons people might have for not wanting to give blood?
3. What sort of people do you think would be willing to give blood and ought to be encouraged?
4. Are there people who you think should be discouraged from donating blood? Why?
5. What effect do you think AIDS has had on blood donation?
6. What do you think are the ways people can get the virus that causes AIDS?
7. Who do you think has a high risk of having HIV, the virus that causes AIDS, in his/her blood?
8. Who is not at risk?
9. In your opinion, what are some ways donors could be educated and reassured about AIDS?
10. What methods do you think could be used to encourage more blood donations?
11. How would you feel if you knew your blood was going to be tested for HIV?
12. If your blood were tested, how would you feel about being informed of the result?
13. In your opinion, who, or what, could be good sources of information about AIDS in your community, to whom people would really listen? Why?
14. If you visited a donating centre, what sort of information and advice would you like to have about AIDS, and how should this information be made available?
15. Do you have any other questions about blood donation?