Mixing up focus groups: the power of heterogeneous sessions

A 'golden rule' for organising focus groups - ensure a nice spread of homogeneous participants; a similar age, mix of gender and in the case of medical devices research, either all patients with the same condition or all HCPs of a certain speciality and seniority. However, as with many methodologies, one size does not fit all and there may be times where having participants with similar criteria doesn't provide the breadth options and diverse insights that can adequately or appropriately help shape the future of a product or service. In this article CMR's Research Director, Alper Hulusi, discusses the opportunities for mixing up the participants of a focus group and the benefits that can be gained.

There’s no denying that homogeneous focus groups work, and work well.  As a moderator, you have a room of six or seven participants who are almost primed to discuss a specific issue from a specific perspective. Obviously, skilful moderation is still a prerequisite, to ensure participants are facilitated and enabled to express their views and suggestions.  Where patients are concerned, being in a room full of other people with a similar medical condition or device experience provides a ‘safe’ arena in which to share common views and bounce ideas off one another.  Added to this, client RFPs often request this level of homogeneity in how their focus groups are composed.   Also, when the task in hand is to validate marketing materials, having a group that consists of purchasers or nurses only is important, to ensure we understand how and whether messages resonate and appeal with target audiences.

So why change?

From as far back as its origins, the focus, remit and very purpose of qualitative research has been to expose and understand ‘real world’ experiences. So, what exactly do we mean by real world? Real world is sometimes unpredictable, happy and sad, sometimes placid and tranquil and at other times fraught with tension and conflict; it’s fundamentally diverse! Diverse? Why then, are focus groups mostly organised to include a uniform and homogeneous group of participants, that is far from diverse?

Let’s consider a person with Type 1 diabetes, for a moment. Life with diabetes requires a person to engage with a plethora of healthcare professionals; GPs, Endocrinologists, Diabetes Nurses, Nutritionists and Podiatrists to name but a few. Why then do we rarely bring these people together as one to discuss diabetes devices, services and provisions in a market research setting? Wouldn’t that provide a rich, true and insightful understanding of the real world where diabetes is concerned?

Does a heterogeneous focus group work?

Well, in short, yes!  Like most qualitative research methodologies, they have their time and place. Past examples of heterogeneous focus groups that we’ve moderated here at CMR include OR Managers/ Biomedical Engineers sessions, Surgeons/ICU Nurses, Surgeons/Hospital Purchasers and in a previous life I once moderated a group of Police Officers, social workers and young people!  Having moderated such sessions, their value, uniqueness and power is undeniable.  Bear in mind that elite moderation is a ‘must have’ for all focus groups but especially for heterogeneous groups; strong moderation that can facilitate and manage contrasting and at times strongly conflicting perspectives and personalities, while maintaining the session’s open and inviting ambience, for all participants to feel able to talk openly and honestly.

So, what are the benefits?

Dynamic discussion fuelled by fundamentally contrasting perspectives; bringing patients and HCPs together exposes both parties to perspectives which they don’t often get the opportunity to critically engage with. Furthermore, sessions reveal the dynamics and ‘rules’ that characterise patient/HCP engagement which, when moderated well, generate uniquely illuminating insights.  One example of this was seen when we moderated mixed Surgeon/Purchaser focus groups; seeing how Surgeons justified the clinical need to use our client’s new medical device in surgery, while also hearing the Purchasers’ take on why they would or wouldn’t set aside budget for the new product.  We also got to see and hear first-hand how both parties rationalised and presented their stance and vied for influence, which our client’s marketing and sales managers found phenomenally useful!

Mutual learning and appreciation; exposure to contrasting opinions and needs, allows participants to suggest tangible and beneficial device or service suggestions and improvements.  This has proven especially useful when researching connected devices; understanding how and who data should be shared with and how it will be used, while factoring in privacy and confidentiality needs.

The message here is that, we shouldn’t always default to homogeneous sessions. Let’s think for a moment when we’re discussing research requirements and consider whether it’s appropriate to ‘mix it up’ a little, to experience the power of heterogeneous focus groups!

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