Conducting Culturally Sensitive Focus Groups with African Americans: An Interview with Cheryl Johnson

The Internet is everywhere, connecting people and cultures until sometimes it feels like we’re one global human race.  But the truth is, even within the United States, different cultural groups have distinct identities: Hispanic, African American, Native American, Asian, etc.

I have designed and conducted several focus groups with these cultural groups but, not being a person of color, always wondered about the cultural appropriateness of my approach.

Enter Cheryl Johnson, an extremely talented applied researcher.  Cheryl has extensive experience and expertise recruiting participants and conducting community focus groups. She is also African American.

Meeting Cheryl was an opportunity to learn more about cultural sensitivity in conducting focus groups. She graciously agreed to an interview and I was enlightened by her responses. I think you will be too.

Eliot: Let’s start with the focus group work you’ve done over the past several years. I know it’s been extensive. Can you give me a few of the highlights?

Johnson: For the 18 years I worked at Kaiser, my primary role was supervisor of survey research and focus group recruitment. I recruited patients for focus group research studies to gain an understanding of how questionnaires on different health conditions should be developed. But most of my focus group experience has been with community groups.  I did focus groups for the State of Oregon around understanding barriers to immunizing African American, Hispanics and Native American infants. For them, immunization is at a lower rate than in whites and the State wanted to understand what some of those barriers might be.

Additionally, I’ve done focus groups for the African-American Health Coalition around disaster preparedness. That was a big push after Katrina. Also with the African-American Health Coalition, I conducted focus groups around diet and exercise. As a result of the information collected in the focus group, they made exercise available in church basements, Dishman Community Center and other places to provide greater access. And they sponsored some of the farmer’s markets to make fresh produce available.

Eliot: How did you get involved in doing community focus groups?

Johnson: A few years ago I was recruited by the Oregon Research Center for Applied Science (ORCAS) to conduct some focus groups for them. They recruit facilitators from within the community and train them to conduct the focus groups. I’ve gotten some training from them on a range of focus group topics—from smoking cessation to dating habits—in order to help them develop health education materials.  I learned to do focus groups with seniors, with young people, with women—but mostly with women and African Americans.

Eliot: So tell me about the community recruitment you’ve done.

Johnson: With the focus groups that I did with the State around immunization they prepared flyers with the cutest little babies of color. That (pictures) said it without saying it (the group was for African Americans)—well, maybe they also said “African American”—but they also followed that through in the graphics. And I know at Kaiser, unless we were targeting African Americans for a strictly African American group, it was always more effective to have a diverse representation in the recruitment materials.

Eliot: What do you mean by that?

Johnson: So if the study isn’t exclusively targeting blacks or African Americans, but you want them to participate, it’s important to show them as “one of the group.”  That’s important to people.  It’s just like when you go to the store to by hair care products: how do you decide whether or not that’s the product for your hair?  You might look and see whose face is on the box.  You’re not going to read “for African Americans,” but you recognize at a glance the message that they want to communicate.

Eliot: And what if it’s a flyer without a picture?

Johnson: If it’s a flyer without a picture, you want to be clear to say that it’s open to anyone.  It’s in the language: “Open to anyone who is this age, has this condition, etc…”

Eliot: What about your interactions with the individuals who respond to the recruitment flyer?

Johnson: Of course, you’re going to screen based on the criteria, but you can also sort of build motivation at that point.  We all know that sometimes you have to schedule twice as many as you expect to show up, for that reason. If people are wavering, you can give them permission to say “no.”  But for the people that do say “yes,” you can strengthen that rapport so that they’re more apt to show up. And if you were going to be conducting several groups, at the conclusion of the group, you’d say, “If you know other people who might interested and fit the criteria, please have them call us.” And it’s always nice when the recruiter is also the facilitator or involved in some capacity because it builds rapport from the first moment of contact.

Eliot: Do community-based researchers call on you because it’s important that an African American facilitate an African American focus group?

Johnson: Yes. I think they believe that a facilitator that looks like the group will be better able to gain trust and get information.  With the immunization focus groups for the State, not all of the groups were African American, but they definitely wanted an African American facilitator for the African American group. And I did the recruiting for that as well.

Eliot: So what is it like then, as an African American, to facilitate an African American focus group?

Johnson: Well, there’s one story I’ll share with you. I was facilitating a group of exclusively African-American women talking about food choices and diet. It was really fun. They were talkative, but they seemed a little bit apprehensive in their answers.  They wouldn’t volunteer any additional information. One of the questions had to do specifically with the types of food that they ate and they were saying general things like, “Well, you know, we eat Southern-style food.”  And so I challenged them: “Southern-style food—what is that like?” They were still being coy about it and kind of general. At that point, it occurred to me that maybe they perceived me not to be a member of the group, even though I was African American like the group.

Eliot: Oh my. So what did you do?

Johnson: Well, I started to name some of those things [Southern dishes] African Americans eat. And once I was able to establish, “I know what you mean; you mean this and that,” it was like a light turned on for the group.  And then the women started to be more forthcoming and more specific.

Eliot:  Were you surprised that there was still this trust barrier you had to transcend to get them to open up?

Johnson: I don’t think I was totally surprised by it, but it kind of reaffirmed some things that I’ve heard before.  People are extremely diverse even within groups. They come from all kinds of different backgrounds. There is that tendency to think that if someone is professional or educated maybe they no longer closely identify with the group.  Do you know what I’m saying?  That they no longer closely identify with the group as maybe other people do.

Eliot: Are you saying that a person’s social class can make them feel different even if their skin color is the same?

Johnson: Exactly

Eliot: I see. So that could be a barrier to a successful focus group?

Johnson: Hmm hmm. Just looking like and having the same skin color and appearance doesn’t necessarily guarantee you membership. We need to know you. We need to know if we can trust you.  We need to know if you’re going to make negative judgments about us. We need to feel comfortable. Because every culture, every family has some insider information.  The kind you get the evil eye about—the “Don’t you dare tell that!” look—from your mom.

Eliot: What about the opposite problem—the group feeling so comfortable with you as facilitator that they don’t tell you certain things because they think you already understand them?

Johnson: Yes,I think you always run a real big risk of that. For myself, whenever the you-know-what-I-mean statement comes up, I say, “Well, I kind of think I do, but tell me anyway because I could be wrong.” Or I might say, “I don’t want to put words in your mouth so just tell me.” As a researcher and as a facilitator, it’s just something that I always need to be aware of. You always want to have people explain what they mean. Do you know what I mean?  [Laughter]

Eliot: As a researcher, I think I do.  But maybe you should tell me more about that!  [Laughter]

Eliot: So, what do you think about a non-African American person like myself conducting an exclusively African American focus group?

Johnson: When you talk about whether or not it’s important that the facilitator be of the same ethnic group or be a member of the group that they’re facilitating, it really depends on the topic. If the topic is one that could evoke judgment about a cultural practice or cultural norm, I think it may be a shorter distance for a facilitator of color to get there. And the opportunity to uncover richer information is greater if the facilitator is a member of the group.

But, if the topic is not as sensitive, if it’s not about things that people hold really dear to their hearts and have very strong opinions about, I think it’s just important to have some universal understanding of, for instance, what it’s like to be a woman in this country. If you’re a mother, if you’re a single parent, if you’re a grandparent, if you’re a daughter or sister—there’s always some area to connect on and be able to identify with. Or if you’re somebody who struggled to overcome some type of adversity, I think you can find some common ground. Most of all, you must be sincere and authentic because people don’t like fake people. It can’t be a stretch; it can’t be unnatural.

Eliot: Last winter I conducted a focus group of exclusively African-American women. The topic was barriers to access to health care and I did the recruitment myself. About 15 minutes into the group I started feeling like the women were really connecting with me—the discussion was flowing and it seemed that they were really opening up. Many of the women even gave me a little hug on their way out.

Johnson: But here’s the thing: you can feel like you connected and people are pleasant and forthcoming and they talk and you feel like it was a positive experience. But you don’t know if, as an outsider, there were things that you should’ve heard about and didn’t—things that are common to this group that you could not know about. And that’s equally important.  The issue is that sometimes when you’re an outsider, things will go over your head and you’ll miss an opportunity to follow up on something. Things like phrases you heard when you were a little girl or a Southern term they used.

Eliot: So it’s the nuances that–

Johnson: It’s exactly the nuances that get missed.  And you can be sincere and genuine—you’ll get information; people will talk to you.  But there may be things that are nuanced that you won’t follow up on because you won’t have any connection or experience with that.

Eliot: So does that apply to analysis of the focus data also? Or could I take the transcript of an African American focus group you conducted, for instance, and try to make sense of it on my own?

Johnson: I think it would be better if you could debrief with the facilitator and talk about what their experience was also. There are always going to be those things that catch up with the facilitator later—some little prick that, when you’re moving in real time, you don’t have time to analyze right then. It’s easier later when you’re relaxed and maybe not thinking about it specifically. It’s just sort of another layer of due diligence.

Eliot: You’re amazing. How does someone become a “Cheryl Johnson?” How would someone learn to do what you do so well?

Johnson: By observation, by training, by listening and by doing. If you’ve done enough focus groups, you come across the classics: the ones where one person talks too much, ones where nobody’s talking, or the ones where the questions aren’t working and you just feel like a solo that’s not going over very well.

But a big part of it, I think, is so much who we are. We all have gifts but I don’t think that we always appreciate those gifts, especially the ability to listen.  People say they value listening, but no one ever gets an award for listening or being a good listener.  We value good speakers, but when’s the last time there was an award for the “best listener?” People that are good facilitators do interviews even when they’re not doing focus groups because that’s who they are. They have that curiosity. They are always saying things like, “Oh, really?”  “Tell me more!”

Eliot: There are a lot of books available on facilitating focus groups and on group dynamics but it seems like you’re saying that it’s more than just what you can read.

Johnson: It really is. Like I said, it’s what you do. But, it’s not about you. You’re there to get other people to talk. And don’t you just love it when they all talk and they’re speaking appropriately. And you’re just like—somebody catches on to something somebody else said and it just—you know what I mean?

Eliot: Yes, Cheryl, I do know what you mean!

 

 

Feel free to contact Susan or Cheryl directly with questions or comments. We’d be delighted to help you with your next focus group project.

Susan Eliot: 503-287-0693 • susan.eliot@gmail.com • www.qualitative-researcher.com

Cheryl Johnson: grouptalk@msn.com

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