Parent Focus Groups in the USA and Canada

Author: Marilyn Barr, Founder/Former Executive Director, NCSBS

In 2004, Dan Jones and Associates of Salt Lake City, Utah, USA were hired to conduct the United States Parent Focus Groups on the PURPLE materials. The primary purpose was to obtain in-depth understanding about attitudes regarding infant crying, what people know about SBS, and how new parents cope with incessant crying by their infants.

purple focus group

Specific issues addressed in the group testing included:

A total of six focus group sessions were conducted on September 28 - 29, 2004. Prospective participants were screened to ensure that they had infants six months old or younger. A total of 63 people participated in the research: 42 new moms and 21 new dads. Males and females were separated by groups and represented a broad range of socio-economical and geographical areas within the Salt Lake City, Utah metropolitan area.

A summary of the findings from these first focus groups included:

Canadian Parent Focus Groups: Prevent SBS British Columbia also coordinated the evaluation of the PURPLE educational materials from the National Center on Shaken Baby syndrome for their suitability to the Canadian culture in 2004. Samsara Communications was hired to facilitate the focus group presentations, to train project personnel to appropriately handle the comments from participants, and to elicit feedback from participants. MTM Research was hired to analyze the results and report the key findings.

purple focus group

The primary purpose of the research was to elicit feedback and opinions on
dimensions of the materials such as:

In order to meet the objectives, 8 focus group sessions were conducted between June 1st and November 16th, 2004 throughout the Vancouver, Vancouver Island and Fraser Valley Health regions. These areas included Chilliwack, Duncan, Port Moody, Richmond, Surrey, and Vancouver. A total of 66 parents (59 mothers, 6 fathers, and 1 elder) representing various backgrounds of race, economic status and family makeup participated. Participants were biological or adoptive parents of infants <6 months old (excluding the elder) and were proficient in spoken and written English.

A professional moderator representing Samsara Communications Services facilitated the groups. The discussion guide was developed jointly by representatives of the National Center on Shaken Baby syndrome (NCSBS) and the moderator.

During the focus group session, participants were asked for their opinions and feedback on the Period of PURPLE Crying intervention materials developed by the NCSBS . The parental materials included (a) a 10 minute video/DVD; (b) a brochure; (c) a refrigerator magnet; (d) a bib; and (e) a caregiver checklist. The health-care professional materials included (a) a lapel button; (b) an office/ward poster; and (c) a brochure. Participants were informed that a note taker was present and that the session was audio-taped.

At the end of the session, concluding comments were:

The focus group sessions were formulated to provide the opportunity for ‘iterative’ evaluations of the components of the parent and professional materials, both individually and as a group of materials.

purple focus group

Translation Focus Group Testing
Translation Focus Group Testing: Prevent SBS British Columbia has also coordinated focus groups in the process of translating the PURPLE materials into several languages. The goal of the translation project for the Period of PURPLE Crying is to receive a culturally sensitive, accurately translated product that keeps the clarity and cohesiveness of the message.

The objective was to utilize a professional translation company that could provide the most comprehensive service that would meet the criteria necessary for academic publishing. The Provincial Language Services (PLS) was hired to perform the translation procedures. The programs expertise in translations within the health care community was necessary and they offered a comprehensive service which included community testing procedures.

There were additional measures added to ensure our specific project received the highest quality product. First, an initial focus group made up of five qualified and working healthcare interpreters analyzed the materials in order to provide suggestions to the translator in difficult areas. Secondly, once the unilingual parent focus group had viewed the product in the subject language and adjustments were made, an English back translation was requested from a separate translator with no previous knowledge of the product.

The process included two types of focus groups: 1) The Interpreter Focus Group, and 2) the Parent Focus Group.

  1. Interpreter Focus Group: The interpreter focus group included 5-6 participants who were certified interpreters currently working within the health care field. These groups were held on the hospital grounds and participants generally received the documents a day or two before the group. A bilingual facilitator lead the group which also included authors of the materials; Dr. Ronald G. Barr, Director, Centre for Community Child Health Research and Marilyn Barr, Executive Director of the National Center on Shaken Baby syndrome. The translator and coordinators for the PURPLE team and the Provincial Language Services were also present, but not directly part of the group. The facilitator followed guidelines provided by the PLS and based an equal amount of time for both documents (11 page booklet and 10 minute film transcript). The focus groups were scheduled for two hours and the order of the materials was counterbalanced to provide equal coverage. The facilitator kept his/her own notes and provided a report with group suggestions.

  2. Parent Focus Group: The parent focus group participants were recruited by multicultural community agencies and usually held at the agencies’ location. The criterion for recruitment was parents with children under two with as little English as possible. This was not always appropriate, however, as in the Punjabi community it is customary for grandparents to be the primary caregivers so they were included in that particular focus group. Materials to be discussed were only viewed in the target language. Coordinators from the PURPLE team and the PLS were present to answer questions, but did not participate. The facilitator followed guidelines provided which were similarly laid out as the interpreter focus group. The group was given a choice at the end to view the English film and depending on the level of English it was sometimes shown. Again, the facilitator kept his/her own notes and provided a written report with group suggestions.
purple focus group

As an example, the Punjabi parent focus group general comments are below:

Initial Impression:

Main Messages:

Cultural Relevancy:



Translation focus groups will continue to occur with each new language chosen. As of December 1, 2007 the program has been translated into the following languages: Cantonese, Punjabi, Spanish (Mexican-dialect), Korean, Vietnamese, and Japanese. By mid-2008, it was also be available in French and Portuguese (Brazilian Dialect). In 2009 it was translated in Somali. The process above was required for each of these languages.

Through this process it has become very apparent that the program messages are relevant to all parents, of all kinds of families in all the cultures included in this process. It was a very rewarding process to know the program was valued by so many.