Feature Article

Using Focus Groups for Program Planning

and Evaluation
Tami H. Wyatt, RN, PhD, CNE; Patricia B. Krauskopf, RN, PhD, CFNP; and
Rachel Davidson, RN, MSN, CPNP

ABSTRACT: School nurses often find themselves developing health-related programs for children
and adolescents. One way to create compelling and interesting programs that meet the needs of
students is to include them in the planning, development, and evaluation of such programs
through focus groups. Children provide a perspective about their particular needs, interests, and
understandings that cannot be obtained from adults or health care professionals. When children
take part in program planning, the programs become more appealing to children because of the
feedback from their perspective. This article describes ways focus groups can be used to examine
the effectiveness and usability of health-related programs. Included is a discussion of the pros and
cons of using focus groups with school-age children for planning and evaluating programs and
guidelines for conducting focus groups.
KEY WORDS: children, focus group, methodology, program evaluation, program planning,
school nurses

INTRODUCTION essence, focus groups allow children to communicate

Creating compelling and effective health programs
for children and adolescents is an important, though
often challenging, role of the school nurse. A health
program may be defined as any educational activity
designed to inform and teach children about health-
related topics with the goal of affecting their behavior.
Some examples are lesson plans on natural disaster
preparedness, self-guided modules about healthy eat-
ing and exercise, instructional gaming about play-
ground safety, and workbook activities about sun ex-
posure and protection. School children can play an
important role in developing or evaluating such pro-
grams because they are able to provide vital informa-
tion about their learning preferences and their level of
understanding about the content being presented. In
Tami H. Wyatt, RN, PhD, CNE, is an assistant professor at the
University of Tennessee, Knoxville, TN.
Patricia B. Krauskopf, RN, PhD, CFNP, is an associate professor and
coordinator of the Family Nurse Practitioner Track at Shenandoah
University, Winchester, VA.
Rachel Davidson, RN, MSN, CPNP, is a pediatric nurse practitioner
at Shults Pediatrics, Knoxville, TN.
what works for them and what does not—information
that no other source can provide. Using structured fo-
cus groups is an effective way for school nurses who
are planning new or evaluating existing programs to
gain access to and effectively capitalize on this valu-
able information.
Focus groups may be defined as thoughtful,
planned discussions among participants with similar
experiences that allow the moderator to obtain the in-
dividuals’ cognitive and emotional perceptions in a
nonthreatening and relaxed environment (Heary &
Hennessy, 2002). The key feature of focus groups is
that they encourage interaction among the children
in the group, as compared to group interviews, which
are loosely structured and do not encourage interac-
tion (Webb & Kevern, 2001). Specifically, the purpose
of a focus group for school health program planning
and evaluation is to create dialogue among children
about a specific subject. In these groups, children can
offer insight into their current knowledge about a par-
ticular topic and features that can enhance their learn-
ing process—areas that no other method can explore
as effectively.

Volume 24, Number 2 April 2008 The Journal of School Nursing 71

 . . . children can offer insight into their
current knowledge about a particular topic
and features that can enhance their
learning process—areas that no other
method can explore as effectively.
LITERATURE REVIEW
Focus groups were used as early as 1926 for market
research and were later employed in social sciences.
More recently, nurses have adopted focus group tech-
niques to collect information about opinions regard-
ing programming or perceptions about a phenome-
non (McLafferty, 2004). Within the past 25 years, fo-
cus groups have been used with children. During this
time, children have participated in market research,
health, education, and child welfare focus groups
(Heary & Hennessy, 2002). Current research reveals
that using focus groups is an excellent means to iden-
tify young people’s views on health and wellness (Pe-
terson-Sweeney, 2005). In fact, nursing literature focus
groups consisting of children and adolescents are most
often used to understand their attitudes about specific
behaviors that have an impact on health. For example,
adolescents’ attitudes toward tobacco use and cessa-
tion have been examined using focus groups (Den-
ham, Meyer, & Toborg, 2004; Renner et al., 2004).
Teens’ perceptions about staying healthy through
physical activity and nutrition have also been ex-
plored through focus groups (Bauer, Yang, & Austin,
2004; Kubik, Lytle, & Fulkerson, 2005; Mail et al.,
2005; Wilson, Williams, Evans, Mixon, & Rheaume,
2005). Adolescent and children focus groups have also
been used to identify special health care needs (Pat-
terson & Lanier, 1999), as well as the needs of children
and teens with chronic diseases, such as asthma (Ayala
et al., 2006; Boyle, Baker, & Kemp, 2004; Morgan,
Gibbs, Maxwell, & Britten, 2002; Rhee & Wenzel,
2007; Velsor-Friedrich, Vlasses, Moberley, & Coover,
2004) and epilepsy (McEwan, Espie, Metcalfe, Brodie,
& Wilson, 2003; Ronen, Rosenbaum, Law, & Streiner,
2001). Focus groups can also be valuable in eliciting
sensitive information from teens who might be un-
comfortable discussing these topics with the school
nurse in a one-on-one interview. Underage alcohol
consumption and the mechanisms that teens used to
access alcohol were examined through focus groups
by Wagenaar and colleagues (1993). Other personal at-
tributes and perceptions, such as contraceptive knowl-
edge, sexual health behavior, and adolescents’ expo-
sure to sexually explicit material on the Internet, were
explored using focus groups (Cameron et al., 2004;
Peremans, Hermann, Avonts, Van Royen, & Denekens,
2000; Robinson, 1999).
There is limited nursing research regarding the use
72 The Journal of School Nursing April 2008
of adolescent and children focus groups to evaluate
the effectiveness and usability of health programs. The
few studies found in nursing literature are mostly re-
lated to evaluating computer-based programs. For ex-
ample, Websites evaluated by children through focus
groups include a sexually transmitted disease preven-
tion program (Gilbert, Temby, & Rogers, 2005), a
smoking prevention program (Parlove, Cowdery, &
Hoerauf, 2004), and a video-enhanced presentation
for deaf students that evaluates teaching effectiveness
(Debevc & Peljhan, 2004). Other studies reporting pro-
gram evaluation using focus groups with children in-
clude the usability of a glucose monitoring watch
(Hathout et al., 2005), the effectiveness of a video
game that teaches children concussion awareness
(Goodman, Bradley, Paras, Williamson, & Bizzochi,
2006), and the evaluation of the Power Breathing娂
program designed for children with asthma (Berg, Ti-
chacek, & Theodorakis, 2004).
Two studies reported in the nursing literature are
different from the previously mentioned studies be-
cause focus groups with children were used during the
planning stages of health programs. These included an
examination of the needs of children and teens with
asthma to be used in planning a comprehensive asth-
ma Internet site (Rhee, Wyatt, & Wenzel, 2006) and
an assessment of children’s learning preferences with
an on-line digital storytelling and story writing pro-
gram about asthma (Wyatt, 2003).
As the limited number of related studies suggest,
focus groups involving children clearly have not met
their full potential as a major resource in health pro-
gram planning and development. However, lessons
can be learned from market research, which has con-
sistently used focus groups for program planning and
evaluation since the 1950s (Ansay, Perkins, & Nelson,
2004). The same focus group principles used by mar-
ket and educational researchers can be used to plan
and evaluate health programs.
When children are acknowledged as
valued contributors in focus group
sessions, school nurses are able to gain
a detailed and rich perspective of their
views.
ADVANTAGES OF USING FOCUS GROUPS
WITH CHILDREN
Discussing health topics and evaluating programs
with a group of children often enriches the informa-
tion gathered because focus groups take place in a re-
laxed, natural environment where children and ado-
lescents are encouraged to freely voice their opinions.
In a group setting, young people are not as likely to
Volume 24, Number 2
feel pressured to respond in a certain manner as they
might in a one-on-one dialogue with an adult. Unlike
an interview, the focus group does not end when one
child does not respond; the group setting allows other
children to respond creating a unique group dynamic.
Using focus groups with children who cannot read or
write is useful because these skills are not required for
participation (Kennedy, Kools, & Krueger, 2001).
When children are acknowledged as valued contribu-
tors in focus group sessions, school nurses are able to
gain a detailed and rich perspective of their views. Re-
lying only on parental input can be limiting, because
children’s perspectives are often quite different from
their parents’ perspectives (Morgan et al., 2002). Fur-
thermore, children in focus groups often try to make
other group members understand their thoughts and
feelings, while also trying to understand those of their
fellow participants. Due to their lack of development
and social interaction skills, children may be chal-
lenged by this pursuit of mutual understanding. This
group interaction of children struggling to portray
their points of view is a unique and valuable exchange
that can be observed by the school nurse during focus
groups (Kennedy et al., 2001). Sharing perspectives in
a group also reduces the burden and responsibility of
each child to respond; instead, the responsibility is
shared among the group members (Horner, 2000).
By including children in the planning
stages of an evolving program,
modifications are less likely because the
learning needs of children are already
represented which, in turn, streamlines
program development.
Focus groups are also advantageous during program
planning. Small group discussions allow the school
nurse to explore both the cognitive and emotional re-
sponses of the participants. The perspectives garnered
from focus groups enhance the type of information
typically collected from more formal evaluation meth-
ods, such as measuring outcomes (Peterson-Sweeney,
2005). As a result, the information gathered from the
focus group has high validity and can be useful in pro-
gram development for similar audiences (Heary &
Hennessy, 2002). Including stakeholders, who in this
instance are children, in the planning process can
help ensure the program meets their needs. This
method is also efficient because it may eliminate the
need to modify the content based on participant feed-
back. In traditional methods of developing programs,
changes or modifications are made after the program
has been executed. By including children in the plan-
ning stages of an evolving program, modifications are
less likely because the learning needs of children are
Volume 24, Number 2 April 2008
already represented which, in turn, streamlines pro-
gram development (Ansay et al., 2004).
DISADVANTAGES OF USING FOCUS GROUPS
WITH CHILDREN
Gathering information from children during a focus
group has some inherent limitations for program plan-
ning. Focus groups typically require participants to have
some communication abilities, and children often have
limited language and interpersonal skills. Due to varia-
tions in a child’s developmental stage, it may be difficult
for the school nurse to interpret responses. In addition,
children may choose not to respond at all.
Another concern in gathering information from
children who may not communicate effectively is the
potential for more talkative children in the group to
overshadow and persuade opinions of children in the
group. Even though the one benefit of focus groups is
the opportunity to discuss information, there is the
potential for quiet or passive children to be intimi-
dated by group members. Students, especially adoles-
cents who are more concerned with peer approval,
may feel pressure from dominant participants to seek
a consensus that does not really exist (Ansay et al.,
2004). To combat this phenomenon, school nurses
can use probing questions during the focus group to
capture individual responses from more quiet children
while still getting information from the group that
unfolds from interaction and discussion with one an-
other (Heary & Hennessy, 2002). For example, one
child may state that he prefers word searches when
asked, ‘‘How do you learn vocabulary words?’’ This re-
sponse may encourage another child in the focus
group to exclaim that he/she also likes word searches.
Children’s ideas may converge during focus groups
and become similar. This tendency would not have
been noted without the interaction between the chil-
dren and is a process referred to as ‘‘group think’’ (Pe-
terson-Sweeney, 2005). School nurses need to weigh
carefully both individual responses and possible
‘‘group think’’ influences when evaluating and apply-
ing information gathered from focus groups.
Conducting a focus group with children
requires a skilled moderator who is able
to effectively elicit individual and group
responses and gently direct dialogue to
keep it focused on the desired subject
matter.
Conducting a focus group with children requires a
skilled moderator who is able to effectively elicit in-
dividual and group responses and gently direct dia-
logue to keep it focused on the desired subject matter.
Because children often need a moderator to ask lead-
The Journal of School Nursing 73
ing or follow-up questions to fully engage in discus-
sion that provides useful responses, a moderator for
children must take an active role throughout the focus
group (Ansay et al., 2004).
Planning, organizing, and conducting focus groups
with students require a resourceful contact person. It is
essential that the contact person be familiar with chil-
dren’s school schedules and routines. Because conduct-
ing focus groups requires face-to-face contact among
participants, it may be difficult to schedule a time dur-
ing and after the busy school day (Heary & Hennessy,
2002). Therefore, it is imperative that school nurses
communicate with faculty and staff before scheduling
focus groups to ensure maximum participation.
FOCUS GROUP GUIDELINES
Focus groups require extensive planning and prep-
aration. A well-planned focus group will likely pro-
duce valuable information, but a poorly planned focus
group may result in less than optimal outcomes. Suc-
cessful focus groups require attention to group com-
position, style and format, participants’ ages, the role
of the moderator, and ethical issues.
Focus groups with four to six children are
most effective in yielding valuable
information because duplicate responses
are less common, smaller groups are
easier to control, and children may be
reluctant to talk in larger groups.
Group Composition
Focus groups with four to six children are most effec-
tive in yielding valuable information because duplicate
responses are less common, smaller groups are easier to
control, and children may be reluctant to talk in larger
groups (Kennedy et al., 2001; Large & Beheshti, 2001;
Patterson & Kelly, 2005). As a general rule, same-sex fo-
cus group members are recommended to foster produc-
tivity and reduce gender conflicts, especially in adoles-
cents (Peterson-Sweeney, 2005). However, with 6- to 10-
year-old children, both same-sex and co-ed focus groups
yield similar results without significant differences in the
children’s conduct or responses (Kennedy et al.). Other
demographic factors, such as socioeconomic level, edu-
cation, religion, and ethnicity, should also be considered
(Horner, 2000). Without similar characteristics, group
members have limited shared experiences from which
to evoke responses and form opinions (Peterson-Swee-
ney).
Members of the focus group should also have com-
mon interests and backgrounds related to the topic
being discussed (Ansay et al., 2004). For example, chil-
dren with asthma have different experiences than
74 The Journal of School Nursing April 2008
children with diabetes; therefore, a discussion among
children with varying disorders will be less meaning-
ful (Peterson-Sweeney, 2005). When children have
similar backgrounds and are familiar with the topic,
they function at a higher cognitive level, producing
responses that are more substantive and aid in pro-
gram planning (Horner, 2000).
Focus Group Style and Format
The school nurse must consider style and format
when planning the focus group session. The length of
the focus group with children ranges from 30 to 90
minutes depending on the (1) age and developmental
abilities of the children, (2) topic of interest, (3) skill
of the moderator, and (4) time of day (Heary & Hen-
nessy, 2002). For adolescents older than 14 years of
age, focus groups should be completed within 1.5
hours; for children between 10 and 14 years of age,
focus groups should be completed in 1 hour; and for
children younger than 10 years, focus groups should
be completed in 45 minutes (Peterson-Sweeney, 2005).
Focus groups typically include four stages: (1) be-
ginning, (2) openings, (3) discussion, and (4) wrap-up
(Kennedy et al., 2001). Group-building or ice-breaking
activities may be helpful during the beginning stage if
participants do not know each other. For example,
welcoming children and asking them to share their
names and ages helps ensure that all children feel
comfortable to respond. During this stage, ground
rules—such as hand raising and staying seated—help
to establish the expected conduct. During the opening
stage, children reply enthusiastically to simple ques-
tions and when invited to respond. During the dis-
cussion stage, children may need more time to process
questions; therefore, no child should be persuaded to
respond if they appear disinterested. Younger children
may offer insightful information if they are invited to
draw a picture and explain it (Kennedy et al., 2001).
Additional techniques to encourage responses are sto-
rytelling, photographs, films, or case studies. During
the interview, children and adolescents may provide
more information if asked to describe specific events
rather than responding to a broad, open-ended ques-
tion (Owen, 2001). Focus group sessions should end
with the wrap-up stage to briefly review the events of
the focus group and acknowledge the participation of
the children by thanking them and rewarding them
for their participation (Kennedy et al., 2001).
Offering incentives recognizes the contribution of
children’s time and input. Suitable incentives for chil-
dren and adolescents include movie passes or mall gift
certificates. If focus groups are scheduled after school,
adult assistance may be required to transport children
and may be compensated with gas cards (Peterson-
Sweeney, 2005). School nurses can locate funding for
these incentives from grants, advocacy organizations
such as the American Heart Association, local provider
Volume 24, Number 2
groups, health care agencies, professional organiza-
tions, and foundations.
Age of Participants
Restricting the age of the children in the focus groups
to no more than a 12-month range permits the school
nurse to develop appropriate questions and to approach
sensitive topics in a developmentally appropriate man-
ner (Large & Beheshti, 2001). Most focus groups with
children are restricted to children older than 6 years of
age because prior to this age, social and cognitive skills
are not conducive to an effective focus group (Heary &
Hennessy, 2002). By 6 years of age, children are capable
of reporting their thoughts in brief dialogues. Children
who are at least 10 years of age are able to convey their
thoughts and feelings with the school nurse and with
one another. Children aged 10 years and up are gener-
ally less concerned with their peers’ views and more like-
ly to express opposing views than teenagers. Adoles-
cents, on the other hand, are more likely to converge
ideas and feelings to form a social norm within the focus
group (Horner, 2000). While this may promote a cohe-
sive focus group, it will not reveal the diverse feelings or
needs of this group, thereby defeating the focus group
goal of encouraging group interaction among partici-
pants (Webb & Kevern, 2001).
The child’s communication abilities and
attention span should also be considered.
When performing focus groups for the
purpose of developing or evaluating
health programs, it is important that the
moderator be aware of the child’s
evolving understanding of health and
illness.
Role of the School Nurse as Moderator
When a school nurse functions as a moderator, the
initial focus group questions should be based on the
developmental abilities, special needs, and safety con-
cerns of the children who will be participating (Owen,
2001). The school nurse also can use his/her interper-
sonal skills to keep the group focused while listening
and simultaneously formulating follow-up questions.
To elicit descriptions of children’s actual experiences,
questions should progress from specific to general
(Horner, 2000; Owen, 2001). The child’s communica-
tion abilities and attention span should also be con-
sidered. When performing focus groups for the pur-
pose of developing or evaluating health programs, it
is important that the moderator be aware of the child’s
evolving understanding of health and illness (Heary &
Hennessy, 2002).
Once the school nurse has determined the appro-
Volume 24, Number 2 April 2008
priate focus group questions based on the goal of the
group and the children’s developmental ages, he/she
must determine how information from the focus
group will be recorded. This may be done in two pos-
sible ways; one is to assign an observer to record field
notes. A second option is to plan for audio/video-re-
cording of the focus group. It is usually best for the
school nurse to delegate the task of recording or tap-
ing to another individual so his/her attention can be
completely focused on moderating the group. Because
the school nurse is directly involved in creating and
evaluating the health program, it is important to di-
rect the focus group discussion to obtain the infor-
mation needed to meet the goal of the focus group
(McLafferty, 2004).
When conducting focus groups, consent
to participate must be obtained.
. . . parents must provide informed
consent, and children must assent for
participation in focus groups.
Ethical Issues
When conducting focus groups, consent to partic-
ipate must be obtained. In accordance with the U.S.
Department of Health and Human Services (1991) pol-
icy for Protection of Human Research Subjects, parents
must provide informed consent, and children must as-
sent for participation in focus groups (Heary & Hen-
nessy, 2002). Knowing that children lack social power,
it is important to explain to the child that he/she is
free to decline from participating even if the parent or
guardian has given consent. When sensitive issues
such as sexual behavior or sexually-transmitted dis-
eases are being discussed, the moderator must assess
the comfort level of the children and provide appro-
priate support to help them cope with a potentially
stressful discussion.
Confidentiality issues should be addressed before
conducting all focus groups and are especially impor-
tant when interacting with children and adolescents.
Depending on the nature of the focus group and the
information discussed, it may be necessary to review
with children—in an age-appropriate manner—the
importance of maintaining confidentiality of all focus
group members and agree on the information that can
be disclosed prior to dismissing the children (Peter-
son-Sweeney, 2005).
USING INFORMATION FROM FOCUS GROUPS
The school nurse can gather valuable information
from student focus groups during every stage of the pro-
gram planning and evaluation process. In fact, the most
efficient and effective health programs are carefully
The Journal of School Nursing 75

Figure 1. Cycle of Program Planning and Evaluation
planned and evaluated multiple times. While using fo-
cus groups during the planning and evaluation stages
seems the most reasonable place to start, it is recom-
mended that another focus group be added halfway
through the completion of the program if time and re-
sources permit. This midcompletion focus group can be
used to gather additional information about health pro-
gram needs to ensure the programs are progressing log-
ically. This process becomes cyclical in nature because
the focus groups designed to gauge the program’s effec-
tiveness at midcompletion also serve as a foundation for
future programming (Figure 1).
The final focus group evaluates the program after it
is developed for usability to determine how well the pro-
gram will meet the intended goal. Evaluating the health
education program after it is developed but prior to im-
plementation allows the school nurse to modify and im-
prove the program. During this focus group, children
participate in the program so the instructions, content,
and other factors can be evaluated. The school nurse
should note any components of the program that cause
children to appear confused or uninterested. Informa-
tion should also be gathered regarding each child’s likes,
and dislikes about the program.
Once information is collected from the focus group
about the program, the nurse must determine if the
children’s preferences, comments, and remarks war-
rant modifications. Each comment must be evaluated
to determine whether it reflects a flaw in the program
that should be corrected or if it is merely a child giving
his/her individual preference. Each child has unique
preferences, and it is not feasible to address every one.
If the preferences of the group, however, form a con-
sensus, then it can be assumed that those preferences
more closely reflect the entire audience who will par-
ticipate in the completed program. In this case, the
school nurse will consider modifications to the pro-
gram based on the group preferences to ensure that
the program is effective and maintains the attention
of the intended audience.
76 The Journal of School Nursing April 2008
As with any project, effective planning is
more likely to yield quality results.
IMPLICATIONS FOR SCHOOL NURSING PRACTICE
As with any project, effective planning is more like-
ly to yield quality results. School nurses who include
children in the planning stages of their health pro-
gram development via focus groups may reduce their
overall planning time by eliminating the need for ex-
tensive and time-consuming modifications. Children
feel empowered when they are included in the plan-
ning and evaluation of health programs. It may also
generate excitement for the program because the focus
group children may promote the program to their
peers.
When children are involved in the
planning, development, and evaluation of
programs via focus groups, they are more
likely to appeal to children and meet their
learning needs . . .
For school nurses, the initial investment in obtain-
ing children’s feedback may appear overwhelming.
However, once the process is established, the format
can be used again for future health programs. When
children are involved in the planning, development,
and evaluation of programs via focus groups, they are
more likely to appeal to children and meet their learn-
ing needs while also assuring feasibility and usability
of the program because peers have given valuable
feedback (Heary & Hennessy, 2002). Busy school nurs-
es need to know that even if they only have enough
time to conduct one focus group for each of their
health programs, the valuable information they re-
ceive can greatly improve the effectiveness of their
programs.
REFERENCES
Ansay, S. J., Perkins, D. F., & Nelson, J. (2004). Interpreting outcomes:
Using focus groups in evaluation research. Family Relations, 53(3),
310–316.
Ayala, G. X., Miller, D., Zagami, E., Riddle, C., Willis, S., & King, D.
(2006). Asthma in middle schools: What students have to say about
their asthma. Journal of School Health 76(6), 208–214.
Bauer, K. W., Yang, Y. W., & Austin, S. B. (2004). ‘‘How can we stay
healthy when you’re throwing all of this in front of us?’’ Findings
from focus groups and interviews in middle schools on environmen-
tal influences on nutrition and physical activity. Health Education and
Behavior, 31(1), 34–46.
Berg, J., Tichacek, M. J., & Theodorakis, R. (2004). Evaluation of an ed-
ucational program for adolescents with asthma. Journal of School Nurs-
ing, 20(1), 29–35.
Boyle, J. S., Baker, R. R., & Kemp, V. H. (2004). School-based asthma: A
Volume 24, Number 2
 study in an African American elementary school. Journal of Transcul-
tural Nursing, 15(3), 195–206.
Cameron, K. A., Salazar, L. F., Bernhardt, J. M., Burgess-Whitman, N.,
Wingood, G. M., & DiClemente, R. J. (2004). Adolescents’ experience
with sex on the web: Results from online focus groups. Journal of
Adolescence, 28, 535–540.
Debevc, M., & Peljhan, Z. (2004). The role of video technology in on-
line lectures for the deaf. Disability and Rehabilitation, 26(17), 1048–
1059.
Denham, S. A., Meyer, M. G., & Toborg, M. A. (2004). Tobacco cessation
in adolescent females in Appalachian communities. Family Commu-
nity Health, 27(2), 170–181.
Gilbert, L. K., Temby, J. R., & Rogers, S. E. (2005). Evaluating a teen STD
prevention web site. Journal of Adolescent Health, 37, 236–242.
Goodman, D., Bradley, N. L., Paras, B., Williamson, I. J., & Bizzochi, J.
(2006). Video gaming promotes concussion knowledge acquisition in
youth hockey players. Journal of Adolescence, 29, 351–360.
Hathout, E., Patel, N., Southern, C., Hill, J., Anderson, R., Sharkey, J.,
Hadley-Scofield, M., Tran, L., Leptien, A., Lopatin, M., Wang, B.,
Mace, J., & Eastman, R. (2005). Home use of the GlucoWatch G2
biographer in children with diabetes. Pediatrics, 115(3), 662–666.
Heary, C. M., & Hennessy, E. (2002). The use of focus group interviews
in pediatric health care research. Journal of Pediatric Psychology, 27(1),
47–57.
Horner, S. D. (2000). Using focus group methods with middle school
children. Research in Nursing & Health, 23, 510–517.
Kennedy, C., Kools, S., & Krueger, R. (2001). Methodological consider-
ations in children’s focus groups. Nursing Research, 50(3), 184–187.
Kubik, M. Y., Lytle, L., & Fulkerson, J. A. (2005). Fruits, vegetables, and
football: Findings from focus groups with alternative high school stu-
dents regarding eating and physical activity. Journal of Adolescent
Health, 36, 494–500.
Large, A., & Beheshti, J. (2001). Focus groups with children: Do they
work? The Canadian Journal of Information and Library Science, 26(2/
3), 77–89.
Mail, P. D., Hawkins, E. H., Radin, S., La Marr, C. J., Blume, A. W., Chan,
K. K., Chastain, C., Goines, M. A., Hawkins, E. H., La Marr, C. J.,
Larimer, M., Mail, P. D., & Radin, S. (2005). Insights from urban In-
dian teens on staying healthy: Data from focus groups. American Jour-
nal of Health Studies, 20(2), 99–105.
McEwan, M. J., Espie, C. A., Metcalfe, J., Brodie, M. J., & Wilson, M. T.
(2003). Quality of life and psychosocial development in adolescents
with epilepsy: A qualitative investigation using focus group methods.
Seizure, 13, 15–31.
McLafferty, I. (2004). Focus group interviews as a data collection strategy.
Journal of Advanced Nursing, 48(2), 187–194.
Morgan, M., Gibbs, S., Maxwell, K., & Britten, N. (2002). Hearing chil-
dren’s voices: Methodological issues in conducting focus groups with
children aged 7–11 years. Qualitative Research, 2(1), 5–20.
Owen, S. (2001). The practical, methodological, and ethical dilemmas of
Volume 24, Number 2 April 2008
conducting focus groups with vulnerable clients. Journal of Advanced
Nursing, 36(5), 652–658.
Parlove, A. E., Cowdery, J. E., & Hoerauf, S. L. (2004). Acceptability and
appeal of a web-based smoking prevention intervention for adoles-
cents. The International Electronic Journal of Health Education, 7, 1–8.
Patterson, B. J., & Kelly, L. E. (2005). Lessons learned: One experience
with focus groups in a school setting. Journal of School Nursing, 21(3),
158–163.
Patterson, D. L. & Lanier, C. (1999). Adolescent health transitions: Focus
group study of teens and young adults with special health care needs.
Family and Community Health, 22(2), 43–58.
Peremans, L., Hermann, I., Avonts, D., Van Royen, P., & Denekens, J.
(2000). Contraceptive knowledge and expectations by adolescents:
An explanation by focus groups. Patient Education and Counseling, 40,
133–141.
Peterson-Sweeney, K. (2005). The use of focus groups in pediatric and
adolescent research. Journal of Pediatric Health Care 19(2), 104–110.
Renner, C. C., Patten, C. A., Enoch, C., Petraitis, J., Offord, K. P., Angst-
man, S., Garrison, A., Nevak, C., Croghan, I. T., & Hurt, R. D. (2004).
Focus groups of Y-K Delta Alaska Natives: Attitudes toward tobacco
use and tobacco dependence interventions. Preventive Medicine, 38,
421–431.
Rhee, H., & Wenzel, J. (2007). Adolescents’ psychosocial experiences liv-
ing with asthma: A focus group study. Journal of Pediatric Health Care,
21(2), 99–107.
Rhee, H., Wyatt, T. H., & Wenzel, J. (2006). Adolescents with asthma:
Learning needs and internet use assessment. Respiratory Care, 51(12),
1441–1449.
Robinson, N. (1999). The use of focus group methodology—With select-
ed examples from sexual health research. Journal of Advanced Nursing,
29(4), 905–913.
Ronen, G. M., Rosenbaum, P., Law, M., & Streiner, D. L. (2001). Health-
related quality of life in childhood disorders: A modified focus group
technique to involve children. Quality of Life Research: An International
Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation,
10(1), 71–79.
Velsor-Friedrich, B., Vlasses, F., Moberley, J., & Coover, L. (2004). Talking
with teens about asthma management. Journal of School Nursing,
20(3), 140–148.
Wagenaar, A. C., Finnegan, J. R., Wolfson, M., Anstine, P. S., Williams,
C. L., & Perry, C. L. (1993). Where and how adolescents obtain al-
coholic beverages. Public Health Reports, 108(4), 459–464.
Webb, C., & Kevern, J. (2001). Focus groups as a research method: A
critique of some aspects of their use in nursing research. Journal of
Advanced Nursing, 33(6), 798–805.
Wilson, D. K., Williams, J., Evans, A., Mixon, G., & Rheaume, C. (2005).
Brief report: A qualitative study of gender preferences and motiva-
tional factors for physical activity in underserved adolescents. Journal
of Pediatric Psychology, 30(3), 293–297.
Wyatt, T. H. (2003). Pilot testing Okay with Asthma娂: A digital story for
psychosocial asthma management. Doctoral dissertation, University
of Virginia. Dissertation Abstracts International, 64, 3195.
The Journal of School Nursing 77