In recent years, focus groups have become an indispensable tool for developing ways to promote such products as heart-healthy diets or the refusal skills needed by young people to resist alcohol, tobacco, and other drugs. The use of focus groups is one of several pretesting methods for strengthening the message before it is widely released. Focus groups allow message developers to receive detailed reactions to materials-in-progress from members of the target audience and gatekeepers. This process is especially useful because the target audience may view the message in unanticipated ways. Their ethnicity, culture, race, age, or gender may give them a different experience and a different perspective from that of the message developer.

Focus groups can be valuable for understanding children. Children do not have the vocabulary or logic patterns of adults. Children generally think in concrete rather than abstract terms. They are more literal than adults. Children have their own set of social rituals and understandings when they interact with peers. Children have a different set of emotional concerns and responses than those of adults. Using focus groups can be an effective way to learn how to communicate with children. However, conducting the focus group itself requires modified techniques and an understanding of how children think.

Laying the Groundwork

Some focus groups may serve the purpose of providing general background information before any materials have been drafted or planned. These sessions can provide information about the target group's knowledge, attitudes, and practices regarding a particular topic. Other focus groups examine materials at various stages of development.

As with all focus groups, you will need to begin by deciding what you want to learn from your participants. You will also need to select an appropriate moderator, develop a moderator's guide, select your participants, prepare the setting, and analyze the results. Each of these steps will help you to bring out useful responses from your participants.

Decide What You Want To Learn

All message developers want to know if their messages are appealing, comprehensible, believable, and relevant to the target audience. When the target audience is children, these issues should include close attention to language since the vocabulary of children can be surprisingly large in some areas and unexpectedly limited in others. What adults think is crystal clear can be very confusing to children.

For example: In focus groups for CSAP's "Be Smart! Don't Start!" campaign, researchers found that to some children "alcohol-free" meant free beverages containing alcohol.

A well-designed and well-conducted focus group can tell the message developer what words or sentences the children do not understand or do not accept as current. Message developers also will want to learn if any parts of their materials are disturbing or sensitive to children.

Choose the Right Moderator

If you anticipate that your organization will be conducting focus groups frequently, you may want to sponsor moderator training for current members of your group.

If your organization does not have a trained moderator, you may be able to locate a qualified moderator through the services of a marketing research firm. Universities with marketing departments may have trained moderators who could help. The moderator should understand the goals and procedures of focus groups and must work well with children. The moderator will have to establish instant rapport with the children while maintaining flexible control and objectively. Moderators can pick up helpful suggestions for working with the age group from volunteers and professionals who work with these children.

As with all groups, the moderator must also be sensitive to the concerns of the participants not only as children but also as members of ethnic or cultural groups. The moderator must be able to avoid stereotyping. If the children participating in the focus group are from a specific ethnic or racial group, the moderator must understand and respect behaviors that might reflect those cultural values.

For example: In one focus group with children from a specific American Indian tribe, the participants were very careful not to speak out of turn. The moderator discovered that the children were following a strict protocol based on their tribal custom.

In a case like this, the moderator should encourage each member of the group to contribute without undermining the cultural norms or traditions of the group. Such a task requires both an understanding of the cultural norms of the group as well as knowledge of how to interact with children.

The moderator must be able to direct the children through the outline of topics to be covered without imposing his or her own agenda of insight or values. In some cases, this will mean patiently drawing out some of the less vocal participants. In other cases, it may mean knowing how to cut off some talkative participants without stifling their enthusiasm. At the same time, the moderator must be able to recognize potentially harmful ideas held by the participants and address those misconceptions in an appropriate way. This responsibility is discussed in greater detail in the next section, "Developing the Moderator's Guide."

Select Participants

Since the number of participants in a children's focus group will be smaller than the number in an adult group, you may want to conduct additional groups to obtain a broader response.

For adult focus groups, the recommended number of participants is usually between 8 and 12. But some children might be inhibited from participating fully in such a large group. Therefore, the recommended number for a focus group of children is from five to eight. Choose no more than five or six participants for younger children; you can enlarge the group as the grade level increases. Ideally, all participants in a group should be in the same grade at school, or span no more than two grades. The developmental differences between 2 years of early elementary childhood can be striking.

For some topics, girls and boys can be in the same focus groups. However, for sensitive issues, the children should be separated by gender. For example, preadolescent children might be inhibited about talking about some subjects in front of members of the opposite sex.

Therefore, it can be helpful to separate 11- and 12-year-old girls and boys.

If a group is to be recruited from and conducted in a school setting, teachers or supervisors who know the children can be helpful selecting participants who will speak out. These adults should be asked to help select groups of children that do not contain pairs or small groups of close friends who might influence each other. If you are not careful, your group's responses may end up reflecting the feelings of one dominant child.

It is a good idea to provide some background information to the teacher or supervisor who regularly works with the children participating in the focus group. This will allow the teacher to reassure the children that it is all right for them to talk with the "strangers" who will be conducting the group.

With all focus groups, it is customary for the sponsor to offer some incentive to the participants. If conducting the focus group at a school, ask school staff in advance about an appropriate gift for either school, the student participants, or both. Children might appreciate T-shirts, passes to an amusement park, or fun educational materials already developed. These should be passed out at the very end of the session, or even given at the end of the school day. This prevents the disruption of having some children taking something back into a classroom. If parents are required to transport children to the focus group, it would be appropriate to offer a small cash amount to offset those costs.

Protect the Rights of Participants

Your funding source, locality, or organization may have rules that relate to the protection of participants in research and other activities conducted in your project. Contact the appropriate source for clarification of regulations that may govern the way you handle participants and information gathered from them in your focus groups. If, for example, you are a Federal grantee, you must be aware of regulations that protect human subjects in research projects. Although focus groups may not technically be considered "research" as defined by the Code of Federal Regulations, you should protect each individual's confidentiality and privacy, and you must make sure that he or she is participating voluntarily.

While obtaining written consent may not be legally required, it is strongly recommended when conducting focus groups with young children. Not only is this a courtesy to parents and guardians, but in some situations the agency or organization hosting the group may require consent for a child to miss a scheduled activity. Since focus groups are generally tape recorded, and sometimes videotaped, it is important that written consent forms should clearly state that the person giving consent understands what he or she is signing. That may mean having the consent form interpreted or translated into another language, or having it read to a parent or guardian who may not have adequate reading skills.

Children should be cautioned that information within the group is confidential and may not be discussed with others. For particularly sensitive topics, consider recruiting children from a broad geographical area so that neighbors or school friends are not in the same group. All observers should be instructed not to discuss information divulged in the group in a manner that might identify an individual participant.

To ensure participants' privacy, it is best to use a moderator who doesn't know and cannot identify the children participating in the group. Because focus group results are always reported in the aggregate, the individual's privacy is not jeopardized in reporting the results of the session. However, there are other issues to consider.

Any notes that are taken during the focus group should be used only for the preparation of the final report, and should be coded so as not to reveal a child's identity. Videotapes of a session should have a very limited audience. Generally, videotapes are used to review the group process or to verify information used to prepare a report of the findings. Audiotapes are used to prepare a transcript of the session. The person preparing the transcript of the session. The person preparing the transcript should have no knowledge of the identity of the group participants. Once a transcript that protects the identity of the participants has been prepared, the tapes of the session should be erased, and the transcript should be kept separate from any other documents that might identify the participants.

You should know that even when you have satisfied the legal requirements of your governing agency and your professional obligations as a focus group moderator, other ethical dilemmas may arise. For example, a focus group moderator may learn of an abusive home situation where a child is at risk. The issues of confidentiality and ethics can become even more complex when working with teenagers who may have more exposure or experience with alcohol, tobacco, and other drugs, or who, themselves, may have engaged in illegal activities. If your research includes questions or is likely to uncover information about drug usage or other illegal activities, you should develop a protocol for handling this situation and have your legal representative review that protocol before conducting your research. CSAP grantees can contact their Project Officer for guidance.

Prepare the Setting Properly

The setting for your focus group is crucial to the success of your session. Whether you are using a research facility, school, or church, planners should pay close attention to the logistics of the various activities planned and make sure that the room can accommodate those activities. For example, you may need to ensure that there is room to conduct a role playing exercise. The room must be one in which children are comfortable. Make sure that tables and chairs are the appropriate size or that space is available for sitting on the floor.

Plan on using the room no longer than 60 minutes. You will need to limit your sessions to 30 to 45 minutes for younger children.

Test and set up any audiovisual equipment that is to be used -- either to present a program to the children or to record their responses. It is recommended that, in addition to a tape recorder, an assistant or co-moderator be present to note children's responses to questions. An eye witness can pick up on facial expressions and body language that might escape an audio (or even a video) recorder.

For example: In a focus group of Hispanic children, the moderator asked a group of 9- and 10-year-olds whether they preferred to speak in English or Spanish. The group gave a unanimous response in favor of English. But the assistant noticed the body language of one girl who was not comfortable with English. Her lips said "English" along with the rest of the group, but her body said differently. The moderator used both languages to keep the girl involved.

In addition to these mechanical details, planners should do their best to ensure that the environment promotes openness and free exchange of ideas. That is, children should be informed that their answers will not be shared with teachers or parents and that this is not a test. Care should be taken to ensure that the setting is private (no observers in the room, door closed), especially in a school setting.

Developing the Moderator's Guide

The difficult job of the moderator can be made easier with a thoughtfully prepared guide that establishes procedures for the focus group and outlines each issue to be covered during the session. The procedures established in the guide should eliminate conditions that might inhibit open and honest responses from the children. For example, because children are heavily influenced by their peers, some participants may respond to questions in a way they feel will please their friends on the panel. The guide should establish procedures -- such as "blind votes" or writing down answers on paper before discussion - that will allow the children to respond without worrying about peer pressure.

Preparation of the moderator's guide should again include close attention to language. Questions should be carefully phrased, and the moderator should pay strict attention to phrasing when presenting the questions to the participants. If the moderator discovers that a particular question is hard for the children to understand, the questions should then be rephrased for subsequent focus groups.

For example: One moderator asked participants in a focus group, "Does anyone know what health is?" This question brought very little response. "Health" is an abstract concept. But when the moderator asked, "What are some ways to stay healthy?" the participants had immediate responses such as "eating good foods like grapes" or not eating "junk" or "don't smoke."

Once you have laid the groundwork, you have made the job of conducting the focus group easier. But conducting of focus group is not like performing a play where every detail should come off just as it did in rehearsal. You are, after all, looking for the unexpected; otherwise, there is no reason to conduct a focus group. The actual focus group session, then, must be conducted in a such way that it allows free expression and exploration of ideas at the same time that it directs the discussion through a clearly established outline of topics. Flexibility with purpose is crucial to maintaining a good group discussion and getting the most out of the group.

Introductory Activities

Your moderator will need to establish rapport with the children. The moderator's guide should include introductory activities that will allow the children to meet the moderator, understand why they are there, and become comfortable.

Questions the moderator should ask each child include, "What is your first names?" "What grade are you in?" "Who is your teacher?" and "Do you have older siblings?" These questions give each child a chance to participate from the start. They also provide the moderator with some information that may help in understanding any relationships that may exist between members of the group and any unusual responses that may be given later in the session. (Participants from the same classroom are more likely to influence each other. Children with older siblings have a source of information about drugs and other issues that children without older siblings do not have.)

Another way for the moderator to establish rapport is to make it clear that your organization is genuinely interested in what children have to say. Sometimes focus group participants don't respond because they are not convinced their opinions will be valued. It is important to convey that "what you say will help us learn what we need to know to develop new materials for young people like you."

Provide simple language for the moderator to use in explaining why the focus group is being conducted. Even if it was explained to the children in advance, they'll need to hear it again from the moderator. It will probably be a very unusual experience for them.

Ground Rules

Explaining the ground rules lets the children know what's expected of them. Your moderator should establish an open, orderly environment where children are encouraged to speak. Having only five to eight children in the group will increase the chance of everyone feeling free to speak and give ample time to each child.

Instead of telling children that "there are no right or wrong answers," have the moderator explain that everyone may have different opinion and he or she wants to hear from everyone. It is perfectly acceptable to disagree with others in the group. Reinforce that this is not a test.

Explaining why a tape recorder is present is a courtesy to the children. The moderator can explain that will help him or her remember what was said.

Questions and Exercises

While a focus group for adults may consist only of discussion elicited by questions from the moderator, children have a shorter attention span and therefore need a variety of activities. In addition to question-and-answer discussions, include activities that allow the children to express their ideas in a variety of ways such as drawing and role plays.

For example: One focus group included a role play to let children show how they respond to negative peer pressure. One child from the group played a guest who suggested to another child (playing the host) that they throw a ball around inside. The "host's" response gave a sense of the kinds of reasons children give other children when refusing a request. (The answers seldom dealt with the expected authority issues: "My mother would kill me." Rather, replies often dealt with the physical consequences of playing ball in the house: "No, we might break a lamp.")

It may also be helpful to have a pencil-and-paper exercise to help validate the verbal responses that the children give. However, consideration should be given to the age and ability of the group being tested since there is a wide range in the development of writing skills between kindergartners and sixth graders. If a pencil-and-paper exercise is desired, using pictures or a combination of drawing and simple words should be used for younger children.

Activities allow the moderator to determine what children know or believe without the considerable influence of peer pressure. A useful technique is to have children grade materials before group discussion. Children like the idea of playing teacher and grading someone else's work. Having them assign a grade on a prepared form ahead of discussion removes the influence of the group. Do not ask children directly, "Do you understand this message?" Simple pre- and posttests will indicate if children have understood the material better than their verbal answers to a direct questions; few children will admit that they didn't understand if the rest of the group says they know the answers. Once again, pay close attention to the language the children use in their responses to questions and in their role plays. You might find phrases or expressions you can use in your prevention messages.

Dealing With Potentially Harmful Information

When approaching the subject of alcohol, tobacco, and other drugs with children, it is important to find out what they know or believe. Introduce the topic by asking, "Does anyone know what a drug is?" Answers to this question will vary according to the children's exposure. One kindergartner from a drug-infested neighborhood used the expression "smoking drugs" -- a possible reference to crack. Third and fourth graders in the same school mentioned crack, ice, PCP, speed, "sweet lucy" (marijuana according to Drug Enforcement Administration intelligence reports), "red hearts" (amphetamines/methamphetamines according to the same source), and other terms. In another focus group in a rural setting, the only drug -- other than alcohol and tobacco -- the third and fourth graders referred to was cocaine, which, by all indications, they knew about mainly from television.

Also ask the children, "Where have you heard the most about drugs (family, school, other children, TV, neighborhood, nowhere)?" Answers to this question can give insights into the information needed by parents and teachers about where children are learning about drugs, and therefore, where to target their prevention efforts.

In subsequent questions about drugs, the moderator should be careful not to glamorize drugs and to refer only to the drugs that the children have already mentioned. It is important not to introduce the children to more than they can handle. Make it clear to your moderator that this is a particularly sensitive issue when working with young children to prevent alcohol, tobacco, and other drug use. Any research with children should honor the medical tenet: "First of all, do no harm." If the children are already exposed to certain drugs, it is acceptable to probe to see what they know, but it is not acceptable to introduce new information that may be harmful just to see how children will deal with it.

It is also not acceptable to let dangerous misconceptions go by for the sake of "objective" research. Even though you are conducting the focus group to learn rather than to teach, your moderator must temporarily rearrange priorities if a child expresses an idea that may be dangerous.

For example: In one focus group, a second grader expressed the idea that when you find something you think may be a drug, you taste it to see if it is a drug. In this case, the moderator took note of the comment and then returned to the topic at the end of the session by asking. "When you find something and you don't know what it is, do you want put in your mouth?" The moderator immediately exclaimed "No! and was joined by the other children echoing that "No!"

Another strategy for dealing with misconceptions is to take note of the response and then ask other participants in the group if they have a different understanding (which will correct the dangerous notion). In some instances, the moderator may find it necessary to speak to a child after the group. In addition, the moderator can provide materials for the children to take home.

Analyzing the Results

Analyzing the results of focus groups with children requires careful review of all the information that has been gathered because focus groups provide qualitative data rather than generalizable numbers. Pay attention to all contributions, but don't give too much weight to isolated comments. Include the results of the exercises in the analysis as well as the questions and answers.

For example: A group of 8- and 9-year-old children were asked to comment on a booklet that contained both information and games such as find-the-word, mazes, and word scrambles. Before the group began, children were asked to complete the activities. Influenced by a verbal leader, the group insisted that the materials were "too easy" or "okay for younger kids." However, a review of the actual materials, collected at the end of the focus group, revealed that most children could complete some but not all of the games. The next focus group indicated the exercises were just right.

In addition to the group discussion and exercises, the analysis should also include reference to non-verbal information such as body language or ethnic and cultural factors.

Careful consideration of the cultural context in which the group was conducted is a must. Moreover, a member of that particular ethnic or racial group should participate in analyzing the results.

Look for things that you expected to hear but didn't.

For example: A group of 11- and 12-year-old students was asked to comment about several prevention materials being developed. The moderators noted that the children were careful not to be too negative about a videotape script because it was only one presented. When several paper-and-pencil exercises were offered, the children were much more forthcoming as they could compare and contrast the proposed materials. The moderators, familiar with the norms of this particular group, understood that the children placed high value on being polite and noncritical.

Resources

In addition to focus groups, message developers may want to employ other methods of pretesting, such as readability tests, individual interviews, and questionnaires. Receiving a review by a professional (teacher, counselor, principal) is also an important step in developing prevention materials for children. These individuals work with the audience daily and can articulate preferences and point out shortcomings in the material that the children may sense but be unable to express. These individuals also act as gatekeepers to the audience. Without their input and approval, the materials will not be distributed.

For tips on working with teenagers, see CSAP's publications Young Teens: Who They Are and How To Communicate With Them About Alcohol and Other Drugs and Pretesting Is Essential; You Can Choose From Various Methods, which contains a section on pretesting with youth at risk.

The CSAP Communication Team, which worked with National Crime Prevention Council staff in preparing this Bulletin, has developed similar materials on focus groups - You Can Manage Focus Groups Effectively for Maximum Impact -- and on other topics concerning pretesting and prevention programs. Among bulletins in CSAP's Communication Series are Pretesting Is Essential; You Can Choose From Various Methods and A Key Step in Developing Prevention Materials Is To Obtain Expert and Gatekeeper Reviews. CSAP materials are distributed by the National Clearinghouse for Alcohol and Drug Information (NCADI), Box 2345, Rockville, MD 20847, (301) 468-2600 or (800) 729-6686. In addition, NCADI provides information on the research literature, programs, and educational materials. Also ask about the Regional Alcohol and Drug Awareness Resources (RADAR) network, which may have a resource center in your region.

Marketing Research Association, 111 East Wacker Drive, Suite 600, Chicago, IL 60601, (312) 644-6610. Publishes audience research guidelines and interviewer training materials.

Public Relations Society of America, 33 Irving Place, 3rd Floor, 15th and 16th Streets, New York, NY 10003. Ask about publications and local chapters' pro bono projects.