5 Community Focus Group Guide

Attachment E. Community Focus Group Guide

Focus group for community service providers

This protocol will be used to talk to two groups of participants: home visitors at MIEHCV-funded home visiting programs and community service providers who work with similar families. Throughout the protocol, we use two headings to indicate which group(s) of participants will respond to the questions that follow:

• For all participants

• For participants from home visiting agencies

Introduction

Hello, thank you for taking the time to speak to us today. My name is [NAME OF INTERVIEWER] and I’m with Child Trends. We were contracted by the Health Resources and Services Administration, or HRSA, to examine how home visiting can address challenges from COVID-19. Specifically, we are exploring home visiting’s role in addressing health inequities arising from COVID-19, including how home visiting programs have supported families in your community through collaboration. Understanding your experiences during the COVID-19 pandemic is very important to the study.

We plan to record this focus group, but the information you share today will not be identified in any recordings, notes, or transcriptions. The transcript from this focus group will only be seen by the study team. Your individual answers will not be shared with anyone at your program or any local or state agencies. We will also plan to remove any language that could possibly identify you in some way.

Before we start, I would like to establish a couple of guidelines for our conversation today. First, there are no right or wrong answers and we are interested in hearing both positive and negative comments and opinions – or whatever you think is important to share. Second, I ask that you wait until one person has finished speaking before you comment. Third, some questions in our discussion ask you to share about your experiences during the COVID-19 pandemic and may be upsetting for some people. It is up to you to share as you feel comfortable. You do not have to answer any questions you don’t want to, and you are free to leave the discussion at any time. Lastly, we ask all participants to please respect the privacy of other focus group members by not disclosing any content discussed during the focus group.

Do you have any questions before we get started?

Are you willing to complete the focus group? By agreeing, you are providing consent.

Let’s do introductions before we begin. Please tell us your name, what organization you represent, and how long you’ve worked there.

Experiences during COVID-19

First, we will talk about your experiences and the experiences of the families you work with during the pandemic. Then we will do an activity together. Before we get started, since so much time has passed since the start of pandemic, we want to set the scene by reviewing some of the major milestones over the last 2 and a half years.

FACILITATOR’S NOTE: Share the following events on a paper timeline or via on slides.

Key pandemic milestones:

• March 2020: COVID-19 pandemic began in the US, shutdowns and “social distancing” begin; many schools and child care facilities close

• April 2020: Many people begin wearing masks in public spaces

• November 2020: President Biden is elected into office

• Early 2021: Vaccines became widely available for adults (all adults eligible in April)

• Summer/fall 2021: Delta variant peaks

• November 2021: Vaccines become widely available for kids ages 5-11

• Winter 2021/2022: Omicron variant peaks

• Spring 2022: Restrictions begin lifting

1. Based on your experiences and your memories of the pandemic so far, what is missing from this list of milestones? What other events were important to you and families in your community?

2. How have you been affected by COVID-19 infection?

3. How have the families you’ve worked with been affected by COVID-19 infection?

4. Currently, what needs do the families you serve have, if any?

• What are families’ physical and mental health needs?

• What other needs do families have? For example, needs related to housing, paying bills, accessing food, employment, transportation, accessing child care, or accessing social support.

• How have the needs of the families you served changed across the course of the pandemic, if at all?

5. What barriers and inequities have the families you work with faced during the pandemic?

• How have families’ identities and lived experiences affected the barriers they have faced, if at all?

  • Examples of identities or lived experiences could include living in a certain part of the community, being of a specific race/ethnicity, sexual orientation, or age, coming from a specific country of origin, or having a specific immigration status.

• To what extent has the availability of community resources, or the lack of resources, been a barrier for families?

  • What changes have you seen in the availability of services and resources compared to before the pandemic?

6. How has your ability to connect families with the resources they need changed over the course of the pandemic, if at all?

7. How has the process of making referrals or connections to services and resources changed, if at all? In general, how do the families you work with access services, resources, and information when they need them?

• How do they find about what services, resources, and information are available?

• How do they decide which to access?

8. In general, what makes an experience with a service or resource positive for a family?

   1. Thinking about enrollment in services, what makes for an easy or positive enrollment experience for families?

9. In general, what makes an experience with a service or resource negative for a family?

• Thinking again about enrollment in services, what makes for a challenging or negative enrollment experience for families?

10. Throughout the pandemic, what interactions have you had with home visitors or home visiting programs, if any?

• How familiar are you with the services these programs have provided, if at all?

For participants familiar with home visiting:

11. How has home visiting in general supported families in your community in meeting their needs?

12. What needs have home visiting programs not been able to address during the pandemic?

• What factors limit the ability of home visiting programs to address gaps in health equity, if any?

13. Throughout the COVID-19 pandemic, how have you seen home visiting programs address equity when providing services?

• To what extent do you think program leadership incorporates equity?

• To what extent do you think home visitors incorporate equity in their work?

For all participants:

14. How does the history of your community affect families today, if at all?

• How does this history come up in your work with families, if at all?

15. Throughout the pandemic, what about your community has made it easier for the families you serve to cope or be resilient, if anything?

Provider systems mapping activity

As a reminder, one of the goals of this study is to inform a more responsive home visiting system and more equitable health and family support systems. We’re going to do an interactive activity to better understand the services and resources available to families in your community and their experiences using these services. We’ll start by reviewing a list of services and resources developed with the help of key informants and our community researchers. Then, we’ll use the paper, post-it notes and sticky notes available to you to complete the activity.

16. Now, take out your own poster paper, post-it notes, and markers (or virtual equivalents), and we will do an activity together. Of the services and resources listed on the flip chart/Jam Board, which are you familiar with, either personally or professionally? For example, which have you referred clients to, collaborated with, worked for, or generally know about? Write these services/resources on separate post-it notes and place them on your poster paper.

17. Next think about what you know about the experiences families you work with have had with each of the services and resources you’ve listed. For each post-it note, add a colored sticker that matches how you feel about the service or resource based on these experiences. Use a green sticker for services or resources you feel mostly positive about, a red sticker for ones you feel mostly negative about, and a yellow sticker you feel neutrally or have mixed feelings about. When you’re deciding what color sticker to use, you should go with your gut feeling, and think about things like how much of a hassle it is for families to access the services, the kind of interactions families have with staff, and what communication with staff is like.

18. Now, look at your paper again, and add a purple sticker to every service that you have personally connected a family you work with to.

19. Next, draw a line between the resources and services that, as far as you know, are in contact with each other about families’ cases.

20. Now, reflect on the activity we just completed:

• What do you think are the ideal outcomes from coordination across services in your community?

• What is the benefit of coordinating services?

• What are barriers to coordinating services?

21. What questions or topics that we discussed today were most important to you? Which were least important?

22. Is there anything you would like to add that we haven’t discussed already?

Thank you all for your time today! In appreciation of your time, we will be sending each of you a $75 e-gift card to Amazon.

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