Why Focus Groups?

In focus group research, groups of participants are gathered to discuss topics framed by the researchers. The general purpose of focus groups is to grasp respondents’ attitudes and experiences. Frequently mentioned advantages of this procedure are the access to a relatively large amount of information in a relatively short period of time. Further, especially the interactivity of the focus group setting and the opportunity to collectively debate on and mutually validate statements and attitudes expressed is considered as suitable to gain insights in culturally shared, collectivised norms and values. Today, focus group research is successfully employed both in opinion research as well as in participatory technology assessment.

Hence focus groups were considered as meeting the project’s aim to gain insights in lay people’s personal approaches to biomedical technologies and – through the interactive setting – also to access public issues and debates specific to a certain socio-cultural context.     

Focus Group Design

As the design of the focus groups was considered constitutive for the later success of the project’s comparative research, the consortium engaged in extensive exchange and discussion on the organisation and design of the focus groups. In total, 24 focus group discussions were conducted in six of the partner countries – Austria, Cyprus, France, Germany, the Netherlands, and Sweden.

In each of these six countries, two focus groups each on organ transplantation and post natal genetic testing were organised. As affectedness was expected to be a key factor in individuals’ attitudes towards a technology, each biotechnology was discussed in separate groups of either affected or non-affected (“lay”) participants. In total, there was a minimum of one affected and one lay group on organ transplantation, and one affected and one lay group on genetic testing per country. A broad definition of affectedness was used as a selection criterion: experience with the technology as a patient or a person closely linked to a patient. Non-affectedness in turn was defined as having no contact with the technology on a personal or kinship level.

Each group was about two hours in length and consisted of six to ten participants. Although the composition of the groups did not aim at socio-demographic representativeness, special emphasis was placed on a balanced group composition with regard to gender, age, religious background and education in order to represent a broad variety of perspectives and support a lively and productive discussion.

A common interview guideline was used in all countries, which lead the discussion from the level of general assessment of the respective technology over decision scenarios high-lightening ethically controversial aspects of the technology to questions of public information, governance as well as citizen participation.

Focus Group Recruitment & Implementation

For the recruitment of the participants, a combination of different strategies was used. The main method was the dissemination of flyers at suitable public locations. Selectively also bulk mail was used, calls for participation were initiated on homepages and in city magazines and more direct ways of contacting like the snowball system were employed.

Standardised information sheets on the project and the focus groups, pre-questionnaires collecting socio-demographic data as well as informed consent forms were handed out. Each participant was compensated for travelling and engagement.

The focus groups were carried out in university buildings, facilitated by one or two researchers and a technical assistant responsible for the recording and transcription. The discussions were transcribed locally under consideration of the anonymisation of all participants and then translated into English, in order to make the data accessible for each research partner of the consortium.

Problems encountered in the conduction of the focus groups research primarily resulted from difficulties with particular target groups in the recruitment process. With some national differences, especially affected people in the field of genetic testing were problematic to reach by means of the recruitment strategies agreed in advance. This was mainly due to a certain reluctance to openly discuss a hot topic like genetic risk in a semi-public setting. Further also the recruitment of members of ethnic and religious minorities proved to be quite difficult. As a reason for this, in background interviews the rather impersonal way of recruitment lacking any personal contact to spokesmen/gatekeepers of certain communities was criticised by community representatives.

Local Analysis of the Focus Groups

As a first analytic step to structure the focus group data and thus create a basis for further comparative research, the consortium decided on a local analysis of the data. Local findings and research hypotheses of possible interest for further more fine grained analysis were to be described in so called Local Reports.

The consortium used the qualitative data analysis software Atlas.ti to structure the data along a set of predefined codes, developed on the basis of the main research questions of the project. The use of one shared software, data-base and code set was expected to facilitate the interpretation process and guarantee comparability and exchangeability of analytic codes between the partners. Further, the topically assigned codes should allow to define a common structure for the Local Reports as well as to trace certain discussion issues across different national focus groups in later comparative research.      

The Local Reports

On the basis of the shared coding process, a standardised table of contents was defined as guideline for the six reports produced by the partners from Austria, Cyprus, France, Germany, the Netherlands, and Sweden. Each report lined out local findings and working hypotheses for further research steps. They are structured in two main parts. In a first part the context of local focus groups is discussed, comprising

• the local recruitment process,
•  the selection process of participants for the local focus groups, denials and quits,
• the focus group setting,
• anonymised profiles of the participants, 
• and the group dynamics.
  

In the second part, participants’ main lines of argumentation are analysed. Referring to the predefined set of codes, five topical foci were agreed as structuring elements:

• the participants’ approach to the two biomedical technologies discussed,
• personal decision making and coping, 
• the human body as a cultural entity, 
• organisation, governance and participation, and
• gender, religion and cultural values.
  

Special interpretative emphasis was placed on the relation between the participants’ arguments and the specific local socio-cultural and political background. Working hypotheses on possible correlations between local analytic findings and the specific backgrounds are lined out at the end of each sub-chapter.
In a final conclusion each report provides a summary of the most important findings and lines out working hypotheses of further research interest. The Local Reports produced comprise between 70 and 150 pages.

The main challenge of the local analysis and reporting phase was the development of a shared analytic approach between research partners coming from very different disciplinary backgrounds and thus having quite varying levels of experience in structuring and interpreting qualitative data.
A further challenge was to identify “local specificities” on the level of a local analysis. In essence, many specificities of the respective socio-cultural backgrounds only became evident from a comparative angle.

• For further information on the Austrian Local Report, please contact:
  Ulrike.Felt@univie.ac.at
  
• For further information on the Cypriot Local Report, please contact:
  Violetta Anastasiadou, vanast@cing.ac.cy
• For further information on the French Local Report, please contact: Anne.Masseran@univ-nancy2.fr
• For further information on the German Local Report, please contact: Silke.Schicktanz@medizin.uni-goettingen.de
• For further information on the Dutch Local Report, please contact:
  Marcus Düwell,  M.Duwell@uu.nl
• For further information on the Swedish Local Report, please contact:
  Susanne.Lundin@etn.lu.se