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Abstract

Although researchers have convened focus groups to collect individuals’ opinions for some time, many have transitioned data collection from in-person to online groups. Online focus groups became even more important as COVID-19-related restrictions to movement and shared spaces interrupted the ability of researchers to collect data in person. However, little is published about conducting online groups with populations whose physical and emotional safety is at risk, such as those experiencing domestic violence. Working with these populations raises concerns related to participant safety, mental and emotional well-being, COVID-19 social distancing requirements, participant confidentiality, and data security. To address these concerns, we developed a set of protocols for conducting online focus groups with individuals whose experiences put them at high risk for emotional distress and social harm due to research participation. As part of a larger project with community-based partners, we sought more information on the impact of violence on mothers. IRB-approved online protocols were successfully implemented by researchers during two focus groups, each with five to six participants (mothers) who had experienced violence. Innovative strategies included identifying the safest virtual platform, having a licensed counselor and advocates on standby during the focus groups, developing trauma-informed distress and disclosure protocols, using technological safeguards to ensure confidentiality (e.g., assigning non-identifying nicknames in waiting rooms before the online focus group), providing onsite technical assistance, and co-locating participants in the same building while maintaining social distancing. The successful implementation of these methods suggests that it is possible to collect quality information on sensitive topics using a virtual format while maintaining confidentiality and using a trauma and resilience-informed approach. We hope that future data collection efforts with groups experiencing behavioral health risks related to research participation may benefit from sharing this methodology.

Keywords

Qualitative Data Collection Focus Group Intimate Partner Violence Domestic Violence Methodology

Background and Assessment of Need

Methodological studies on focus groups with individuals who have experienced interpersonal violence (IPV; e.g., domestic, intimate partner, family violence, etc.) or are otherwise at risk for re-traumatization are rare in the research literature. Although some researchers have previously suggested that individual interviews are preferable to focus groups for sensitive topics such as IPV (Guest et al., 2017; Holland et al., 1994), others suggest that having individuals with similar experiences in a group might make participants more comfortable and lead to more productive group discussions and disclosures (Pollack, 2003; Wilkinson, 2004; Woodyatt, Finneran, & Stephenson, 2016). A systematic review of literature on methods for qualitative data collection from women who have experienced IPV found that such data collection can be beneficial as survivors process through their stories and are able to relay personal details beyond what a screening instrument can capture (Synder, 2016), and focus groups in particular can elicit contextual information that may be missed in individual interviews (Pollack, 2003; Wilkinson, 1998). Some researchers (Stanley et al., 2012) have suggested that traumatic experiences should be in the past for research participants, but we found no information regarding how far in the past violence needed to occur to be less triggering when discussed in focus groups. While important, these recommendations for qualitative work with individuals at risk for re-traumatization come from in-person rather than online studies.

The COVID-19 pandemic presented challenges to conducting qualitative research, namely, that in-person data collection was complicated by social distancing and stay-at-home mandates, causing many researchers to move to online forms of data collection (Lobe et al., 2020). Although qualitative data collection has traditionally used in-person methods, researchers began investigating the efficacy of online data collection methods as early as 2005 (Reid & Reid, 2005; Stewart & Williams, 2005). Findings from recent studies suggest that online data collection may have a limited, if any, effect on the quality or authenticity of the information gathered (see Abrams et al., 2015; Janghorban, Latifnejad Roudsari, & Taghipour, 2014; Reisner, et al., 2018), and participants may prefer alternate to in-person methods due to convenience. For example, in a study investigating a different sensitive topic (parents’ experiences following their child’s burn injury), when given the choice between a telephone, email, Skype, or an in-person interview, a telephone interview was most preferred by participants followed by email and then Skype, with a face-to-face interview preferred by only one person (Heath et al., 2018). Other researchers have also found that using the online platform Zoom was easy, cost-effective, secure, and helpful for data management for both researchers and participants and that most participants preferred the online platform over in-person data collection (Archibald et al., 2019).

Researchers with experience working with sensitive topics and participants at risk of re-traumatization (outside of IPV) stress the magnitude of ethical considerations and trauma-informed approaches for collecting data online. For example, when conducting interviews via video conferencing, it is even more important that participants be aware of ethical concerns related to confidentiality, recording, transcription, and their ability to leave or stop interviews at any time (Janghorban, Latifnejad Roudsari, & Taghipour, 2014; Lobe et al., 2020). When working with parents in the childhood burn study, authors also noted the value of providing appropriate support options, such as information for counseling services, following interviews on sensitive topics (Heath et al., 2018). Populations experiencing disparities, including those experiencing IPV, often are less available (work demands, transportation issues, etc.) and/or have less access to resources, which can affect their ability to participate in research (Edelman, 2022). Although online qualitative data collection has its benefits, researchers need to acknowledge that individuals with access to quality high-speed internet and who understand how to communicate online (i.e., email, video conferencing, user interface, technology savvy, etc.) are more likely to participate compared to those with limited internet access and technological knowledge, unless measures are taken to facilitate access and use of technology (Archibald et al., 2019; Deakin & Wakefield, 2014; Hamilton & Bowers, 2006).

Even with recommendations for in-person focus groups with survivors of IPV and for online focus groups on other sensitive topics, little is known about the feasibility and preferred methodology for collecting information on experiences of IPV directly from survivors online. The purpose of this paper is to fill this gap by presenting an example of how protocols for collecting focus group data were altered to shift data collection online while remaining trauma-informed and maintaining participant safety and confidentiality. During the pandemic, a cooperative research-to-practice partnership between an IPV service provider and a research team sought to implement an evidence-based, paired intervention, Kids’ Club and Moms’ Empowerment Program. This intervention has been found to reduce internalizing and externalizing behaviors in children, reduce post-traumatic stress for parents, positively shift attitudes about violence among children, and improve parent/child communication (Graham-Bermann et al., 2007). To help guide program implementation, we first sought input from mothers with past experiences of IPV about the needs of women and children who have experienced violence and how service providers can assist (Edelman, 2022). However, due to concerns about COVID-19 transmission, organizational protocols prohibited in-person data collection. This led us to develop new protocols for online focus groups to safely involve women with past experiences of IPV. Other researchers may find these protocols useful in planning qualitative data collection with populations for which online participation in focus groups may present potential safety risks (e.g. being overheard).

Explanation of Methods

We conducted online focus groups to obtain data to inform the adaptation and implementation of an evidence-based pair of interventions for mothers and children (Kids’ Club and Moms’ Empowerment Program) who had experienced or been exposed to IPV. We followed existing recommendations for in-person research with this population by convening and discussing all research protocols, plans, and instruments with a community advisory board (CAB) consisting of women with lived experience with IPV and with staff from our partner IPV service provider. Although initial meetings of the CAB were in-person, COVID-19 protocols led us to move the CAB meetings online as well. Online focus groups involved at least two live facilitators, one researcher and the other a licensed counselor and Principal Investigator from the partner IPV service provider. The Evaluation Lead (first author) and Research Project Director (second author) also attended online focus groups as listeners and to help facilitate technology for users less familiar with the platform.

Sample Population and Recruitment

The IPV service provider’s COVID-19 protocols prohibited anyone visiting the facility who did not already live or work there. We, therefore, relied on convenience sampling to recruit parents from the residential crisis shelter and transitional housing program (both on the IPV service provider’s campus) and asked staff from our partner IPV service provider already working with eligible individuals to identify and recruit participants using researcher-developed scripts. Asking staff with existing relationships with clients to lead recruitment also helped ensure that the recruitment process felt supportive and genuine to participants. The appendix includes the recruitment script with some specifics about the community service providers redacted. We incentivized participation by providing $40 VISA gift cards, an amount that the online CAB indicated would not be so much as to be coercive to participants for sharing 90 minutes of their time.

Eligibility Criteria

To reduce any risk of re-traumatization from mothers living in the shelter who have likely had recent IPV exposure, service-providing staff recommended that only mothers who had been in the shelter for more than 72 hours and who had met with their staff advocate to establish short-term goals for their stay would be eligible to participate. Recommendations from the literature informed two additional eligibility criteria: mothers in transitional housing should not be living with a violent perpetrator or currently experiencing abuse and should directly agree that they would feel safe and comfortable participating in a focus group during recruitment. Full eligibility criteria were as follows:

• Female-identifying clients between 18–28 years of age.

• Has experienced intimate partner or family violence in their lifetime but is not currently.

• Not currently in an abusive relationship.

• Not currently living with an abusive partner.

• Has one or more children, even if the children are currently separated from the mother.

• Residing in transitional housing or domestic violence shelter.

• Client indicates they would feel safe participating in an online focus group at the facility.

Protocols

All protocols were reviewed by the [Pacific institute for Research and Evaluation] Institutional Review Board, which also granted a waiver of documentation of informed consent for the focus group sessions as the only record linking the participant to the data would have been this document. During recruitment, to empower individuals by emphasizing participant choice and consent throughout the research experience, staff from the partner IPV service provider used a script to review the following materials that were also given to clients: (1) the client consent document and (2) a resource document including a list of referral resources for clients (local agencies providing medical care, behavioral health services, violence services, and national resources such as National Domestic Violence Hotline). These materials were given to clients and revisited before the focus group began (see Focus Group Guide in Appendix).

In collaboration with our IPV service-providing partner, we also established that online participation would occur at the IPV service provider’s facility to ensure safety from perpetrators and COVID-19 exposure. Focus group participants recruited from the shelter participated from either the shelter computer lab or another private space in the shelter, and participants recruited from the transitional housing program participated from a private, safe space at the service provider’s offices, outside of the shelter. All focus group participants were, therefore, on-site at the violence service provider’s offices in individual, physically separate spaces during the focus group to keep COVID-19 distancing protocols, and they joined online using personal or provided devices. Informed by previous research, researchers expected a low response rate and encouraged staff from the IPV service provider to recruit more clients than needed for the focus group. A total of 24 clients were recruited, which resulted in a total of 11 focus group participants (45.8%).

Recognizing that trauma is unpredictable and that talking about traumatic events online may trigger participant distress, we planned for potential distress by appropriately training researchers to support participants through online and in-person strategies (explicit protocols are provided in the Appendix). All researchers and practitioners participating in the focus groups were trained in techniques emphasizing strengths and resilience that could be used online, such as active listening and using person-first language (“survivor” or “person who has experienced violence” instead of “victim”). Focus group guides followed these same principles by using language that focused on participant strengths and asking hypothetical questions to avoid asking about participants' traumatic experiences (see Focus Group Guide in Appendix). Facilitators also practiced all the technological components of the group and distress and disclosure protocols as approved by the IRB (see the Distress and Disclosure protocols section and Exhibit 2).

Children of Participants

Considering that childcare is a known barrier to seeking and obtaining services for mothers who have experienced violence (Jackson & Shannon, 2012), we addressed cultural competency by removing this barrier for participants. Our IPV service-providing partner recommended that children under 3 were unlikely to understand the online focus group and, therefore, were allowed to stay with the parent, reducing COVID-19 risks to the child. Older children (> 3 years of age) were invited to play in a communal play space on a separate floor staffed by volunteers or staff from the IPV service-providing partner (masked and socially distanced). Organizing an activity for older children in a separate location ensured that they did not overhear the conversation and become upset (avoiding re-traumatization) or inadvertently disclose their parent’s participation.

Distress and Disclosure Protocols

We defined distress using cues that would be available online, such as “a participant indicates they are experiencing a high level of physical or emotional distress” or “a participant exhibits behaviors suggestive that the focus group or survey is too stressful, such as uncontrolled crying, shutting down, disengaging, or anger.” Our protocol then detailed two levels of online response. At stage 1, the focus group leader would stop the distressed individual from participating and the counselor co-facilitator would provide immediate support in the group or a breakout room. Then, the counselor co-facilitator was to assess if individuals wanted to continue the focus group.

If the distressed participant was not ready to continue, the second stage of protocols advised the counselor co-facilitator to join a separate call or otherwise continue engaging to try to help the distressed individual calm themselves. Protocols also included a statement that if a participant verbally disclosed that they or someone else was in immediate danger during the focus group, the counselor co-facilitator engaged with that client directly online or in-person and followed organizational policies for disclosures of harm. Follow-up protocols for all distressed individuals and disclosures of harm included reviewing the incident with the project team, reporting adverse events to the IRB, and assessing whether protocols needed to be altered to better serve participants. During the focus groups, there were no incidents of distress or disclosures of harm.

Implementation

Focus groups were held virtually via Zoom for approximately 60 minutes each (additional time was allocated for setup and the arrival of participants, making the total time closer to 90 minutes). The focus groups were co-led by a researcher and the Principal Investigator from the partner IPV service provider, a licensed counselor (LPCC, LMHCA). Participants connected by dialing the toll-free number provided to them or joining online via a Zoom link. As participants connected to the group, staff from the IPV service provider were available in-person to provide technical assistance to connect online. At the start of the focus group, the focus group lead moved each participant one by one from the virtual waiting room into a separate breakout room. Facilitators empowered participants to use the focus group features, including disabling their camera and exiting the session if they were uncomfortable. Participants were also informed on how to text the counselor co-facilitator if they needed assistance or felt uncomfortable during the focus group and how to use the chat box if they did not want to speak aloud. The lead facilitator converted any displayed name or identifier to a dummy client ID (Client 1, 2, 3, etc.) to prevent disclosure of names before moving participants back to the main meeting room. No participant was allowed to enter the main meeting room until being relabeled with a dummy client ID, to protect names and phone numbers. These protocols ensured that participants would not recognize each other or risk anyone overhearing their participation.

Emphasizing the need to repeat informed consent during online data collection, the lead facilitator re-reviewed the consent document and resource document with all participants at the start of the focus group and emphasized that participation was voluntary. At the conclusion of the focus group, the lead facilitator asked participants to complete a short demographics questionnaire via Qualtrics link in the chat box so that participant demographics were not linked to participant identities and so that no data collector needed to be on-site at the service provider’s campus (see Appendix). Participants who called in were given the option of having the survey emailed or sent via a text for online completion. Finally, at the end of the focus group, staff at the IPV service provider physically distributed $40 grocery gift card incentives and checked on participants’ emotional well-being.

Data Handling

Additional safety protocols included using a secure online platform, safely storing data on the research institution’s data management system, and deleting the meeting invitation after its conclusion. At the time, the secure online platform Zoom was the most freely accessible option available, which was easier for participants to use and allowed the meeting group room to be “locked” to any outside attempts to enter (Archibald et al., 2019). To further protect the identity of the participants, researchers deleted the meeting invitation and chat room notes afterward, and Client IDs (rather than names) tracked attendance (Lobe et al., 2020). Focus groups were recorded and transcribed by staff trained in qualitative data collection. Two main coders reviewed the transcripts and extracted main themes and concepts. A third reviewer examined the transcripts and themes and handled any disagreements.

Discussion

The methods presented here convey a trauma-informed, strengths-based approach to conducting online focus groups with a population that is at higher risk of experiencing stress: women who have experienced violence. This approach meets rigorous standards of data collection and avoids any distressing events for participants. Although we designed these protocols independently, the methods outlined here also follow specific research practices associated with the Trauma and Resilience Informed Research Principles and Practice (TRIRPP) framework (Edelman, 2022). To summarize, Table 1 shows each of the TRIRPP principles and how our protocols meet each principle.

Table 1.

TRIRPP Framework Principles Alignment With Research Protocols.

TRIRPP principle	Our protocol
Researchers should ensure that relevant groups are involved in the research practice.	• Having a licensed counselor from the IPV service provider, trained in using Zoom breakout rooms and other features co-facilitate the online focus group. • We continued to convene the CAB online after COVID-19 protocols made it impossible to meet in person, to ensure that relevant groups reviewed all research practices ahead of time.
Researchers should account for social inequalities that may affect individuals’ ability to participate in and benefit from research.	• We provided childcare for participants at the facility that we asked them to arrive at to participate online, as women experiencing violence often cannot participate in research if they lack childcare. • We discussed a non-coercive incentive amount with our online CAB.
The participant – researcher relationship should be warm, real, and equal.	• Participants were recruited in-person by known IPV advocates with established trust and rapport. • The online focus group co-facilitator was a counselor who worked at the partnering service provider and knew many of the clients who would be participants.
Approaches, language, and participant choices should be empowering.	• Participants were empowered regarding technology choices, such as turning off their cameras and using chat to respond to prompts.
Dialogue and interactions should focus on strengths and resilience.	• Researchers used techniques to demonstrate strengths that were compatible with the online format, such as active listening and person-first language.
Researchers must avoid re-traumatization.	• A licensed counselor co-facilitated the online focus group to ensure participant well-being. • Childcare was separated from the rooms where mothers participated, to avoid children overhearing the focus group through the device mothers used to join online.
Researchers should recognize that trauma has impacted all participants to some level.	• Staff at the IPV service provider and the counselor co-facilitator conducted online and in-person check-ins on participant well-being before, during, and after the focus group.
Researchers should prioritize participant safety and cultural competency.	• The Zoom room was locked, and all participants joined from a safe physical location. • Advocates were available in person and research staff were available online to help with any technical issues connecting to the Zoom meeting. • Researchers instructed participants in how to change their name and turn off their camera, if they chose to, to keep their identity as confidential as possible.

Our work met each of these principles using online methods, and it is our hope that providing concrete examples of implementing the framework will be useful to other researchers planning online qualitative data collection, especially among populations with safety risks or who have been historically marginalized and who therefore are at greater risk of violence.

Ethics

Others have discussed the importance of involving survivors of violence in research as part of the “healing process” (Burke Draucker, 1999; Synder, 2016). Rather than excluding participants because they may be at risk of re-traumatization, conducting research with such populations can be beneficial. However, as the author of the TRIPP framework (Edelman, 2022) explains, research methods that ignore the impact of trauma risk excluding participants with adverse and historically marginalized backgrounds. This is particularly problematic for researchers working in health-related fields as it excludes participants with some of the poorest health outcomes. Edelman states:

“Poor health is linked to the social inequalities that arise from inequities in power, money and resources, with high rates of trauma in general populations impacting health and access to interventions. The majority of health outcomes, and many of the ‘risk behaviors’ known to precipitate are associated with social inequalities and trauma… [which] can also affect willingness and ability to engage with research, such that societies’ most disenfranchised may be less likely to experience good health and to participate in the studies which inform health care decisions” (Edelman, 2022, pp. 1).

Ignoring the effect of trauma on the general population and specifically on health-related outcomes has the potential to further exacerbate social inequalities due to “intervention-generated inequality” (Edelman, 2022). Further, it may be difficult to uncover the contextual factors affecting people who have experienced trauma outside of a group setting (Pollack, 2003). In this study, our population of focus were individuals who were known to have experienced trauma and adversity, making it clear that we needed to develop trauma-informed research protocols for collecting data from a group that would work in an online format. Online research focused on general health outcomes may also need a framework like TRIRPP to guide research design and implementation as a matter of ethical research practice to ensure inclusivity and generalizability.

Edelman further explains that including participants who have experienced trauma in research that does not consider how trauma may be impacting their participation could violate the basic principles of ethical research (2022). In our case, without adapting online protocols to the trauma experienced by our group of parents, we risked disrespecting our participants, violating beneficence, and conducting unjust research (Beauchamp, 2008). Instead, we acknowledged the trauma experienced by our participants and respected them by empowering participants to make their own decisions about engaging online, ensuring that they had access to appropriate online supports, and reiterating consent and voluntary participation before starting the online focus group. Individuals who have experienced violence may be more susceptible to coercion than those who have not due to the forms of power and control used by violent perpetrators (Pence & Paymer, 1993). We were mindful of the potential to coerce participants into agreeing to the focus group when we decided to incentivize online participation and relied on trusted service providers to help recruit participants to the focus group in person. Moreover, the approaches we used safeguarded against online coercion by continually emphasizing consent in person and online, minimizing re-traumatization to children by separating them from the ability to overhear the Zoom call, and stressing safety—both physically by locating participants in a safe place before joining online and emotionally by having the counselor co-facilitator in the online meeting, as the TRIRPP framework explains.

Considerations

In our case, working with a group of mothers who were experiencing risks for distress and even physical harm, the largest hurdles for online data collection were potentially being overheard by a perpetrator, risking potential physical and emotional safety; disclosing participant names or phone numbers outside of the group, especially in a close-knit, shelter community (due to the way online platforms display participant information); allowing children of parents to inadvertently overhear sensitive information; and managing the infectious disease risks associated with COVID-19. We overcame these challenges by taking a trauma-informed approach to designing our online methods, co-locating participants in private spaces, using innovative online protocols that emphasized participant confidentiality and the provision of counseling support, and hiding participant identities from each other, practices which follow TRIRPP recommendations. There are always barriers to participation in data collection when the target population experiences adversity, as is the case with mothers who have experienced violence. As TRIRPP principles and practice advise (Edelman, 2022), we tried to alleviate such barriers by providing a separate space for childcare for children over 3 years of age and finding a non-coercive incentive amount to compensate participants for their time.

Like others (Lobe et al., 2020), we found that Zoom was a good platform for qualitative data collection with women who have experienced IPV, as it has many features that helped ensure confidentiality, including the ability to use breakout rooms, change meeting hosts, change participant names, have a pre-meeting virtual waiting room, and lock the discussion room (Archibald et al., 2019). The platform is also available in a free version and is widely used, which made joining easier for participants. Introducing the focus group and changing participant names one at a time did help ensure confidentiality, but it also took a large portion of the time allotted for the focus group. Even though we asked participants to join the meeting 30 minutes early, some were still late to join and the one-at-a-time process took away some of the 60-minute time allotted for discussion. Furthermore, we learned from participants during the focus group and from reports afterward from staff at the IPV service provider that parents with children who stayed with them (under 3 years of age) were distracted and drained by trying to participate while having their child present.

Implications for Practice.

Future researchers looking to collect data from people who have experienced violence, especially parents, could use Zoom or other online platforms with similar meeting options as long as TRIRPPs are followed. To keep participant identities confidential, we suggest the waiting room and breakout room features, recognizing that the process to join the meeting will take time and that participants may have to devote extra time to compensate. We strongly encourage future researchers to follow TRIRPP and ensure that participants are physically safe from perpetrators and any other co-location risks (e.g., social distancing; Edelman, 2022). Specifically, we highly recommend that service providers (counselors, advocates, etc.) be present and able to help participants connect to the group and discuss anything that may upset or distress participants. Using incentives and including childcare both contributed to successful implementation of focus groups with this population and helped recognize the trauma that individuals have faced. If we had included childcare for all prospective participants’ children, regardless of age, it would have likely made participation even more accessible. Other barriers to consider addressing would include accommodations for non-English speakers and those with hearing or visual impairments and providing transportation for participants if they are not already co-located.

We believe that this work describes innovative strategies to focus group data collection that account for participant safety and social distancing requirements. Furthermore, specific examples of the TRIRPP framework will help future researchers follow these guidelines. The successful implementation of these methods suggests that it is possible to collect quality information on sensitive topics using a virtual format while maintaining confidentiality of all participants and following TRIRPP recommendations. Furthermore, we hope that future data collection with groups experiencing adversity and at risk for behavioral health concerns may benefit from our experience.

Supplemental Material

Supplemental Material - Prioritizing Participant Safety During Online Focus Groups With Women Experiencing Violence

Supplemental Material for Prioritizing Participant Safety During Online Focus Groups With Women Experiencing Violence by April Schweinhart, Katharine Atwood, Camila Aramburu, Rachel Bauer, Winnie Luseno, and Ashley Simons-Rudolph in International Journal of Qualitative Methods.

Footnotes

Acknowledgements

The authors wish to thank the community partners who do the work every day to support survivors of violence.

Declaration of Conflicting Interests

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Funding

This work was made possible by cooperative agreement grant number 90EV0465 from the Administration for Children and Families Family and Youth Services Bureau awarded to an intimate partner violence service provider in the largest metro region of a southern U.S. state.

ORCID iDs

April Schweinhart

Rachel Bauer

Supplemental Material

Supplemental material for this article is available online.

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