Focus Groups/Workshops

Three focus groups/workshops with (1) community members, (2) investigators and (3) both groups combined will be conducted using a group model building (GMB) activity methodology12 (figure 2). GMB is a powerful participatory method for actively engaging stakeholders or communities to provide perspective on a complex problem, structure, or dynamic process as well as the results and solutions.12 13 To facilitate knowledge sharing, discussion and consensus on the issue, participants will be engaged in a number of activities (scripts). The objective of the first two sessions is to elicit discussion on factors contributing to a lack of African-American clinical trial participation by creating a systems-based map or causal loop diagrams (CLDs).

Our rationale for conducting separate workshops prior to the combined sessions is to develop a richer understanding of participants’ unbiased perceptions surrounding clinical trial participation. Additionally, this strategy improves stakeholders’ engagement and participation in group activities that may suffer due to power imbalances. The research team will work offline between sessions to refine and synthesise the CLDs or informal causal maps, created during sessions 1 and 2 by participants. During the third combined session, participants will evaluate the synthesised map.

This is necessary to ensure that the model reflects the insights and stories shared by participants. In addition, this allows for participants to identify potential areas in the system where they believe change is needed. Following the iterative process, all participants will be provided copies of the combined systems map to provide final feedback to the research team.