Use of focus groups in multi-site, multi-ethnic research projects for women's health: a Study of Women Across the Nation (swan) example.
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OBJECTIVE: To outline the lessons learned about the use of focus groups for the multisite, multi-ethnic longitudinal Study of Women Across the Nation (SWAN). Focus groups were designed to identify potential cultural differences in the incidence of symptoms and the meaning of transmenopause among women of diverse cultures, and to identify effective recruitment and retention strategies. DESIGN: Inductive and deductive focus groups for a multi-ethnic study. SETTING: Seven community research sites across the United States conducted focus groups with six ethnic populations: African American, Chinese American, Japanese American, Mexican American, non-Hispanic white, and Puerto Rican. PATIENTS OR PARTICIPANTS: Community women from each ethnic group of color. INTERVENTIONS: A set of four/five focus groups in each ethnic group as the formative stage of the deductive, quantitative SWAN survey. MAIN OUTCOME MEASURES: Identification of methodological advantages and challenges to the successful implementation of formative focus groups in a multi-ethnic, multi-site population-based epidemiologic study. RESULTS: We provide recommendations from our lessons learned to improve the use of focus groups in future studies with multi-ethnic populations. CONCLUSIONS: Mixed methods using inductive and deductive approaches require the scientific integrity of both research paradigms. Adequate resources and time must be budgeted as essential parts of the overall strategy from the outset of study. Inductive cross-cultural researchers should be key team members, beginning with inception through each subsequent design phase to increase the scientific validity, generalizability, and comparability of the results across diverse ethnic groups, to assure the relevance, validity and applicability of the findings to the multicultural population of focus.
