How Focus Groups Can Inform Your Community Health Assessment

Community health assessments (CHAs) are essential tools for understanding the health needs, priorities, and assets within a community. When done well, CHAs do more than just catalog health statistics—they tell the story of the community’s lived experiences, challenges, and aspirations for wellbeing.

Focus groups offer one of the most powerful ways to bring those stories to life. They allow us to move beyond numbers and listen deeply to the voices of people who are most impacted by health disparities, access barriers, and systemic inequities. In this post, we will explore how focus groups can strengthen a community health assessment, drawing on real-world examples and highlighting additional qualitative methods you can use to amplify community voice.

Why Use Focus Groups in a CHA?

Focus groups are small, facilitated discussions that gather rich, qualitative information directly from community members. When incorporated into a CHA, they offer several important benefits:

• Contextualizing Quantitative Data: Focus groups help explain why certain health trends appear in survey data or administrative records, such as why vaccination rates may be lower in certain neighborhoods or why mental health services remain underutilized.

• Identifying Priorities and Barriers: Community members often surface priorities, challenges, and assets that professionals might overlook when relying only on surveys or secondary data.

• Building Trust and Empowerment: Participating in focus groups can help foster relationships between health systems and communities, particularly when facilitation centers dignity, inclusion, and respect.

Focus groups are not a replacement for surveys or epidemiological data, but they are a critical companion—providing the color, nuance, and depth needed to design truly responsive health initiatives.

Examples from the Field

Maricopa County, Arizona

In 2016, the Maricopa County Department of Public Health undertook a coordinated community health needs assessment with a strong qualitative component. As part of the process, they conducted 36 focus groups with more than 300 participants, prioritizing medically underserved communities across the county.

Focus groups were intentionally designed to reach diverse populations, including groups based on age, race, ethnicity, and physical ability. Materials were made available in English and Spanish, and facilitators used culturally responsive practices to encourage open discussion.

Participants shared insights about healthcare access, quality of life, environmental health concerns, and the importance of preventive care. Focus group findings underscored the need for culturally competent healthcare, better communication between providers and communities, and expanded access to mental health services. These qualitative results were instrumental in shaping the county’s health improvement priorities.

Richmond County (Augusta), Georgia

The Richmond 2024 CHA combined quantitative data collection with a series of focus groups engaging individuals receiving services, staff, stakeholders, and peers.

Through these discussions, important themes emerged: participants highlighted cultural and linguistic barriers to accessing behavioral health services, challenges related to transportation and appointment availability, and the need for more integrated service models.

Focus group findings offered critical insights into not only service gaps but also the broader social determinants of health affecting community members’ experiences. These insights are now informing strategic planning for behavioral health system improvements in Augusta.

Best Practices for Conducting Focus Groups for your CHA

If you are considering incorporating focus groups into your CHA, a few best practices can help ensure the process is meaningful and equitable:

Planning and Recruitment

Identify key populations you want to hear from, considering geography, cultural identity, age, ability, and other lived experiences.

Partner with trusted community organizations and leaders for recruitment.

Offer appropriate incentives and make participation logistically accessible (location, timing, childcare if needed).

Facilitation and Design

Center the facilitation on values of dignity, inclusion, and care.

Develop open-ended, equity-focused questions that invite diverse perspectives.

Allow for flexibility within the guide to follow important threads raised by participants.

Documentation and Analysis

Use audio or video recording ethically and with informed consent.

Analyze themes collaboratively, when possible involving community partners in reviewing findings.

Validate themes with participants through follow-up activities such as data walks or community feedback sessions.

Making Focus Group Data Actionable

The real value of focus groups lies in how the insights are used:

• Informing Prioritization: Focus groups can help clarify which health issues feel most urgent or visible to the community.

• Guiding Program or Policy Design: They surface ideas for solutions and strategies grounded in lived reality.

• Supporting Grant Applications and Reports: Rich qualitative data strengthens narratives for funding opportunities.

• Building Relationships: Sharing findings back with participants closes the feedback loop and shows a commitment to accountability and partnership.

Exploring Other Qualitative Methods Photovoice

While focus groups are a cornerstone of qualitative CHA work, other methods can also be powerful in elevating community voice. One method increasingly used in public health settings is photovoice.

Photovoice is a participatory approach where individuals use photography to document and reflect on their environments, experiences, and community conditions. It is particularly effective in capturing perspectives that might otherwise go unheard.

A recent article in the Journal of Prevention and Health Promotion describes how photovoice projects can support mental health recovery, community empowerment, and policy change by centering the visual narratives of participants.

For a real-world example, the Clark County Activity Coalition Photovoice 2022 Project showcases how community members in Kentucky used photography to share their experiences with health, activity, and neighborhood environments. The project not only provided valuable assessment data but also helped inform local health initiatives in a way that honored community voice and leadership.

Conclusion

Focus groups are more than a data collection tool—they are a pathway to building a deeper, more human-centered understanding of health within our communities. By creating spaces for people to share their stories, challenges, and hopes, we can craft community health assessments that truly reflect the needs and aspirations of those we serve.

Whether through focus groups, interviews, or photovoice, elevating lived experience must be at the heart of how we design healthier, more equitable communities.