analysts (Makosky-Daley et al., 2010). The participatory research model has underpinned many pieces of research with ethnic minority groups, carried out with the aim of developing what Maiter et al. (2013) have described as a ‘shared critical consciousness’. This approach has chimed well with the orientation of feminist researchers, leading some to claim focus groups as an inherently feminist method, although Wilkinson (1999) suggests that this is perhaps slightly overstating the case. However, many such projects have focused on women, including a recent project in Thailand which sought to strengthen women weavers’ self-care (Nilvarangkul et al., 2013). Focus groups have also been employed in order to give voice to many other marginalized groups in a range of contexts – e.g. Khadka et al. (2012) who sought to elicit the perspectives of visually impaired children
Practitioner-researchers have also fused elements of the community development and organizational research model in order to carry out action research with fellow professionals in order to address specific aspects of practice – e.g. Jimbo et al. (2013) who convened focus groups with primary care clinicians and medical office staff in order to identify perceived barriers and facilitators with regard to using a web-based interactive decision aid for colorectal cancer screening. The example provided by Fardy and Jeffs (1994), however, provides the most detailed account to date of the use of focus groups as part of their approach to developing consensus guidelines on managing the menopause in general practice/family medicine.
Although most examples of such usages come from the health and social care fields, one participatory project in Baltimore involved research with fire union leaders and firefighters aimed to inform implementation of an urban firefighting canvassing programme (Frataroli et al., 2012). In the city of Philadelphia, which the authors note, is characterized by a history of experimentation in relation to its criminal justice system, Wood and Beierschmitt (2014) applied a participatory action research approach to address the practice of policing mental and behavioural health incidents.
Again drawing on the community development approach and, here, echoing its concern with addressing power differentials between researcher and participants, focus groups have frequently been employed in action-oriented projects, seeking to work with patients, clients, or community members in order to inform or, even to change, professional practice or policy. Examples include the work of Makosky-Daley et al. (2010) who explored, with American-Indians in Kansas and Missouri, the barriers to breast and colorectal cancer screening and use of the Internet for obtaining health-related information. Another example is afforded by Littlechild et al. (2015) who engaged with older people (including black and minority ethnic community members and people with dementia) in order to evaluate the impact of health services and policy. (These projects are further discussed in the next chapter, in relation to the specific advantages afforded by focus groups.)
Some researchers have also employed focus groups to good effect in communicating with or, even, working collaboratively with policy makers. Examples include the work of Wutich et al. (2010) who elicited the views of water policy makers in Arizona. In the context of research into sustainability and everyday practice of members of the general public, Prades et al. (2013) also sought to engage policy makers through an action research approach.
As suggested by this quick rundown of the various uses to which focus groups have been put, there is no one hard and fast approach. However, where researchers casually employ focus groups without weighing up the respective merits afforded by these very different traditions, they may miss out on possibilities. The advice dispensed via marketing research manuals, for example, although it may be helpful with regard to some aspects of focus group studies in other contexts, may be less appropriate where the method is being employed to achieve different ends.
While marketing researchers and political pollsters seek to ‘multiply up’ (Asbury, 1995) their findings from focus groups to make inferences about the population at large, health and social care or social science endeavours using focus groups are generally carried out on a much smaller scale and rely on sampling techniques (see Chapter 5) that preclude statistical generalization. Although much of the research carried out within the field of health and social care is also concerned with eliciting participants’ perspectives, the focus is less on establishing simply whether audience responses are positive or negative, as on teasing out the reasons behind these views; who holds particular views and why; and, ultimately, how attitudes are formed. Accordingly, health and social care researchers would be well-advised to look beyond the sampling strategies offered by marketing texts (see the discussion in Chapter 5), and to explore, instead, approaches which move beyond the notion of ‘representative’ sampling. Here researchers could learn important lessons from community development applications of focus groups, where recognition is given to the different lenses through which various sectors of a ‘community’, or social situation, may view events, suggesting that the researcher should be mindful of the need to consult with, or even simply to reflect the views of, these different constituencies – regardless of how many people are involved, or how ‘representative’ they are of the wider population.
Puchta and Potter (2002) argue that ‘attitudes’ are, in practice, the result of a series of analytic decisions on the part of those who profess to hold certain views. This references the capacity of focus groups to unpick these processes and to arrive at a deeper understanding of how ‘attitudes’ are articulated, contested, defended, qualified and revised through interaction. This moves away from the notion of measuring views enshrined in much research employing questionnaires, and explores, instead, the many shades of meaning that may be involved, allowing for inconsistencies and contradictions. Those usages of focus groups which capitalize on this feature of group discussions produce more nuanced explanations that can, ultimately, provide more useful – although more complex – insights (see the discussion in Chapters 8 and 9 on analysis). Moreover, community development approaches – and others which pay attention to the content and process of interaction within groups – are much better suited to dealing with such complexities, treating ‘messiness’ as data rather than as ‘noise’ or a source of frustration for the analyst.
Similarly, the organizational model of focus group usage tends to prioritize the concerns of employers – or professionals – rather than those of patients or clients. (This topic is re-visited in Chapter 2.) This raises a different set of questions, relating to why the research is being carried out; who has commissioned it; and whose interests it ultimately serves. Again, such topics are more fully addressed within the community development literature – and important insights can be gained from such discussions, even where the research is not specifically geared towards effecting change.
Returning to the myriad possibilities afforded by different approaches to using focus groups by these different models, each potentially has something to offer the researcher. However, uncritical acceptance of advice dispensed in different contexts can serve to merely exacerbate some of the tensions and challenges involved. There is no right or wrong way to go about doing focus group research; however, there are less- and better-considered ways, depending on the thought that has gone into selecting approaches or elements of different focus group traditions. The researcher is free to adapt, borrow, or combine any approaches that take his or her fancy, but should always be mindful of the fit between these and the research question at hand (Kitzinger and Barbour, 1999). The development of hybrids is entirely acceptable – and may even result in the most innovative use of focus groups and the most insightful data and analysis. As Morgan and Bottorff (2010) advise: researchers need to find what works for them and should ‘select a way of using focus groups that matches the goals of the project’ (p. 579). This, however, is easier said than done and the next two chapters set about equipping the focus group researcher to make a considered choice, having weighed up the advantages and potential disadvantages
