What about N? A methodological study of sample-size reporting in focus group studies

Carlsen, Benedicte; Glenton, Claire

doi:10.1186/1471-2288-11-26

Cited by 670Focus Groups and Qualitative MethodsQualitative Research Methods and ApplicationsDelphi Technique in Research

What about N? A methodological study of sample-size reporting in focus group studies

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Carlsen, Benedicte, Glenton, Claire·2011·BMC Medical Research Methodology

DOI 10.1186/1471-2288-11-26PMC PMC3061958

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Abstract

BACKGROUND: Focus group studies are increasingly published in health related journals, but we know little about how researchers use this method, particularly how they determine the number of focus groups to conduct. The methodological literature commonly advises researchers to follow principles of data saturation, although practical advise on how to do this is lacking. Our objectives were firstly, to describe the current status of sample size in focus group studies reported in health journals. Secondly, to assess whether and how researchers explain the number of focus groups they carry out. METHODS: We searched PubMed for studies that had used focus groups and that had been published in open access journals during 2008, and extracted data on the number of focus groups and on any explanation authors gave for this number. We also did a qualitative assessment of the papers with regard to how number of groups was explained and discussed. RESULTS: We identified 220 papers published in 117 journals. In these papers insufficient reporting of sample sizes was common. The number of focus groups conducted varied greatly (mean 8.4, median 5, range 1 to 96). Thirty seven (17%) studies attempted to explain the number of groups. Six studies referred to rules of thumb in the literature, three stated that they were unable to organize more groups for practical reasons, while 28 studies stated that they had reached a point of saturation. Among those stating that they had reached a point of saturation, several appeared not to have followed principles from grounded theory where data collection and analysis is an iterative process until saturation is reached. Studies with high numbers of focus groups did not offer explanations for number of groups. Too much data as a study weakness was not an issue discussed in any of the reviewed papers. CONCLUSIONS: Based on these findings we suggest that journals adopt more stringent requirements for focus group method reporting. The often poor and inconsistent reporting seen in these studies may also reflect the lack of clear, evidence-based guidance about deciding on sample size. More empirical research is needed to develop focus group methodology.

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More participants may be recruited in additional focus groups and/or interviews until saturation is met in line with established recommendations for focus group thematic analysis.
“More participants may be recruited in additional focus groups and/or interviews until saturation is met in line with established recommendations for focus group thematic analysis.72”
From Novel ACT-based eHealth psychoeducational intervention for students with mental distress: A study protocol for a mixed-methodology pilot trial (2019) · cites this paper as [72]

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BackgroundMethodInfluential
Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period
Vasileiou, K., Barnett, J., Thorpe, S., & Young, T. (2018) · BMC Medical Research Methodology · doi:10.1186/s12874-018-0594-7 · Cited by 3,115 · see citing works
Systematic text condensation: A strategy for qualitative analysis
Malterud, K. (2012) · Scandinavian Journal of Public Health · doi:10.1177/1403494812465030 · Cited by 2,305 · see citing works
“reviews reveal that this concept is often poorly specified and far from corresponding with the original meaning of this concept [12].”
Background
What Influences Saturation? Estimating Sample Sizes in Focus Group Research
Hennink, M. M., Kaiser, B. N., & Weber, M. B. (2019) · Qualitative Health Research · doi:10.1177/1049732318821692 · Cited by 1,227 · see citing works
“This goal contributes to continual calls for an evidence base of empirical research on saturation (Carlsen & Glenton, 2011; Guest et al., 2006; Kerr et al., 2010; Morse, 1995).”
Background
Saturation in qualitative research: an evolutionary concept analysis
Rahimi, S., & khatooni, M. (2024) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2024.100174 · Cited by 560 · see citing works
Data collection and sampling in qualitative research: does size matter?
Cleary, M., Horsfall, J., & Hayter, M. (2014) · Journal of Advanced Nursing · doi:10.1111/jan.12163 · Cited by 377 · see citing works
Sample Sizes for 10 Types of Qualitative Data Analysis: An Integrative Review, Empirical Guidance, and Next Steps
Wutich, A., Beresford, M., & Bernard, H. R. (2024) · International Journal of Qualitative Methods · doi:10.1177/16094069241296206 · Cited by 416 · see citing works
“Meta-analyses of the peer-reviewed research on sample sizes for qualitative data are also widely cited in the sample size estimation literature (Carlsen & Glenton, 2011; Marshall et al., 2013; Mason, 2010; Sobal, 2001; Thomson, 2011).”
Applying GRADE-CERQual to qualitative evidence synthesis findings—paper 5: how to assess adequacy of data
Glenton, C., Carlsen, B., Lewin, S. A., Munthe‐Kaas, H. M., Colvin, C. J., Tunçalp, Ö., Bohren, M. A., Noyes, J., Booth, A., Garside, R., et al. (2018) · Implementation Science · doi:10.1186/s13012-017-0692-7 · Cited by 279 · see citing works
“As the process of data saturation is potentially limitless; and determining the point at which “saturation” has happened is difficult, if not impossible [26]; the concept of data adequacy may be a more pragmatic and feasible approach.”
BackgroundSelf-citation
How, When and Why People Seek Health Information Online: Qualitative Study in Hong Kong
Chu, J. T., Wang, M. P., Shen, C., Viswanath, K., Lam, T. H., & Chan, S. S. C. (2017) · Interactive Journal of Medical Research · doi:10.2196/ijmr.7000 · Cited by 181 · see citing works
“Before recruitment, we proposed to conduct five focus groups based on recommendations from the literature on qualitative methods [24]—which allows flexibility in increasing or decreasing the number of focus groups after data collection has begun, and the focus group can stop when the point of data saturation is reache…”
Method
Developing a Standard Set of Patient-Centred Outcomes for Inflammatory Bowel Disease—an International, Cross-disciplinary Consensus
Kim, A. H., Roberts, C. J., Feagan, B. G., Banerjee, R., Bemelman, W. A., Bodger, K., Derieppe, M., Dignass, A. U., Driscoll, R., Fitzpatrick, R. M., et al. (2017) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjx161 · Cited by 149 · see citing works
Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework
the Canada PRIme Plus Team, Bussières, A., Patey, A. M., Francis, J., Sales, A. E., & Grimshaw, J. (2012) · Implementation Science · doi:10.1186/1748-5908-7-82 · Cited by 143 · see citing works
“As a result, the number of participants in focus groups conducted was relatively small, and inclusion of other participants may have provided different beliefs either in favor of or against the targeted behavior [85].”
Physical activity on prescription (PAP) from the general practitioner’s perspective – a qualitative study
Persson, G., Brorsson, A., Hansson, E. E., Troein, M., & Strandberg, E. L. (2013) · BMC Family Practice · doi:10.1186/1471-2296-14-128 · Cited by 120 · see citing works
“We conducted three focus groups to collect data, a number recommended in recently published studies [25,26].”
Supports for people with intellectual and developmental disabilities during the COVID-19 pandemic from their own perspective
Navas, P., Amor, A. M., Crespo, M., Wolowiec, Z., & Alonso, M. Á. V. (2020) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2020.103813 · Cited by 116 · see citing works
A qualitative investigation into patients’ views on visual field testing for glaucoma monitoring
Glen, F. C., Baker, H., & Crabb, D. P. (2014) · BMJ Open · doi:10.1136/bmjopen-2013-003996 · Cited by 115 · see citing works
“42 Also, some biases could have been introduced during interview and analysis due to the preconceived ideas held by the experimenters about the areas of importance, although care was taken to adhere to expected practice by following the COREQ checklist for focus group research.”
The impact of chronic low back pain is partly related to loss of social role: A qualitative study
Bailly, F., Foltz, V., Rozenberg, S., Fautrel, B., & Gossec, L. (2015) · Joint Bone Spine · doi:10.1016/j.jbspin.2015.02.019 · Cited by 98 · see citing works
“The number of focus groups and participants were close to published focus group studies [29].”
Result
Edible insects and young adults in a north-east Italian city an exploratory study
Balzan, S., Fasolato, L., Maniero, S., & Novelli, E. (2016) · British Food Journal · doi:10.1108/bfj-04-2015-0156 · Cited by 94 · see citing works
Is there really “nothing you can do”? Pathways to enhanced flood-risk preparedness
Fox‐Rogers, L., Devitt, C., O’Neill, E., Brereton, F., & Clinch, J. P. (2016) · Journal of Hydrology · doi:10.1016/j.jhydrol.2016.10.009 · Cited by 88 · see citing works
“Ideally, focus groups should 440 comprise between four and twelve participants (Kitzinger, 1995; Carlsen and Glenton, 2011).”
Background
Social resistance drives persistent transmission of Ebola virus disease in Eastern Democratic Republic of Congo: A mixed-methods study
Claude, K. M., Underschultz, J. G., & Hawkes, M. (2019) · PLoS ONE · doi:10.1371/journal.pone.0223104 · Cited by 85 · see citing works
“FGDs were continued until a point of saturation, when no new themes emerged in discussions [18].”
Background
Psychosocial determinants of fruit and vegetable consumption among students in a New Zealand university. Results of focus group interviews
Hartman, H., Wadsworth, D., Penny, S., van Assema, P., & Page, R. (2013) · Appetite · doi:10.1016/j.appet.2013.02.005 · Cited by 85 · see citing works
“Conducting six separate focus groups has been found to be adequate in reaching a point of saturation, i.e. a point after which no more new information is retrieved from the interviews (Carlsen & Glenton, 2011; Onwuegbuzie et al., 2009).”
A qualitative study of experiences with and perceptions regarding long-acting injectable antipsychotics: part II-physician perspectives.
Iyer, S., Banks, N., Roy, M.-A., Tibbo, P., Williams, R., Manchanda, R., Chue, P., & Malla, A. (2013) · The Canadian Journal of Psychiatry · doi:10.1177/088740341305805s04 · Cited by 81 · see citing works
Developing a Contemporary Patient-Reported Outcomes Measure for Spinal Cord Injury
Tulsky, D. S., Kisala, P. A., Victorson, D. E., Tate, D. G., Heinemann, A. W., Amtmann, D., & Cella, D. F. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2011.04.024 · Cited by 83 · see citing works
“Saturation in focus groups is a method to ensure that all themes are identified.(30,31) As seen in our qualitative analysis of the data, we eached saturation for new issues for the primary themes in ach domain during group 2.”
Method
Preferences for Injectable PrEP Among Young U.S. Cisgender Men and Transgender Women and Men Who Have Sex with Men
Biello, K. B., Hosek, S., Drucker, M. T., Belzer, M. E., Mimiaga, M. J., Marrow, E., Coffey-Esquivel, J., Brothers, J., & Mayer, K. H. (2017) · Archives of Sexual Behavior · doi:10.1007/s10508-017-1049-7 · Cited by 81 · see citing works
Toward an Understanding of Advance Care Planning in Children With Medical Complexity
Orkin, J., Beaune, L., Moore, C., Weiser, N., Arje, D., Rapoport, A., Netten, K., Adams, S. L., Cohen, E., & Amin, R. (2020) · PEDIATRICS · doi:10.1542/peds.2019-2241 · Cited by 78 · see citing works
Bilateral vestibulopathy: beyond imbalance and oscillopsia
Lucieer, F., van de Berg, R., van Stiphout, L., Duijn, S., Fornos, A. P., Guinand, N., Rompaey, V. V., Kingma, H., Joore, M. A., & van de Berg, R. (2020) · Journal of Neurology · doi:10.1007/s00415-020-10243-5 · Cited by 79 · see citing works
Using G oogle D rive to facilitate a blended approach to authentic learning
Rowe, M., Bozalek, V. G., & Frantz, J. M. (2013) · British Journal of Educational Technology · doi:10.1111/bjet.12063 · Cited by 76 · see citing works
Patient Perspective on Acute Intermittent Porphyria with Frequent Attacks: A Disease with Intermittent and Chronic Manifestations
Simon, A. R., Pompilus, F., Querbes, W., Wei, A., Strzok, S., Penz, C., Lyon, D., Hungate, J. R., Kim, J. B., Agarwal, S., et al. (2018) · Patient · doi:10.1007/s40271-018-0319-3 · Cited by 75 · see citing works
“While the concept of saturation and at what point it is possible to conclude that no new insights will occur are sources of debate among researchers [27], we cannot conclude that saturation of non-pain chronic symptom concepts was achieved.”
Background
Migrant Sexual Health Help-Seeking and Experiences of Stigmatization and Discrimination in Perth, Western Australia: Exploring Barriers and Enablers
Agu, J., Lobo, R. C., Crawford, G., & Chigwada, B. (2016) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph13050485 · Cited by 73 · see citing works
“Focus groups contained five to 12 participants, an adequate number to generate discussion, but not too large that it impeded the contribution of other reticent members [49].”
Background
Towards a Conceptualization of Young People’s Political Engagement: A Qualitative Focus Group Study
Pontes, A. I., Henn, M., & Griffiths, M. D. (2018) · Societies · doi:10.3390/soc8010017 · Cited by 72 · see citing works
“Additionally, it has been recommended that focus groups should range from two to five groups per category of participants [67].”
BackgroundInfluential
The heuristics that guide healthiness perception of ultra-processed foods: a qualitative exploration
Machín, L., Antúnez, L., Curutchet, M. R., & Ares, G. (2020) · Public Health Nutrition · doi:10.1017/s1368980020003158 · Cited by 72 · see citing works
“The final number of focus groups was selected based on saturation(25).”
Background
Concepts and evaluation of saturation in qualitative research
Yang, L.-P., Qi, L.-Q., & Zhang, B. (2022) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2022.00511 · Cited by 59 · see citing works
“…质性研究中的资料饱和往往是在对前期所搜集的资料进行分析的基础上所做出的判断。而一旦资收稿日期: 2021-07-01 * 江苏省社会科学基金项目(19SHB007)。通信作者: 杨莉萍, E-mail: lpy2908@163.com 料搜集达到饱和, 就意味着资料分析也同时告一段落。以往多以两种方式判定质性研究的样本量 , 或依据经验法则, 或通过资料饱和检验(Marshall et al., 2013)。基于经验法则, 已有研究总结出了不同类型质性研究适合的样本量, 但是这类文献大多缺乏对基本原理的清晰描述, 其所建议的样本量标准往往差异很大。例如, 在研究者给出的建…”
Service providers' experiences and perspectives on recovery-oriented mental health system reform
Piat, M., & Lal, S. (2012) · Psychiatric Rehabilitation Journal · doi:10.2975/35.4.2012.289.296 · Cited by 69 · see citing works
“C IH R A uthor M anuscript C IH R A uthor M anuscript C IH R A uthor M anuscript number of respondents (n=68) comparative to the average number of focus groups and sample sizes found in health studies using focus group methodology (Carlsen & Glenton, 2011; Twohig & Putnam, 2002).”
Method
Why do physicians lack engagement with smoking cessation treatment in their COPD patients? A multinational qualitative study
van Eerd, E. A. M., Risør, M. B., Spigt, M., Godycki-Ćwirko, M., Andreeva, E., Francis, N. A., Wollny, A., Melbye, H., van Schayck, O. C. P., & Kotz, D. (2017) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-017-0038-6 · Cited by 68 · see citing works
Understanding the role played by parents, culture and the school curriculum in socializing young women on sexual health issues in rural South African communities
Mpondo, F., Ruiter, R. A. C., Schaafsma, D., van den Borne, B. H. P., & Reddy, P. S. (2018) · SAHARA-J Journal of Social Aspects of HIV/AIDS · doi:10.1080/17290376.2018.1455603 · Cited by 66 · see citing works
“The research team agreed that the number of FGDs held here were sufficient as research also shows that the average number for adequate data analysis is four to five (Carlsen & Glenton, 2011).”
Method
Impact of a temporary stoma on patients' everyday lives: feelings of uncertainty while waiting for closure of the stoma
Danielsen, A. K., Soerensen, E. E., Burcharth, K., & Rosenberg, J. (2013) · Journal of Clinical Nursing · doi:10.1111/jocn.12011 · Cited by 66 · see citing works
Student perceptions of evaluation in undergraduate medical education: A qualitative study from one medical school
Schiekirka-Schwake, S., Reinhardt, D., Heim, S., Fabry, G., Pukrop, T., Anders, S., & Raupach, T. (2012) · BMC Medical Education · doi:10.1186/1472-6920-12-45 · Cited by 65 · see citing works
“Both the number of groups and the number of students included were small but within the range used in similar research [32].”
Result
A Mobile-Based App (MyChoices) to Increase Uptake of HIV Testing and Pre-Exposure Prophylaxis by Young Men Who Have Sex With Men: Protocol for a Pilot Randomized Controlled Trial
Biello, K. B., Marrow, E., Mimiaga, M. J., Sullivan, P. S., Hightow‐Weidman, L., & Mayer, K. H. (2018) · JMIR Research Protocols · doi:10.2196/10694 · Cited by 64 · see citing works
“We aim to have 5-8 participants per group in order to balance the need to have an intimate enough group to share insights, yet large enough to ensure diversity of opinions [26,27].”
Background
Children&s views on microneedle use as an alternative to blood sampling for patient monitoring
Mooney, K. M., McElnay, J. C., & Donnelly, R. F. (2013) · International Journal of Pharmacy Practice · doi:10.1111/ijpp.12081 · Cited by 62 · see citing works
“While criticisms exist regarding this approach, clear recommendations for a better method for determining focus group sample size are lacking.([51]) Each participant was given a unique identifier code outlining their gender, age and focus group number, allowing distinction of those sharing attributes.”
Method
Focus Group Research: An Intentional Strategy for Applied Group Research?
Luke, M. M., & Goodrich, K. M. (2019) · The Journal for Specialists in Group Work · doi:10.1080/01933922.2019.1603741 · Cited by 61 · see citing works
Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups
Giles, E. L., Sniehotta, F. F., McColl, E., & Adams, J. M. (2015) · BMC Public Health · doi:10.1186/s12889-015-1409-y · Cited by 62 · see citing works
“This number of individuals per group is large enough to generate discussion, but not too large that it impedes reticent group members from contributing [56].”
Opportunities and barriers that females face for study and employment in sport
Forsyth, J. J., Jones, J., Duval, L., & Bambridge, A. (2019) · Journal of Hospitality Leisure Sport & Tourism Education · doi:10.1016/j.jhlste.2019.01.005 · Cited by 62 · see citing works
Point of data saturation was assessed using resampling methods in a survey with open-ended questions.
Tran, V.-T., Porcher, R., Falissard, B., & Ravaud, P. (2016) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2016.07.014 · Cited by 108 · see citing works
“Let's talk about sleep”: a qualitative examination of levers for promoting healthy sleep among sleep-deprived vulnerable adolescents
Quante, M., Khandpur, N., Kontos, E. Z., Bakker, J. P., Owens, J. A., & Redline, S. S. (2018) · Sleep Medicine · doi:10.1016/j.sleep.2018.10.044 · Cited by 59 · see citing works
“Participants’ recruitment A sample size of 25–30 was deemed to be sufficient for data saturation for this study [29,30].”
Method
A Qualitative Study of Experiences with and Perceptions regarding Long-Acting Injectable Antipsychotics: Part I—Patient Perspectives
Iyer, S. N., Banks, N., Roy, M., Tibbo, P. G., Williams, R., Manchanda, R., Chue, P. S., & MALLA, A. K. (2013) · The Canadian Journal of Psychiatry · doi:10.1177/088740341305805s03 · Cited by 58 · see citing works
Development of core outcome sets for effectiveness trials of interventions to prevent and/or treat delirium (Del-COrS): study protocol
Rose, L., Agar, M. R., Burry, L. D., Campbell, N. L., Clarke, M. J., Lee, J. S., Siddiqi, N., & Page, V. J. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016371 · Cited by 55 · see citing works
Crossroad decisions in deep endometriosis treatment options: a qualitative study among patients
Metzemaekers, J., Slotboom, S., Sampat, J., Vermolen, P., Smeets, M. J. G. H., Marle, M. E. V. D. A., Maas, J. W. M., Bakker, E. C., Nijkamp, M. D., Both, S., et al. (2020) · Fertility and Sterility · doi:10.1016/j.fertnstert.2020.06.041 · Cited by 56 · see citing works
“Higher vocational education 6 (38) 3 1 2 Postgraduate 7 (44) 2 3 2 Nationality Dutch 16 (100) 7 4 5 Employment Full time 7 (44) 3 2 2 Part time 8 (50) 4 1 3 Unemployed 1 (6) 0 1 0 Marital status Married, committed relationship 11 (69) 5 3 3”
Background
Latino Fathers’ Perspectives and Parenting Practices Regarding Eating, Physical Activity, and Screen Time Behaviors of Early Adolescent Children: Focus Group Findings
Zhang, Y., Hurtado, G. A., Flores, R., Meraz, A. A., & Reicks, M. M. (2018) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2018.03.025 · Cited by 55 · see citing works
Beliefs about people with albinism in Uganda: A qualitative study using the Common-Sense Model
Bradbury‐Jones, C., Ogik, P., Betts, J., Taylor, J. S., & Lund, P. M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0205774 · Cited by 55 · see citing works
“Sample size in qualitative research is contentious, with much debate about the point at which data saturation is likely to occur [45, 46].”
Background
Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak
Emam, K. E., Mercer, J. G., Moreau, K. A., Grava-Gubins, I., Buckeridge, D. L., & Jonker, E. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-454 · Cited by 54 · see citing works
“Furthermore, the size of our focus groups and their number is consistent with the considerable precedent in the health sciences research literature [79] and recommendations in the qualitative research literature [76-78].”
BackgroundResult
African American perspectives on racial disparities in child removals
Kokaliari, E. D., Roy, A. W., & Taylor, J. (2019) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2018.12.023 · Cited by 54 · see citing works
Qualitative study of social and healthcare educators’ perceptions of their competence in education
Mikkonen, K., Koskinen, M., Koskinen, C., Koivula, M., Koskimäki, M., Lähteenmäki, M., Mäki‐Hakola, H., Wallin, O., Sjögren, T., Salminen, L., et al. (2019) · Health & Social Care in the Community · doi:10.1111/hsc.12827 · Cited by 53 · see citing works
What factors influence community wound care in the UK? A focus group study using the Theoretical Domains Framework
Gray, T. A., Wilson, P. M., Dumville, J. C., & Cullum, N. A. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-024859 · Cited by 52 · see citing works
The views and attitudes of health professionals providing antenatal care to women with a high BMI: A qualitative research study
Knight-Agarwal, C. R., Kaur, M., Williams, L. T., Davey, R., & Davis, D. L. (2013) · Women and Birth · doi:10.1016/j.wombi.2013.11.002 · Cited by 51 · see citing works
Online learning resources in anatomy: What do students think?
Johnson, I., Palmer, E., Burton, J., & Brockhouse, M. (2013) · Clinical Anatomy · doi:10.1002/ca.22219 · Cited by 51 · see citing works
“This sample size is at the lower end of the number considered suitable for a focus group (Tang, 1985; Carlsen and Glenton, 2011), but results are included here as they high-”
Background
“So how do we balance all of these needs?”: how the concept of AI technology impacts digital archival expertise
Cushing, A. L., & Osti, G. (2022) · Journal of Documentation · doi:10.1108/jd-08-2022-0170 · Cited by 50 · see citing works
Improving the interface between informal carers and formal health and social services: A qualitative study
McPherson, K. M., Kayes, N. M., Moloczij, N., & Cummins, C. (2013) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2013.07.006 · Cited by 50 · see citing works
Somali women’s view of physical activity – a focus group study
Persson, G., Mahmud, A. J., Hansson, E. E., & Strandberg, E. L. (2014) · BMC Women s Health · doi:10.1186/1472-6874-14-129 · Cited by 50 · see citing works
“We conducted four focus groups to collect data, a number recommended in published studies [25,26].”
‘Even if you don't pay attention to it, you know it's there’: A qualitative exploration of adolescents' experiences with digital food marketing
Ares, G., Antúnez, L., de León, C., Alcaire, F., Vidal, L., Natero, V., & Otterbring, T. (2022) · Appetite · doi:10.1016/j.appet.2022.106128 · Cited by 48 · see citing works
Engaging Field-Based Professionals in a Qualitative Assessment of Barriers and Positive Contributors to Breastfeeding Using the Social Ecological Model
Dunn, R. L., Kalich, K. A., Henning, M., & Fedrizzi, R. (2014) · Maternal and Child Health Journal · doi:10.1007/s10995-014-1488-x · Cited by 48 · see citing works
“was collected from six focus groups, which falls within Carlen and Glenton’s [39] review of focus group sample”
Method
A clinical reasoning model focused on clients’ behaviour change with reference to physiotherapists: its multiphase development and validation
Elvén, M., Hochwälder, J., Dean, E., & Söderlund, A. (2014) · Physiotherapy Theory and Practice · doi:10.3109/09593985.2014.994250 · Cited by 48 · see citing works
“Fewer groups are common when combining focus groups with other data collection methods (Carlsen and Glenton, 2011) and when the research question is limited (Kitzinger, 1995; Krueger”
Background
Shared decision-making with involuntary hospital patients: a qualitative study of barriers and facilitators
Giacco, D., Mavromara, L., Gamblen, J., Conneely, M., & Priebe, S. (2018) · BJPsych Open · doi:10.1192/bjo.2018.6 · Cited by 48 · see citing works
Advancing the science of literature reviewing in social research: the focused mapping review and synthesis
Bradbury‐Jones, C., Breckenridge, J. P., Clark, M., Herber, O. R., Jones, C., & Taylor, J. S. (2019) · International Journal of Social Research Methodology · doi:10.1080/13645579.2019.1576328 · Cited by 48 · see citing works
Bringing Transparency to Medicine: Exploring Physicians' Views and Experiences of the Sunshine Act
Chimonas, S. C., DeVito, N., & Rothman, D. J. (2017) · The American Journal of Bioethics · doi:10.1080/15265161.2017.1313334 · Cited by 47 · see citing works
Implementing commercial autonomous road haulage in freight operations: An industry perspective
Sindi, S., & Woodman, R. (2021) · Transportation Research Part A Policy and Practice · doi:10.1016/j.tra.2021.08.003 · Cited by 46 · see citing works
Routine failures in the process for blood testing and the communication of results to patients in primary care in the UK: a qualitative exploration of patient and provider perspectives
Litchfield, I. J., Bentham, L., Hill, A., McManus, R. J., Lilford, R. J., & Greenfield, S. (2015) · BMJ Quality & Safety · doi:10.1136/bmjqs-2014-003690 · Cited by 46 · see citing works
Prevention of COVID-19 in Internally Displaced Persons Camps in War-Torn North Kivu, Democratic Republic of the Congo: A Mixed-Methods Study
Claude, K. M., Sahika, S. M., Alexis, K. K., & Hawkes, M. (2020) · Global Health Science and Practice · doi:10.9745/ghsp-d-20-00272 · Cited by 46 · see citing works
“FGDs lasted 30–45 minutes and included 3 or 4 participants in each group.(24) The FGD topic guide was adaptive, allowing us to confirm findings and explore emerging themes from each FGD session.”
Background
Microaggression and the adult stuttering experience
Coalson, G. A., Crawford, A., Treleaven, S., Byrd, C. T., Davis, L., Dang, L., Edgerly, J., & Turk, A. (2021) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2021.106180 · Cited by 49 · see citing works
Informed health choices intervention to teach primary school children in low-income countries to assess claims about treatment effects: process evaluation
Nsangi, A., Semakula, D., Glenton, C., Lewin, S. A., Oxman, A. D., Oxman, M., Rosenbaum, S., Dahlgren, A., Nyirazinyoye, L., Kaseje, M., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-030787 · Cited by 45 · see citing works
“The amount of data we collected was guided by considerations of the variation in issues emerging from the data collection and the extent to which we are able to explain these variations; our time and resource constraints; and the need to avoid large volumes of data that cannot be easily managed or analysed as emphasis…”
MethodSelf-citation
Teaching critical thinking about health using digital technology in lower secondary schools in Rwanda: A qualitative context analysis
Mugisha, M., Uwitonze, A. M., Chesire, F., Ssenyonga, R., Oxman, M., Nsangi, A., Semakula, D., Kaseje, M., Lewin, S. A., Sewankambo, N. K., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0248773 · Cited by 45 · see citing works
“We considered our time and resource constraints and the need to avoid large volumes of data that cannot be easily managed or analysed as highlighted in the literature [35, 36].”
Background
Patient-Centered Outcomes Research
(2017) · doi:10.25302/67.2017.1 · Cited by 44 · see citing works
General practitioners’ strategies to identify alcohol problems: A focus group study
Lid, T. G., & Malterud, K. (2012) · Scandinavian Journal of Primary Health Care · doi:10.3109/02813432.2012.679229 · Cited by 44 · see citing works
Intercultural Interactions Outside the Classroom: Narratives on a US Campus
Lehto, X. Y., Cai, L. A., Fu, X., & Yi, C. (2014) · Journal of college student development · doi:10.1353/csd.2014.0083 · Cited by 44 · see citing works
“…data collection methods because of its advantages: (a) it is suitable for eliciting participants’ subjective interpretation of their experience (Carlsen & Glenton, 2011), (b) the interactive atmosphere is conducive to the exchange of ideas and perspectives with other individuals who had…”
Method
Touching the void
Kerrebroeck, H. V., Willems, K., & Brengman, M. (2017) · International Journal of Retail & Distribution Management · doi:10.1108/ijrdm-09-2016-0156 · Cited by 44 · see citing works
“Focus Retail & Distribution Management, 45(7/8), 892-909. groups are informal discussions between participants on an a priori determined topic (Beck et al., 1986) that allow for exploring subjective experiences, attitudes and opinions (Carlsen and Glenton, 2011).”
Background
Patient perspectives of vigorous intensity aerobic interval exercise prehabilitation prior to radical cystectomy: a qualitative focus group study
Banerjee, S., Semper, K., Skarparis, K., Naisby, J., Lewis, L. S., Cucato, G. G., Mills, R., Rochester, M. A., & Saxton, J. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2019.1651907 · Cited by 44 · see citing works
Mid-Adolescents’ Social Media Use: Supporting and Suppressing Autonomy
West, M., Rice, S., & Vella‐Brodrick, D. (2023) · Journal of Adolescent Research · doi:10.1177/07435584231168402 · Cited by 49 · see citing works
“This is a recommended size for focus groups as it provokes diverse insights, encourages contribution from each participant, whilst avoiding fragmentation, which can occur in larger groups (Carlsen & Glenton, 2011; Krueger & Casey, 2000).”
The meanings of cultural competence in mental health: an exploratory focus group study with patients, clinicians, and administrators
Aggarwal, N. K., Cedeño, K., Guarnaccia, P. J., Kleinman, A., & Lewis‐Fernández, R. (2016) · SpringerPlus · doi:10.1186/s40064-016-2037-4 · Cited by 42 · see citing works
“There is no consensus among focus group methodologists on the numbers of participants needed to achieve data saturation among methodologists (Carlsen and Glenton 2011).”
Background
Test result communication in primary care: clinical and office staff perspectives
Litchfield, I. J., Bentham, L., Lilford, R. J., & Greenfield, S. (2014) · Family Practice · doi:10.1093/fampra/cmu041 · Cited by 42 · see citing works
“The number of focus groups was limited to four, this is however within the range reported in existing literature (17) and similar experiences were repeatedly described across the four groups, suggesting that we were approaching theoretical saturation (18).”
Result
Understanding disaster resilience in communities affected by recurrent drought in Lesotho and Swaziland—A qualitative study
Kamara, J. K., Agho, K., & Renzaho, A. M. N. (2019) · PLoS ONE · doi:10.1371/journal.pone.0212994 · Cited by 42 · see citing works
Patriarchal norms, practices and changing gendered power relations - narratives of Ultra-Orthodox women in Israel
Kook, R. B., & Harel‐Shalev, A. (2020) · Gender Place & Culture · doi:10.1080/0966369x.2020.1762546 · Cited by 42 · see citing works
Patients’ and parents’ perspective on the implementation of Patient Reported Outcome Measures in pediatric clinical practice using the KLIK PROM portal
van Muilekom, M. M., Teela, L., van Oers, H. A., van Goudoever, J. B., Grootenhuis, M. A., & Haverman, L. (2021) · Quality of Life Research · doi:10.1007/s11136-021-02950-x · Cited by 43 · see citing works
“Focus groups with patients and parents were held separately and for each focus group inclusion of three to six participants was pursued [32].”
Background
Determining Sample Size in Qualitative Research: Data Saturation
Yağar, F. (2023) · Aksaray Üniversitesi Sosyal Bilimler Enstitüsü Dergisi · doi:10.38122/ased.1030365 · Cited by 39 · see citing works
The role of ICU nurses in the spiritual aspects of end‐of‐life care in the ICU: an explorative study
Noome, M., Kolmer, D. M. B. G., van Leeuwen, E., Dijkstra, B. M., & Vloet, L. C. M. (2016) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.12371 · Cited by 40 · see citing works
Finding the sweet spot: Developing, implementing and evaluating a burn out and compassion fatigue intervention for third year medical trainees
Tucker, T., Bouvette, M., Daly, S., & Grassau, P. A. (2017) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2017.07.006 · Cited by 40 · see citing works
Theorizing in Information Systems Research Using Focus Groups
Bélanger, F. (2012) · AJIS. Australasian journal of information systems/AJIS. Australian journal of information systems/Australian journal of information systems · doi:10.3127/ajis.v17i2.695 · Cited by 40 · see citing works
“…been accomplished in terms of knowledge elicitation in these studies since the goal in focus group research is usually saturation, where repeated focus group sessions should result in similar findings to a point where no new insight is gained from additional focus groups (Carlsen and Glenton 2011).”
BackgroundResult
Patient perspectives on test result communication in primary care: a qualitative study
Litchfield, I. J., Bentham, L., Lilford, R. J., McManus, R. J., & Greenfield, S. (2015) · British Journal of General Practice · doi:10.3399/bjgp15x683929 · Cited by 39 · see citing works
Gruppendiskussionen in der Versorgungsforschung – Teil 1: Einführung und Überlegungen zur Methodenwahl und Planung
Pohontsch, N. J., Müller, V., Brandner, S., Karlheim, C., Jünger, S., Klindtworth, K., Stamer, M., Höfling-Engels, N., Kleineke, V., Brandt, B., et al. (2017) · Das Gesundheitswesen · doi:10.1055/s-0043-104379 · Cited by 39 · see citing works
“Wiesbaden: VS Verlag für Sozialwissenschaften; 2011 [21] Glaser B, Strauss A. Grounded Theory: Strategien qualitativer Forschung.”
BackgroundInfluential
Self-management and adherence in childhood-onset systemic lupus erythematosus: what are we missing?
Harry, O., Crosby, L. E., Smith, A. W., Favier, L., Aljaberi, N., Ting, T. V., Huggins, J., & Modi, A. C. (2019) · Lupus · doi:10.1177/0961203319839478 · Cited by 39 · see citing works
Exchanging focus groups for individual interviews when collecting qualitative data
Baillie, L. (2019) · Nurse Researcher · doi:10.7748/nr.2019.e1633 · Cited by 42 · see citing works
Can Sharing Economy Platforms Increase Social Equity for Vulnerable Populations in Disaster Response and Relief? A Case Study of the 2017 and 2018 California Wildfires
Wong, S. D., Broader, J. C., & Shaheen, S. (2020) · Transportation Research Interdisciplinary Perspectives · doi:10.1016/j.trip.2020.100131 · Cited by 39 · see citing works
“While we achieved a focus group size (between 4 and 12 participants) that is consistent with literature (Carlsen and Glenton, 2011), we likely did not reach saturation of themes and topics for each specific demographic.”
Background
General Practitioners Views of Implementing a Stratified Treatment Approach for Low Back Pain in Germany: A Qualitative Study
Karstens, S., Joos, S., Hill, J. C., Krug, K., Szécsényi, J., & Steinhäuser, J. (2015) · PLoS ONE · doi:10.1371/journal.pone.0136119 · Cited by 37 · see citing works
“For qualitative group approaches, Carlsen and Glenton identified recommendations ranging from two to five groups adding that the necessary number depends on the research question and the composition of the groups [39].”
Method
‘Language is the source of misunderstandings’–impact of terminology on public perceptions of health promotion messages
Buckton, C. H., Lean, M. E. J., & Combet, E. (2015) · BMC Public Health · doi:10.1186/s12889-015-1884-1 · Cited by 37 · see citing works
“There was no predefined limit to the number of focus groups planned, with the intention of reaching theoretical saturation [32].”
Background
Design Considerations for Supporting Mindfulness in Virtual Reality
Kelly, R., Seabrook, E., Foley, F., Thomas, N., Nedeljkovic, M., & Wadley, G. (2022) · Frontiers in Virtual Reality · doi:10.3389/frvir.2021.672556 · Cited by 36 · see citing works
“Guidelines suggest that the sample size for a focus group should balance the research aims against project constraints (Tang and Davis, 1995) and that three focus groups is suf ﬁ cient to acquire detailed feedback (Gutteling et al., 2008; Carlsen and Glenton, 2011).”
Background
Use and disuse of malaria bed nets in an internally displaced persons camp in the Democratic Republic of the Congo: A mixed-methods study
Brooks, H. M., Paul, M. K. J., Claude, K. M., Mocanu, V., & Hawkes, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0185290 · Cited by 36 · see citing works
“FGDs were continued until a point of saturation, when no new themes emerged in discussions [17].”
Unequal access: Applying Bourdieu's practice theory to illuminate the challenges of ICT use among senior citizens in Singapore
Tan, K. S. Y., & Chan, C. M. L. (2018) · Journal of Aging Studies · doi:10.1016/j.jaging.2018.04.002 · Cited by 36 · see citing works
Implementing an arts-based intervention for patients with end-stage kidney disease whilst receiving haemodialysis: a feasibility study protocol
Carswell, C., Reid, J., WALSH, I. K., McAneney, H., & Noble, H. R. (2019) · Pilot and Feasibility Studies · doi:10.1186/s40814-018-0389-y · Cited by 37 · see citing works
Patients as Collaborators: Using Focus Groups and Feedback Sessions to Develop an Interactive, Web-Based Self-Management Intervention for Chronic Pain
Moore, S. K., Guarino, H., Acosta, M. C., Aronson, I. D., Marsch, L. A., Rosenblum, A., Grabinski, M. J., & Turk, D. C. (2013) · Pain Medicine · doi:10.1111/pme.12200 · Cited by 35 · see citing works
A mobile hospice nurse teaching team’s experience: training care workers in spiritual and existential care for the dying - a qualitative study
Tornøe, K. A., Danbolt, L. J., Kvigne, K. J., & Sørlie, V. M. (2015) · BMC Palliative Care · doi:10.1186/s12904-015-0042-y · Cited by 35 · see citing works
“Carlsen B, Glenton C.”
Background
The Patient Experience with DSM-5-Defined Binge Eating Disorder: Characteristics, Barriers to Treatment, and Implications for Primary Care Physicians
Herman, B. K., Safikhani, S., Hengerer, D., Atkins, N., Kim, A. J., Cassidy, D., Babcock, T., Agus, S., & Lenderking, W. R. (2014) · Postgraduate Medicine · doi:10.3810/pgm.2014.09.2800 · Cited by 35 · see citing works

How many focus groups are enough? Building an evidence base for nonprobability sample sizes
Guest, G., Namey, E., & McKenna, K. (2017) · Field Methods · doi:10.1177/1525822x16639015 · Cited by 1,752 · see citing works
What Influences Saturation? Estimating Sample Sizes in Focus Group Research
Hennink, M. M., Kaiser, B. N., & Weber, M. B. (2019) · Qualitative Health Research · doi:10.1177/1049732318821692 · Cited by 1,227 · see citing works
A review of 5 existing guidelines for planning focus groups in GP research.
Kc, T., Davis, A., Sullivan, S., & Fisher, J. (1995) · PubMed · Cited by 16 · see citing works
Durchführung und Berichterstattung von Fokusgruppen in der Gesundheits- und Pflegewissenschaft: ein Scoping Review
Hoffmann, L., Seegers, F., & Stephan, A. (2022) · Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen · doi:10.1016/j.zefq.2021.12.004 · Cited by 6 · see citing works
Number of groups and group size
Hennink, M. M. (2007) · Cambridge University Press eBooks · doi:10.1017/cbo9780511619458.008 · Cited by 7 · see citing works

Authors: Carlsen, B., & Glenton, C.
Affiliations: SINTEF (NO)
Corresponding author: Carlsen, Benedicte
ORCID: Glenton, Claire
Venue: BMC Medical Research Methodology
Publisher: Springer Science and Business Media LLC
Published: 2011-03-11
Volume: 11
Issue: 1
Pages: 26-26
ISSN: 1471-2288 (ISSN-L)
DOI: 10.1186/1471-2288-11-26
PMC: PMC3061958
OpenAlex: W2013335946
Cited by: 670
References: 72
Citations by year: 2026: 29 · 2025: 47 · 2024: 53 · 2023: 53 · 2022: 68 · 2021: 52 · 2020: 66 · 2019: 56 · 2018: 50 · 2017: 52 · 2016: 40 · 2015: 29 · 2014: 24 · 2013: 30 · 2012: 16
FWCI: 80.06
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/2.0 (tdm)
Locations: BMC Medical Research Methodology (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Bergen Open Research Archive (BORA) (University of Bergen) (submittedVersion, cc-by)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
Funders: Universitetet i Bergen
Topics: Social Sciences › Sociology and Political Science › Focus Groups and Qualitative Methods
Social Sciences › Education › Qualitative Research Methods and Applications
Social Sciences › Sociology and Political Science › Delphi Technique in Research
Keywords: focus groups, sample size reporting, data saturation, grounded theory, qualitative research methodology, reporting guidelines, health journals, methodological quality
MeSH terms: Humans, Research Design, Focus Groups, Sample Size, PubMed

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