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What do you explore in a focus group? There are three main phases to a focus group: a) understanding the target group; b) testing out a new idea c) looking back on the intervention.

In the first phase, the minimum thing for me is to know how the world looks like to them. I mean, how would they describe their circumstances? Their life? How do they feel about their lives? What drives them, what gets them down, are they optimists, pessimists? Everything else is probably for later focus groups when you’ve got something to go on. The old way of doing things – let’s say we were doing smoking cessation – we’d go in to focus groups and say right tell me what you think about smoking and they’d immediately change their thoughts to what they think you want to hear and that is why those focus groups didn’t work.

If we go in and ask them to tell us what their life is like, then out of that usually comes several things about what you could do for them to improve their lives. Then, on the back of that, you can hang an intervention in relation to what they want. So it’s a complete flip over of things.

In the past I have had problems with some of the people I have used as moderators. If they were trained in the old way they would keep coming back to me saying for example, ‘Can we ask them about oral cancer please?’. My response was to tell them to get the important things out of the way first and then they can talk to them about whatever they want. Afterwards, they’ll come back and tell me that if we do this and that then we’ll find the cure for oral cancer but I throw all of that away because it is completely useless at that stage. But they feel that they have to do that, that they have to come back with something useful from the focus groups. What they don’t realise is that the stuff they do in the first two thirds of the session is the important stuff. But they are fieldworkers rather than interventionists. A lot of researchers that do focus groups have never actually had to apply their findings to change behaviour so they can indulge in that sort of activity.

How do focus group results help you to engage with the target audience? I have recently done something on people with cardiovascular disease and those focus groups were dripping with emotion. The people were just waiting for a lottery win, working flat out then coming home and flopping in front of the telly eating, drinking and smoking. Now if you turn around and tell that group they’re pessimists, they’d say, no we’re realists. So you don’t confront them with things, you say to them that you think you know what life is like for them and feed back the findings. What happens is that they turn around and say, ’Bloody Hell, for the first time in our lives, we’re dealing with people who know us’. They’ll engage with you then because they think you have gone a way to find out what life is like for them and that’s part of the engagement process.

When I did the smoking in pregnancy work, we learnt that they are most likely to read magazines like `Take a Break ‘ because it feeds back to them exactly what life is like to them and that’s why they find it so engaging. Why do people read the Guardian or the Daily Mail? It’s because they reflect the world that the reader sees.

How many focus groups are needed? In the oral cancer project we probably did six rounds of focus groups. The more you need to know, the more you do.

Do you use the same focus group each time? I use a new focus group every time. You can’t use people more than once otherwise they become professional focus group employees. That’s why things like citizen’s juries and all those other pseudo objective, qualitative research techniques are absolutely useless. I would never use any of those other techniques because I know that what we do actually works.

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