texasmotherfriendly.orgtexasmotherfriendly.org/files/program/document_24.doc · Web viewFlexible breaks and work options: Gradual transition back to work (e.g., part-time employment

Why Use a Focus Group?

Focus groups and interviews allow you to get more in-depth responses about what people think and how they feel. They can be sources of additional information to inform your planning or can sometimes be used to better understand data you’ve collected in another way, such as by survey or statistical data.

Suppose you have data showing that a majority of mothers in your agency have chosen not to continue to breastfeed once they’ve returned to work. In a focus group of mothers at your workplace, you can find out why by probing for beliefs, attitudes, and motivations for their choices regarding combining work with breastfeeding.

Focus Group Guide | 1

2 | Focus Group Guide

Planning a Focus Group

1. Select the committee Usually two people can get the job done—one who moderates the discussion and another who takes meeting notes and possibly records the session electronically.

2. Select the participants Based on the information you need, decide who would be the most suitable employees to participate.

You might want to talk to both female and male employees who have had children during the time they have been employed at your worksite, pregnant/expectant employees, employees who were able to combine work and breastfeeding to successfully achieve their breastfeeding goals, employees who were not able, employees who are supportive of the effort, and perhaps even employees who are not supportive. Ideally, you should have no more than 10 people so that everyone has a chance to express their ideas and so that you can manage the discussion and the time. Consider the composition and size of your workforce as well as the constraints on time and resources when deciding whom to invite and how many focus group sessions to hold.

3. Decide on a time and location Try to choose a space that is large enough and comfortable, free from intrusion or distractions, and convenient. Be sure to give yourself enough time to cover the topics you want—between one and two hours is usually enough time, depending on the number of people in each group. Allowing 7 to 10 minutes per person is a good rule of thumb. Consider providing food and drink, as it tends to boost attendance and facilitates rapport building.

4. Invite the participants Give your selected participants as much notice as possible, schedule reminders for them, and provide all reading materials ahead of time.

5. Prepare the focus group guide This guide will help you cover the topics related to the information you need and your project objectives.


Tips for Conducting Focus Groups

Obtain consent A consent form is provided in this section. Read it aloud and have attendees sign an acknowledgement, or place it at the top of a sign-in sheet and ask people to read it before they sign in.

Establish rapport This is a good time to lay the ground rules and create an informal but fair environment. Examples of good ground rules:

Only one person speaks at a time. Everything said will be kept confidential with no identifiers attached to information recorded. Everyone should be made to feel comfortable and respected, regardless of whether their opinions on the issues are positive or negative and despite their personal attributes (e.g., male or female; breastfed or did not, etc.)Ask whether anyone would like to add to this list before beginning the session, and give everyone a copy as a reminder. Follow the focus group guide We have provided a guide to keep you on track with your objectives while respecting time constraints. This guide will help you be more efficient as you gather comprehensive and quality responses. If the discussion falls flat, try not to veer from the guide or alter the questions too much. Try the following: Repeat the question. Pause for the answer. Repeat the reply. Ask what, when, where, why, and how

questions. Use neutral comments such as

“Anything else?” Of all of the “W” questions, “why” can

sometimes put people on the defensive. Possible alternatives include: “Can you expand on that?” “Tell me more about that point.”

“Where does that stem from?” Stay in control of the discussion Some people may be reluctant to contribute, while

there may be others who try to dominate the discussion. As a moderator, try to ensure you get information that represents the entire group rather than just an outspoken few. Address reluctant individuals directly, and to subtly deter a dominant speaker, politely summarize his or her point, then refocus the discussion.


Record the discussion Having two types of recording methods is ideal, preferably one handwritten and the other, some type of electronic recording. Handwritten notes can include observations not apparent in electronic recordings, such as group dynamics, facial expressions, and other non-verbal behavior. Notes are also useful to have in the event of a technical failure.

Mother-Friendly Worksite Focus Group Guide—Needs Assessment

Below is a script for your moderator to follow. The moderator should become familiar with the materials and questions ahead of time in order to be familiar with what information is relevant to your assessment and to help keep the conversation flowing.

Ad-libbing is discouraged. The guide will help you to be more efficient as you gather information relevant to your planning. The italicized parts of the guide are what the moderator should read aloud to the group.

I. Warm-up and Explanation

A. Background of the Project Our organization is working to develop and implement a worksite lactation support program in order to become designated as a Texas Mother-Friendly Worksite by the Texas Department of State Health Services. Breastfeeding is a public health imperative that is promoted and protected in federal and state laws. It is a free, accessible, cost-effective practice that has been proven to result in optimal health outcomes for both mother and child, including reducing the risk for both infectious and chronic diseases. Breastfeeding is accepted and promoted as an integral part of employee wellness programs worldwide. Supporting breastfeeding in the workplace allows for more mothers to continue breastfeeding for periods longer than the usual parental leave they take. While breastfeeding may not be possible for every new mother, returning to work should not be a barrier to her breastfeeding goals. It is the intention of the Mother-Friendly Worksite Program to provide support to worksites such as ours for the development of Mother-Friendly Worksite employee lactation support policies, environments, and programs that are:

Responsive to the breastfeeding needs of parenting employees and their children. Feasible and sustainable for employers. Beneficial for the health of Texans.

Because the development and implementation of our Mother-Friendly Worksite program will impact our organization as a whole, we are interested in your input regarding how to make this transition a collaborative, positive, cost-effective, and well supported effort.


B. Introduction 1. Tailor your introduction and welcome statement to your audience.2. Provide a brief overview of the elements of worksite lactation support, using

abbreviated highlights from the Committee Orientation PowerPoint and a summary of the work your committee has completed to date.

C. Purpose We will discuss your thoughts about

how to best support the ability of our employees to successfully establish and maintain breastfeeding, or lactation, after returning to work. We would like your input on challenges, untapped resources, personal experiences, and current unmet needs regarding worksite lactation support.

I am interested in your ideas, comments, and suggestions.

There is no right or wrong answer. All comments, both positive and

negative, are welcome. Please feel free to disagree with one

another. We would like to have many points of view.

D. Procedure Explain the use of video and/or audio

recorders if applicable. All comments are confidential and will be used for planning purposes only.

This is to be a group discussion, so you don’t have to wait to be called upon, but please do speak one at a time.

We have a lot of ground to cover, so if I change the subject or move ahead, please stop me if you want to add something.

E. Self-Introductions 1. Ask each participant to introduce him or herself. Perhaps give a name, position, and say

how long they’ve been with the company.

II. Needs Assessment

Instructions: This is an anonymous activity. Post the provided responses somewhere visible and accessible to the group, such as on sheets of paper on the wall. Provide attendees with colored dots, sticky notes, and pens. Ask them to read the responses and to follow the directions provided below. To save time, attendees can be given the information before the meeting so that they can think over their responses in advance.


The provided responses are actual responses given by employees in similar focus groups. They cover a wide variety of topics, all of which employees felt influenced their breastfeeding relationship with their child. The diversity of answers illustrates the extent to which breastfeeding is related to other aspects of parenting.

A. During Pregnancy Please share from your own experience or from the choices below, the three biggest challenges that employees (both male and female) face with balancing the demands of an expected or new baby and work. (Place one dot next to your three top choices, or use the Post-its provided to add up to three items to the list.) Figuring out policies, procedures,

required paperwork, etc. for taking time off from work for the birth of a child Scheduling appointments to cause as

little disruption of work as possible Handling the transfer of work for the

time while out of office Deciding how long to take off from work Concerns about not being able to afford

time off from work Difficulty communicating with

supervisor about plans for leave and return to work Balancing additional tasks and logistics

of preparing for a major life transition Feeling tired or other discomforts

related to pregnancy Not knowing what to expect

postpartum Stress Trying to save time for leave while also

attending necessary medical appointments Not having enough time to rest, work,

and prepare for the baby’s arrival Anticipating readjustment to workplace

after birth Preparing for post-baby responsibilities

(child care, finances, housing, etc.) Planning for logistics of balancing

parenting and working after return to work


Other____________________________________________

Other____________________________________________

Other____________________________________________

B. Early postpartum (first 6-12 weeks) Please follow the same directions as in Part A. Determining when and how to come

back to work (flex-schedule, half days, telecommuting) Do I have options? What are they?

Adding baby to health insurance Difficulty understanding FMLA:

o How does it affect retirement, leave accrual, etc.?o Do prenatal appointments count against FMLA, shortening the time I am eligible to

be out postpartum? Difficulty understanding other leave

options Pressure from employer to come back

to work before 12 weeks Adjustments to new life demands, time

schedules, roles, routines, responsibilities, and home life Concerns about using all of accrued

leave time Fatigue Breastfeeding questions, concerns, or

difficulties Parenting/infant care concerns

(support, knowledge, resources) Postpartum self-care concerns Medical problems (self or infant) Questions about how to plan for

combining work and breastfeeding (when and how do I begin pumping, when and how do I introduce a bottle, how much milk should I have stored?)

What are the logistics of breastfeeding/pumping at work—Where? When? How often? How does this affect my time and leave?


Uncertainty about how to find a comfortable and private place to pump breastmilk at workplace

Concerns about being separated from child after return to work

Having to find and arrange for adequate child care

Having to return to work full time Concern about managers and peers

being supportive and understanding about the additional stress and demands that are part of a major life change and with combining working with parenting

Concerns about being able to balance shifting—and sometimes competing—priorities between home and work life

Other____________________________________________

Other____________________________________________

Other____________________________________________

C. During the first year after birth? Again, follow the same directions as on Parts A & B Difficulty arranging for gradual return to

work (options for returning—part-time, telecommuting, flex-time, etc.) Not enough time on parental leave to

get breastfeeding off to a good start Difficulties with finding adequate or

reliable child care Baby frequently sick because she was so

young when she started child care Concerns about breastfeeding/pumping

at work. When? Where? How often? How does this affect my time? How does it affect my relationship with managers and peers?

Problems with communicating with boss about logistics of working and breastfeeding (time, space, storage, privacy issues, lack of support, treated with scrutiny, suspicion, or impatience)

Problems with communicating with boss about balancing family needs and work needs (e.g., caring for sick child, navigating child care issues, etc.)

Dealing with unexpected absences


Juggling pump schedule with work schedule

Not having enough time to pump Having the time to pump but feeling

guilty about using the time Concern about diminishing milk supply Difficulty balancing family and work

priorities due to inflexible work schedule Distracted or worried about or missing

baby during the work day Difficulties coordinating child care drop-

off and pick-up with work schedule Financial worries due to extra expenses

related to new baby Lack of any leave after return to work,

due to all leave having been used for parental leave Difficulty with taking time off for doctor

appointments, both for well-baby checks and for illness

Adjusting breastfeeding expectations and/or goals to realities of work situation

Other____________________________________________

Other____________________________________________

Other____________________________________________

Provide a few minutes for review of responses and discussion. Is there anything that should be added or changed? Is more detail needed to clarify any of the responses?

III. Program Components

Here we would like you to brainstorm to come up with your perfect worksite lactation “dream world.” What would it look like? What resources would be available? We will go through the components step by step and ask you at each step to think about the continuum of the prenatal period that we considered above. You have been provided with a page of dot stickers, which you will use to indicate your preferences as we complete this exercise. (Again, please have these pre-written or displayed in a way to accommodate the voting.)


A. Policy and education Please take two of your dots and place them next to the two most important policy and education components of your dream program. Written breastfeeding policy

Employees informed about policy in New Employee Orientation

Policy education for all employees within six months of hire

Educational packet about breastfeeding and related policies provided to all expectant parents

Managers trained in policy implementation

Manager toolkit for breastfeeding and related policies

Other____________________________________________

B. Facilities Please choose two things you think you must have and three you think would simply be nice to have in addition to the must haves. Note: Provide two columns: (A) Must Have and (B) Nice to Have. Allow two “A” choices and three “B” choices. Private room with a lock on the door

Curtain or partition to allow more than one user to access the room at same time

Comfortable chair for pumping (what kind?)

Footstool

Table or desk Disinfectant wipes/hand sanitizer

Refrigerator for milk storage

Microwave for pump sanitation


Nearby sink with running water

Small table

Radio/CD player, art, low lighting, paint (what color?)

Bulletin board for posting photos of babies/notes

Breastfeeding literature in literature display

Multi-user electric breast pump

Coat hooks Full-length mirror

Other____________________________________________


C. Flexible break and work options Please place dots next to two that seem feasible, ideal, or both. Gradual transition back to work(e.g.,

part-time employment or telecommuting for several weeks before resuming full-time work)

Compressed work week—working longer hours four days of the week and taking off in the middle of the work week to be with the baby and rebuild milk supply

Flexible scheduling (combining existing breaks, coming in early, leaving late, shortening lunch break, using admin time, etc.) to allow for adequate breaks for pumping as needed throughout the workday (most employees will need three 30-min. breaks during an average eight-hour workday, though needs may vary between individuals and throughout the time that a woman is breastfeeding)

Helping employees locate nearby child-care providers who will accommodate direct breastfeeding on lunch breaks

Accommodating (through space and flexible scheduling) for child-care provider to bring baby to mother for feeding at lunch and other break times

Other____________________________________________

D. Education resources Please place one dot next to each of three of your top choices for this section. Remember that you have the option to add an idea to the list on a Post-it. Lending library of breastfeeding

literature, books, videos Breastfeeding classes offered during

lunch hour (for employees and partners of employees) Breastfeeding classes offered after-

hours Administrative leave provided to attend

classes offsite Parental leave informational toolkit

developed and made available Resource list with lactation consultants

and other levels of lactation support provided Counseling by phone or email provided

by trained breastfeeding counselor or certified lactation consultant


Return-to-work educational toolkit developed and given

Return-to-work orientation/consultation provided

Other____________________________________________


E. Workplace support Please place one dot next to your three top choices for this section. Remember that you have the option to add an idea to the list on a Post-it. Managers and supervisors provide

information about basic needs of breastfeeding employees Dissemination of information about the

worksite lactation program Breastfeeding awareness campaign at

worksite Promotion of program as a wellness

benefit for employees Promotion of program as beneficial to

all employees because of reduced absenteeism and turnover rates and increased productivity

Informal monthly mothers’ meeting during the lunch period

Electronic discussion board for program participants

Trained peer mentor program (mother-to-mother support)

Onsite La Leche League meeting Other____________________________

________________

F. Dissemination strategies / program promotion Please place one dot next to your four top choices for this section. Employee wellness or health fairs Agency-wide mailing or email Staff meetings Open-house for the lactation room

(serve refreshments and invite the media!) Articles in internal print or web-based

newsletters Outreach tables set up in prominent

areas, with representatives from the program on hand to answer questions and distribute materials to employees

Promotional packets for pregnant employees and partners


Word of mouth “Lunch and Learn” sessions Baby shower for expectant employees

and partners Posters and bulletin board displays Company-wide mailing or email Paycheck stuffers promoting the

program Promotion through health benefits

program Other____________________________

________________

Provide a few minutes for review of responses and discussion. Is there anything that should be added or changed? Is more detail needed to clarify any of the responses?

IV. Implementation

Now we would like to hear from you about what tools you think would be helpful in implementing the vision that we’ve mapped out during this meeting. This will be important in determining how feasible it is to implement our ideas at this time. I am going to ask some questions, and we will record your responses. We are looking for your “off-the-top-of-the-head responses” and will spend only a few minutes on each question.

A. What resources will we need in order to provide the supports we’ve discussed today? Consider human resources, space, time, funding.

B. What ideas do you have for gaining buy-in from key decision makers?

C. What ideas do you have for gaining buy-in from our organization’s employees?

D. What groups/departments/stakeholders, inside and outside of our organization, might contribute to this program?

V. Evaluation

Now we would like to hear from you about what things we would measure to determine how successful we have been at implementing the vision that we’ve mapped out during this meeting. I am going to ask some questions, and we will record your responses. We are looking for your “off-the-top-of-the-head responses” and will spend only a few minutes on each question.

A. How would we measure success?

VI. Closing


Before we end, I’d like to go around the room and ask each of you whether there’s anything you’d like to say about what more we should consider as we work toward becoming a Mother-Friendly Worksite. Anything we haven’t mentioned or considered that would be important to you if you were planning on combining work and breastfeeding or expressing breastmilk?

Thank you for coming today. Your time is much appreciated and your insights have been very helpful. We will provide a summary of the meeting notes and will ask you to provide any additional information to make sure we’ve accurately captured the work we completed today.


Pre-Focus Group Email Invitation

(Best to send at least a week ahead to give people enough time to consider, and then send a brief follow-up email letting them know the logistics of the meeting.)

Dear Worksite Lactation Support Program Stakeholders,

Below are the discussion questions for our upcoming focus group (insert time, date, room #). Your input at this meeting will help us develop our worksite lactation program. Before the meeting, please take a moment to think about what an ideal worksite lactation support program would look like to you. What support and services would be available prenatally, in the early weeks postpartum, and for the first year of parenthood? Think about what our expectant and parenting staff (both male and female) would need in order to achieve work/life balance. Then review and consider the questions below. We will use our meeting to rate and discuss the following questions/topics.

Topic 1: Needs Assessment

What are the three biggest challenges that employees (both male and female) face in the workplace with balancing the demands of a new baby and work?

Note: For this question, we will ask you to write your ideas on Post-its. You may do this in advance of the meeting if desired.

During pregnancy or prenatally?

1.

2.

3.

Early postpartum in the first 6-12 weeks?

1.

2.

3.

During the first year after birth?

1.

2.

3.


Topic 2: Program Components

Brainstorm your worksite lactation program dream world. What would an ideal worksite lactation support breastfeeding program look like to you? What resources would be available? Think about policy, facilities, scheduling, education, support, and other resources. Think about the continuum of the prenatal period, early postpartum (before return to work), time immediately after return to work, and the first year.

Note: For this question, we will ask you to rank your ideas in order of importance. You may do this in advance of the meeting if desired.

Policy and education:

Written breastfeeding policy Employees informed about policy in New Employee Orientation Policy education for employees included in employee intake process Educational packet about breastfeeding and related policies provided to all expectant parents Managers trained in policy implementation Managers Toolkit for breastfeeding and related policies developed Other____________________________________________

Facilities: (must have/nice to have):

Private room with a lock on the door Curtain or partition to allow more than one user to access the room at same time Comfortable chair for pumping Footstool Disinfectant wipes Hand sanitizer Refrigerator for milk storage Microwave for pump sanitation Nearby sink with running water Small table Electrical outlet Wall clock Radio/cassette/CD player Bulletin board for posting photos of babies/notes Breastfeeding literature in literature display


Art Low lighting Multi-user electric breast pump Paint (what color?) Trash can Coat hooks Full-length mirror Other___________________________________________

Flexible breaks and work options:

Gradual transition back to work(e.g., part-time employment or telecommuting for a few weeks before resuming full-time work)

Compressed work week—working longer hours four days of the week and taking off in the middle of the work week to be with the baby and rebuild milk supply

Flexible scheduling (coming in early, leaving late, shortening lunch break, combining breaks, using admin time, etc.) to allow for adequate break time for pumping throughout the workday

Helping employees locate nearby child-care providers who will accommodate direct breastfeeding on lunch breaks

Accommodating (through space and flexible scheduling) for child-care provider to be brought to mother to feed at lunch and other break times

Other____________________________________________

Education Resources:

Lending library of breastfeeding literature, books, videos Breastfeeding classes offered during lunch hour (employees and partners of employees) Breastfeeding classes offered after-hours Admin leave provided to attend classes offsite Parental leave informational toolkit developed and made available Resource list with lactation consultants and other levels of lactation support provided Phone and email counseling provided by trained breastfeeding counselor or certified lactation

consultant Return-to-work educational toolkit developed and given Return-to-work orientation/consultation provided Other____________________________________________


Workplace Support:

Managers and supervisors trained in basic needs of breastfeeding employees Dissemination of information about the worksite lactation program Promotion of program to all employees as a wellness benefit Promotion of program as beneficial to all employees by lowering absenteeism and turnover

rates and increasing productivity Monthly informal mothers’ meeting during the lunch period Electronic discussion board for program participants Trained peer mentor program Onsite La Leche League meeting Other____________________________________________

Dissemination Strategies/Program Promotion:

Employee wellness or health fairs Agency-wide mailing or email Staff meetings Open-house for the lactation room Articles in internal print or web-based newsletters Outreach tables set up in prominent areas, with representatives from the program on hand

to answer questions and distribute materials to employees Promotional packets for pregnant employees and partners Word of mouth “Lunch and Learn” sessions Baby shower for expectant employees and partners Posters and bulletin board displays Company-wide mailing or email Paycheck stuffers promoting the program Promotion through employee benefits provider Other____________________________________________


Topic 3: Implementation

What tools are needed to help implement this vision? (Note: This will be a brainstorming session.)

What resources will we need? (Human resources, space, time, funding)

Ideas for gaining buy-in?

What groups/departments/stakeholders, inside and outside our organization, might contribute to this program?

Topic 4: Evaluation

How do we measure success? (Note: This will be a brainstorming session.)

Topic 5: Participation

Are you able to help? If so, how?

Short-term, intermediate, long-term

Planning, implementing, evaluating


Pre-Meeting Checklist

Remember to bring the following:

Two writing utensils A notepad with sufficient paper for taking notes during the entire focus group A flip chart Dry erase and/or regular markers of different colors Nametags or badges Tape for affixing flip chart pages to the wall, as needed Recording equipment:

A recorder Extension cord Extra batteries

Consent forms (enough copies for all participants) Extra pens for signing consent forms Focus group guide Enough stickers for participants’ use Enough Post-its for exercises Food, drink, and any cups, utensils, napkins, serving utensils, ice, plates necessary

Remember to do the following…

Become familiar with the focus group guide. Review this checklist. Arrive at the focus group location a few minutes before participants to organize the room and

your materials. Welcome focus group participants, inviting them to get something to eat. Explain, in a general and brief way, the purpose of the focus group and how information

collected during focus groups will be used and toward what goal. Introduce yourself, the note taker, and other observer (if present). Explain participants’ rights and what participating in the focus group will entail. Remind participants of the duration of the focus group, emphasizing the importance of their

participation during the entire discussion. Let people know where the closest restrooms are. Obtain written consent to participate and be recorded.


At the end of the focus group meeting, give the participants the contact information for Name of Company Representative if they have any questions.

The following sources were consulted in creating this tool: Toolkit for Conducting Focus Groups from the OMNI Institute. Available from: http://www.omni.org/docs/FocusGroupToolkit.pdf and The Handbook for Excellence in Focus Group Research. Available from: http://www.globalhealthcommunication.org/tool_docs/60/handbook_for_excellence_in_focus_group_research_(full_text).pdf


http://www.globalhealthcommunication.org/tool_docs/60/handbook_for_excellence_in_focus_%20group_research_(full_text).pdf

http://www.globalhealthcommunication.org/tool_docs/60/handbook_for_excellence_in_focus_%20group_research_(full_text).pdf

http://www.omni.org/docs/FocusGroupToolkit.pdf

Consent Form/ Sign-In Sheet Intro

The purpose of this group discussion and the nature of the questions have been explained to me.

I consent to take part in a focus group about making our organization a Mother-Friendly Worksite.

My participation is voluntary. I understand that I am free to leave the group at any time. If I decide not to participate at any time during the discussion, my decision in no way will affect my job status or performance ratings as defined by the company standard measures.

None of my experiences or thoughts will be shared with anyone outside this group unless all identifying information is removed. The information that I provide during the focus group will be grouped with answers from other people so that I cannot be identified.

____________________________________________ _________________

Please Sign Your Name Date


Documents

texasmotherfriendly.orgtexasmotherfriendly.org/files/program/document_24.doc · Web viewFlexible breaks and work options: Gradual transition back to work (e.g., part-time employment