Implementation of Virtual Focus Groups as an Effective Strategy in Qualitative Research to Engage With Undersupported Communities: Protocol for Virtual Focus Groups.

Background: Qualitative research offers a valuable lens for understanding human experiences, behaviors, and social contexts, drawing upon communication, social interaction, and sociological perspectives. Focus groups are a key method within qualitative research for exploring these complex topics. While traditional focus groups offer valuable insights into group dynamics and shared perspectives, they can be limited by logistical challenges, such as geographic constraints and participant availability. To mitigate these issues, virtual modalities have emerged as a viable alternative, offering greater flexibility and accessibility for diverse populations. However, they also highlight persistent challenges, such as managing group dynamics in online settings and ensuring participant engagement and privacy concerns. Our protocol considers these issues and implements strategies, such as cofacilitators, more engaged research assistants, and the use of important security measures (participant name obfuscation, sharing links only on the day of the session, and password protection) as a way to overcome said issues. Objective: Expanding the methods for data collection in qualitative research is essential for advancing health differences research in hard-to-reach populations and public health emergencies. In this paper, we aim to describe our experience when implementing an adapted protocol for conducting virtual focus groups, the barriers encountered, and how we obtained a participation rate of 86% (63/73) compared to 55% (40/73) when done in person. Methods: To achieve this, we adapted and implemented a focus group protocol that approaches undersupported populations (social vulnerability index ≥0.45) who face challenges participating in traditional focus groups and addresses reported barriers in scientific literature using virtual focus groups. Our protocol was implemented in an exploratory qualitative study conducted from 2020 to 2021 to understand the community's health needs in southern Puerto Rico. This protocol ensures participant and research team interactions in circumstances that require it, including pandemics, geographically displaced populations, and patients who are bedridden. After evaluating the practical and ethical considerations, our research team established this new protocol for collecting qualitative data in a virtual focus group environment and promoting the inclusion of groups experiencing health differences. Results: As a result, we collected quality data and found added benefits. We obtained a participation rate of 86% (63/73) compared to 55% (40/73) when done in person. Our findings also reveal further benefits that could impact groups that generally do not have the chance to participate in focus groups. Conclusions: This approach to focus groups could aid researchers who wish to study these hard-to-reach participants and support qualitative health differences research.