Using Focus Groups for More Responsive Programming: A School Wellness Case Study

Transcription

1 Using Focus Groups for More Responsive Programming: A School Wellness Case Study Michelle Brill, M.P.H. Alexandra Grenci, M.S., RD, LDN, CDE Joanne Kinsey, M.S. Rutgers Cooperative Extension Family & Community Health Sciences

2 Objectives Present a step-by-step overview of the process of effective focus group implementation Explore how to apply this process to design Extension programming that is relevant and responsive to your own communities

3 Background The input of parents is sometimes overlooked in the development of school wellness initiatives, yet their support is critical for reinforcing wellness messaging at home. Parents bring valuable resources and ideas to the table. A first step in program development is seeking the support of parents on the front-end of a project!

4 Issues Schools are the optimal setting for providing children with a healthy environment: nutritious meals, snacks & beverages regular physical activity learn the importance of healthy behaviors Obesity - Strong evidence links healthy nutrition and physical activity to improved academic performance and classroom behavior among school age children.

5 Grow Healthy: A Garden-Based School Wellness Initiative Funded by a USDA Team Nutrition Grant via NJ Dept. of Agriculture (FCHS sub-contractor)

6 Farm to School: A national, state, and local movement connecting kids, food, farms, and community. Teach good nutrition Expand the number and variety of fruits and vegetables offered in school cafeteria Set up opportunities for schools to buy more locally grown products Provide opportunities for education and experiential learning through school gardens

7 Grow Healthy Project Concepts Serve healthier foods in schools, especially more fruits and vegetables Improve student wellness through fun, interactive nutrition and physical activity opportunities in elementary schools Engage foodservice staff, teachers, administrators, families, and the community in school wellness initiatives Identify opportunities to work with local farmers/growers and bring more locally produced foods into schools Support sustainable improvements in the school wellness environment by supporting effective school wellness councils

8 Grow Healthy Goal #1: Foodservice Trainings to Support Healthier School Meals Goal 1 By participating in regional foodservice trainings, school foodservice personnel learn about: The newly released 2010 Dietary Guidelines for Americans Team Nutrition Resources The HealthierUS School Challenge Promoting USDA foods (i.e. commodities, especially fruits & vegetables) in school meals 3 Regional Trainings conducted in March and April, 2011

9 Grow Healthy Goal #2: Nutrition and Physical Activity Education and Promotion Goal 2 Provide fun & interactive nutrition education and/or physical activity opportunities for children, teachers, parents and other caregivers, as well as a school garden and Farm-to-School initiatives that link classrooms and cafeterias. Two components for the school year: Nutrition education in the classroom through standardized lessons Increase physical activity in the school day through walking programs and mini-activity breaks

10 Grow Healthy Goal #3: Sustaining A Healthier School Environment Goal 3 - Provide schools with technical assistance and support to: 1) Create and maintain a healthier school environment 2) Implement and enforce their wellness policies that address competitive foods, nutrition education, physical education, and physical activity. 3) Develop a school wellness council.

11 Grow Healthy Specifics Target audience: schools in 9 NJ counties (Atlantic, Burlington, Cape May, Gloucester, Hunterdon, Mercer, Somerset, Union & Warren) Mini-grant awards to 9 pilot schools: $7,500 plus support services from local FCHS office Grant period: September 2010-September 2012

12 Aura ES Knowlton Twp ES Francis A. Desmares ES Ethel McKnight ES Chesterfield ES Project Sites Queen City Academy Mt Prospect School Uptown School Cape May ES

13 The Research About Focus Groups Carefully planned series of discussions designed to obtain perceptions on a defined area of interest in a permissive, nonthreatening environment. Krueger & Casey 2000 Small structured groups led by a moderator, to explore specific topics and individual views and experiences through group interaction. Litosseliti 2010 Methodology valuable for social research projects. Gibbs 1997; Catterall & Maclaren 1997 Qualitative research as a result of testing concepts, new messages. Edmunds 1999 Focus groups limitation not representative sample. Gamon 1992

14 Focus groups: Tools to Seek Input from Parents Grow Healthy goals include engagement of parents to: serve on school wellness councils volunteer to help with school events support school wellness policies model and reinforce healthy behaviors at home Seek parent input on issues of concern and begin dialog with schools Solicit support for school wellness initiatives Identify community issues and resources

15 Early Planning Phase Engaged services of an experienced focus group facilitator Outlined focus group (protocol, training needs, budget, timeline, staffing, data collection, FG questions, and analysis) Prep work (building relationship with the schools, background information to collect from the schools, recruitment of parents)

16 Focus Group Protocol Identify major areas for discussion that align with grant objectives Parent questions developed around: Eating behaviors Physical activity Family health concerns School wellness issues Information exchange

17 The planning continues Finalize protocol Gather background information & prepare PowerPoint Session logistics Training of 4 facilitators

18 Recruitment Work with school champion to determine a local recruitment plan Flyers sent home to parents Phone calls made to parents by school staff Parent to parent recruitment

19 Focus Group Protocol Outline (10mins) Meet and greet period (5mins) Introductions (5mins) Setting at ease (15mins) Presentation of the problem (75mins) Focus Group questions: (10mins) Question and Answer Time, Next Steps Adjournment and presentation of incentives

20 Process Create a checklist Organize key roles Refreshments Incentives Equipment Room set-up

21 Process The day of the meeting: Plan to arrive early Have all materials prepared Have staff available to assist with parent consent forms, scribe notes, external notes, sign-in sheets Bring food and incentive gifts

22 Process Parents participate in a non-threatening environment. (Krueger, 1994) Ice breaker: Everyone Brings Something to the Table! Everyone s input is valuable Integrate all participants (school staff, parents, community, partners, & facilitators)

23 Facilitation Techniques Facilitators Teachers Not the expert Guide discussion Encourage group interaction Use reflective listening skills Are the expert Do the majority of the talking Focus is on individual learning Check for understanding All comments valid Encourage problem solving through discussion Students are graded on knowledge Answers usually provided

24 Early Findings from Parent Focus Groups

25 Demographics of Focus Group Participants County # Parents # Other Participants Race* Sex Female/Male Warren W 11/0 Union W/11B/2H 12/3 Somerset W/1A/1H 22/1 Hunterdon W/2H 14/1 Mercer W/1Pi/2H 12/3 Burlington W/2B/2A 19/3 Gloucester Atlantic Cape May TOTALS W 9B 11W/1H *W=white, B= Black, A=Asian, Pi= Pacific Islander, H=Hispanic 7/0 9/0 9/3 115/14

26 Common Themes Food and Eating Behaviors Fruits & Vegetables All parents thought it was important to eat them, reported intake: average 2 to 3 servings/day, kids don t get fresh fruits/vegetables at school, kids don t always eat fruits/vegetables when provided Family Meals - Most thought family meals were important, reported practice: average 4 to 5 times per week, range 1-7/week, it s easier to go out to eat for meals, lack of meal prep skills Barriers Busy schedules (parents work, after school activities, homework), Access (cost, distance, poor choices at school events), Kid s preferences (picky eaters, prefer unhealthy foods), lack of meal planning/prep skills

27 Physical Activity Common Themes Do kids get enough - Most parents thought their young kids got enough physical activity, less physical activity for older middle/high school kids Where Organized recreation programs (sports, swimming, dance) for a fee or cost-free, open play (local recreation facilities, fields, bike/walking paths) Barriers Access or cost in some areas, to sports & recreation centers, safety (unsafe areas, lack of sidewalks, traffic), competition with screen/video games more fun for kids

28 Common Themes Family Health Concerns Time management Over scheduling (kids, siblings, parents) leading to little unstructured play time and family time Stress Job stress, academic pressure, competitive environments, need for stress reduction measures

29 School Wellness Common Themes Improve quality of foods available in schools Quality of snacks and a la carte foods, access to nutrition information for school meals, enforce or improve school foodrelated policies (fundraising) Improve parent engagement/involvement Parent involvement must improve (parents don t attend PTO/ other school events), engage parents through kids Provide wellness education for children and parents Engage kids with fun, exciting school/community-wide activities, provide home-economics education, healthy recipes, cooking tips and fast facts

30 Common Themes Health Information Exchange From schools , hard copy flyers etc., school website In general Internet, friends and family, health care providers Preferences - A mix of communication modalities is preferred (i.e., not all parents have access/time for , some districts are paperless, etc.)

31 Eye Openers! Ethnic foods served at home rejected by kids who prefer unhealthy American food Parents lack information about what is being served at school (mealtime, snack time, celebrations) Lack of active school wellness councils Lack of awareness and enforcement of school wellness policies Use homework as a vehicle to involve and educate parents about nutrition and health Disparity in access to health care between urban and other settings Universal concern about children s safety

32 Lessons Learned Recognized need for experienced facilitation trainer to start the process Working within our project timeline and within the schools calendar (i.e. state testing dates, school priorities) Identifying a key contact at the school for parent recruitment Balance focus group size and number with resources/time available to conduct them

33 Next Steps Complete detailed data analysis Develop/implement parent survey to obtain additional input and confirm attitudes and behaviors of parents Develop/implement School Wellness Council survey Present focus group summary reports to schools and begin dialog with school wellness councils Enhance relationships with Cooperative Extension and other community partners

34 Using Focus Groups in Your Communities: Steps to Follow 1. What is the issue? 2. What are your goals? 3. Whose input do you need? Who are your community resources? 4. What will your recruitment strategy be? How will you get the group size and representation that you are looking for? 5. Who needs to be part of the planning and implementation team? Are they trained? If not, how will you train them? 6. What is your timeframe? Budget? Staffing?

35 Protocol and Consents 1. What specific topics do you need participants views on? 2. Design protocol with questions that are open-ended and that will prompt active group discussion. 3. Design recruitment flyer. 4. Design consent forms (address any bi-lingual needs). 5. Get IRB approval for protocol, recruitment flyer and consent forms.

36 Logistics Time (when are your participants available?) Location Space design Staff roles Equipment Refreshments Incentives

37 References Edmunds, H. (2000). Focus Group Research Handbook. McGraw- Hill Gibbs, A. (1997). Focus groups. Social Research Update, Issue Nineteen. Department of Sociology, University of Surrey, UK. Retrieved 6/20/2011 at Catterall, M. & Maclaren, P. (1997). Focus group data and qualitative analysis programs: Coding the moving picture as well as the snapshots. Sociological Research Online, Vol. 2, No. 1. Retrieved 6/1/2011 at Ferlazzo, L. & Hammond, L. (2009). Building Parent Engagement in Schools. ABC-CLIO/ Libraries Unlimited, Santa Barbara California

38 References Gamon, JA.(1992). Focus Groups- A Needs Assessment Tool. Journal of Extension, [On-line], 30(1). Available at: Kitzinger, J. (1994). The methodology of focus groups: the importance of interaction between research participants. Sociology of Health 16(1): Krueger, R.A. & Casey MA. (2000). Focus Groups: a Practical Guide for Applied Research (3 rd Edition). Thousand Oaks, CA: Sage. Litosseliti, L. (2003). Using Focus Groups in Research. Continuum International Publishing Group, New York.

39 Contact Information Michelle Brill, MPH, Mercer County Alexandra Grenci, MS, RD, LDN, CDE, Hunterdon County Joanne Kinsey, MS, CFCS, Atlantic & Ocean Counties