A 6P framework for engaging consumers in focus group discussions to identify needs, experiences, and expectations with digital health solutions (Preprint)

BACKGROUND Focus group discussions (FGDs) have been used as an effective method to capture consumers’ needs, experiences and expectations for the design of future digital health solutions. However, engaging consumers in FGDs is challenging. To date, there is little guidance for the best practice of moderating FGDs. OBJECTIVE This study describes the development of a 6P framework for effectively engaging consumers in FGDs to identify their needs, experiences and expectations for future digital health solutions. METHODS A 6P framework – prototype, people, protocol, place, parity and parallelism – for consumer engagement in FGDs was developed by a multidisciplinary team via synthesizing the evidence in the literature. The 6P framework was implemented in two FGDs at a hospital in South-West New South Wales, Australia. Patients with obesity (35kg/m2) who were undergoing weight-loss treatment at the hospital were recruited using purposive sampling. Discussions collected user needs, experiences, and expectations with a prototype mobile health app to support self-management of obesity. The FGD recordings were transcribed verbatim and content analysis was conducted. RESULTS Twelve adult participants (5 men, 7 women) participated in two FGDs. The well-prepared prototype (a mHealth app), people (developing team, moderator, observers, and technical assistants), protocol (interview guide, plan and handout), and place (physical and virtual friendly one) enabled the participants to actively engage in FGDs to express their needs, experiences and expectations. Participants expressed positive thoughts about the overall usability and usefulness of the app. They provided suggestions for further improvement of the app in terms of information quality (the presence of some irrelevant, incomprehensible, or incomplete information) and system quality (difficulty of using app functions). Participants also expressed an expectation to see more personalized graphical designs that are easy to comprehend. The moderator used the two techniques – parity and parallelism, to control the dominant participants and encourage silent participants, so that they can express their opinions as objectively as possible. CONCLUSIONS Following the 6P framework to moderate FGDs is conducive for consumers to understand the discussion topic, engage in peer interaction about a prototype and relate the interactional experience with their previous digital solution usage experiences. The framework provides insight for managing dominant participants and eliciting further functions. It also enables consumers to effectively reflect, understand and express their needs, experiences and expectations in digital solution co-design in FGDs.