3 Not in Session

Study to Improve Thyroid Doses from Fallout Exposure in Kazakhstan

Appendix C - KAZ Women_FocusGroupGuide_NOTInSession-5-14-07[1]

Study to Improve Thyroid Doses from Fallout Exposure in Kazakhstan

OMB: 0925-0582

Document [pdf]
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5/17/2007

OMB No.:0925-XXXX and Expiration Date: XX/XX/2010
Appendix C
FOCUS GROUP GUIDE (Women)
School was NOT in Session

I. Greeting (10 minutes)
Welcome. My name is ____________ and this is my assistant, __________________. I want to
thank everyone for coming today. The Semipalatinsk State Medical Academy and the National
Cancer Institute in the United States are working on a study of radiation exposure and long-term
health effects.
The goal of today’s meeting is to learn about children’s diets, activities, and living conditions
around the time of the nuclear tests between the years 1949-1962, including information about
dairy animals providing the milk they drank. This will help our team from Semipalatinsk State
Medical Academy and the National Cancer Institute in their studies of radiation exposure and
long-term health effects.
Most of you have children who were less than 18 years old in the 1950s. Some of you had very
young children at that time, whereas others had older children. Other women in this group did
not have children but cared for younger siblings or were themselves adolescents at this time. You
are all knowledgeable about the daily life practices of children at that time, and we appreciate
your willingness to share your knowledge with us.
II. Logistics (5 minutes)
I have a set of discussion topics that I would like to go over with you today. This discussion
should last no more than 2 hours. I’ll be asking questions, and ______________, who works with
me, will help with note-taking during our discussion. We would like to tape-record the session so
that we do not miss anything important. You will be personally identified only with first name
and month of birth. We will also ask you for your children’s first names and years of birth. At
the end of our discussion, we will ask you to complete a brief anonymous evaluation form in
which you will be asked about your impressions of this focus group.
We hope that you will speak freely about your memories, feelings, observations, and opinions
because it will help us to understand what daily life was like for your children and adolescents as
well as for other children in general at the time of the nuclear tests. We want everyone to feel
comfortable participating in this group. Please be courteous and give everyone a chance to speak.
Please know that there is no requirement for you to answer questions or participate in any
discussions that make you feel uncomfortable. We will be making notes about your recollections
and general reactions to the discussion.
_____________________________________________________________________________________
Public reporting burden for this collection is estimated to average 1.9 hours (115 minutes) per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (xxxx-xxxx). Do not return the completed form to this address.
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OMB No.:0925-XXXX and Expiration Date: XX/XX/2010

III. Consent and confidentiality (10 minutes)
Before we start, we need you to read and sign a consent form. Please read through the form as I
read it out loud. Please take your time to make sure the consent form is clear to you. Please let
me know if you have any questions.
Moderator Note: File signed forms in an envelope with the date, time, and village name clearly
written on the front.
IV. Introductions (10 minutes)
Many of you already know each other, but it would be helpful to me if we could introduce
ourselves. Give us your first name and your month of birth. Also, please tell us the first names of
each of your children. For each child, please tell the group what year your child was born and the
child’s gender. If you did not have your own children during the 1950s, please tell the group
about brothers or sisters, nieces or nephews, or other children in the village for whom you cared
and fed. Let us start with those participants who were born in January, then February, all of the
way through December.
V. Developing context and stimulating recall (30 minutes)
Let’s spend a few minutes thinking about the time of the nuclear tests in the 1950s. Tell me
about your memories of the day of the test or tests.
1. What do you remember seeing or feeling at this time?
2. At the time of the tests, did the military contact you?
a. Probe: If yes, what did they tell you?
b. Probe: Did you have to leave your home?
c. Probe: If yes, when did you leave your home? When did you come back to your home?
We just talked about events on the day of the nuclear tests. Now let’s talk about the food and
activities of children in the late summer and fall months, August through October, following the
nuclear tests.

_____________________________________________________________________________________
Public reporting burden for this collection is estimated to average 1.9 hours (115 minutes) per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (xxxx-xxxx). Do not return the completed form to this address.
Appendix C - KAZ Women_FocusGroupGuide_NOTInSession-5-14-07

5/17/2007

OMB No.:0925-XXXX and Expiration Date: XX/XX/2010

VI. Breast milk, milk and milk products (90 minutes)
For this next part of our discussion, let’s talk about breast milk, milk and milk products that
children consumed at the time of the test or in the years of the 1950s. On the charts on the wall, I
will record your responses for the typical amounts and types of milk your children drank in the
1950s. I’d like to first ask you about breast feeding of infants.
3. Did you breastfeed your children? If so, how many months total did you breastfeed each
child?
a. Probe: At about what age were some other foods and milk introduced besides
breast milk? What were these foods?
Notetaker’s note: For each cell in the breastfeeding column, please record (1) whether the
participant breastfed their children, (2) duration of breastfeeding- from birth to what age, (3) at
what age other foods besides breast milk were introduced, and (4) what were these foods
4. Now, I’d like to ask you about the animal milk that your children drank. I’m going to ask you
what kind and how much of each type of milk your children typically drank when they were
young. If children drank milk in their tea or with kasha, think about those milks too.
a. When your children were less than a year old, how much of each of these types of
milk did your children drink?
b. When your children were 1 to 3 years old, how much of each of these types of milk
did your children drink?
c. When your children were 4 to 6 years old, how much of each of these types of milk
did your children drink?
d. When your children were 7 to 14 years old, how much of each of these types of milk
did your children drink?
e. When your children were more than 14 years old, how much of each of these types of
milk did your children drink?
f. Were there any differences between the types of milk that boys and girls drank?
g. Were there any differences between the amounts of milk that boys drank compared
to girls? If so, who drank more? How much more? Did this depend on age?
h. Were there any differences between the types of milk that Kazakh and Russian
children drank?
i. Were there any differences between the amounts of milk that Kazakh and Russian
children drank? If so, who drank more? How much more? Did this depend on age?
j. Was milk consumption different on days when children were not in school- Sundayscompared to days when they were in school?
Notetaker’s Note: For each cell in table below, please record the number of cups of milk
consumed of the various types by age group. If a participant cannot answer a question,
_____________________________________________________________________________________
Public reporting burden for this collection is estimated to average 1.9 hours (115 minutes) per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (xxxx-xxxx). Do not return the completed form to this address.
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OMB No.:0925-XXXX and Expiration Date: XX/XX/2010

please note this and any reasons given (e.g., can’t remember, don’t know). For each age and
type of milk, please write down the quantity of amount consumed, with an indication of units
(cups per week, glasses per day, etc.), using container models to standardize the units.
Please note how many children consumed that amount for each participant and if milk was
not consumed at all by a child. Please write down one response per participant unless the
participant offers different estimates for some/each of her children.
Wall Chart 1. Breast milk and milk consumption
Age of Child

Breastfeeding

Cow

Goat

Sheep

Mare

Other

0-12 months
1-3 years
4-6 years
7-14 years
>14 years

5. For this next part of our discussion, let’s talk about the dairy products, other than milk, that
your children typically consumed in the 1950s. Tell me about the consumption of koumiss,
tvorog (fresh cottage cheese), and prostokvasha/airan? How much of this did children eat?
[record on table]
a. When your children were less than a year old, how much of each of these types of
milk products did your children eat?
b. When your children were 1 to 3 years old, how much of each of these types of milk
product did your children eat?
c. When your children were 4 to 6 years old, how much of each of these types of milk
products did your children eat?
d. When your children were 7 to 14 years old, how much of each of these types of milk
products did your children eat?
_____________________________________________________________________________________
Public reporting burden for this collection is estimated to average 1.9 hours (115 minutes) per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (xxxx-xxxx). Do not return the completed form to this address.
Appendix C - KAZ Women_FocusGroupGuide_NOTInSession-5-14-07

5/17/2007

OMB No.:0925-XXXX and Expiration Date: XX/XX/2010

e. When your children were more than 14 years old, how much of each of these types of
milk products did your children eat?
f. Were there any differences between the types of milk products that boys and girls
ate?
g. Were there any differences between the amounts of milk products that boys ate
compared to girls? If so, who ate more? How much more? Did this depend on age?
h. Were there any differences between the types of milk products that Kazakh and
Russian children ate?
i. Were there any differences between the amounts of milk products that Kazakh and
Russian children ate? If so, who ate more? How much more? Did this depend on
age?
j. Did you ever feed the children in your care shubat (fermented camel milk)?
k. Did children eat other types of dairy products (not counting milk) that I didn’t
mention?
Notetaker’s Note: For each cell in table below, please write down the different answers
offered by participants in the 1950s. If a participant cannot answer a question, please note
this and any reasons given (e.g., can’t remember, don’t know). For each age and milk
product, please write down amount consumed with an indication of units (cups per week,
glasses per day, spoons per day, grams per day, etc.). If a participant reports a milk product
that is not listed, record the name of the product and the responses provided by the
participants to that item. Please write down one response per participant with the number of
children consuming that amount unless the participant offers different estimates for
some/each of her children.
Wall Chart 2. Milk product consumption.

Age of Child

Koumiss

Tvorog
(Fresh Cottage
Cheese)

Prostokvasha/
Airan

Other milk
products

0-12 months
1-3 years
4-6 years

_____________________________________________________________________________________
Public reporting burden for this collection is estimated to average 1.9 hours (115 minutes) per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (xxxx-xxxx). Do not return the completed form to this address.
Appendix C - KAZ Women_FocusGroupGuide_NOTInSession-5-14-07

5/17/2007

OMB No.:0925-XXXX and Expiration Date: XX/XX/2010

7-14 years
>14 years

6. Now I am going to ask you about your own consumption of milk and how much you typically
drank in the 1950s. How much of each type did you typically drink when you were breast
feeding?
Notetaker’s Note: For each question, please write down the different answers offered by
participants. For each milk product, please write down the amount consumed with indication of
units (cups per week, glasses per day, etc.). Please note if milk was not consumed at all by a
participant.
Wall Chart 3. Your own milk consumption during breastfeeding
Participant

Cow

Goat

Sheep

Mare

Koumiss

Other

_____________________________________________________________________________________
Public reporting burden for this collection is estimated to average 1.9 hours (115 minutes) per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (xxxx-xxxx). Do not return the completed form to this address.
Appendix C - KAZ Women_FocusGroupGuide_NOTInSession-5-14-07

5/17/2007

OMB No.:0925-XXXX and Expiration Date: XX/XX/2010

7. Were there women who were unable to consume fresh milk while breastfeeding?
a. Probe: If so, what were some of the reasons that women could not drink fresh milk?
VII. Daily life in the village in the 1950s (30 minutes)
8. Think about where children spent their time when school was not in session (home, with
neighbors, working in the fields, other) in late summer (August). What types of activities did
children do inside (eating meals, at school, household chores) and how many hours a day did
your children spend indoors when they were in these age groups?
a. Probe: Did boys and girls have different daily schedules?
b. Probe: Did the amount of time spent indoors differ for boys and girls? If so, who spent
more time indoors and how much more?
c. Probe: Did Kazakh and Russian children have different daily schedules?
d. Probe: Did the amount of time spent indoors differ for Kazakh and Russian children? If
so, who spent more time indoors and how much more?

Moderator Note: Go through probe e for all age groups. Example: For your children when
they were 0-12 months old, how much time per day did they typically spend indoors in the
1950s? What types of activities were they doing when inside? If they say “all day”, ask how
many hours that would be.
Notetaker’s Note: For each cell in the table hanging on the wall, record average hours spent
indoors for boys and then girls in the 1950s. If a participant cannot answer a question,
please note this and any reasons given (e.g., can’t remember, don’t know…).

_____________________________________________________________________________________
Public reporting burden for this collection is estimated to average 1.9 hours (115 minutes) per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (xxxx-xxxx). Do not return the completed form to this address.
Appendix C - KAZ Women_FocusGroupGuide_NOTInSession-5-14-07

5/17/2007

OMB No.:0925-XXXX and Expiration Date: XX/XX/2010

Wall Chart 4. Time Spent Indoors (August- school was NOT in session)
Time spent indoors (Hours)
Age of Child
Before and during
breakfast

Between breakfast
and lunch and
during lunch

Between lunch and
supper and during
supper

0-12 months

1-3 years

4-6 years

7-14 years

> 14 years

VIII. Conclusion
We’ve reached the end of our discussion. Thank you all very much for your time and valuable
input. Does anyone have any questions? Is there something about the topics we covered today
that we did not address? Before you leave, we have a brief anonymous evaluation form for you
to fill out to evaluate your experience with the focus group. There are only a few questions.
Moderator Note: Please distribute the post-focus group evaluation forms.

_____________________________________________________________________________________
Public reporting burden for this collection is estimated to average 1.9 hours (115 minutes) per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (xxxx-xxxx). Do not return the completed form to this address.
Appendix C - KAZ Women_FocusGroupGuide_NOTInSession-5-14-07


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