Focus groups

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Using Focus Groups in the Development of Structured Surveys

Center for Aging in Diverse Communities (CADC), UCSF


In studies of health disparities, focus groups are widely used in the formative stage of research to obtain the perspectives of persons from the ethnic groups being included. As such, they allow research to reflect the concerns and issues of those being studied. Focus groups are especially useful to explore poorly understood and complex phenomenon, such as health disparities.

Another more specific application of focus groups is in the process of developing measures to be culturally sensitive and appropriate. Using focus group methodology to develop surveys can yield evidence of the face validity of the constructs or domains to be assessed in a structured survey for use in the targeted groups.

Focus groups elicit information on how the target respondents think about an issue and articulate it in their own words. Examples are emerging in the literature of how focus group transcripts can be analyzed to generate candidate domains and items for structured surveys on a specific health related topic. We summarize here several key publications that illustrate the use of focus groups to develop structured surveys.


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Key Articles that use Focus Groups to Develop Surveys

  • Bauman LJ, Adair EG. The use of ethnographic interviewing to inform questionnaire construction. Health Educ Q. 1992;19(1):9-23.
Instead of focus groups, qualitative interviews are used to develop domains for a structured survey. The same advantages as those described in the use of focus groups to develop surveys apply here. In this study the interview data was used to modify their model of how women of children with a chronic illness obtain social support, identify unanticipated constructs that needed to be addressed in the survey, and identify appropriate survey item wording.


  • Fuller TD, Edwards JN, Vorakitphokatorn S, Sermsri S. Using focus groups to adapt survey instruments to new populations, in Morgan DL (ed), Successful Focus Groups: Advancing the State of the Art. Newbury Park, CA, Sage Publications, Inc., 1993.
Focus groups were used to investigate the portability of U.S. concepts and measures relating to the effects of crowded housing on psychological well-being and family relations. They provide examples of how phrases from the focus group transcripts helped inform the translation of emotional well-being items and others. They also describe how the focus groups facilitated the development of scales to assess family conflict that were relevant to Thai respondents.


  • Hughes D, DuMont K. Using focus groups to facilitate culturally anchored research. Am J Community Psychol. 1993;21:775-806.
The authors describe how focus groups were used to formulate a research model and develop instruments in an area with little prior research, namely, work and parenting issues in African American dual-earner families. The article illustrates how focus groups facilitate culturally sensitive research. In this context, they were used to understand from participants’ perspectives, how being African American shaped their experiences as employees and parents. New survey items to assess interpersonal racism and racial socialization also resulted from the focus groups. Examples are provided on the use of focus groups to develop new items, revise item wording, and pretest the clarity and relevance of existing items. Examples of coding schemes used to identify a smaller number of constructs to summarize a large volume of data are also provided.


The authors describe the use of focus groups to develop a measure of trust in emergency department physicians and staff. A literature review and phrases from the focus group transcripts were used to develop an item pool. Items were refined or dropped based on comments of respondents to the draft survey. The authors describe criteria used to drop items, and present items that were dropped and retained after psychometric testing.


In this study, transcripts of focus groups with parents were subjected to systematic thematic analysis to identify key items for a parenting self-efficacy instrument. The author presents the themes emerging from the focus groups, which led to the identification of 99 items and nine domain specific subscales. An expert panel was then used to assess the face validity of the draft instrument. A revised instrument was subsequently field tested and psychometric analyses were conducted.


Focus groups are one of several qualitative methods used to develop new measures. The author describes the use of focus groups as the first step in a series of qualitative and quantitative stages of development of a measure of religion. Because a series of focus groups were conducted, the author describes the use of a funnel approach in designing the open-ended questions, in which subsequent groups used modified questions based on results of early groups.


This article illustrates the use of focus groups to develop and refine items for a structured questionnaire on volunteer work behaviors. After an initial item list was generated from the literature, focus groups were used to assess the appropriateness of these items for volunteers in mental health services, and to develop new items/uncover new domains. Participants were asked to listen to each item, indicate whether it was part of their volunteer duties, and provide alternative terminology in cases where items were unclear. This process resulted in a revised draft instrument with reduced items and rewording of items to be appropriate to the target population.


The author relates the use focus groups to identify language used by respondents to describe their emotional and behavioral experiences related to HIV risk behaviors, identify appropriate recruitment strategies for the final survey, and build community support for the survey project. The article illustrates how focus group findings were used to develop specific indicators of new constructs, and research questions about new hypotheses emerging in the focus groups.


This article describes focus group research conducted in seven countries to explore children’s and adolescents' perceptions of their chronic illness and quality of life using a “bottom-up” approach starting with children’s perspectives. The focus group data was used to generate 310 statements from the children which were sorted into piles of items with similar content. This strategy was used to reduce the number of items and produce sub scales for a measure of coping. The authors describe the field test and psychometric studies of the instrument.


Focus groups were used to explore the ways in which older adults conceptualize their expectations of aging, and to compare their expectations of aging with those of physicians who care for older adults. Data analysis revealed 26 domains of expectations of aging. Items for the Expectations Regarding Aging Survey were developed from the focus groups by using the exact language of participants to the extent possible.


The authors explain the importance of consulting members of target populations for content validation of existing measures in new populations. They examine the role of focus groups in the process of adapting measures for diverse populations. They describe how the focus groups led to the expansion and addition of constructs, the confirmation of existing items, and the identification of relevant quotes that could be used for new items. The appendices provide examples of detailed definitions of constructs and the focus group guide.


The author discusses the value of using focus groups to develop culturally appropriate instruments in immigrant populations. She describes a process where transcripts were used to delineate content domains and identify phrases and terms for potential items that preserved the language of participants. A second round of focus groups was used to elicit feedback on the draft items. She also describes unique factors that needed to be taken into account in executing the focus groups in an immigrant Chinese community.


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Practical Guides on Methods for Conducting Focus Groups

  • Kruegar RA, Casey MA. Focus Groups: A Practical Guide for Applied Research, 3rd ed. Thousand Oaks, CA: Sage Publications, Inc., 2002.


Last updated December 2005

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