FOCUS GROUP DISCUSSION KEY INFORMANT INTERVIEWS And KEY INFORMANT INTERVIEWS Amol Dongre MD MPS Department of Community Medicine MGIMS, Sewagram

What is focus group discussion? Why focus group When to use FGD Composition & Selection of participants Role of moderator Role of note-taker Guidelines for the FGD Participants Process of FGDs and Essential steps Strengths and Limitations of FGD

What is focus group discussion? Technique of gathering data and insights from discussions and interactions among participants in a group, facilitated by a moderator Exchange of ideas among participants Focused, but flexibly structured discussion Ideal for exploring norms, expectations, values and beliefs and NOT personal experiences

What is focus group discussion? Contd… FGD is a group discussion of approximately 6-12 persons guided by a facilitator, during which the members of the group talk freely and spontaneously about a certain topic. FGD thus aims to be more than question-answer interaction where in the members are also encouraged to discuss the topic among themselves.

When to use FGD Focus research & develop relevant research hypotheses Formulate appropriate questions for more structure and large scale surveys Help understand and solve unexpected problems in interventions Develop appropriate messages for health education programs Explore controversial topics

Why focus group Defining the research concept Developing hypothesis Generating Vocabularies Framing a questions in large scale surveys Providing supplementary information related to the community's knowledge, beliefs, attitudes and behavior on specific issues

Composition and Selection of Participants 8-10 individuals in a group willing participants NOT individuals who will dominate the discussion or inhibit the participation of others in the group Participants are selected in advance by either random sampling or by any alternative criteria The members are homogenous viz. regarding major social divisions and/or background characteristics. Age and sex often considered for assigning participants into different groups

Composition and Selection of Participants contd… Inform about the topic of exploration through personal experience or interest arising from a particular role or position Date, time and venue of the FGD is fixed in advance. A time limit of one and one- half hours is desirable and two hours is the maximum Anonymity of the participants is preferred Members of the research team: a moderator (facilitator), a note-taker & recorder

Guidelines for the FGD Participants One participants speak at one time and clearly Try gather everyone's perspective/opinion Encourage participation

Process of FGDs FGD guidelines to be pre-tested in advance More than one FGD is to be conducted Moderator /note-takers should be trained in advance Recruitment of the participants (help from key informant, homogeneity)

Process of FGDs Contd... Should also be recorded beside note-taking Ideally FGD should be of 90 minutes duration Make physical arrangements for setting, equipment, food and drinks, and child care if necessary Selection of location and time for FGD

Essential steps – starting the discussion Collect socio-demographic details informally Summarize the purpose of the study Describe the focus group discussion process - No right or wrong answers - All should participate - All should respect the opinions of others Make sure everyone understood the informed consent Ask participants to guard the confidentiality of others in the groups

Essential steps - conducting the discussion Begin with warm-up questions Be aware of who is talking and who is not - Do not allow one or two individuals to dominate Use broad, open-ended questions - Avoid yes or no or short answer questions Always probe Record body language, nonverbal communication

Essential steps - documenting discussion Expand notes of the discussion Record in writing any nonverbal data Don’t imply judgement Add researcher’s comments in parentheses Finalise field notes as soon as possible after the discussion If tape recorder is used, complement taped transcripts with field notes in preparing final transcripts

Role of moderator Introduce the session Encourage discussion Creating a climate for open exchange - explaining the goal of discussion - setting ground rules - encouraging participation by all Guiding the discussion - introducing topics with main questions - eliciting detailed information with follow up questions - probing meaning of responses - Should not dominate the discussion Keeping the discussion focused Encourage involvement of every member Monitor involvement & interaction among participants

Role of moderator contd… While maintaining the core theme of the discussion ensure flow of conversation. Avoid being placed in the role of expert Control of rhythm of the meeting, but avoid an unobtrusive way Take time to end the meeting to summarize and check for agreement / disagreement on important topics Build rapport, empathize Thank each of the participants personally for their participation Monitor involvement & interaction among participants Encourage involvement of every member

Role of note-taker / Recorder Items to be recorded Date, time and place Number, names and description of each participant General description of group dynamics (level of participation, presence of dominant participant, level of interest etc.) including non-verbal interaction among the participants Opinions of the participants including key statements Emotional aspects (reluctance, strong feelings attached to a certain topic) including any non-verbal communication Taking notes without disturbing the discussion including identity of the speakers Spontaneous relevant discussion during breaks or after the formal session / discussion Works as back up to the moderator by drawing attention to missed comments from participants and missed topics

Designing the Interview Guide for FGD Must provide the moderator with he topics and issues that are, to the extent possible, to be covered at some point during the discussions The guide is loosely structure and does not suggest potential responses. The questions should be unstructured, unbiased and non-threatening Progression of the topics in the guidelines should be logical and should move from general topic to specific topic The guide should not overly done or have too many questions (preferably should have no more than 20 questions / topics) Pretesting of guidelines with several mock sessions is essential

Strengths and Limitations of the FGD Should not be used for quantitative purpose, e.g. the testing of hypotheses or generalization of findings for larger areas that may need more elaborate surveys FGD can be used to complement findings from the surveys and other qualitative techniques as using it alone may be risky as the people tend to centre their opinion on the most common ones on Social Norms. FGD may not be very useful on sensitive topics where members may hesitate to air their feelings and experiences freely (sexual behavior/HIV AIDS) Evaluator has less control than individual interview Groups are often difficult to assemble

Dos and Don’ts of the Moderator Make everyone feel welcome Speak in a loud and clear voice Be flexible Include everyone in the discussion Leave enough time for people to answer question (enjoy the silence) Vary your style of asking questions to get a variety of answers Probe for clarity Allow diverse opinion to emerge Talk too much Let one person dominate Fail to stay neutral on the issue More than one question at a time Ask ‘Yes’ or ‘No’ questions (instead ask open ended questions) Go over the allotted time Forget to thank people for participating

Exercise Select a study topic Prepare three questions for FGD discussion

Key Informant Interviews Definition: “Qualitative, in-depth, flexible interviews with persons who know what is going in the community, “experts” (knowledgeable) about a topic on which we want to get information.” Note that the key informant interview is usually not about that person herself, but about the topic on which she has information.

Objectives The purpose of Key Informant Interviews is to collect information from a wide range of people- including community leaders, professionals, or residents-who have first hand knowledge about the community , and our research topic. To get general information about the local community These community experts, with their particular knowledge and understanding, can provide insight on the nature of problems and give recommendations for solution.

When to conduct KII To get more candid or in-depth answers. Focus Group dynamic may prohibit you from candidly discussing sensitive issues or getting the depth of information you need. Sometimes group dynamic can prevent some participants from voicing their opinions about sensitive topics

Choosing Key Informants KI must have first- hand knowledge about community, its residents and issues or problems you are trying to investigate KI can be a wide range of people, agency representatives, community residents, community leaders, or community business owners. ex., Religious leaders, government officials, young mothers, youth, minority population etc. Should have a diverse mix of key informants to ensure variety of perspectives

Exercise Select a study topic Identify key informant for your research topic

Thank You for your patience