The Sociogram

BackgroundNovel, technology-based methods are rapidly increasing in popularity across multiple facets of quantitative research. Qualitative research, however, has been slower to integrate technology into research methodology. One method, computer-mediated communication (CMC), has been utilized to a limited extent for focus group discussions.ObjectiveThis study aimed to assess feasibility of an online video conferencing system to further adapt CMC to facilitate synchronous focus group discussions among transgender women living in six cities in eastern and southern United States.MethodsBetween August 2017 and January 2018, focus group discussions with adult transgender women were conducted in English and Spanish by research teams based in Boston, MA, and Baltimore, MD. Participants were sampled from six cities: Baltimore, MD; Boston, MA; New York, NY; Washington, DC; Atlanta, GA; and Miami, FL. This was formative research to inform a technology-enhanced cohort study to assess HIV acquisition among transgender women. This analysis focused on the methodologic use of CMC focus groups conducted synchronously using online software that enabled video or phone discussion. Findings were based on qualitative observations of attendance and study team debriefing on topics of individual, social, technical, and logistical challenges encountered.ResultsA total of 41 transgender women from all six cities participated in seven online focus group discussions—five English and two Spanish. There was equal racial distribution of black/African American (14/41, 34%) and white (14/41, 34%) attendees, with 29% (12/41) identifying as Hispanic/Latina ethnicity. Overall, 29 of 70 (41%) eligible and scheduled transgender women failed to attend the focus group discussions. The most common reason for nonattendance was forgetting or having a scheduling conflict (16/29, 55%). A total of 14% (4/29) reported technical challenges associated with accessing the CMC focus group discussion. CMC focus group discussions were found to facilitate geographic diversity; allow participants to control anonymity and privacy (eg, use of pseudonyms and option to use video); ease scheduling by eliminating challenges related to travel to a data collection site; and offer flexibility to join via a variety of devices. Challenges encountered were related to overlapping conversations; variable audio quality in cases where Internet or cellular connection was poor; and distribution of incentives (eg, cash versus gift cards). As with all focus group discussions, establishment of ground rules and employing both a skilled facilitator and a notetaker who could troubleshoot technology issues were critical to the success of CMC focus group discussions.ConclusionsSynchronous CMC focus group discussions provide a secure opportunity to convene participants across geographic space with minimal time burden and without losing the standardized approach that is expected of focus group discussions. This method may provide an optimal alternative to engaging hard-to-reach participants in focus group discussions. Participants with limited technological literacy or inconsistent access to a phone and/or cellular data or service, as well as circumstances necessitating immediate cash incentives may, however, require additional support and accommodation when participating in CMC focus group discussions.

Background: Focus group discussions are becoming an increasingly popular methodology in primary healthcare research. They can be used to understand people's beliefs, opinions and attitudes about the topic of interest. With the increasing emphasis on critical appraisal of scientific research, it is obvious that reporting qualitative research has to be transparent. Not only should the methodology itself be easy to understand and evaluate, but also the question whether focus group methodology is the most appropriate way to serve the research question should be answered. Focus group discussions are relatively new to biomedical journals, often resulting in misunderstanding and frustration for authors, reviewers and editors.Objectives: To develop a reliable and valid checklist for the critical appraisal of focus group research articles for the information of referees and editors of medical journals, commissioners of research, but most of all to help authors to report transparently.Methods: A review of the literature in different databases from 1990 to 2000 using the keywords “qualitative research”, “focus groups”, “methodology” and “standards” resulted in a checklist being issued. This checklist was submitted to an expert panel, its feasibility was addressed and the inter-rater agreement was assessed by members of the European General Practice Research Workshop.Results: A critical appraisal checklist for focus group research articles.Conclusions: The checklist does not replace training in the research method but it can act as a tool for authors, reviewers, editors and commissioners of research.

ABSTRACTHuntington’s disease (HD) is a progressive, neurodegenerative, autosomal dominant disease, characterized by motor disturbances, behavioral and psychological symptoms and cognitive decline. These characteristics often result in loss of expressive and communicative skills, especially in the advanced stage of the disease, frequently giving rise to behavioral problems such as anxiety, irritability and apathy. Music therapy is potentially a good non-pharmacological intervention to improve communication skills and thus possibly reduce behavioral problems, leading to a better quality of life (QoL) overall. As there is little knowledge on how music therapy may contribute to improve the QoL in HD, a qualitative research was conducted to gain insight: a focus group study was performed, following the guidelines of naturalistic inquiry and grounded theory. In three open-structured group discussions, participants (six HD professionals with different experience with and knowledge about music therapy) were asked to reflect on what defines QoL in patients with HD and on the potential role of music therapy for patients with HD. The results show that, according to the focus group participants, psychosocial aspects seem to be the most important aspects which contribute to improve QoL in patients with HD, with sense of security, confidence and structure being the qualifications most mentioned. Autonomy and self-esteem are other important QoL factors. The participants stated that the stage of the disease and the living conditions of the patient are crucial. Poor insight, unawareness and denial, all due to cognitive decline, mean that it is extremely difficult for patients to reflect on their own QoL. As the ability to communicate and express oneself deteriorates over time, music therapy could play an important role in the treatment of patients with HD in all phases of the disease. By providing an additional means of communication, thus enabling the patient to express emotions, music could be used as a mood indicator to determine in which state of mind the patient is. This article describes six HD clinicians’ perception of QoL for patients with HD and the potential role music therapy can play in improving the QoL of patients with HD using focus group discussions. These insights were used to inform an empirical trial looking at the effects of music therapy on improving the QoL of patients with HD.

Purpose This paper explores the ethical and methodological challenges of conducting qualitative field research in the disaster-prone southwestern coastal region of Bangladesh. It aims to reflect on local-level disaster risk reduction (DRR) practices and community coping strategies, highlighting ethical concerns, adaptive techniques, and methodological innovations essential for meaningful and safe engagement in such fragile contexts. Design/methodology/approach The study employed a qualitative research design that integrated in-depth interviews, focus group discussions (FGDs), field observations, and geo-tagged photographic documentation. The methodology was iteratively adapted during fieldwork to ensure safety, data richness, and ethical compliance. Special attention was paid to informed consent, community trust, and researcher positionality. Findings Key challenges included disrupted access due to seasonal hazards, power asymmetries in gender-mixed FGDs, resistance from communities due to outsider status, and ethical dilemmas related to photographic documentation and data visibility. These were addressed through flexible scheduling, women-only focus groups, ethical translation practices, and long-term trust-building. The integration of visual ethnography emerged as a methodological advancement that enhanced contextual understanding of climate-impacted livelihoods. Research limitations/implications The context-specific nature of the study may limit generalizability. However, the methodological strategies outlined can guide future research in similarly vulnerable or low-resource regions, particularly where DRR intersects with socio-environmental inequality. Originality/value This paper contributes to the sparse methodological literature on qualitative research in climate-vulnerable zones. It proposes a practical, ethical, and reflexive model for conducting fieldwork in such areas and foregrounds the voices of marginalized communities often overlooked in DRR discourse.

The use of focus group discussions in qualitative research has been increasing for the last decades, both in academics and applied research areas, mostly in social sciences, health, management and education. The focus group approach is a qualitative method to collect the data on the selected topic with a structured and focused discussion in a small group of people. Focus groups are especially useful as a complement to other methods of data collection for providing in-depth information in a relatively short period of time. The aim of the present paper is to give a review on focus group methods. It provides an overview of the current focus group concepts, including the definition, planning and organization of focus groups as well as discussing the importance and the limitations of these concepts in qualitative research. In addition to ‘traditional’ concepts, online focus groups, new approaches that are conducting the focus groups using internet online platforms are discussed.

Foot pain can be a significant burden for patients. Custom foot orthoses (CFOs) have been a mainstay in podiatry treatment for foot pain management and improving foot function. However, little is known about podiatrists' experience of prescribing CFOs or patient experience of using foot orthoses (FOs), including CFOs, for foot pain. A focus group (FG) discussion with three FOs users (Female=2 and Male=1) was conducted in November 2022 within a private podiatry practice. This group represented non-experts from the general local population of individuals with existing or previous foot pain who have personally experienced using either over-the-counter FOs or CFOs. An online FG discussion with five musculoskeletal (MSK) specialist podiatrists (Female=2 and Male=3) was also conducted in December 2022. This group represented podiatrists with specialist knowledge in foot biomechanics and clinical experience in CFO provision. The FG discussions were recorded and lasted 49 and 57min respectively. Transcribed data was manually coded, and a thematic analysis was undertaken to identify patterns within the collected data. The participants in the patient FG detailed mixed experiences of the prescription process and CFOs received, with reports of limited involvement/input in their prescription, the need for frequent adjustments and high costs. The impact on footwear choices, replicability and transferability of CFOs into different types of shoes and technologies to aid design were also highlighted. In the podiatrist FG, lack of confidence in design and manufacture processes, prescription form language, relationship and communication building with manufacturers, variability in the CFOs issued and the need for better student education in CFO provision emerged as key themes. Patients and podiatrists shared similar views on CFO provision, namely poorcommunication with manufacturers leading to dissatisfaction with the CFOs prescribed causing negative impacts on patient experiences. Podiatrists called for greater education at registration level to increase new graduate podiatrist knowledge in CFO design and manufacture and better collaboration with manufacturing companies.

ObjectiveThe study aimed to explore the experience of male members of a rapidly grown community of Bangladeshi immigrants while accessing primary healthcare (PHC) services in Canada.DesignA qualitative research was conducted among a sample of Bangladeshi immigrant men through a community-based participatory research approach. Focus group discussions were conducted to collect the qualitative data where thematic analysis was applied.SettingThe focus group discussions were held in various community centres such as individual meeting rooms at public libraries, community halls and so on arranged in collaboration with community organisations while ensuring complete privacy.ParticipantThirty-eight adults, Bangladeshi immigrant men, living in Calgary were selected for this study and participated in six different focus groups. The sample represents mostly married, educated, Muslim, Bangla speaking, aged over 25 years, full-time or self-employed and living in an urban centre in Canada >5 years.ResultThe focus groups have highlighted long wait time as an important barrier. Long wait at the emergency room, difficulties to get access to general physicians when feeling sick, slow referral process and long wait at the clinic even after making an appointment impact their daily chores, work and access to care. Language is another important barrier that impedes effective communication between physicians and immigrant patients, thus the quality of care. Unfamiliarity with the healthcare system and lack of resources were also voiced that hinder access to healthcare for immigrant Bangladeshi men in Canada. However, no gender-specific barriers unique to men have been identified in this study.ConclusionThe barriers to accessing PHC services for Bangladeshi immigrant men are similar to that of other visible minority immigrants. It is important to recognise the extent of barriers across various immigrant groups to effectively shape public policy and improve access to PHC.

This article sets out to report our first-hand experience with using focus groups as a method of data collection in higher education research. We were interested in shedding light on how university lecturers coped with remote teaching during the Covid pandemic and how the unusual circumstances affected their teaching. The analysis of the resulting data is still ongoing. In this study, we summarise our experiences of using the focus group methodology in our research. By discussing and evaluating our research experiences, we aim to demonstrate the usability and the potential risks of the Focus Group Discussion (FGD) in a higher education context by identifying further areas of application, such as for supporting the development of the education system. We argue that the main characteristic of FGD is its interactive nature, and we back this claim by providing a detailed presentation of the focus group methodology, as well as by describing and analysing the experiences of group discussions conducted with the involvement of university lecturers. Due to their interactive nature, focus group discussions are particularly suitable for research on educational methodology, specifically within the training system for public officials operated by the Ludovika University of Public Service (LUPS) in Budapest, Hungary since 2013. The focus group research method can be used either as a tool for quality assurance or as a tool for assessing training needs. Our study is highly relevant for those who are planning to conduct focus group research in a higher education context or in related fields such as adult education programmes, by providing practical recommendations.

Hak T. Data collection in qualitative research. Huisarts Wet 2004;47(11):502-8. This article discusses the main methods of data collection in qualitative research. Ways of achieving appropriate levels of validity and reliabilityand of avoiding selection bias are discussed. Because qualitative research is characterised by an iteration between data collection and analysis, it is quite common that multiple types of data collection are used in a single research project, each of which plays a role in a specific phase of the research project. Unfortunately, the most common research design published in medical journals is the ‘cross-sectional qualitative survey’, in which conclusions are based on data from one-off unstructured or semi-structured interviews with a limited number of individuals (usually patients), selected in a more or less unsystematic manner (‘convenience sample’). This design is rather problematic. Data collection through focus groups is also a popular method used in medical and health services research. It is often invalid in terms of the research objective and question. The best qualitative research consists of consecutive parts. Each of these is steered by a research objective and a question that is dependent on the results of the preceding parts. In each part, a method of data collection is chosen that is appropriate for that part's particular research objective and question.

Objectives: Over the last 2 decades, the World Health Organization (WHO) has proposed a global strategy and initiatives to establish a Health Research System (HRS) focusing on Health Research Quality and Standardization (HRQS), Health Research Knowledge Transfer and Dissemination (HRKTD), and Health Research Translation and Utilization into Health Care Decisions and Policies (HRTUDP). Despite the increase in health research productivity over the past several decades, HRS Capacity (HRSC) in Palestine and in the Middle East and North Africa (MENA) region has rarely been objectively evaluated. This study aims at eliciting the perceptions of HRS performers in Palestine in order to understand the status of HRSC, identify gaps, and generate policies and solutions capable of strengthening HRSC in Palestine.Methods: Key informants from three sectors, namely government, academia, and local and international organizations, were selected purposively based on different sampling methods: criterion, critical case, snowball, and homogeneous sampling. Fifty-two in-depth interviews with key informants and a total of fifty-two individuals, participating in six focus groups, were conducted by the principal investigator in Palestine. Data were analyzed by using MAXQDA 12.Results: The overall pattern of the Palestinian HRSC is relatively weak. The key findings revealed that while HR productivity in Palestine is improving, HRQS is at an average level and quality guidelines are not followed due to paucity of understanding, policies, and resources. HRKTD is a central challenge with both a dearth of conceptualization of translational science and inadequate implementation. The factors related to inadequate HRKTD include lack of awareness on the part of the researchers, inadequate regulatory frameworks and mechanisms for both communication and collaboration between and among researchers and policy-makers and clinicians, and lack of availability of, and credibility in, systematized and reliable HR data. Despite the limited knowledge translation, in general, HRTUDP is not considered an essential decision-making methodology mainly due to the lack of interface between knowledge producers (researchers) and users (policymakers), understanding level, HR credibility and availability of applied research, and governance, resources, and political fluctuations. Recommendations to strengthen HRS in Palestine include: a consolidated research regulatory framework and an effective capacity strengthening strategy overseen by Palestinian authorities; the promotion of HRQS and concepts and practices of translational science; and, most importantly, the use of findings for evidence-based policies and practice.Conclusion: Strengthening HRSC is both an imperative step and an opportunity to improve the Palestinian health system and ensure it is based on research evidence and knowledge. Building a successful HRS characterized by capacities of high-quality research and well-disseminated and translated knowledge is a prerequisite to effective health systems and services. This can be achieved by political commitment to support such strengthening, a consolidated leadership and governance structure, and a strong operational capacity strengthening strategy.

This study examines the potential that shared political documentary viewing coupled with public deliberation via focus group discussion has for political sensemaking and civic engagement. Specifically, we examine college students’ perceptions of sensemaking, future civic engagement, and benefits of participating in group discussion following the shared viewing of D’Souza’s political documentary 2016: Obama’s America. Focus group participants reported that engaging in discussion served to clarify, affirm, and reinforce some initial impressions while opening their eyes to new insights and information. Focus group participation triggered a desire to seek out and hear additional diverse points of view and offered participants the opportunity to diffuse negative emotions and reflect upon media content. Participants reported that they enjoyed participating in this form of guided discussion, reported increased confidence in their abilities to engage in public political deliberation, and reported feeling a call to future civic action. Our findings show that political documentary viewing coupled with focus group discussions can be a productive site for public deliberation that can lead to enhanced sensemaking and positive future civic behaviors including intentions to extend discussions to personal networks and to research issues raised in the discussion or documentary. We address implications for deliberative pedagogy and focus groups as public deliberation.

To explore determinants of participation in breast cancer screening in orthodox Jewish women living in Antwerp, Belgium, and to uncover their opinions and attitudes towards screening, and thereby to detect ways to optimize participation. Focus group discussions were performed during the last months of 2011 and the first half of 2012 to explore motivation to participate or not in breast cancer screening. Groups consisted of five to seven women. Inclusion criteria were: being female, considering oneself as orthodox Jewish, aged between 50 and 69 years. Three focus group discussions with in a total of 20 women had taken place. All participants in the focus group discussions had a screening mammography taken on a regular base. All participants agreed that the social cohesion between Jewish orthodox women and the importance that is given to healthcare within the Jewish tradition are important contributors to their participation in a breast cancer screening program. Pain, lack of information during the exam, lack of confidence in the quality of the exam, perceived problems when the examining doctor/technician is male, and fear of the results are mentioned as barriers. The participants, however, state that these were not important enough to result in non-participation. Barriers could be diminished by information sessions specifically aimed at orthodox Jewish women. This qualitative research demonstrates a generally positive attitude of orthodox Jewish women living in Antwerp, Belgium, towards mammographic breast cancer screening. Increased and repeated structured information sessions are likely to improve breast cancer awareness in this population.

BackgroundFocus groups are commonly used to explore participants’ experiences in health and social care research. Although it is suggested that having demographically homogenous groups may help put participants at ease, the evidence is sparse.The aims of the paper are to: explore the impact of relative ethnic homogeneity and heterogeneity of focus group participants on the group discussions; improve understanding of homogeneity and heterogeneity in focus groups; suggest ways to operationalise concepts such as being ‘more comfortable’ with other focus group participants.MethodDigitally recorded focus groups were undertaken with family carers of stroke survivors and were later transcribed and analysed using framework analysis. Groups were designated as more or less ethnically homogenous. More homogenous groups included, for example, only White British or Asian Indian participants whilst more heterogeneous groups comprised a mixture of, for example, Asian, White British and Black Caribbean participants.ResultsForty-one carers participated in seven focus groups. Analysis revealed differences in discussions around ethnicity between the more or less ethnically homogenous groups. For example, participants in more ethnically homogenous focus groups were more likely to say ethnicity might influence perceptions of social care services. On the other hand, more heterogeneous groups emphasised similarity in carers’ experiences, irrespective of ethnicity. Participants in the more homogenous groups were also more likely to make potentially controversial comments relating to ethnic differences. Additionally they appeared to be more at ease with each other discussing the topic. For example, they spontaneously mentioned ethnic differences earlier in these groups.In contrast, analysis of topics not specifically related to ethnicity, such as the difficult experiences of being a carer, produced no discernible patterns when comparing more and less homogenous focus groups.ConclusionConsiderations around focus group participant demographic homogeneity and heterogeneity are complex and these terms may be most usefully applied only in relative terms.Data derived from more homogenous groups complement data from more heterogeneous groups providing different perspectives. Depending on the focus of the discussion, having characteristics in common, such as being a carer can override other differences.

The adoption rate of point of care ultrasound (POCUS) for the confirmation of central venous catheter (CVC) positioning and exclusion of post procedure pneumothorax is low despite advantages in workflow compared to traditional chest X-ray (CXR). To explore why, we convened focus groups to address barriers and facilitators of implementation for POCUS guided CVC confirmation and de-implementation of post-procedure CXR. We conducted focus groups with emergency medicine and critical care providers to discuss current practices in POCUS for CVC confirmation. The semi-structured focus group interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). We performed qualitative content analysis of the resulting transcripts using a consensual qualitative research approach (NVivo software), aiming to identify priority categories that describe the barriers and facilitators of POCUS guided CVC confirmation. The coding dictionary of barriers and facilitators consisted of 21 codes from the focus group discussions. Our qualitative analysis revealed that 12 codes emerged spontaneously (inductively) within the focus group discussions and aligned directly to CFIR constructs. Common barriers included provider influences (e.g. knowledge and beliefs about POCUS for CVC confirmation), external network (e.g. societal guidelines, ancillary staff, and consultants), and inertia (habit or reflexive processes). Common facilitators included ultrasound protocol advantage and champions. Time and provider outcomes (cognitive offload, ownership, and independence) emerged as early barriers but late facilitators. Our qualitative analysis demonstrates real and perceived barriers against implementation of POCUS for CVC position confirmation and pneumothorax exclusion. Our findings discovered organizational and personal constructs that will inform development of multifaceted strategies toward implementation of POCUS after CVC insertion.

Background: Now a days trend of eating out has increased so also the responsibility of catering establishments to serve safe and wholesome food to its consumers. In India food safety is currently considered to be an important issue for all the stakeholders in the area of food production. This study was conducted to understand food handlers perceptions, opinions, beliefs to compliance to food safety standards in the catering establishments in Delhi. Methods: Nine focus group sessions were conducted with catering establishments owners ,administrators and food handlers ,from March to September 2017. One FGD was conducted in each District of Delhi , India ,with 6 to 8 participants in each group to identify their barriers, opinions and belief systems to compliances to food safety operations in the catering establishments. Focus group were conducted using a questionnaire having check points for discussions with participants which included questions related to personal hygiene and their understanding to FSSAI norms and facilities. Hygiene game (word hunt game) was also developed and was played with participants to build rapport before focus group sessions. Results: A total of 64 food handlers including catering establishments owners and administrators participated in focus group discussions . Affinity diagram had been used to compile data and six themes emerged out of interactive sessions which reflected the participant’s perception, barriers, opinions and belief systems to compliance to food safety norms and standards in the catering establishments. Though the participants realized the importance of implementing food safety standard principles but being busy with their daily routine jobs ,they had never tried to gather relevant information .They had also addressed other major barriers like attachment with their old deep rooted practices and pressure of delivering orders on time, less space and poor infrastructure facilities. Conclusions: The perceived barriers gathered from these focus groups sessions can provide a base to sensitize the catering establishment administrators/owners and workers towards the specific food safety needs.