How-To Data Collection Series: The Evolution of the Focused Discussion Group: From Non-Participant to One of the Crew

A growing number of participant observers are investigators who relate to and/or have lived the phenomenon under observation. Sheba Maraim George's When Women Come First: Gender Roles in Transnational Migration (2005) is a classic example. Searching for answers to questions that arose in her childhood and early adult life, she describes her journey from Kerala, India to California and back as a researcher who empathized with and lived the experience of gender resilience in the Keralite community in the US. It only occurred to me after reading Sheba's book for Dr. Chenail's qualitative research course that I realized just how much we had in common (she is a colleague and personal friend whose book I had finally read). Sheba is an accomplished and highly intelligent, deep thinker, qualitative researcher, and social scientist out of University of California, Berkeley. I'm a social scientist trapped in a medical doctor's body out of old school Harvard. So we got along smashingly from the start in 2003. Before that in 1997, in true socio-medicalist form (some would say medical socialist for sharing my time without pay for years) I began to use what I then called "qualitative focus group research." We were at the edge of a new trend and wanted validation of our method in conducting focus group research about health related topics. So a cohort of faculty from Charles Drew University and UCLA were trained by Richard Kreuger on how to conduct focus group research in the vein of Madison Avenue marketing. We then applied lessons learned for health services research purposes. Dick Krueger was psyched about that and as often as possible probed for Madison Avenue application to Watts, Los Angeles type health issues. Seven years, two dozen projects and well over a hundred focus groups later, the lions share targeting inner city African American and Latino health issues, two realizations hit home about the discussion groups I had moderated the past couple of years. First I had gotten involved. With a script in hand I asked questions, probed for answers, commented on them, answered questions asked of me by participants, and realized the discussions had digressed from the subjective, robotic role of focus group moderation about one specific topic and turned it into a debate of sorts. Men or women, Black or Latino, young or older, they were usually charged and energized conversations. I had taken and had given participants a 'poetic' phenomenological license. We laughed, we complained, we agreed and disagreed, we shared and cared, we met and made friendships but most importantly we learned. This brings me to the second realization. A pattern was developing wherein participants were regularly making comments, English and Spanish speakers, that there was a need for more of these groups. The groups felt supportive. "We need more of these classes," was a comment that I heard often. What blew me away was that the focus groups were educational. Across gender and racial/ethnic make-up, participants labeled the discussion groups as a class and forum for expression of their own concerns. The made comments like: "We need to be able to say these things to the doctor." "They don't really understand what we go through." "Now that I've heard this I'm going to go for my mammogram." "I thought it was folks who ate a lot of sweets that got diabetes." "I didn't know I could get it because my father had it." Participants were learning building on what they heard from their maverick moderator and discussions with their peers. They were responding with new found understanding and were open about it. These realizations made me see how unethical even ethical research can be. If I could collect the qualitative data I sought and beyond, why shouldn't we use these groups as a forum for learning as well? Many of the groups were held with marginalized populations who are difficult to recruit and who do not benefit from most of currently used written health information for reasons of limited educational attainment and limited literacy skills that come with poverty. …