The influence of ethnic group composition on focus group discussions.

BACKGROUND: Focus groups are commonly used to explore participants' experiences in health and social care research. Although it is suggested that having demographically homogenous groups may help put participants at ease, the evidence is sparse.The aims of the paper are to: explore the impact of relative ethnic homogeneity and heterogeneity of focus group participants on the group discussions; improve understanding of homogeneity and heterogeneity in focus groups; suggest ways to operationalise concepts such as being 'more comfortable' with other focus group participants. METHOD: Digitally recorded focus groups were undertaken with family carers of stroke survivors and were later transcribed and analysed using framework analysis. Groups were designated as more or less ethnically homogenous. More homogenous groups included, for example, only White British or Asian Indian participants whilst more heterogeneous groups comprised a mixture of, for example, Asian, White British and Black Caribbean participants. RESULTS: Forty-one carers participated in seven focus groups. Analysis revealed differences in discussions around ethnicity between the more or less ethnically homogenous groups. For example, participants in more ethnically homogenous focus groups were more likely to say ethnicity might influence perceptions of social care services. On the other hand, more heterogeneous groups emphasised similarity in carers' experiences, irrespective of ethnicity. Participants in the more homogenous groups were also more likely to make potentially controversial comments relating to ethnic differences. Additionally they appeared to be more at ease with each other discussing the topic. For example, they spontaneously mentioned ethnic differences earlier in these groups.In contrast, analysis of topics not specifically related to ethnicity, such as the difficult experiences of being a carer, produced no discernible patterns when comparing more and less homogenous focus groups. CONCLUSION: Considerations around focus group participant demographic homogeneity and heterogeneity are complex and these terms may be most usefully applied only in relative terms. Data derived from more homogenous groups complement data from more heterogeneous groups providing different perspectives. Depending on the focus of the discussion, having characteristics in common, such as being a carer can override other differences

Bisexual women's understandings of social marginalisation: 'The heterosexuals don't understand US but nor do the lesbians'

Drawing on interviews with 20 self-identified bisexual women, this paper contributes to the limited psychological literature on bisexual women by exploring their experiences of social marginalisation. These (mainly white and middle class) British bisexual women reported that they did not feel at home in either lesbian or lesbian, gay, bisexual and transgender communities, nor in the wider (heteronormative) society. They identified a number of understandings - bisexuality as a temporary phase on the path to a fully realised lesbian or heterosexual identity and bisexuals as immature, confused, greedy, untrustworthy, highly sexual and incapable of monogamy - which they reported as arising from lesbian, gay, bisexual and transgender communities and the wider society. The women refuted these accounts which they stated did not reflect their experiences of bisexual identity and which positioned bisexuality as invisible and invalid. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav

Overcoming barriers to engaging socio-economically disadvantaged populations in CHD primary prevention: a qualitative study

<p><b>Background:</b> Preventative medicine has become increasingly important in efforts to reduce the burden of chronic disease in industrialised countries. However, interventions that fail to recruit socio-economically representative samples may widen existing health inequalities. This paper explores the barriers and facilitators to engaging a socio-economically disadvantaged (SED) population in primary prevention for coronary heart disease (CHD).</p> <p><b>Methods:</b> The primary prevention element of Have a Heart Paisley (HaHP) offered risk screening to all eligible individuals. The programme employed two approaches to engaging with the community: a) a social marketing campaign and b) a community development project adopting primarily face-to-face canvassing. Individuals living in areas of SED were under-recruited via the social marketing approach, but successfully recruited via face-to-face canvassing. This paper reports on focus group discussions with participants, exploring their perceptions about and experiences of both approaches.</p> <p><b>Results:</b> Various reasons were identified for low uptake of risk screening amongst individuals living in areas of high SED in response to the social marketing campaign and a number of ways in which the face-to-face canvassing approach overcame these barriers were identified. These have been categorised into four main themes: (1) processes of engagement; (2) issues of understanding; (3) design of the screening service and (4) the priority accorded to screening. The most immediate barriers to recruitment were the invitation letter, which often failed to reach its target, and the general distrust of postal correspondence. In contrast, participants were positive about the face-to-face canvassing approach. Participants expressed a lack of knowledge and understanding about CHD and their risk of developing it and felt there was a lack of clarity in the information provided in the mailing in terms of the process and value of screening. In contrast, direct face-to-face contact meant that outreach workers could explain what to expect. Participants felt that the procedure for uptake of screening was demanding and inflexible, but that the drop-in sessions employed by the community development project had a major impact on recruitment and retention.</p> <p><b>Conclusion:</b> Socio-economically disadvantaged individuals can be hard-to-reach; engagement requires strategies tailored to the needs of the target population rather than a population-wide approach.</p&gt

‘This In-Between’: How Families Talk about Death in Relation to Severe Brain Injury and Disorders of Consciousness

These comments encapsulate some common themes in how people describe having a severely brain-injured relative in a coma-like condition, medically known as a ‘disorder of consciousness’. In the past it was highly unusual for such individuals to survive very long after the initial trauma that caused their injury. However, the emergence of modern medical technologies, and how they are deployed, has led to the creation of new long-term conditions including the ‘vegetative state’ (in which the patient shows no awareness at all) and the ‘minimally conscious state’ (in which the the patient displays some intermittent and minimal awareness). These conditions are modern phenomena — the vegetative diagnostic category was first created in the early 1970s (Jennett and Plum, 1972) and the ‘minimally conscious state’ [MCS] was only defined in 2002 (Giacino et al., 2002). Patients with disorders of consciousness disrupt previous ways of understanding life. The family may experience their vegetative or minimally conscious relative as ‘present but absent’, ‘living, but dead’, making comments such as ‘this is no life’ and ‘my son is gone’ — and experiencing a sense of loss and grief that may be ‘like a death’, although not a death

The Social Construction of Lesbianism: a Reappraisal

The commentators in this reappraisal describe The Social Construction of Lesbianism (1987) as 'classic' (Coyle), 'exciting' (Tiefer), 'important', (MacBride-Stewart), 'fascinating' (Snelling), a 'remarkable achievement' (Snelling), and an 'engagingly written, political tour de force' (Coyle). Like some of the commentators (Coyle, Snelling), one of us (VC) owns a well-read copy of The Social Construction of Lesbianism, highlighted in all the colours of the rainbow and covered in (now) rather cryptic notes. This was the copy that passed back and forth between us as we completed our PhDs in lesbian and gay psychology, both of which were supervised by Celia Kitzinger. As young lesbian feminists, we were drawn to Celia?s radicalism and uncompromising political commitment. She was an inspiring, challenging, passionate and energetic PhD supervisor, and we are honoured and privileged to edit this reappraisal of The Social Construction of Lesbianism, a book based on her PhD

Qualitative Story Completion: A Method with Exciting Promise

This chapter introduces the story completion (SC) method of collecting qualitative data, a novel technique that offers exciting potential to the qualitative researcher. SC involves a researcher writing a story “stem” or “cue” – or, more simply put, the start of a story, usually an opening sentence or two – and asking the participants to complete or continue the story. Originally developed as a form of projective test, the use of SC in qualitative research is relatively new. The authors comprise the Story Completion Research Group, a group of researchers that have come together to share their experience of using and further developing the method. This chapter explains what SC offers the qualitative researcher – including choices about the “best” epistemiological lens and analytic approach for their research question, the potential to collect data about sensitive or taboo topics and to access socially undesirable responses, as well as the possibility of research designs that allow comparisons (for example between male and female respondents). This chapter also provides key guidance, such as what constitutes an appropriate research question, and sampling and design considerations. As a recently developed method, SC has fewer published research studies than some of the other research methods covered in this volume. For this reason, the chapter aims not only to provide a description of the method and recommendations for how best to use it, but also to explore some of the unresolved theoretical and practical questions about SC as well as to suggest future directions for SC

Reflecting on reflexive thematic analysis

Since initially writing on thematic analysis in 2006, the popularity of the method we outlined has exploded, the variety of TA approaches have expanded, and, not least, our thinking has developed and shifted. In this reflexive commentary, we look back at some of the unspoken assumptions that informed how we wrote our 2006 paper. We connect some of these un-identified assumptions, and developments in the method over the years, with some conceptual mismatches and confusions we see in published TA studies. In order to facilitate better TA practice, we reflect on how our thinking has evolved – and in some cases sedimented – since the publication of our 2006 paper, and clarify and revise some of the ways we phrased or conceptualised TA, and the elements of, and processes around, a method we now prefer to call reflexive TA

Lysistratus, Lysistrata, Lysistratum:coconstructing the identities of mother and activist

Instances of women's involvement in politics are prevalent both in the historical and cross-cultural literature. However, as we know, the involvement of some women in political life has not always produced greater access to political power for women in everyday life. This article aims to examine how the identities of mother and activist have been produced and brought together, or coconstructed, in published texts and in interviews conducted with women activists. The analysis aims to illustrate the usefulness of looking at contexts and relationships for empirical work in this area. In doing so the article unpacks the concepts of "mother," "woman," "politics," and "activist" to argue that we can reach a more useful understanding of identity if we address these not as stable and pre-existing, but rather as shifting and multiply-determined, products