Transcript PHAC Project Mobilizing Newcomers and Immigrants to Cancer
Focus Group Facilitator Training
Today’s Agenda
1.
2.
Welcome Role of Peer Health Educators 3.
a.
b.
c.
d.
Focus Groups What is a Focus Group?
Types of Focus Groups How to Organize a Focus Group How to Facilitate a Focus Group 4.
Review Focus Group Questionnaire 5.
Practice 6.
Conclusion and Next Steps
Role of Peer Health Educators
Source of information of each community Advocacy for each community Passion for and interest in health promotion (promotion of healthy behaviors) Being a role model
Role of Peer Health Educators
Help to prepare and organize focus groups Facilitate focus groups Help to develop an educational model to be adapted for each immigrant population Deliver education modules Implement the education model to target communities
What is a Focus Group?
A focus group interview is an interview with a small group of people on a specific topic (Patton, 2002). Focus groups are typically semi-structured to allow participants to discuss their perceptions and experiences with others in the group. Generally small to allow all participants enough time to talk and deal with topics in-depth (not possible through a survey).
Collects in-depth information from a group of people who represent the population of interest Sometimes groups are audio taped and/or notes recorded by hand to ensure all opinions/input are captured
What is a Focus Group?
A focus group is NOT a: Brainstorming session Team building session Project meeting Consensus-building session It is a facilitated focused discussion guided by questions It is an opportunity for participants to share their views
Focus Group Phases
Focus Group Process
Review Material Post Meeting Debriefing Be Ready Focus Group Meeting
How to Organize a Focus Group
London Intercommunity Health Centre and/or Each Peer Health Educator
Provide a contact list of possible participants 7 – 10 days before F0cus Group, PHE will contact them to invite to the focus group 2-3 days before Focus Group, PHE confirm their attendance
How to Organize a Focus Group
How to Organize a Focus Group
Materials for facilitators
Questionnaire Consent forms Digital recorder Markers, pens, notepad Travel vouchers/honoraria (if needed) Food/Refreshments (water, snacks)
How to Organize a Focus Group
Time and location:
Consider the time of day/day of the week that will be easiest for participants to attend your focus group (daytime or evening during the week, on a weekend). Find a suitable location, perhaps one that is familiar to people in the community, or centrally located with easy transportation access and parking
How to Organize a Focus Group
Setting up the Focus Group:
Arrive 30 minutes early to make sure the room is set up, flip chart is available Set up refreshments Welcome participants as they arrive
How to Organize a Focus Group
Setting up the Focus Group:
Use a room with few distractions, in an area where you are unlikely to be interrupted Sitting around a table may be more comfortable for many people, although people may share more openly if they simply sit in a circle without a table Name tags can sometimes help - at least, the interviewer should know everyone’s name
How to Facilitate a Focus Group
Role of the facilitator:
S/he needs to be familiar with the questions S/he needs to be welcoming and should make participants feel comfortable S/he must listen, clarify, and reflect back what people say S/he must summarize what is said and validate people’s experiences S/he needs to ensure that everyone has a chance to speak
How to Facilitate a Focus Group
Role of the facilitator:
S/he needs to keep participants updated on time, prioritize questions if time is running short, and ask whether people want to devote extra time to a topic S/he needs to remind participants about the importance of maintaining confidentiality and respecting everyone’s right to voice their views S/he needs to try to cover all the topics
How to Facilitate a Focus Group
Role of Assistant Facilitator/Note-Taker: Hand out and collect consent forms Help participants with consent forms Responsible for audio equipment (tapes) Take detailed notes during discussion Distribute payment to participants at end Review focus group results with facilitator after participants leave
How to Facilitate a Focus Group
Guiding principles for Researchers:
Do no harm to participants, staff, and other people involved in or affected by the research process Give opportunities for individuals to fully express themselves and capture their true meaning Listen to the research participants. Listening is more than simply hearing -- it may mean "being with" and "getting to know" the experiences that people live through Be sensitive to power relations among different stakeholders
How to Facilitate a Focus Group
Ethical Considerations:
Confidentiality and Privacy
The name of a participant should never be written on the summary notes or any other documentation of the assessment All information you gather must never be discussed or repeated with anyone else Focus groups should be held at a place where all participants feel comfortable. This location should allow for a private, uninterrupted conversation All information that you collect should never be seen by anyone else or be left unattended
How to Facilitate a Focus Group
Ethical Considerations:
Informed Consent
In order to make an informed choice, potential participants must understand the research project, how they are involved in the research project, and what sort of risks it poses to them. An informed consent form/information letter has two purposes: to enable potential research participants to make an informed choice as to their participation in a project to document their decision to participate
How to Facilitate a Focus Group
Ethical Considerations:
Informed Consent
Freedom to Refuse When reviewing the consent form with the participant, you indicate to the participant that they have the freedom to refuse to participate and that their participation is completely voluntary Unexpected effects You prevent negative effects on participants by providing them with the option to not answer questions that make them uncomfortable and asking them to inform you if they are beginning to feel uncomfortable Disclosure of illegal activity If a participant discloses abuse or other illegal activity, you should respond by notifying the project coordinator. In these circumstances, we are required by law to report this information
How to Facilitate a Focus Group
Before you start:
Become familiar and comfortable with the protocol/interview questions Remember that the first impression is important (your appearance and professional attitude towards the work are essential in setting the tone of the discussion)
How to Facilitate a Focus Group
As you begin:
Introduce yourself (and co-facilitator) and describe how you became involved in the study Explain the confidentiality arrangements and have each participant read and sign the consent form before starting the focus group discussion
How to Facilitate a Focus Group
You may set ground rules:
Helps the facilitator set the tone of the discussion Builds on principle of trust, respect and good manners Can help get the discussion back on topic and stay on time by simply referring to ground rules as needed
Ground Rules Activity
How to Facilitate a Focus Group
As you begin:
Talk about the purpose of the discussion Set rules for discussion (e.g. agree to disagree, respect for all, listening to others, time) Ask their permission to record the interview, or take notes Tell them about the duration of the focus group
How to facilitate a Focus Group
During the focus group:
Use active listening skills Using clarifying questions with short examples from your own experience may help people feel more comfortable Use probes to get more detailed information or to remind participants of another aspect of the question
How to Facilitate a Focus Group
During the focus group:
Encourage people to describe their own experiences specifically instead of speaking in general terms If you feel that someone is uncomfortable, let them know that they may choose not to respond Remind participants that there is no "right" or "wrong" answer
Probing Activity
How to Facilitate a Focus Group
At the end of the focus group:
Ask people whether there is anything else that they would like to say Take a moment to check the questions to make sure that you have covered all the topics Let participants know that they can contact you or a member of the research team if they have any further questions or comments
How to Facilitate a Focus Group
At the end of the focus group:
Thank everyone for taking the time to share their ideas and experiences Tell them about the next steps (i.e. community forum) Put consent and demographic forms in sealed envelopes, labeled with type of form, date of focus group, names of co-facilitators, name of community
How to Facilitate a Focus Group
After the focus group:
Summarize your handwritten notes in English as soon as possible. Include: • a brief summary of your impressions of the focus group (describing the setting, the participants, the mood of the focus group) • a summary of the content of the discussion (what people said under each main questions, the themes raised) • your reflections and insights Return all completed forms to the leader
How to Facilitate a Focus Group
Dealing with challenging participants:
The real or self-appointed expert • Who controls conversation or intimidates others - assign a special role, use nominal group technique, where facilitator invites each person, in turn, to speak Friends who sit together and form a ‘clique’ • Avoid interviewing friends in the same group if possible, or have them sit apart
How to Facilitate a Focus Group
Dealing with challenging participants:
The most hostile group member • Avoid personal confrontation - allow the group to police itself - e.g. "do others in the group feel that way too?” The quiet person • Give them a chance to share their ideas one-to-one respect their right to be quiet - use the nominal group technique to get their opinions out
How to Facilitate a Focus Group
Dealing with challenging participants:
The outsider (a person who has a very different perspective than other group participants) • Make their differences into strengths - use them as a topic of discussion - avoid taking sides
How to Facilitate a Focus Group
Tips:
Probe for answers Active listening Summarize responses Encourage participants to speak personally
Review Questionnaire
PHASE 1 FOCUS GROUP UNDERSTANDING KNOWLEDGE AND BARRIERS Introduction Knowledge of Cancer Screening Barriers to Cancer Screening Suggestions
Introduction
1. Please introduce yourself and tell us a little bit about yourself (country of origin; length of time in Canada, London, etc.) 2. What have been your experiences with cancer screening (in your home country and in Canada)?
a. What did you usually do when you felt sick in your home country?
b. What do you usually do when you feel sick in Canada?
Knowledge of Cancer Screening
3. What do you know about cancer screening in Canada?
a. Do you know where you can get information about cancer screening services?
b. What do you want to know about cancer screening?
4. What thought or image comes to mind when you hear the word cancer?
5. What thought or image comes to mind when you hear the words cancer screening?
Barriers to Cancer Screening
6. What are some of the barriers you face or have faced in accessing cancer screening services?
Possible answers to probe for: Language Scare/fear Not knowing what cancer screening means Not knowing what kind of test is (blood test, XR, US…) Low priority Not having a family doctor Physician have not offered or explained the test Not having a female doctor Lack of time Transportation Child care 7. Could you describe any barriers or challenges your community may not access cancer screening services (breast, cervical, colorectal)?
Suggestions
8. What suggestions do you have for women/men to be better supported to access cancer screening programs?