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Objectives Focus groups used for data collection in health research are increasingly conducted online. In two multi-center health research projects, we applied available methodological instructions for synchronous online focus groups (SOFGs). We describe necessary changes and specifications regarding the planning (recruitment, technology, ethics, appointments) and conduct (group composition, moderation, interaction, didactics) to enhance knowledge about the planning and conduct of SOFGs. Results Recruiting online proved to be challenging and necessitated direct and analogue recruiting, too. To ensure participation, less digital and more individual formats may be offered, e.g. telephone calls. Explaining verbally the specifics of data protection and anonymity in an online setting can foster participants’ confidence to actively engage in the discussion. Two moderators, one moderating, one supporting technically, are advisable in SOFGs, however, due to limited nonverbal communication, roles and tasks need to be defined beforehand. Participant interaction is central to focus groups in general, but sometimes difficult to achieve online. Hence, smaller group size, sharing of personal information and moderators increased attention to individual reactions appeared helpful. Lastly, digital tools such as surveys and breakout rooms should be used with caution, as they easily inhibit interaction.

Focus groups are becoming increasingly popular in research, especially in parent and child research. Focus group interviews allow participants to tell their own stories, express their opinions, and even draw pictures without having to adhere to a strict sequence of questions. This method is very suitable for collecting data from children, youths, and parents. However, focus group interviews must be carefully planned and conducted. The literature on focus group interviews with adult participants is extensive, but there are no current summaries of the most important issues to consider when conducting focus group interviews with children, youths, or parents. This article outlines the use of focus groups in child, youth, and parent research and the important factors to be considered when planning, conducting, and analyzing focus groups with children, youths, or parents.

The focus group (FG) technique has been recently rediscovered by social scientists. It has become the subject of important methodological discussions and it is now considered a very innovative research method. However, such a widespread use of FG seems to have become a fashionable research technique. The impression is that FG is often adopted without any prior consideration of whether it really is the most suitable research technique for achieving the cognitive goals of the research. At the same time, it seems that the FG is often adopted only because it is considered an easy-to-organise and inexpensive technique. The goal of this paper is to evaluate the nature of the FG, analyse its advantages and disadvantages and identify the cognitive problems that it helps to face. In order to discuss these two points, I will focus on the two main characteristics that differentiate the FG from other techniques of information gathering in social research. Firstly, in FGs the informative source is a group. Secondly, the heuristic value of this technique lies in the kind of interaction that emerges during the debate. Several researchers have indicated these two aspects as the main characteristics of FG; but only few authors have translated these comments into serious epistemological and methodological knowledge, thus allowing the FG to give its best results.

Despite the abundance of published material on conducting focus groups, scant specific information exists on how to analyze focus group data in social science research. Thus, the authors provide a new qualitative framework for collecting and analyzing focus group data. First, they identify types of data that can be collected during focus groups. Second, they identify the qualitative data analysis techniques best suited for analyzing these data. Third, they introduce what they term as a micro-interlocutor analysis, wherein meticulous information about which participant responds to each question, the order in which each participant responds, response characteristics, the nonverbal communication used, and the like is collected, analyzed, and interpreted. They conceptualize how conversation analysis offers great potential for analyzing focus group data. They believe that their framework goes far beyond analyzing only the verbal communication of focus group participants, thereby increasing the rigor of focus group analyses in social science research.

Background The International Consortium for Health Outcomes Measurement (ICHOM) was founded in 2012 to propose consensus-based measurement tools and documentation for different conditions and populations.This article describes how the ICHOM Older Person Working Group followed a consensus-driven modified Delphi technique to develop multiple global outcome measures in older persons. The standard set of outcome measures developed by this group will support the ability of healthcare systems to improve their care pathways and quality of care. An additional benefit will be the opportunity to compare variations in outcomes which encourages and supports learning between different health care systems that drives quality improvement. These outcome measures were not developed for use in research. They are aimed at non researchers in healthcare provision and those who pay for these services. Methods A modified Delphi technique utilising a value based healthcare framework was applied by an international panel to arrive at consensus decisions.To inform the panel meetings, information was sought from literature reviews, longitudinal ageing surveys and a focus group. Results The outcome measures developed and recommended were participation in decision making, autonomy and control, mood and emotional health, loneliness and isolation, pain, activities of daily living, frailty, time spent in hospital, overall survival, carer burden, polypharmacy, falls and place of death mapped to a three tier value based healthcare framework. Conclusions The first global health standard set of outcome measures in older persons has been developed to enable health care systems improve the quality of care provided to older persons.

Background Focus group studies are increasingly published in health related journals, but we know little about how researchers use this method, particularly how they determine the number of focus groups to conduct. The methodological literature commonly advises researchers to follow principles of data saturation, although practical advise on how to do this is lacking. Our objectives were firstly, to describe the current status of sample size in focus group studies reported in health journals. Secondly, to assess whether and how researchers explain the number of focus groups they carry out. Methods We searched PubMed for studies that had used focus groups and that had been published in open access journals during 2008, and extracted data on the number of focus groups and on any explanation authors gave for this number. We also did a qualitative assessment of the papers with regard to how number of groups was explained and discussed. Results We identified 220 papers published in 117 journals. In these papers insufficient reporting of sample sizes was common. The number of focus groups conducted varied greatly (mean 8.4, median 5, range 1 to 96). Thirty seven (17%) studies attempted to explain the number of groups. Six studies referred to rules of thumb in the literature, three stated that they were unable to organize more groups for practical reasons, while 28 studies stated that they had reached a point of saturation. Among those stating that they had reached a point of saturation, several appeared not to have followed principles from grounded theory where data collection and analysis is an iterative process until saturation is reached. Studies with high numbers of focus groups did not offer explanations for number of groups. Too much data as a study weakness was not an issue discussed in any of the reviewed papers. Conclusions Based on these findings we suggest that journals adopt more stringent requirements for focus group method reporting. The often poor and inconsistent reporting seen in these studies may also reflect the lack of clear, evidence-based guidance about deciding on sample size. More empirical research is needed to develop focus group methodology.

Overweightness and obesity rates have increased dramatically over the past few decades and they represent a health epidemic in the United States (US). Unhealthy dietary habits are among the factors that can have adverse effects on weight status in young adulthood. The purpose of this explorative study was to use a qualitative research design to analyze the factors (barriers and enablers) that US college students perceived as influencing healthy eating behaviors. A group of Cornell University students (n = 35) participated in six semi-structured focus groups. A qualitative software, CAQDAS Nvivo11 Plus, was used to create codes that categorized the group discussions while using an Ecological Model. Common barriers to healthy eating were time constraints, unhealthy snacking, convenience high-calorie food, stress, high prices of healthy food, and easy access to junk food. Conversely, enablers to healthy behavior were improved food knowledge and education, meal planning, involvement in food preparation, and being physically active. Parental food behavior and friends’ social pressure were considered to have both positive and negative influences on individual eating habits. The study highlighted the importance of consulting college students when developing healthy eating interventions across the campus (e.g., labeling healthy food options and information campaigns) and considering individual-level factors and socio-ecological aspects in the analysis.

Background Despite the widely known benefits of exercise and physical activity, adherence rates to these activities are poor. Understanding exercise facilitators, barriers, and preferences may provide an opportunity to personalize exercise prescription and improve adherence. The purpose of this study was to develop the Personalized Exercise Questionnaire (PEQ) to identify these facilitators, barriers, and preferences to exercise in people with osteoporosis. Methods This study comprises two phases, instrument design and judgmental evidence. A panel of 42 experts was used to validate the instrument through quantitative (content validity) and qualitative (cognitive interviewing) methods. Content Validity Index (CVI) is the most commonly used method to calculate content validity quantitatively. There are two kinds of CVI: Item-CVI (I-CVI) and Scale-level CVI (S-CVI). Results Preliminary versions of this tool showed high content validity of individual items (I-CVI range: 0.50 to 1.00) and moderate to high overall content validity of the PEQ (S-CVI/UA = 0.63; S-CVI/Ave = 0.91). Through qualitative methods, items were improved until saturation was achieved. The tool consists of 6 domains and 38 questions. The 6 domains are: 1) support network; 2) access; 3) goals; 4) preferences; 5) feedback and tracking; and 6) barriers. There are 35 categorical questions and 3 open-ended items. Conclusions Using an iterative approach, the development and evaluation of the PEQ demonstrated high item-content validity for assessing the facilitators, barriers, and preferences to exercise in people with osteoporosis. Upon further validation it is expected that this measure might be used to develop more client-centered exercise programs, and potentially improve adherence.

This article presents a Finnish social design study that was targeted at future Generation Z consumers. The main objective was to gain understanding of the target group’s attitudes, routines and skills relating to food consumption, diets and food waste within their households. The sustainability framework studied the Generation Z experience, obstacles and opportunities relating to behavior patterns, in addition with current habits—with respect to planning, shopping, cooking, eating and storing—and future motivations. The aim of the social design investigations was to provide contributions to the design outcome: a behavior change application that steered young consumers’ behavior patterns towards a more sustainable direction. The design framework was applied in two case studies that focused on 17–26-year-old consumers in Finland. The main method was qualitative online focus group discussions. Based on the results, the most important behavior change opportunities related to social aspects, the role of company sponsoring, localization and context-awareness potential in young consumers’ close environment and the need to engage wider sustainability aspects—such as carbon footprint, comparison of diets and financial savings—to the behavior change framework. Based on the results, the participants took the climate change challenge associated with food waste and biased diets very seriously.

The literature on top-down strategy implementation has overlooked social-emotional factors. The results of a three-year field study of a large technology firm show how top executives who favor an affect neutral task approach can inadvertently activate middle managers' organization-related social identities, such as length of time working for the company (newcomers versus veterans) and language spoken by senior executives (English versus French), generating group-focus emotions. These emotions prompt middle managers—even those elevated to powerful positions by top executives—to support or covertly dismiss a particular strategic initiative even when their immediate personal interests are not directly under threat. This study contributes to the strategy implementation literature by linking senior executives' actions and middle managers' social identities, group-focus emotions, and resulting behaviors to strategy implementation outcomes.