Focus Groups Involving Children Moderator's Guide

Appendix F

Children’s/Youth Focus Groups Discussion Outline

Project: “Formative Research of Adults’ and Children’s Views Related to Promotion of Healthy Food Choices”

Phases 1 or 2

Children’s/Youth Focus Groups

Discussion Outline

Project: “Formative Research of Adults’ and Children’s Views Related to Promotion of Healthy Food Choices”

Focus groups with tweens (ages 9-10 and 11-12)

Phases 1 or 2

Form Approved

OMB No. ______

Exp. Date: _______

Discussion Outline

I. Introduction: Welcome

A. Purpose: We’re going to spend the next hour and a half to 2 hours talking about a variety of topics, including what you think about foods, eating habits, messages about food, and what’s healthy. Most of all, we need your help and suggestions – we want to understand how to get families to eat healthier. We know that’s hard. Everyone eats things that might not be so good for them from time to time. So, we hope you will tell us what you really think. Thank you for taking part today.

B. Disclosure

• Observation

• Audio and Video

Public reporting burden of this collection of information is estimated to average two hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, ad completing and reviewing the collection of information. As 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 CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX)

C. Ground Rules

• Need to hear from everyone; one at a time please

• There are no right or wrong answers here; moderator isn’t looking for any specific answers – just wants to hear what you think and how you feel. Please feel free to speak your mind.

D. Participant Introduction

• Name (Ask participants to use first name only, and tell them no last names will be recorded if inadvertently disclosed.)

• Your favorite food

• Your favorite restaurant

2. General Discussion: Healthy Diet

1. How do you describe “healthy eating”? Probe.

2. How healthy would you say your diet is?

3. How healthy do you think your mom or dad’s diet is? Why? (Note: Moderator will be sensitive to the fact that a lot of young people may only live with one parent)

2. Concept testing: Current vs. Ideal Behavior

1. What are your favorite foods?

2. What foods do you eat the most?

3. Picture sort. Participants will be asked for their ideas around a variety of food images, to include foods in the following categories:

• Foods recommended in the new Dietary Guidelines and/or from the bottom half of the Food Guide Pyramid (or new graphic if it is available), i.e. fruits and vegetables, whole grains, nonfat or low fat milk, etc.)

• Foods from the top of the pyramid (or new graphic if it is available) such as fats, oils, sweets

• Foods from the top of the pyramid that are fortified with particular nutrients or ingredients such as vitamins, calcium, etc. or that are produced with reduced fat, oil, or sweetener.

Participants will sort the images, making a Pile A for the first group named above and Pile B for the remaining two food types.

D. We’re going to talk about your ideas around specific characteristics of healthy food. What helps you decide if a certain food is good for you? (If necessary, moderator might probe for presence of whole grains, high-fiber foods, dairy, Vitamin C, low in fat/sugar, etc)

E. What do you like about eating foods you selected for Pile A?

F. What don’t you like about eating foods you selected for Pile A?

G. As you think about this, would you say it easy or difficult to eat mostly food from Pile A? What could make it easier for you? Explore.

H. Now let’s talk about Pile B. What do you think /how do you feel about replacing some of your favorite in Pile B with some of the foods you selected for Pile A?

• Eating more fruits and vegetables, whole grains, low fat dairy,

• Eating less fat, sugar, sweetened drinks, salt

IV. Message Testing for Concepts around Environments for Eating (10 minutes)

1. Everyone close their eyes for just a few moments. Think about all the foods you have at home. Picture what’s inside your kitchen cabinets and your refrigerator.

• When you had your eyes closed, what are the first foods you saw? What else is in there? (Moderator will go around the room)

• What’s the first thing you look for when you want a snack at home? What are some other things you like to snack on? How many snacks do you have in a day?

• Where at home do you typically have your snacks? Why?

2. Describe a typical dinner time for you. Unaided, then probe as necessary.

• Do you usually eat at home or do you eat out?

• If typical dinner is at home: Does everyone eat together? What do you have for dinner? Who decides what’s for dinner? Probe exhaustively.

• If typical dinner is out: Who decides where to eat when you go out? Where do you usually go? Probe exhaustively.

C. Now let’s talk about eating at school.

• Do you eat any meals at school? If so, which ones? If not, why not?

• How do you decide what to eat at school?

• Who do you think has the most influence on what you choose to eat when you are at school? (e.g., you, your parents, your teachers, friends) Why?

22. Message testing regarding communication dynamics: Social Influence and Promotion

A. Who and what do you think has an effect on the way you eat and all the food choices you make? (Young people will generate an unaided list.)

B. To get more concepts and ideas from participants for message development, moderator will present a list of food choice “influences” on cards. Influences will include the following:

• My Mom

• My Dad

• My Grandma

• My Friends

• My Sister

• My Brother

• Feeling Stressed

• Feeling Sad

• Feeling Mad

• Availability

• Boredom

• Where I Am

• Advertising

• Store displays

• Others (some blank cards will be available for additions by the group)

1. Moderator will post cards around the room. Young people will look at all the cards, and be allowed to add any ideas on influences they think are missing.

2. Moderator will lead group in a high-medium-low categorization exercise. Participants will decide which influences are the strongest (High) on their eating behaviors, which are of middling importance (Medium), and which ones don’t have much of an impact on their eating behaviors (Low).

3. Participants will then discuss why they placed the cards in each category.

4. Moderator will probe to understand how the influences in the “high” category affect young people’s food choices, and why they don’t think influences in the “low” category have a major impact.

• How does (_________) affect your choices about what to eat? Or Why do you think this doesn’t affect your eating decisions?

• Give some specific examples of when this has affected your decisions about what to eat.

3. Has there been a time when you made a decision to eat foods from Pile A for any period of time? Describe the situation as specifically as you can (it could be for one meal or for an extended period of time). What motivated you? What was going on in your life at the time? Explore.

4. Has there ever been a time when you ate lots of food from Pile B? Describe a situation (it could be for one meal or for an extended period of time). What motivated you? What was going on in your life at the time? Explore.

E. Parent child interaction. Do you ask your mom or dad to buy certain foods when they go grocery shopping? If so, which ones? Why do you ask for that?

• What happens if they don’t buy what you want?

• Describe a situation in which you wanted to eat something, but your mom or dad wouldn’t let you. What did you want to eat? What happened in the end?

D. Food marketing concepts discussion. Moderator will probe specifically to understand young people’ views on how much of an impact advertising has on their eating decisions.

• What advertising, specifically, have you seen about foods and/or restaurants that has gotten your attention?

• What are your favorite food ads? What gets your attention about them? Why do you like them? Moderator will ask a few participants to identify/describe favorite food ad, and tell why they like it and/or what messages they recall. (Show sample ads as prompts for discussion if needed.)

• What are your least favorite food ads? Why don’t you like about them? Moderator will ask a few participants to identify/describe least favorite food ad, tell why they like it, and what messages they recall.

• Think about television, radio, magazine, and the Internet. Do you think that advertising about food and restaurants affects your decisions about what to eat/where to go out to eat? If so, how? Explore.

2. Concept/Message Testing

A. A series of messages regarding healthy eating will be tested with young people. Messages will be determined and developed by CDC. Message themes could include:

• Power

• Fun

• Energy

• Taste

VII. Conclusion (5 minutes)

A. Check with clients for additional questions

B. Thank and dismiss participants