Step 2: Conduct Focus Groups or Community Roundtables
An important next step is to use community assessment techniques (surveys and focus groups) to reveal in-depth details on the barriers and specific communication needs of at-risk populations in your community. Although these techniques can be the same used in research, you can use them for local program purposes not for creating general knowledge. Policies and procedures should be followed to ensure the privacy of the participants and the information collected.
Focus groups and community roundtables allow you to talk directly with members of the populations you want to reach. Your COIN members can help you in establishing and facilitating these focus groups. For example, their existing relationships could be beneficial to you as you recruit participants, pose appropriate questions, and gather information. This information can give you a better understanding of your at-risk populations by delving into topics such as:
- Barriers to receiving information based on past experiences
- Preferred methods of communication
- Key spokespersons and trusted sources for public health messages
- Media usage/habits
- Primary languages spoken
- Developing culturally competent messages
Reaching Specific Populations
The Texas Department of Health undertook a project to identify message content and channels of communication among eight specified hard-to-reach populations. Methodology included a literature review, demographic mapping to determine key areas of concentration, key informant interviews, and focus groups.
Interviews and/or focus groups were conducted with population members and key informants for these populations: African American, Hispanic, the mentally ill, and rural. Interviews were used to validate key informant opinions and to assess effective communication strategies. Topics covered include:
- Best communication methods to reach the population in an emergency
- Most and least trusted messengers
- Who the population would contact to confirm information they receive; and
- Most preferred way for the information to be presented
(Barriers to and Facilitators of Effective Risk Communication Among Hard-to-Reach Populations in the Event of a Bioterrorist Attack or Outbreak; Texas Department of Health; February 2004; www.dshs.state.tx.us)
This information can be obtained by asking leading questions like:
- In the past, what types of barriers have kept you from receiving important information?
- What sources do you usually use to get news and other information?
- Whom do you trust to give you information about health care and other health-related issues?
- When there is an emergency, how do you get information?
- If there were a public health emergency, where would you go for information?
- How do you prefer information to be communicated (e.g., in what language, verbal, or written)?
Before you conduct focus groups or community roundtables, check with your COIN and within your own agency to determine if these have already been done. Also consider the best ways to access your intended population. For example, if your target demographic is the elderly, conducting a focus group might not be effective because elderly people might have transportation or mobility issues that prohibit them from attending a focus group. This population may also mistrust people they do not know and worry about their personal safety.7
In these instances, a telephone interview might be a more appropriate data collection method if trusted members of the community adequately prepare this population for such outreach. Telephone surveys are not without limitations and do not capture those without telephones, are possibly biased due to mobile phone use, and have a potentially low response rate because of caller identification and answering machines. As an alternative, a written survey delivered by a trusted source, such as a Meals on Wheels provider or a family member, could be an effective way to encourage participation.
A written survey, whether administered in-person or through the Internet, does not have the qualitative capability of assessing perceptions, attitudes, and behaviors through interpersonal communication and interaction. However, it can provide statistical data that reveal recurring themes, best communication methods and practices, media outlets used most often, and information sources that are trusted by the populations you are trying to reach.
If you plan focus groups for your intended population, schedule them at convenient times and at locations such as multi-cultural community centers, churches, schools, or senior centers that are easily accessible. You might need to arrange for interpreter services, depending on the specific population you are inviting.
American Sign Language Resources
The following resources can help you locate foreign language and American Sign Language (ASL) interpreting services and additional information that will be helpful:
- National Council on Interpreting in Health Care (NCIHC)
- Registry of Interpreters for the Deaf (RID)
- National, state and local on-site interpreting providers
- State and local interpreting associations
- Recommendations from local organizations that frequently use interpreting services (CBOs, clinics, hospitals, courts, law offices, etc.)
7 McKinlay, JB. (1991). Optimal survey research methods for studying health-related behaviors of older people. Vital Health Stat 5, 6, 81-92.
