Keeping Our Kids Safe: Community Focus Groups to Examine Sex Risk Behaviors in Adolescents

Culturally sensitive and accurate assessment is essential prior to the development and implementation of intervention programs, but is often challenging in underserved, diverse communities. School based health center providers identified a large number of pregnant teens and a high incidence of sexually transmitted infections among primarily African American and Hispanic high school students in an urban high school. Evidence based intervention programs targeted at middle school students are supported by the literature as an effective method to reduce sex-risk behaviors during high school. The first step in program selection is identification of the community's own perception of sex-risk behaviors and the community's ideas and preferences for appropriate risk reduction interventions. The Theory of Planned Behavior by Ajzen provided the theoretical framework for the project, including attitudes, social norms, and perceived control as factors influencing intention. A nurse-led interprofessional research team was formed. Nine structured focus groups (N=38) were conducted with middle school students (10-14), parents, and community adults over a one year period. Lessons learned include the importance of a realistic plan for mixed method research and focus groups in the community. Ethical and legal considerations regarding inclusion of early adolescents in sex risk focus groups needs careful consideration and methodological control. The challenges of conducting community focus groups include; recruiting participants; choosing/training culturally appropriate moderators; and planning for data collection, transcription, coding, and analysis. Genuine participation in research by low income populations requires tremendous time and effort by researchers. Recommendations for successful needs assessment and focus groups are presented.