Supporting and Strengthening the Home Visiting Workforce (SAS-HV): Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting

Instrument 2: Focus Group Protocol Exploring Relevance Among Subgroups

NOTE to OMB: This focus group protocol is semi-structured and serves as a guide, rather than a script. The protocol includes example questions that are similar to all of the questions we may ask participants. We will tailor the question wording and which questions are asked based on findings from the pretest in the most recent phase of the study. We will also tailor questions during the focus group, based on participant responses, probing as needed to follow-up on brief responses or rephrasing questions if a participant doesn’t understand the original question. The text marked as a “probe” are clarifications for the main question, to be used if participants do not understand the main question or give brief responses. The sub-bullets are questions/topics related to the main question that will be asked if the participants don’t touch on those topics when answering the main question.

Section 1: Introduction and Consent (~10 minutes)

1.1 Verbal Consent Script

Thank you for taking the time to talk with me about your experiences and perspectives on the measure of reflective supervision we are developing. I’m [NAME] and I’ll be the primary facilitator for our focus group today. My colleague [NAME] is also on the call and will primarily take notes and manage the chat, but please know that you can message either of us if you need anything.

First, I’d like to read an informed consent statement, which you also received by email.

As a home visiting supervisor, you are invited to participate in a focus group to share your perspectives on the measure of reflective supervision we are developing. We are conducting different focus groups with individuals who identify themselves as Black, Hispanic/Latine, American Indian and/or Alaska Native. The goal of these focus groups is to elevate the voices of racial and ethnic groups whose voices are often not heard so we can ensure the measure incorporates multiple perspectives. What you share with us today will be used to help us revise and refine the measure of reflective supervision and strengthen how useful the measure will be for home visitors of different races and ethnicities.

The focus group will take approximately 60 minutes and we will send you a $45 electronic gift card after we finish, as a thank-you for participating.

Voluntary Nature: Participation in the focus group is voluntary. You may choose not to participate in the focus group or end your participation at any time without affecting your employment. You can decline to answer any questions for any reason.

Benefits and Risks: There are no foreseeable risks to your participation in the focus group. Although you do not receive any direct benefits from participating, your experience and input will help to improve the measure of reflective supervision, and we hope lead to improved support for home visitors.

Privacy: Your name or other personally identifying information will not appear in any report and your responses to the focus group questions will remain private to the extent permitted by law. We will not share any of your responses with anyone else at 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. Since this is a group discussion, we cannot guarantee that others in the group will not talk with others about our discussion, though we ask that you and all participants respect the privacy of others in this group and do not share anything that is said in this focus group with anyone outside of this group.

Data Security: The research team will follow strict policies to keep your information secure. All of the information you share in this focus group will be stored in a password protected electronic database and will only be accessible to the research team. Audio recordings of the focus group will be transcribed and analyzed, and then destroyed.

Audio Recording: I will audio-record our discussion today so we can be sure to capture your responses accurately. I will only record audio, not video. No one besides the research team will listen to the recording. If you want to say anything you do not want recorded, please let me know and I will be glad to pause the recording. If you do not want to be audio-recorded, you have the option to not participate in the focus group.

Do you have any questions?

Do you agree to participate in the focus group?

Participant 1: • Yes • No

Participant 2: • Yes • No

Participant 3: • Yes • No

Participant 4: • Yes • No

Participant 5: • Yes • No

1.2 Warm-up and Introductions

Great, thank you for agreeing to take part in today’s conversation. In our conversation, we want to prioritize creating a space for everyone to participate in the conversation as they desire. To accomplish this, we suggest the following practices:

• Welcoming everyone to turn on your cameras.

• Inviting everyone to respond to each question and welcoming the option to skip any questions. Please know there are no right or wrong answers to any of the questions.

• Demonstrating respect for everyone in the focus group by giving our attention to the person who has the floor. We suggest muting your microphone when you aren’t speaking.

• Creating space for others’ perspectives, experiences, ideas, and contributions.

• Taking space and making space by paying attention to how frequently, how long, and how quickly we participate.

Does anyone have any questions?

In this focus group we are going to talk about your reflective supervision process, based on your experience as a [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisor. We understand that you don’t represent all [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisors, that you’re just one of many [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisors and that your experiences and opinion may not be the same as everyone else’s.

We know that some people are very comfortable with this topic of discussion, while others are not. We also understand that there are many different opinions on how to achieve equity.

Before we begin the discussion, I would like to invite you to take a moment to do what works for you to become fully present and prepared to engage in the conversation. I am going to turn my camera off for just a moment. Please feel free to turn your camera off too, or to keep it on.

You can do what works for you to help yourself be fully present. For example, you could get a glass of water and find a comfy chair to sit in, turn off your phone or other distractions, or close your eyes, take some deep breaths, and give yourself a moment of quiet and calm.

Now we will just observe a quiet moment for about 15 seconds.

[TURN CAMERA BACK ON]

Thank you for participating in a moment to help us all become fully present. I will turn my camera back on and invite you to do the same.

Now, we will begin the discussion. I will start the recording.

[BEGIN RECORDING]

To start us off, let’s begin with some brief introductions.

1. I will go first. My name is [NAME], I’m a researcher and I have [EXPERIENCE WITH HOME VISITING OR RELATED], and I identify as [RACIAL/ETHNIC IDENTITY, OTHER ASPECTS OF IDENTITY]. Please tell us your name, as well as your job title and how long you have been working in home visiting.

ELAPSED TIME BY END OF THIS SECTION: 10 MINUTES

Section 2: Reflective Supervision Practices and Racial/Ethnic Identity (~15-20 minutes)

As I mentioned, we are interested in refining the reflective supervision measure that we are developing, so that it is relevant and useful for people with different racial and ethnic identities. We know that there are many different ways you may define yourself and different aspects of your identity that are important. For today’s discussion, we are interested in learning about how race and ethnicity may show up in and influence your reflective supervision practices. Let’s get started.

2. What personal factors do you think influence reflective supervision?

[PROBE: To what extent do you think race or ethnicity influences reflective supervision, if at all?]

3. Next, tell me about the ways your identity may influence how you provide reflective supervision.

   • In what ways does your identity as a [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisor influence how you provide reflective supervision, if at all?

• How does your identity as a [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisor influence…

  • The strategies or techniques you use in reflective supervision (if at all)?

  • The topics you discuss during reflective supervision sessions (if at all)?

  • Your relationships, trust, and rapport with the home visitors you work with (if at all)?

4. In what ways – if any – do you tailor your reflective supervision practices or methods in consideration of the racial or ethnic identity of the home visitor you are working with?

• What has been your experience talking about race or ethnicity during your reflective supervision sessions?

ELAPSED TIME BY END OF THIS SECTION: 25-30 MINUTES

Section 3: Feedback on Reflective Supervision Measure (~25-30 minutes)

Now, we would like to get your feedback on the current draft of the reflective supervision measure we are developing. We will share the measure on our screen and review specific parts together.

We will ask you some questions as we review, to get your perspective on the items. The focus of this conversation is not on your response to the items themselves. Rather, we’d like to understand the extent to which you think the items are relevant, based on your experience as a [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] home visiting supervisor. We want to understand if the questions and response options would allow you and other supervisors who identify as [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] to accurately report on your reflective supervision practices.

I welcome you to share your honest feedback. Your perspective is important and will help us make sure the measure reflects the experiences of- and is clear to- [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisors – though, I acknowledge that you are just one voice and do not represent the experiences and opinions of all [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisors). It’s okay if your feedback is that the items don’t accurately represent your experiences or that they don’t make sense to you – this is valuable and important feedback to share.

Let’s get started, first by looking at [items #]. Please take a moment to read the items and consider how the items resonate with you.

[SHOW FIRST SET OF ITEMS ON SCREEN. PAUSE TO LET PARTICIPANT REVIEW THE ITEM(S).]

Note to OMB: The facilitator will ask the questions below about a predetermined, subsample of items from the reflective supervision measure. The items will be grouped so focus group participants are presented with several items at a time, on related topics. Not all items in the measure will be included; we will determine which items to include based on findings from the pretest in the most recent phase of the study. The questions below are meant to be a list of possible questions the facilitator will choose from when asking about items in the measure, but not all questions will be asked. The facilitator will tailor which questions are asked based on the focus of each set of items from the measure.

5. How do these items and the practices they describe resonate with you (if at all)?

[PROBE: How do the items and practices resonate, based on your experience as a [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisor?]

6. To what extent are these the words and terms you would typically use?

[PROBE: To what extent are these the words and terms you would use, based on your experience as a [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisor?]

• [IF THEY SHARE THAT THE TERMS AREN’T WHAT THEY USE, ASK:] How would you rewrite these items to make them more applicable to your home visiting program?

[REPEAT QUESTIONS ABOVE FOR EACH SET OF ITEMS ASKED ABOUT DURING INTERVIEWING, SHOW THE ITEMS ON THE SCREEN. PAUSE TO LET PARTICIPANT REVIEW THE ITEM(S).]

ELAPSED TIME BY END OF THIS SECTION: 55 MINUTES

Section 4: Overall Impressions of Measure and Wrap-up (~5 minutes)

We have just a few questions left. For these final questions, we would like to understand your overall impression of the measure and the extent to which it captures the reflective supervision practices at your program. Just so you know, we only had time to show you a few items during today’s discussion; the current draft of the full measure has more questions that address different aspects of reflective supervision.

7. Is there anything else you would like to share about how the items you saw in this measure overall resonated with you, based on your experience as a [BLACK, HISPANIC/LATINE, OR AMERICAN INDIAN OR ALASKA NATIVE] supervisor and your reflective supervision practices?

8. For my final question, I’m hoping to get your feedback on what it was like to participate in this discussion. How did it feel to discuss these topics and types of questions in a virtual, group format? What suggestions do you have for improving these discussions for future focus groups?

[STOP RECORDING] 

I’ll go ahead and stop the recording now. Did you have any other questions for me before we end the focus group?

Thanks so much for your participation. We’ll use your feedback, and that from other participants to help further refine this measure. As a thank you for your time today, we’ll email you a $45 gift card, sent to the same email address we’ve used for our other communications.

ELAPSED TIME BY END OF FOCUS GROUP: 60 MINUTES

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