Health Care Consumer Focus Groups

ATTACHMENT D:

MODERATOR’S GUIDE FOR HEALTH CARE CONSUMER FOCUS GROUPS

Form Approved

OMB No. 0920-XXXX

Exp. Date xx/xx/xxxx

Moderator’s Guide for Health Care Consumer Focus Groups

Consumers’ Practices regarding Preventive Health Behaviors and Screenings

Moderator Discussion Guide

I. BACKGROUND AND INTRODUCTIONS (@ 20 minutes)

A. Background (@10 minutes)

Hello. My name is ____ and I work with ____, a consulting firm. I want to thank you for participating today. We are working on a project sponsored by the U.S. Centers for Disease Control and Prevention, or CDC, to understand what people do to take care of their health and learn about what their doctors tell them and recommend with regard to preventive health care and health screening tests. My role is to guide our discussion today and to encourage everyone to share their thoughts and ideas.

The group discussion will take about two hours. Your participation in this discussion is voluntary and you can end your participation at any time. The discussion will be audio recorded for note taking purposes. Observers, including someone from CDC, are also present so that they can take additional notes about our conversation. Your name will not be connected to any of the written notes or transcripts. Data collected will be kept private. Results will be presented in aggregate for this group and quotes will not be attributed to any specific individual.

Do you have any questions for me before I ask you to introduce yourselves?

Public reporting burden of this collection of information is estimated to average 2 hours 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 CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX)

B. Participant Introductions (@ 10 minutes)

I’d like you to introduce yourself, and have you name one thing you do to take care of your health that is a “good” habit and one thing you do, or don’t do, that is a “not so good” habit. For instance, maybe you try to eat right, but you don’t exercise as much as you’d like, or you never go to the doctor. Let’s hear what you have to say. I’m going to record your answers. Just to reiterate, your names will be removed from all data collected.

[MODERATOR RECORDS RESPONSES ON AN EASEL USING TWO SHEETS – ONE FOR THE GOOD THINGS AND ONE FOR THE BAD ONES. AT THE END OF THE EXERCISE, MODERATOR VERBALLY SUMMARIZES RESPONSES.]

II. HEALTH CONCERNS AND PREVENTIVE HEALTH BEHAVIORS (@ 35 MINUTES)

You already know that taking care of your health is our main topic. I’d like to begin by asking you two questions and have you write down your answers. [MODERATOR PASSES OUT PAPER AND PENS]

The reason I am asking you to write down your answers is so that we get your first reaction to the question. Then we will spend some time talking about your answers and the answers from the rest of the group. Please keep in mind sometimes in group discussions, people can be reminded about something when they hear someone else talking about it. That’s ok if that happens, but we’d really like to hear your first reaction because we’ll be using your answers to help guide today’s discussion.

Questions:

1. What’s the health problem you are most worried about getting in the future?

2. What preventive screening tests do you get on a regular basis?

Future Health Concerns (@ 15 minutes)

3. Let’s go over our first question. What were some of the health concerns you have for the future? Anyone want to volunteer?

Probe: Has anyone else listed the same concern?

Probe: Any other concerns?

[MODERATOR RECORDS RESPONSES ON EASEL AND AT THE END OF THE EXERCISE SUMMARIZES RESPONSES]

Preventive Health Behaviors (@ 20 minutes)

4. Let’s move on to the next question, what are some of the screening tests you gotten on a regular basis? I’m going to make a list and then we’ll come back and discuss some of these in depth. [MODERATOR RECORDS RESPONSES ON EASEL].

Probe: Did anyone else list the same test?

Probe: Other tests?

Probe: What about…

• blood pressure

• cholesterol levels

• colorectal screening tests

  • Probe: which tests

• blood sugar testing for diabetes

• EKG or other heart tests

• [MALE GROUPS] PSA

• [FEMALE GROUPS] mammograms

• [FEMALE GROUPS] pap smear

[NOTE TO MODERATOR: DO NOT PROBE ON THESE TESTS IF THEY DO NOT COME UP]

• Dental exams

• Vision

• Hearing

• Skin exams

5. I just want to make sure we have captured all the tests. So, let me check. Has anyone had any…

Probe: blood sugar tests?

Probe: chest x-rays?

Probe: cholesterol tests?

Probe: EKG’s?

6. Has anyone had any [TESTS/OTHER TESTS] for their lungs?

[IF YES, MODERATOR WILL LIST ON AN EASEL AND ASK…]

Probe: Has anyone else had the same test?

Probe: What about chest x-rays?

Probe: What about CT scans?

[NOTE TO MODERATOR: RECORD SPUTUM CYTOLOGY OR BRONCHOSCOPY IF OFFERED BUT DO NOT PROBE ON THESE.]

[MODERATOR VERBALLY SUMMARIZES FOR THE GROUP CONNECTIONS BETWEEN HEALTH CONCERNS, HABIT AND TESTS MENTIONED.].

III. DIET-RELATED HEALTH ISSUE (@ 10 minutes)

Several of you mentioned you are concerned about [INSERT DIET-RELATED HEALTH CONCERN FROM QUESTION 1]

7. What, if anything, has your doctor told you about [DIET-RELATED HEALTH CONCERN]?

Probe: Which tests listed here [MODERATOR REFERS TO LIST OF TESTS FROM PREVENTIVE HEALTH QUESTION] are related to [DIET-RELATED HEALTH CONCERN]?

8. What has your doctor told you about tests related to [DIET-RELATED HEALTH CONCERN]?

Probe: What did they tell you about the tests?

Probe: Was that test done as part of your routine care / check-up?

Probe: Or did you have that test because of a particular problem / symptom?

IV. SMOKING (@ 40 minutes)

[IF SMOKING WAS NOT MENTIONED AS A BAD HABIT IN INTRODUCTIONS, THEN ASK 9A]

[IF SMOKING WAS LISTED AS A BAD HABIT INTRODUCTIONS, THEN ASK 9B]

9A. When we introduced ourselves and discussed our health habits, I noticed no one mentioned smoking. Does anyone have any thoughts about that?

Probe: What has your doctor told you about smoking?

Probe: What has your doctor told you about health tests for smokers?

9B. When we introduced ourselves and discussed our health habits, several of you mentioned that one of your “not so good” habits was smoking. What, if anything, has your doctor told you about [SMOKING]?

[IF LUNG TESTS WERE NOT LISTED IN PREVENTIVE HEALTH QUESTION, THEN ASK Q.10]

[IF LUNG TESTS WERE LISTED IN PREVENTIVE HEALTH QUESTION, THEN ASK Qs 11 – 12. DEPENDING ON TYPE OF TEST LISTED BY PARTICIPANTS]

10. Did your doctor ever talk to you about tests for your lungs?

IF YES, ASK

10a. What they say?

10b. Was there a particular test they brought up?

10c. What they explain to you about the test?

THEN GO TO Q. 15.

IF NO, ASK

10d. Just to confirm, no one has had any tests to check your lungs? Let me just double check with the names of a few tests… [NOTE TO MODERATOR ASK ALL THREE, IN THIS ORDER]

10d1. Chest x-ray?

[IF YES ASK

• What they say?

• Was there a particular test they brought up?

• What they explain to you about the test?

IF NO, GO TO 10d2.

10d2. CAT scan?

[IF YES ASK

• What they say?

• Was there a particular test they brought up?

• What they explain to you about the test?

IF NO, GO TO 10d3]

10d3. Sputum sample/cytology? LOW PRIORITY, ASK ONLY IF TIME.

[IF YES ASK

• What they say?

• Was there a particular test they brought up?

• What they explain to you about the test?

IF NO, GO TO Q.13]

11. IF CHEST X-RAY LISTED IN PREVENTIVE HEALTH QUESTION ASK…

Several of you mentioned you had a chest x-ray. Can you tell me why you got this test?

12. IF CT LISTED ASK…

Some of you mentioned that you have had a CT scan. Why did you get one?

Probe: What did your doctor tell you about the test?

Probe: What did your doctor tell you about why you needed the test?

Probe: What happened after the test?

Probe: Did you have any follow-up tests?

Probe: What tests?

Probe: How often?

Probe: Anyone else ever have [follow-up test]?

Probe: How was your experience similar or different?

13. IF OTHER TESTS LISTED ASK…

Has anyone had any other tests to look for lung problems?

Probe: What did you get?

Probe: Why did you get one?

Probe: Tell me about the types of thing you and your doctor talked about regarding the test.

Probe: Did you ask for the test?

Probe: Did the doctor recommend the test to you?

Probe: What did your doctor tell you about why they wanted to do the test?

14. Has anyone else had this test?

[IF NO]

Probe: What have you heard about using [INSERT TEST NAME] to check for lung problems?

[IF YES]

Probe: Where did you learn about it?

Probe: Was that test done as part of your routine care / check-up?

Probe: Or did you have that test because of a particular problem / symptom?

Probe: What symptoms or problems were you experiencing?

SKIP TO SECTION V.

15. Has anyone else talked to their doctor about any tests for their lungs?

V. EXERCISE/PHYSICAL ACTIVITY-RELATED HEALTH CONCERN (@ 10 minutes)

[NOTE TO MODERATOR: IF TIME REMAINING IS LESS THAN 10 MINUTES PROCEED TO VI. SUMMARY AND WRAP UP]

We are just about out of time for this discussion. Before we end, I’d like to discuss one more health issue; [INSERT EXERCISE/PHYSICAL ACTIVITY-RELATED HEALTH CONCERN]

Several of you mentioned you feel you [INSERT EXERCISE/PHYSICAL ACTIVITY-RELATED HEALTH CONCERN FROM QUESTION 1].

16. What, if anything, has your doctor told you about the link between physical activity and heart health?

17. What has your doctor told you about tests related to about heart health?

Probe: What did they tell you about the tests?

Probe: Was that test done as part of your routine care / check-up?

Probe: Or did you have that test because of a particular problem / symptom?

III. SUMMARY AND WRAP UP (@ 5 min.)

We are just about out of time now. I’d like to close with a question for which I would like you to write down your answer while I check on your paperwork.

Question: If you could give one piece of advice to people who provide health care to people who smoke, what would it be? “For example, I would like it if my doctor did or did not...”

Thank you for being a part of the group. Your feedback is very important to CDC. I’ll show you out and direct you to the person who will provide you with your payment for your time today.

TOTAL TIME: @ 120 minutes

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