Focus group study: qualitative studies
How to use focus groups to evaluate your digital health product.
This page is part of a collection on guidance on evaluating digital health products.
Focus groups are facilitated group discussions. The facilitator is the person guiding the discussion. Carry out a focus group study if you want to understand people’s views and experiences.
What to use it for
Focus groups use group dynamics to get shared experiences of people with similar characteristics. This is different from an interview study, where the focus is on individuals.
Focus groups can be used to get feedback before, during, or after your product is developed (formative or summative evaluations).
Use focus groups when:
- you want to get a breadth of understanding of the thoughts and experiences of users
- you have open-ended questions about your product
Pros
Benefits include:
- group dynamics can promote discussion, idea sharing and debate
- they provide a breadth of shared experiences from people with similar characteristics, for example people experiencing similar health conditions or health professionals using your digital product
- they can be used at every stage of creating a digital product, from finding out more about the needs of your users to refining and testing new content and features of your product
Cons
Drawbacks include:
- staff needed – you will need a facilitator who encourages discussion and possibly also a separate note-taker
- it might be difficult to get the users you need together in one room at the same time
Focus group studies are not a time-saving alternative to interview studies.
How to carry out a focus group study
You can use interviews to collect qualitative data, but you can also collect some quantitative data. The same principles apply to focus groups as to interview studies. You will need to create a plan in advance of the focus group session. Think about what you want to find out. You can use your model of how your product works to help you put together questions to guide the discussion during the focus group.
Depending on what you want to find out, you might want to recruit people who are similar to each other (homogeneous sampling), or recruit more varied users to get a wider understanding of their experience of your digital product (heterogeneous sampling). For example, when developing a fitness tracker for people with physical disabilities, you might want to recruit people with disabilities who have used a tracker before in order to find out their needs and preferences. Then, once the tracker is developed, you might want to recruit people with disabilities who are physically inactive to find out their experiences of the product.
There is no set size of the group; 6 to 8 people often works well. Smaller groups can work too. You will need to decide how many focus groups to conduct. One approach is to keep recruiting participants until you are not getting any new insights from focus groups (saturation of answers).
Focus groups need facilitators. They should:
- encourage participants to discuss their views openly
- use prompts and questions to make sure the discussion points you are interested in are covered
If you have not facilitated a focus group before, it is a good idea to get someone to run it for you until you become familiar with the role.
You will need to consider:
- venue – neutral places are best because participants will be more open in what they say
- duration – 1–2 hours is usual
- refreshments
- whether you will pay transport costs or give participants incentives for participating
It is important to spend some time at the beginning of the focus group building trust and rapport. It is also a good practice to have some ground rules, such as:
- respect others’ opinions
- listen without interrupting
- don’t talk over each other
- maintain confidentiality – what is said in the room stays in the room. This is especially important if you are conducting focus groups around a sensitive topic.
Example: What do people with physical disability want from a tracking app?
Olsen and others (2019), Content and Feature Preferences for a Physical Activity App for Adults With Physical Disabilities: Focus Group Study
The team wanted to develop an app for people with physical disabilities to track fitness.
To find out user preferences, they chose to run focus groups with active people with physical disability who had used fitness tracking at least once before (homogeneous sampling).
Choosing active people who had used fitness tracking meant that participants had a shared common experience. This would help to spark discussion and debate around the fitness tracking features users wanted and any unmet needs this group of users had.
They used an experienced facilitator and an observer who was also taking notes.
They conducted 4 groups with 15 participants. They stopped at this point because they had reached saturation. During the focus group session, the facilitator and the note-taker recorded all the fitness tracking features mentioned. At the end of each group session, they compared their notes and compiled the list of features. Each participant was asked to rate the priority of features as ‘must have’, ‘nice to have’ or ‘not needed’.
The focus group sessions were recorded and transcribed. The team used thematic analysis, but also focused their analysis to find out more about the features, functionality and appearance of the app that they wanted to develop.
The results included the compiled list of 34 recommended features and functions of the app. They also identified five overarching themes around intuitive and accessible design, personalisation of the app, gamification and social features. These were ranked according to their importance.
Note that these results on user preferences might apply to people with physical disability who are active, but they might be quite different for those who are inactive. It is important to think about which users of your digital product you want to focus on. This will dictate your sampling.
More information and resources
Avis and others (2015), Lessons Learned from Using Focus Groups to Refine Digital Interventions. Practical advice on how to run focus groups to refine your digital product.
Kitea and Phongsavan (2017), Insights for conducting real-time focus groups online using a web conferencing service. Practical advice on how to run online focus groups.
Examples of focus group studies in digital health
Garrido and others (2019), Young People’s Response to Six Smartphone Apps for Anxiety and Depression: Focus Group Study. The team ran focus groups with young people to find out about users’ needs to inform and recommend the development of the apps.
Alkhaldi and others (2017), Promoting Engagement With a Digital Health Intervention (HeLP-Diabetes) Using Email and Text Message Prompts: Mixed-Methods Study. Researchers wanted to find out how best to use prompts to promote engagement with an online intervention for Type 2 Diabetes.
Lally and others (2018), Feasibility of Synchronous Online Focus Groups of Rural Breast Cancer Survivors on Web-Based Distress Self-Management. The team ran online focus groups exploring the views of an online intervention for breast cancer survivors.