Focus group moderator's guide

OMB Control No.: 0970-xxxx

Expiration Date: xx/xx/20xx

Length of time: 120 minutes

INSTRUMENT 4: FOCUS GROUP MODERATOR’S GUIDE

Introduction and Overview of Purpose (10 minutes, including ground rules)

NOTE: Before reading the text below, the moderator will distribute two copies of a consent form (Attachment D). The consent form will include the OMB control number and expiration date. The interviewee will sign and return one copy to the moderator, and can keep a copy for his or her own records. The moderator will also distribute the Self-Administered Questionnaire (INSTRUMENT 5) which also includes the OMB information.

Hello and welcome to our focus group. I’d like to begin by thanking each of you for taking time out of your day to be here. We really appreciate it.

My name is [NAME], and my colleague here is [NAME]. We both work at the Urban Institute, an independent policy research firm in Washington, D.C. We have been engaged by the Health Resources and Services Administration (HRSA) and the Administration for Children and Families Office of Planning, Research, and Evaluation (OPRE) to conduct a study that will help us better understand who makes up the home visiting workforce; hiring, training, and retention of home visiting staff; and the career aspirations and opportunities for home visitors. This focus group is a critical part of that study because it will allow us to talk directly with all of you about your experiences working in this field. (We have also conducted interviews with agency directors and supervisors to get their perspectives; and we have fielded a national survey of home visitors which some of you may have received.)

Each of you has been invited here because you are currently working as a home visitor at [AGENCY]. Over the next 90 minutes or so, we will talk with you about your experiences working for [AGENCY], what initially drew you to apply for work here, what you like about your job, what you don’t like about it, and about your ideas for how to make [AGENCY] a better place to work. We will also talk with you about your career aspirations, and the extent to which you see working as a home visitor as a “stepping stone” to other kinds of jobs. Together, these focus groups will allow us to better understand the strengths and weaknesses of [AGENCY] as a place of employment and how it might be improved. The goal of this work is to better understand who makes up the home visiting workforce and how to make home visiting a more positive and supportive profession, so that talented home visitors like all of you will be continue to enjoy their jobs. So let’s get started!

Ground Rules

Before we go any further, let me go over a few “ground rules” for today’s discussion.

By a show of hands, have any of you ever been in a “focus group” before? Just so you know, a “focus group” is an informal discussion, with a facilitator (me) who will guide the discussion through a series of questions about a special topic (in this case—what it’s like to work as a home visitor). I’d like us to just imagine that we’re sitting around a kitchen table, relaxed and casually chatting with some new friends. Sound good?

Public reporting burden for this collection of information is estimated to average 120 minutes per response, including the time for introductions, consenting participants, addressing questions, distributing and collecting a self-administered questionnaire, and participation in the focus group discussion. This information collection is voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Urban Institute (Attn: Heather Sandstrom), 2100 M Street, NW, Washington, D.C. 20037).

Now, for the ground rules. First, there are no “right” or “wrong” answers to the questions I’ll be asking you today. Please feel free to share your views, even if they are different from what others have said. Please tell us your thoughts and opinions, whether they are positive or negative.

Second, your participation in this group is entirely voluntary. You are free to leave at any time.

Third, our research team will keep the information you share with us private to the extent permitted by law. This means that when we write reports about what we hear during focus groups, all responses will be “anonymous,” nobody’s name will appear, and nothing you say or write will be connected to you. Please be as open as possible in sharing your thoughts with us.

I cannot guarantee that other participants of this focus group will protect your privacy like the research team will. So please keep that in mind when deciding whether to respond to a particular question and when deciding what you want to share. But I want to encourage you all to respect one another by keeping the information shared inside this group private. Please do not talk to others outside of this group about what you heard here today.

Fourth, I would like to encourage everyone to participate, because these groups work best when everyone contributes. You don’t have to answer each and every question. You don’t have to raise your hand to speak. But if some of you are shy or don’t get a chance to speak, I may call on you to give you a turn, because I’d like to know what everyone here thinks.

Fifth, it is important that only one person speaks at a time. We want to be respectful of everyone and give everyone their chance to speak. Also, we would like to record today’s discussion, so taking turns is important — if two people talk at once, we won’t be able to understand the recording.

Now, about the recording. We’re recording the session because we don’t want to miss anything. Even though we’ll be taking notes as fast as we can, I know we won’t be able to write everything down! So, the recording is simply a back-up tool to ensure that we get all of your comments. Don’t worry, no one will be listening to the recordings besides the research team; your privacy will be protected. If you are not okay with being recorded, please let us know now so that you can be excused from the group.

I have a lot that I want to talk about with you today. So I may be forced, from time to time, to interrupt the discussion and move us along to another topic. But, don’t let me cut you off! If there’s something important you want to say, let me know before we change the subject.

Just a word about cell phones and restrooms — please either turn off your cell phone or put it in “vibrate/silent” mode. If you need to use the restroom, please do so at any time; you do not need to ask permission. The restrooms are located _________.

We will be on a first name basis today, and we’ve placed name cards on the table in front of you to help us remember each other’s names.

Finally, you’ve probably noticed the consent form on the table in front of you. It covers the same information we’ve just discussed — privacy, risks and benefits of being part of a focus group, and the fact that this is voluntary. We need a copy of this form with your signature before you leave today; the second copy is for you to keep for your records, if you wish.

There is also a short questionnaire in front of you that asks for some basic information about you, like age and relationship status. We’d appreciate it if you could fill this out before leaving. This will be anonymous, so please do not put your name on this questionnaire.

Do you have any questions? Okay, let’s begin.

Note: Start audio recording after completion of introductions.

A. Background (15 mins)

1. Let’s start by going around the table and introducing ourselves.

I’d like each of you to tell us your first name. Then, to break the ice, why don’t you share with us a little bit about yourself – how long have you been working as an early childhood home visitor (at this Agency or with another program)? And then share a quick story about the best thing that happened to you during a visit this week.

B. Recruitment – How you came to be employed by [AGENCY] (20 mins)

Now, to I’d like to learn a little more about how you came to be a home visitor at [AGENCY].

2. How did you learn about job openings at [AGENCY]?

[PROBES:]

• Advertisements/marketing materials?

• Direct recruitment/job fair?

• Referral from current or former employee?

• Working here in a different capacity?

• Seek out [AGENCY] on your own?

3. What kind of jobs were you looking for when you found this job?

[PROBES:]

• Specifically home visiting?

• Other types of work (which?)?

4. What was it that attracted you to [AGENCY]? In other words, what factors or characteristics of [AGENCY] were attractive to you and made you want to apply here?

[PROBES:]

• Goals of the agency to help [children/families/target population]? Salary?

• Reputation or brand? (home visiting specific or otherwise)

• Location?

5. Did you have any concerns about doing home visiting work? Or working at [AGENCY]?

[PROBES:]

• Were your concerns specifically about the home visiting position?

• The nature of the work?

• The agency?

• Something else?

6. What was the application process like?

[PROBES:]

• Easy? How so?

• Onerous/Challenging? Many steps? Tests, interviews, etc?

• Clear?

• Complicated?

7. What were some of the job requirements?

[PROBES:]

• Education

• Experience

• Flexibility

• Language proficiency

• Others

8. What other skills or requirements would you recommend supervisory staff consider when hiring new home visitors?

9. To what extent did you personally feel like you had the right set of skills to do this job?

[PROBES:]

• How well did your educational or employment experience make you a good fit for this position?

• What gaps in your skill set (if any) did you feel there were?

• What other characteristics enable you to do the job well?

10. Did you have other job offers when you accepted the position at [AGENCY], and if so, what kinds of jobs were they? Which factors held the most sway in helping you choose to take this job over other offers?

Next I have a few questions for you about what happened after you were hired.

11. When you first started your job at [AGENCY], what was done to prepare you for working in clients’ homes? For example, were you offered any “on-the-job” training? [Please describe.]

    • Were these trainings required, or optional?

    • What topics did the training cover?

    • Was job shadowing a component of your training?

    • Were the trainings specific to the home visiting model employed at this agency? Or more general?

12. Who conducted the trainings (e.g. [AGENCY] staff, model-specific experts, or outside experts)?

13. What did you think of these trainings?

[PROBES]:

• Were they on the right topics?

• Were they well executed? (e.g., high quality instructors, clear information, etc.?)

14. After the trainings, how prepared did you feel to go out in the field and provide services to families?

    • Was there other training you would have liked to receive?

15. What ongoing training opportunities are available to you now that you work here?

16. Have you pursued any other resources (outside of those offered at [AGENCY]) that enable you to be an effective home visitor? If so, can you describe them to me and how you found them?

C. Retention – What is it like to work at [AGENCY]? (25 mins)

Let’s now turn to your experiences at [AGENCY], since you started working here. During this part of our chat, I will have questions that relate to a variety of factors that may influence working conditions here at [AGENCY]. These include things like: your clients; the overall work environment; supervision and feedback; compensation; benefits; work schedules; workplace climate, culture, and relationships. The goal of this part of the discussion will be to talk about what factors make you happy to be working at [AGENCY], and what factors are more negative, that sometimes make you think you may want to work somewhere else.

But before we get into the specifics, let me ask you a couple of very broad questions:

17. Overall, how satisfied would you say you are with your job as a home visitor?

By a show of hands, how many are:

• Very satisfied?

• Satisfied?

• Dissatisfied?

• Very dissatisfied?

18. Overall, how satisfied would you say you are working at [AGENCY] specifically?

By a show of hands, how many are:

• Very satisfied?

• Satisfied?

• Dissatisfied?

• Very dissatisfied?

19. What is your favorite part of the job?

[PROBES:]

• Very interesting/stimulating cases

• Intensely challenging/stressful cases

• Too big a caseload, feeling challenged to do a good job with all

• Too small a caseload, lack of engagement

• Too few resources for handling cases

20. What is your least favorite part of the job?

    • What do you find frustrating?

Okay, that helps us set a baseline. Let’s now take a deeper dive and talk about specific components of your job and how you feel about them. Let’s begin with…

21. How satisfied are you with the kind of assistance you are able to provide to families as a home visitor?

22. To what extent do you feel burnout or “compassion fatigue” from your work?

• How does [AGENCY] provide support to help you cope with stress and burnout?

23. Has there ever been a time that you’ve felt “over your head”? How did you handle it?

24. Relationships, Teamwork, and Culture: How satisfied are you with your relationships with co-worker, the role you play on your “team,” and the level of autonomy you have? What are some examples?

[PROBES:]

• To what extent do you have positive relationships with fellow home visitors?

• To what extent do you have good relationships with your supervisors?

• To what extent do you receive the guidance needed from supervisors?

• To what extent do you receive constructive feedback and praise when deserved?

• Overall, how strong or positive is the culture and morale of your team?

• How much autonomy do you feel like you have in your position?

25. To what extent do you feel like you are “valued” as a home visitor?

By whom? (Families/supervisors/community leaders?)

26. Work Schedules: Can you tell us about your work schedule? How many of you are part-time (35 hours/week) vs. full time home visitors? Have any of you shifted from part-time to full-time or vice versa? Why?

27. How satisfied are you with your work schedule?

[PROBES:]

• How predictable are your hours and schedules?

• Do you have the right balance of day, night, and weekend shifts?

• In the field vs. administrative work?

• Is there sufficient flexibility in scheduling, so that you can adjust your shifts to meet your personal needs?

• Are there enough staff on your team to share the workload?

• Are you given adequate time to complete your tasks? In the field and administrative?

• Are you frequently asked to work over time?

28. Work Environment: How satisfied are you with overall work environment(s), both in the office and out in the community?

[PROBES:]

• Do you feel safe doing the work you do?

• Do you feel that you are ever exposed to violence or injury?

• Mental/psychological harm?

29. Compensation: How satisfied are you with the monetary compensation you receive for your job?

[PROBES:]

• Overall, do you feel like [AGENCY’s] salaries are competitive with other home visiting programs?

• How about compared to other jobs you considered before you took this one?

• Do you receive fair or adequate pay raises each year?

• Do you feel like you receive adequate compensation for overtime hours worked?

30. Benefits: What, if any, benefits do you receive? How satisfied are you with the benefit package you receive?

• What benefits are most important to you?

• What benefits are least important to you?

• What benefits are missing (i.e., that you’d like to see that are not part of your current package)?

[PROBES:]

• Health insurance

• Sick leave

• Family leave

• Paid time off/vacation

• Retirement

• Mileage reimbursement

• Others?

D. Career Growth and Advancement (15 minutes)

Let’s take a few minutes to discuss your long-term career goals. Think about the job you might hope to have two, five or ten years from now, and the extent to which your current home visiting position relates to that job.

31. What are your long-term career goals? In other words, are you hoping to be a home visitor for a long time, or do you have something else in mind that you’d like to do eventually?

[PROBES:]

• Home visiting supervisor

• Nurse

• Social Worker

• Childcare worker

• Other

32. How do you expect this job might help you to achieve your ultimate career goals? Please Describe.

• Good experience/training?

• Relevant community contacts

• Important stepping stone?

• References?

• Others?

33. How satisfied are you that [AGENCY] offers you opportunities to advance your career, either as a home visitor, or as something else?

[PROBES:]

• Do you have opportunities to continue your education and training as home visitor?

• Do you have time to take advantage of these opportunities?

• Are there any formal mentorship programs at [AGENCY]? (If not, how helpful would a mentoring program be? And what would you want that to look like?)

• Are there opportunities for promotion? Or are there plateaus beyond which it can be challenging to advance?

34. Are there ways in which you are concerned that this job is not helping you to achieve your ultimate career goals? In what ways?

35. Are there any other issues or concerns related to your job that we haven’t discussed?

E. Summary and Wrap up (15 mins)

You’ve shared a great deal of information about what you like about your job, and what you don’t like. Let’s now try to prioritize among these many issues, and see if we can identify the most important challenges for home visitors at [AGENCY].

36. Of the things that you feel are negative, which ones concern you most?

    • Which are the ones that really undercut your satisfaction and/or make it harder to do your job, or might cause you to leave [AGENCY]?

(Ask for show of hands as each is listed.)

• Challenges surrounding your work with clients?

• Relationships, teamwork and culture?

• Work schedules?

• Workplace environment?

• Compensation

• Benefits?

• Career growth and advancement?

• Anything else?

37. Of all the topics we just discussed, and all the issues with your job, what is the part that you value the most about this job?

38. If you think about what we’ve discussed today, and of all the things that being a home visitor requires of you, what do you think are the most important traits or skills needed to be a good/effective home visitor?

Let’s wrap things up. I have heard from you all that [SUMMARIZE HIGHLIGHTS FROM THE CONVERSATION]. Does that sound right?

30. Is there anything I missed? Is there anything that anyone wanted to talk about, or was expecting to talk about, that we didn’t address?

Those are all the questions I have. It was nice to meet all of you and to have this discussion. We’d like to thank you once again for taking the time to talk with us today!

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Home Visiting Career Trajectories OMB Supporting Documents: Focus Group Moderator’s Guide