4 Family Focus Group Protocol

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INSTRUMENT 4: Family Focus Group Protocol

Public Burden Statement: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0906-XXXX. This information collection aims to explore how families that experience disparities in outcomes targeted by the MIECHV program experience home visiting services. This study is an initial step in understanding those experiences and will provide a better understanding of how MIECHV-funded home visiting programs currently address disparities and promote equity. Data collection activities include interviews, focus groups, online surveys, program observations, and review of documents and management information systems data. The time required to complete this information collection is estimated to average less than 1 hour per response, including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This information collection is voluntary and confidentiality is followed according to law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: HRSA Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N39, Rockville, MD or paperwork@hrsa.gov. 

Note to OMB: The Family Focus Groups use a semi-structured qualitative approach, as recommended by Weiss (1995).¹ This approach allows us to pursue the same constructs across participants while developing depth and coherence from groups regarding the meaning of the constructs from their subject position. These focus groups are focused primarily on the co-construction of knowledge². Therefore, the items in the protocols are designed to address the constructs under investigation while providing adequate space for the moderator and participants to develop meaning through an exchange of ideas. The focus groups are distinct from a “survey interview approach,” which collects categorical data in a fixed-item interview format.

This is a guide, not a script. The guide has been developed to apply to caregivers with young children who are/were enrolled in an early childhood home visiting program. Moderators will tailor questions and add probes to further explore the experiences recounted by group members.  We may also tailor the questions based on the specific findings from the Family Survey. We will also tailor the questions based on the specific information about the program the families are enrolled in and information from home visitors and program leadership interviews.

Family Focus Group Guide

Introduction and Consent

Thank you for taking the time to talk with us about your experiences as a Black caregiver [currently or previously enrolled] in home visiting services.

First, I’d like to read an informed consent statement, which you also received by email. It may be helpful to follow along with the statement I read as it includes the standard language we are required to state.

You are invited to participate in a small group discussion about your experiences as a Black caregiver in a home visiting program. The information collected in this discussion will inform considerations for program improvement efforts related to removing potential barriers to family enrollment and engagement in home visiting services and providing supports for families from historically marginalized communities.

Participation in the group discussion is voluntary. The discussion will take approximately 60 minutes. Some of the questions asked may cause discomfort or remind you of difficult situations or experiences. You have the right to skip questions and stop participation at any time. You may choose to not participate in this discussion or end your participation at any time without affecting your home visiting services. There are no foreseeable risks to your participation in this small group discussion.

Although you do not receive any direct benefits from participation, your stories and input will help to inform program improvement and services for other families. Your name or other personally identifying information will not appear in any report, and your responses to this small group discussion will remain private to the extent permitted by law. If you say something that suggests you are likely to harm yourself or someone else, or someone is likely to harm you, we are required to report that information to the appropriate authorities. We will not share any information you provide in this small group discussion with your home visitor or your home visiting program. Your anonymous responses, however, may be included in a report that is shared with our funders and made available to the public.

We would like to record our discussion so we can be sure to capture your responses accurately. No one besides the HV-AIM project team will listen to the recording. If you want to say anything you do not want recorded, please let us know and we will be glad to pause the recording. Recordings will be transcribed and analyzed, and then destroyed. All the information you share in this discussion will be stored in a password protected electronic database and will only be accessible to the HV-AIM project team.

Do you agree to participate in this small group discussion?

• Yes • No

May I record this small group discussion?

• Yes • No

[If a participant does not want to be recorded, a team member will take notes.]

Great, let’s get started. Today’s discussion will focus on understanding how your home visiting experience has been responsive to your experiences as a Black caregiver.

Introduction

We would like to start by getting to know everyone a bit more. Let’s go around and everyone can introduce themselves, tell us your children’s ages, and how long you have been (or were) enrolled in home visiting. And, if you feel comfortable sharing, please tell us one thing you are proud of as a parent.

As we go through introductions, please complete the poll using the link provided in the chat or the instructions on the slide so we can learn about who is joining the discussion. [Will provide poll to respondents to gather demographic and background information, using questions listed below].

1. I identify my race or ethnicity as (please select all that apply): 

   1. American Indian or Alaska Native (For example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.)

   2. Asian (For example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, Japanese, etc.)

   3. Black or African American (For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc.)

   4. Hispanic or Latino (For example, Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, etc.)

   5. Middle Eastern or North African (For example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, Israeli, etc.)

   6. Native Hawaiian or Pacific Islander (For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc.)

   7. White (for example, English, German, Irish, Italian, Polish, Scottish, etc.)

   8. Prefer not to answer

2. Are you: Mark all that apply.

1. Female 

2. Male 

3. Transgender, non-binary or another gender 

4. I prefer not to answer 

3. I am: 

1. Under 18 years old

2. 18-21 years old 

3. 22-29 years old 

4. 30-44 years old 

5. 45 years old or older 

3. How long have you been (or were you) enrolled in home visiting services?

1. Less than 6 months

2. 6–12 months

3. More than 1 year

Now, we would like to talk a little about your experiences and thoughts on being a Black caregiver.

Experiences as a Black Caregiver

1. What, if anything, do you feel is significant or special about being a Black caregiver today, given the current society and environment?

2. Ideally, what role or gap do you want a home visiting program to fill as it relates to being a Black caregiver?

3. As a Black caregiver, what aspects of your home visiting program would you want to change or customize to better support you as Black caregivers?

Accessing and Enrolling in Home Visiting Services

1. How did you learn about the home visiting program you participated in?

   1. Tell us about any initial hesitations or worries you may have had about participating in home visits.

   2. How did you end up deciding to enroll in home visiting services?

   3. Based on your experiences learning about and enrolling in home visiting services, how do you think other Black caregivers might respond to home visiting services?

   4. In what ways would home visiting services be appealing to other Black caregivers?

   5. In what ways would home visiting services not be appealing to other Black caregivers?

   6. What, if anything, might prevent Black caregivers from deciding to enroll in home visiting services?

2. In your experiences with your home visiting program, how are Black caregivers represented in the content, materials, or resources shared by your home visitor?

3. How do you think the race and ethnicity of home visitors impacts Black caregivers’ participation in home visiting services?

Acknowledgement and Affirmation as a Black Caregiver

1. How are your ideas about raising a child right supported by your home visitor?

2. What about experiences when you felt like your ideas about raising a child right were not supported. Tell us about a time when you felt like your ideas were not supported.

   1. How are your ideas about raising a child right are influenced by your identity as a Black caregiver?

3. Tell us about how your child’s other parent, your co-parent, participates in your home visiting program.

   1. How is their identity as a parent recognized and acknowledged by your home visitor?

   2. What are the ways in which your home visiting program could do more to support your co-parent?

4. Tell us about your experiences with your home visitor where you felt your identity as a Black caregiver was acknowledged.

   1. How did that experience make you feel that your identity as a Black caregiver was acknowledged?

5. How about an experience with your home visitor where you felt your identity as a Black caregiver was not acknowledged.

   1. How did that experience, with your home visitor, make you feel that your identity as a Black caregiver was not acknowledged?

6. Tell us about your experiences when you felt your home visitor did something to affirm or celebrate your identity as a Black caregiver?

   1. [If the participant is not able to describe a time, move to 6]

   2. How did this experience change your relationship with your home visitor?

   3. How did this experience change how you felt about your home visiting program?

7. Thinking back on your interactions with your home visitor, tell us about a time when you would have benefited from having your identity as a Black caregiver celebrated or affirmed.

8. Do you feel like you can be yourself during a home visit?

   1. For example, do you ever change the way you talk, the subjects you consider appropriate, or the way you express yourself?

   2. If you make changes, do the changes get in the way of having a successful home visit? If so, how?

Race Talk

1. Please describe a time when you shared an experience of racism with your home visitor.

1. How did your home visitor respond to you sharing your experience?

2. Was their response satisfying to you? If so, how? If not, how could it have been more satisfying?

1. Tell us about a time when you had an experience of racism on your mind and chose not to share it with your home visitor?

1. What got in the way of sharing the experience?

Implicit and Conscious Bias

1. Have you ever thought that your home visitor viewed you negatively or treated you differently because you are Black?

1. Can you tell me a story about what led you to that belief?

2. Have you ever felt like your home visitor believes you or your parenting practices need to be fixed because you are Black?

Recommendations for Home Visiting Programs

1. What would you and others need to see that would make Black mothers want to be a part of a home visiting program?

2. What recommendations do you have for home visiting programs that are trying to be more aware of and supportive of Black caregivers’ experiences, strengths, and culture?

3. What about home visitors, what recommendations do you have for home visitors that are trying to be more aware of and supportive of Black caregivers’ experiences, strengths, and culture?

1 Weiss, R. S. (1995). Learning from strangers: The art and method of qualitative interview studies. Simon and Schuster.

2 Berner-Rodoreda, A., Bärnighausen, T., Kennedy, C., Brinkmann, S., Sarker, M., Wikler, D., ... & McMahon, S. A. (2020). From doxastic to epistemic: a typology and critique of qualitative interview styles. Qualitative inquiry, 26(3-4), 291-305.

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