Issue 44	Winter 2004

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Telephone Focus Groups

Associate Professor Rosalind Hurworth is the Director of the Centre for Program Evaluation at the University of Melbourne, Australia, where she teaches within the Masters of Assessment and Evaluation, D.Ed and PhD. courses. She has carried out numerous national, state and local evaluations, particularly in the health, education and welfare sectors. In addition, she also has particular expertise in the use of qualitative methods (such as focus groups and the use of photographs as data) and is a Past President of the Association of Qualitative Research.

• While face-to-face focus groups have been a popular topic in the recent research literature, very little has been written about the use of telephone groups
• They are particularly useful when research requires the inclusion of participants from large or remote geographic areas and people who are extremely busy
• Although the approach has some limitations, these can be overcome and it can save time and money.

Using the telephone to run face-to-face focus groups had never occurred to me until 1995 when I was asked to study the education needs of the over 60s in Victoria, Australia. While funders were keen for focus groups to be held with a great variety of older adults, they thought that it would be impossible to recruit carers, the frail, or those from lower socio-economic levels. Fortuitously, I met the manager of a telephone link-up program for older people, organised mainly for social contact but also for education programs 'down the phone'. On hearing about my research, groups were arranged across Melbourne suburbs. These interviews were undertaken from home with a note-taker on another line. At the end of the interviews the older adults said that it had been “fantastic to have an intellectual discussion from our homes” and I believed that it had enabled the acquisition of data not possible by other means (Hurworth, 1996).

After this project I returned once more to face-to-face interviews until another evaluation was commissioned by the Overseas Services Bureau (now Volunteers Australia International). They wanted me to talk to groups of returned volunteers about how to improve returning home to Australia. I suggested that, instead of expensive plane fares, hotel accommodation and trying to lure people into major centres, it would be much simpler and more economic to organise telephone groups. Consequently, I found myself communicating across thousands of miles with an engineer in Darwin, a weaver from New South Wales, a teacher in Hobart and a farmer on a remote Queensland farm. Once again such interviews proved to be a satisfying and fruitful experience and the commissioners were surprised at the high quality of the data. Following these experiences, I decided that this form of focus group was often preferable, especially when it would be difficult for participants to come to an interviewing centre. Such feelings confirmed Krueger's comment that, “the telephone focus group offers the advantage of allowing participants to interact over distances at a fraction of the cost of transporting the same people to a central location.” (1994:221) I have since used this technique with busy bank managers to discuss how to improve staff training, nurses about evolution of the new Hospital-in-the-Home role and and with lymphoedema patients to discuss provision of services.

A Lack of Literature

Surprisingly, almost nothing has been written about telephone focus groups (except for half a page presented by Stewart & Shamdasani, 1990:60 and Krueger, 1994:221). Cooper et al. (2003) searched seven medical and social science databases and found only thirteen studies mentioning telephone focus groups of which only five had used them as their major or sole way to collect data (Appleton et al 2000a, 2000b, MacMahon & Patton, 2000, Ruef, 1997, Ruef & Turnbull, 2001, White et al. 1994, White and Thomson, 1995, Wright et al., 2002). Furthermore, none of these addressed methodological issues.

Organising Interviews

Telephone focus groups are normally run as a simple conference call using an ordinary telephone, cordless phone or speakerphone. It is also possible to use more sophisticated equipment: a console with lights, name tags to identify those speaking and special switching mechanisms that only allow one person to speak at a time, but such equipment is beyond the budgets of most research projects.

Once one has recruited (as for face-to-face groups) and sent a confirmation letter containing an informed consent form, it is simple to organise the conference call. The telephone company's conferencing service (e.g. Australia's Telstra Conferlink or British Telecom's BT Conferencing) is sent a fax of the names and phone numbers of those to be interviewed, the phone number of the interviewer and note taker, the organization to be billed, and whether the interview is to be taped and, if so, the address to where the tape should be sent.

Each participant is given a reminder call the day before the session. At the time of interview, the telephone company links in the interviewees and calls the interviewer. If anyone is missing, they keep trying while the interview is in progress. They then take a roll call, give a number to ring in case of technical problems, tell the participants that the discussion will be taped and ask the interviewer to go ahead.

I always introduce myself and explain, for ethical reasons, that there is a notetaker on-line. I also repeat that the only people who will listen to the tape later will be the moderator and the note-taker. If there are more than four people I also ask people to state their name before speaking. While it may seem cumbersome, people are good at complying with this request.

At the end of questioning it is a good idea for interviewees to have ten minutes for free conversation. This allows participants to exchange news or to share information. For instance, in the lymphoedema study, many gave details of support groups or where to buy special garments.

Once the interview is over, I thank the participants and say goodbye, telling them that the notetaker and I will stay on line to organise further groups. This allows us to debrief. Meanwhile, the telephone company labels the tape with date, time and name of the project before sending it in an express bag that is delivered to the transcriber within 24 hours. Other matters for consideration when running groups are to:

• recruit just four to six people. This is smaller than for a face-to-face group, but seems to work well (Krueger, 2002:2). Voice recognition can be achieved quite quickly and removes the need to announce names.
• ask participants to use a land-line as mobile phones can be problematic e.g. batteries run out.

Advantages of the Telephone Focus Group

Jeffery (1998) discovered that teleconferencing systems are just as effective as face-to-face meetings, if not more so, for gathering factual information (Champness, 1972); information exchange (Hough, 1977); group discussions (Neal 1997); and information seeking (Short et al., 1976).

Furthermore, telephone focus groups are advantageous because they:

• Overcome wide geographical dispersal and so provide “the richness of group interaction desired with people who cannot be brought together face-to face easily” (Silverman, 1994). For example, successful telephone groups were used in discussions with school counsellors across the vast state of Queensland (McMahon & Patton, 2000).
• Can involve those not likely to come to an interviewing centre such as people with busy schedules (e.g. GPs, chief executives); the ill or housebound (Hurworth, 1995) or 'those rare on the ground' such as people with unusual medical conditions (Hurworth, 2004).
• Offer an increased level of anonymity, especially when discussing sensitive topics because they allow people to be more emotional and personal. Lack of visual contact and the ordinariness of telephone conversation create a kind of psychological distance and (therefore) safety. So, for example, White and Thomson (1995) believed an investigation into physicians' relationships with patients would be easier and more productive using 'anonymous' phone groups. Similarly, Silverman describes how:

  During telephone focus groups, we discovered that physicians are willing to discuss even how they have killed people by using inappropriately high dosages of medications, how they have treated patients incorrectly, how they cut corners from accepted practice and where they are uncomfortable with gaps in their knowledge. (Silverman, 1994:6)

• Remove the need for travel to an interview venue. Furthermore, there is no need to provide refreshments or to 'dress up' for the occasion.
• Are cost-effective. As a result of the above savings, telephone groups are usually cheaper to run than face-to-face groups and are, therefore, more cost-effective (Parke, 1997).
• Can be held out of business hours. For example, groups can be held at weekends, early in the morning and during the evening. Interviewees seem quite willing to talk 'out of hours' if they do not have to move from home.
• Foster higher 'attendance' rates. People seem to commit to a phone call and so few dropout once calls have been arranged.
• Allow more groups to be run per day. Several groups can be run per day while this would be more difficult and exhausting if face-to-face.
• Enable interviews to be part of the normal working day. Because there is no travelling or time needed to socialise with participants as they arrive or leave, the only time required is for the interview itself.
• People, especially the young, are used to talking on the phone every day whereas talking before others in a specified venue constitutes an unusual event. As Silverman reports:
• People have compared groups of teenagers on the phone versus face-to-face focus groups and have found that teenagers were much more comfortable talking on the phone. (Silverman, 2003:4)
• Telephone focus groups seem easier to control than face-to-face ones. This is because during phone calls people are used to talking one at a time. Participants tend to be polite and are good at taking turns.
• The sound quality of the recording made on professional equipment by the telephone company is generally high and can often be better than that of the original phone call.

Overcoming Limitations

In what literature exists, only a few limitations have been suggested. These include:

The moderator needs extra skills

While the face-to-face interviewer needs to have strong interpersonal and group process skills, the invisible telephone interviewer has to have extra ability in projecting friendliness, naturalness and informality and in being able to fill any 'gaps'. The interviewer also has to make extra efforts to make sure that everyone is heard if they want to be and that an individual's silence does not mean that their line has dropped out for some reason.

In addition, the moderator also has to respond with phrases such as 'That's interesting' or 'Thank you for that' as there is no way to show interest by the nodding, eye contact and so on used in face-to-face groups.

Discussion may be less spontaneous

Krueger (1994) suggests telephone groups may stifle discussion and there can be a lack of the spontaneity and creativity found in face-to-face groups. In over 200 interviews carried out this way for a variety of projects, I have never found this to be the case — in fact the conversations often need to be curtailed rather than the moderator needing to urge people to participate.

Non-Verbal cues cannot be seen

Some writers criticise the approach because it is impossible to see non-verbal cues (NVCs) (Krueger & Casey, 2002). Hough (1977) says that this perceived problem is overstated and Champness (1972) adds that lack of NVCs for teleconferencing is only likely to be a disadvantage if the discussion is associated with bargaining or negotiation or is important for building up long-term relationships. Short et al. (1976) also made a study of physical separation in telecommunications and found that even though audio-only environments eliminate cues, this seems to have little significant effect on the outcome of groups engaging in problem-solving or discussion.

Stimuli cannot be used to encourage response

Some suggest that the use of photos, cartoons, pictures etc., which can help to stimulate some kinds of focus group interview, cannot be used during phone focus groups. However, it is possible to post or fax material in advance or have material ready on the Web for people to access from computers near their phones. Through the use of a browser, combined with presentation slides from Microsoft Powerpoint, the moderator is able to speak while presenting slides to interviewees via the Internet.

It is Not Yet Widely Accepted

While face-to-face focus groups are known as a research tool, telephone groups have yet to be accepted widely. Funders and researchers can be sceptical – until they have tried them. For instance, researchers in the School of Pharmacy at Monash University, in a study to find out about consumer and professionals' views about wider prescribing powers for pharmacists (2004-2005) began with conventional focus groups but abandoned them in favour of telephone groups.

Conclusion

Technology is making an impact on many forms of research and evaluation. Telephone focus groups can expand the pool of participants; link those who are dispersed geographically; allow greater flexibility in scheduling; and be cheaper to run than traditionally run groups.

References

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Edited by Nigel Gilbert.

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