Abstract

Background

The Internet is increasingly being used as a medium for collecting data for scientific research [1–4]. Online focus groups, also referred to as Internet-based focus groups, electronic focus groups, chat-based focus groups, or virtual panel discussions, are one of these Internet-based research methods. The feasibility and effectiveness of online focus groups (OFGs) have been clearly demonstrated for various age groups [2, 5–9], although a recent study reported less favourable results for young children [10]. OFGs have several advantages compared to traditional face-to-face focus groups (FTFs), for participants as well as researchers [2, 6, 7, 11–13], while producing similar amounts and quality of information [14]. Firstly, they allow spatiotemporally separated participants to join the discussion from their home and at a convenient time. Secondly, the higher level of anonymity in online discussions is perceived to allow participants to speak more freely and provide more honest answers, particularly regarding sensitive topics [13, 15–17]. Thirdly, the written contributions of participants yield immediately available data, which considerably decreases costs and time needed for data entry and analysis.

Studies until now have mainly focused on the advantages and disadvantages of OFGs for researchers and the quality of the produced data. Participants’ opinions about the advantages and disadvantages of OFGs have, however, seldom been investigated. An exception is the study by Reid and Reid [16], who found that participants’ main reasons for preferring participation in an OFG instead of an FTF were: (a) the greater amount of time to think about their feelings in an OFG, (b) the anonymity of OFGs, which leads to more openness, and (c) feeling less inhibited and intimidated in an OFG. However, these results can merely be viewed as illustrative, as they were based on the answers of a small group of participants (N=20). Moreover, the study included adult participants only, whereas OFGs are increasingly being used for younger age groups [e.g., [9, 10]. It would therefore be useful to investigate children’s and adolescents’ perceptions of OFGs as well.

The purpose of the present study was to fill a gap in the literature by providing insight into participants’ perceptions of OFGs in a large sample of children, adolescents and adults (N=284, aged 8–72 years), who participated in an OFG. Participants’ preference for participation in an OFG or an FTF was studied, as well as their perceptions of the advantages of both methods. This allowed us to investigate whether the advantages of OFGs as perceived by their participants concur with the advantages of OFGs as a research method. We also investigated whether any differences exist between the perceptions of children, adolescents and adults. This information can be useful to adapt the design of OFGs to the preferences of their participants and thereby elicit the most optimal responses.

Methods

A web-based application to conduct OFGs was developed as part of a previous study [8, 9]. This application was made available to other researchers, provided that we were allowed to send a short evaluative questionnaire to the participants of the OFGs.

Fifty OFGs were conducted between December 2005 and December 2013 as part of 19 separate studies (Table  1). All studies were executed in the Netherlands, except for one, which was executed in Switzerland. A total number of 420 persons participated in the OFGs, an average of 8 persons per OFG. The majority of participants were adults (71.2%) and female (60.2%) Forty-five percent of the OFG participants were patients/consumers, 43.3% were health care providers or other professionals, and 11.7% were parents (Table  2).

Table 2

Characteristics of OFG participants and respondents of the questionnaire

	OFG participants (N=420)		Respondents of questionnaire N=284
	N	%	N	%
Age in categories
Child (<12 years)	58	13.8	41	14.4
Adolescent (12–20 years)	63	15.0	52	18.3
Adult (>20 years)	299	71.2	158	55.6
Unknown	-	-	33	11.6
Gender
Male	108	25.7	78	27.5
Female	253	60.2	185	65.1
Unknown	59	14.1	21	7.4
Type of participant/respondent
Health care provider/other professional	182	43.3	84	29.6
Patient/consumer	189	45.0	162	57.0
Parent/guardian	49	11.7	38	13.4

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The OFGs were conducted in an asynchronous form [6, 13], i.e. participants could read others’ comments and could respond at any time, not necessarily simultaneous with someone else’s participation. This allowed participants to respond from their home at any time convenient to them. The participants received individual login names and passwords, with which they could anonymously access the OFG website.

OFGs lasted 11 days on average, ranging from 5 to 30 days. In most OFGs, the first 5–7 days were used by the researchers to post one question or statement per day, whereas the remaining days were used to give participants the opportunity to react to questions of previous days and to the reactions of other participants. The researchers monitored the discussion and asked additional questions when necessary.

After the end of each OFG, the participants were asked to fill in an online questionnaire in which the method of OFGs was being evaluated. Topics were derived from the literature on the advantages and disadvantages of OFGs versus FTFs. The questionnaire started with a question regarding the preference for participation in an OFG or an FTF. Respondents were subsequently asked to rate on a predetermined list which advantages they perceived of participating in OFGs or FTFs, respectively. They could also fill in any additional advantages. Respondents who preferred to participate in an OFG were asked to indicate the advantages of OFGs, whereas respondents who expressed a preference for participation in an FTF were asked to indicate the perceived advantages of FTFs. Respondents who expressed no preference for either OFG or FTF were requested to rate the advantages of both methods.

The remaining questions addressed the duration of the OFGs, and whether or not to introduce all questions at the start of the OFG. Questions for children, adolescents and adults were comparable in content, but the wording was adapted to the age range of the respondents.

Invitations to fill in the questionnaire were also sent to persons who agreed to participate in the OFG but eventually did not post any reactions on the website (N=150, data were not complete for three OFGs). A reminder was sent one week after the first request. A total number of 284 persons completed the questionnaire (of whom 14 did not post any reactions in the OFG). Characteristics of the respondents are reported in Table  2. All child and adolescent respondents were patients/consumers. Approximately half of the adult respondents (51.3%) were health care providers or other professionals, 33.5% were patients/consumers and 15.2% were parents or guardians (data not shown in Table  2).

Results may have been clustered within OFGs. For instance, some perceived advantages (e.g. the preference of participating anonymously) may have been more relevant in OFGs in which sensitive topics were discussed than in other OFGs. We tested whether results were clustered within OFGs by means of multilevel analyses. Since our analyses did not show significant effects of clusters, traditional chi square tests with p<0.05 were used to test differences in perceived advantages of OFGs and FTFs between children, adolescents and adults. When significant chi squares were found, post-hoc tests with Bonferroni correction (p<0.02) were used to investigate between which age groups the difference exists.

Results

When asked whether they preferred to participate in an OFG or an FTF, the majority of respondents (64.4%; N=183) expressed a preference for participation in an OFG. A minority (23.6%; N=67) expressed a preference for participation in an FTF, and 34 respondents (12.0%) had no preference for either OFG or FTF. There were no significant differences between the preference to participate in an OFG or an FTF between children, adolescents and adults (chi square test, p>0.05).

The perceived advantages of participating in an OFG or an FTF are reported in Tables  3 and ​and44.

Table 3

Advantages of OFGs according to child, adolescent and adult respondents (N=217), in percentages

	Child N=26	Adolescent N=42	Adult N=123	Total N=217	p
I am able to participate at a moment most convenient to me	30.8	90.5	95.9	86.2	0.00*
I can react from my own home and do not have to travel to participate	65.4	69.1	68.3	69.1	0.99
Responding via the Internet gives me more time to think about my answers	50.0	42.9	44.7	46.1	0.29
I am better at expressing my answers when I have to write them down	42.3	26.2	21.1	24.4	0.06
I prefer to give my answers anonymously	26.9	19.1	19.5	19.4	0.61
I find it easier to discuss personal issues through the Internet	23.1	23.8	11.4	15.7	0.02*
Other advantages**	11.5	4.8	4.1	4.6	0.27

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Numbers of respondents with a preference for participation in an OFG or with no preference for OFG or FTF are reported. Because the age of 26 of these respondents was unknown, the total number of respondents exceeds the sum of the three subgroups.

*Differences between the age groups are statistically significant (chi-square test, p<0.05).

**The most important other advantage of OFGs mentioned by respondents was that it is easier to stick with the original subject in OFGs than in FTFs (N=3).

Table 4

Advantages of FTFs according to child, adolescent and adult respondents (N=101), in percentages

	Child N=21	Adolescent N=17	Adult N=51	Total N=101	p
It is easier to have a discussion with the whole group when there is personal contact with others	4.8	17.7	78.4	48.5	0.00*
I like to see who I am talking to	52.4	70.6	39.2	45.5	0.07
I am better at expressing myself orally	47.6	17.7	29.4	29.7	0.13
I prefer to express my opinions in personal contact with others	23.8	35.3	45.1	33.7	0.23
I find it easier to discuss personal issues in direct contact with others	14.3	5.9	9.8	9.9	0.76
An FTF costs less time than a OFG that lasts several days	0.0	11.8	15.7	9.9	0.16
Other advantages**	4.8	11.8	15.7	13.9	0.44

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Numbers of respondents with a preference for participation in an FTF or with no preference for OFG or FTF are reported. Because the age of 12 of these respondents was unknown, the total number of respondents exceeds the sum of the three subgroups.

*Differences between the age groups are statistically significant (chi-square test, p<0.05).

**The most important other advantage of FTFs mentioned by respondent was that FTFs provide more opportunities for clarification and nuance than OFGs (N=4).

Discussion

OFGs have been shown to be a feasible tool for collecting data from children and adolescents as well as adults [2, 5–9]. As found in previous research [8], most respondents valued the convenience of participating in an OFG at their own time and place most. Whereas the possibility to respond from their own home was valued equally by all age groups, the flexibility to respond at a moment most convenient to them was probably more relevant for the busy lives of adolescents and adults, since they reported this significantly more often as an advantage of OFGs than children did.

Previous research [8] has suggested that the anonymity of OFGs may cause participants to feel more comfortable to express their views. OFGs are therefore suggested to be particularly useful to discuss sensitive or personal issues [2, 13, 15, 16]. In our study, however, only a minority of respondents (19.4%) perceived the anonymity of OFGs as an advantage, and merely 15.7% of respondents found it easier to discuss personal issues via the Internet. This finding may be ascribed to the fact that a considerable number of studies included in this paper did not address particularly sensitive topics. The finding that adolescents significantly more often than adults reported the ease to discuss personal issues via the Internet as an advantage of OFGs may reflect their familiarity with the Internet.

Reid and Reid [16] found that participants’ reasons for preferring participation in an FTF rather than in an OFG were mainly related to the communication flow. Participants in that study found that FTFs provided a more fluid debate and that it was easier to follow the discussion in an FTF. Similarly, we found that the most important perceived advantage of FTFs was respondents’ perception that it was easier to have a discussion with the whole group in an FTF than in an OFG. This also corresponds with the remarks made by some OFG participants that the OFG in which they participated hardly had the character of a group discussion, but could merely be viewed as answers to questions. This underlines the importance of posing questions or statements that provoke discussion and the important role of the moderator in enabling a constructive discussion. Of course, these requirements do not only apply to OFGs, but to FTFs as well.

Apart from this, our study provided some additional suggestions for future researchers who want to organise an OFG. Firstly, most participants prefer a new question or statement to be posted each day. Secondly, sending reminders during the OFG, for instance each time a new question is posed or each time another participant has posted a reaction, will probably increase participants’ involvement and participation in the OFG.

Conclusions

Our results show some strengths and weaknesses of OFGs and FTFs, which we believe can contribute to the debate regarding the merits of both methods. Participants’ perceptions of OFGs partly concur with the advantages of OFGs as a research method. Whereas respondents generally value the convenience of participating at their own time and place, the anonymity of OFGs and the increased ease to discuss personal issues were valued less by participants. A weakness of OFGs, or at least an aspect that needs considerable attention when organising an OFG, can be the lack of a fluid discussion, which is, according to our respondents, easier to achieve in an FTF.

Acknowledgements

Footnotes

Contributor Information

Marieke Zwaanswijk, Email: [email protected].

Sandra van Dulmen, Email: [email protected].

References