Focus Group Moderator Guide - All

Evaluation of health communication messages for

Infertility Prevention Campaign

0920-09XX

Attachment 3A

Focus Group Moderator Guide:

Female Adult and Minor (15-25 yr old)

2/3/2021

Form approved

OMB no. 0920-XXXX

Expiration date xx/xx/20xx

MODERATOR DISCUSSION GUIDE

CHLAMYDIA CONCEPT TESTING

Focus Group Moderator Guide (15-25)

Public reporting burden of this collection of information is estimated to average 2 hours per response, including the time to participate in the focus group discussion. 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)

I. BACKGROUND (2 minutes)

Greetings:

Good evening/afternoon everyone. My name is ___. Thank you for agreeing to participate in the discussion tonight/today. As you know from the call inviting you to participate and the information you read when you arrived today [a print copy of the informed consent information will be given to participants when they arrive], we’re going to be talking about ideas for materials that may be used to get information to young people about the importance of getting screened for a sexually transmitted disease called chlamydia. The purpose of this focus group is to help CDC understand how to communicate with teens and young women about measures they can take now to protect their health and prevent infertility in the future.

We won’t be talking about any personal health experiences; only your reactions to some materials and words to promote chlamydia screening.

Guidelines:

Before I ask you to do any talking, I want to go over just a few guidelines that will help us cover all the questions I have… [Moderator can review these very quickly because they will already have been covered in the informed consent.]

Sponsor:

Our discussion is sponsored by the Centers for Disease Control and Prevention or CDC. CDC is part of the public health service and is interested in your ideas about materials that may be used for a health education program

Candid responses/no right or wrong answers:

Please bear in mind that I am interested in your ideas and opinions – there are no right or wrong answers. I encourage you to share your opinions, whether they are positive or negative about your view on any of the topics that come up. Please be respectful of each other’s opinions, even when disagreeing. I will not use anyone’s name in the report and hope that you will feel comfortable speaking your mind. I do not have any knowledge about the topic we are about to discuss, so I will not be able to answer any questions. However, you will receive at the end of this session a fact sheet, prepared by CDC, and available on their website, that may answer some of your questions and that provides resources that you may contact for additional information (e.g., a 24-hour hotline number).

Recording and observers:

I have asked for our discussion to be recorded so that I can concentrate on talking with you and, just in case there is a problem with the recording, I’ve asked for some people interested in your opinions to take notes in the room behind this mirror. [Moderator gestures toward mirror.] This may include people from CDC or from the company that will help develop the health education program I mentioned. Because of the recording, it will be very important that only one person speak at a time as it will be difficult to follow the conversation if several people are talking at one time. Also, I will need for everyone to speak at least as loudly as I am. Please do not be offended if I must interrupt you to move on to another topic. There are a lot of topics to cover and I’d like to get to all of them. That may make us feel a bit rushed. If I must cut you off, I will try to come back to you later on.

II. INTRODUCTIONS (10 minutes)

Before we get started, are there any questions? If not…It is always helpful to start the process off with a short introduction. You already know that my name is ___ and you are seeing what I do for a living. My home is in [state] so I am delighted to have this chance to see your area and talk with people who live here.

I’d like to give you a chance to get comfortable talking in front of a group, so I’ll ask you to answer a question or two when you introduce yourself. Tell us your first name – only your first name or a name that you would like to be referred to in the group.

How long you have lived here in the ___ area and also…

[Each moderator may choose a different topic, such as favorite TV show, ad, season, where you would go if you could take a long vacation for free, etc. to help participants feel comfortable.].

[Calls on first person] ___, will you begin?

III. DISCUSSION TOPICS

1. Brief Discussion About Chlamydia (3 minutes)

Objective: Explore participants’ general knowledge about chlamydia.

1. Has anyone ever heard about chlamydia? (Listen for what, from whom; was it confusing, too scientific, useful). If stated, probe for why it was confusing, too scientific, useful, etc.

Probe:

What can you tell me about chlamydia?

Where did you learn about chlamydia?

How much do you think other young women your age know about this disease?

B. Insert module(s) to be used here: [Print (copy), PSAs, or Radio.]

Placeholder for one of the three modules (Print, PSA, or Radio) since the final materials are yet to be developed.

C. Reaction to Images (10 minutes)

Objective: Obtain reactions to four different identity images.

Now I am going to show you some images that may be used on some of these materials about chlamydia, and ask your opinion on each one. I have copies of these on boards that I’ll hold up, and I’ll pass around copies for each of you.

• Distribute copies of the images to each participant and show all four images on boards.

Before we talk about these images, please number them on your ranking sheet in order from your favorite (number one) to your least favorite (number four). Again, feel free to write additional comments about the designs right on the handout.

• Give participants time to review and rank the images.

Now let’s talk about the images.

1. What was your favorite?

Probe:

• What are some reasons you liked this one the best?
  
  
  

2. What was your initial response to the design/photo/graphic?

Probe:

• What about it do you think triggered that feeling?

3. How likely would this image be to grab your attention? (Listen for: relevance, clarity, etc.)

Probe:

• Does the image make you curious and want to know more about what it is talking about? What makes you say that?

4. Now tell me which image you liked least.
   
   

Probe:

• What are some reasons you did not prefer this image?

D. Reaction to Concepts (10 minutes)

Objective: Obtain reactions to [insert number] concepts.

Now I am going to show you some themes that may be used on some of these materials about chlamydia, and ask your opinion on each one. I will hand out copies of each.

• Distribute copies of the concepts to each participant.

Before we talk about these images, please number them in order from your favorite (number one) to your least favorite (number [insert number]). Again, feel free to write additional comments about the concepts right on the handout.

• Give participants time to review and rank the images.

Now let’s talk about the concepts.

1. Now that you’ve seen all of these concepts, which one catches your attention the most?

Probe:

• What makes this message most effective?

• Would it make you want to [tell your friends; get tested]?

• What about the message makes you more or less likely to [tell your friends, talk openly about STD testing? get tested]?

2. Which one was most inspiring or motivating for you personally?

3. Which one is most believable?

4. Looking over all of the different messages we have discussed, which two or three are the most effective?

Probe:

• What makes it most effective?

5. Which of these is the worst? Why? What, specifically, do you dislike about it? What do you mean by “worst?” What criteria did you use?

Probe

• What could be changed to make it more effective?

IV. CLOSING (5 minutes)

Objectives: Obtain participants’ closing advice and thank them for their time.

We’re almost out of time. I am going to step out of the room for a minute and check with the observers about any last questions they may have. While I am in the other room, I would like you to spend a few minutes discussing the following question:

1. What one piece of advice would you give to the people making these materials?
   
   

• Check with observers for questions, then gather feedback from respondents.

2. Do you have any other questions for me?
   

If you’d like more information about the topics we discussed tonight, you can:

• Visit www.cdc.gov

• Call 1-800-CDC-INFO (1-800-232-4630)

• Thank participants and mention incentives waiting for them as they leave, along with a fact sheet about chlamydia from CDC.

TOTAL TIME: ~ 85-115 minutes depending on whether (A) TV PSA, (B) Radio PSA, or (C) Print materials tested.

MODULES

(A) Evaluation of Television PSA Concepts (40 minutes)

Next, I’m going to present some messaging ideas, like the ones you might see on television during commercials. As we talk tonight, we’ll call these Public Service Announcements “PSAs”. Keep in mind that the ideas I’ll be showing you tonight are just that—ideas. What we’ll see are just the paper-and-pencil versions—not the final videos.

As I discuss each PSA, I want you to be thinking about what is its main message. Write down what you think is the main message on your notepad. You can also make other comments on the notepad for our discussion as a group.

[Present storyboards to the group by pointing to the images and reading the text underneath. Rotate the order of the storyboards (storyboards may differ by how the issue is framed, e.g. as fertility issue or STD issue, or by presentation, e.g. talking with friends or an entertaining presentation).] Ask the following questions after showing each storyboard:

1. If you were watching TV and this spot came on during breaks, how likely is it that it would catch your attention?
   
   

Probe:

Do you think you would ignore it and go do something else, or do you think you would watch part or all of the message?

2. What parts captured your attention? (images, music, narrative)
   
   

Probe:

What did you like most about it?

3. Did anything strike you as distasteful or inappropriate? What?
   
   

Probe:

How could it be changed to make it less problematic?

4. What did you write as the main message?
   
   

Probe:

What do you think of that?

Was this a new idea, or something that you’ve heard before?

Was the message clear? Was it easy to understand?

5. Is this PSA trying to get the viewer to do something? [If yes] What is it trying to get them to do?
   
   

Probe:

Do you think people this PSA is aimed at would take this action? Why? Why not?

6. Who do you think this PSA is for?
   
   

Probe:

Is it for people like you, or someone else?

7. What do you think about the graphics shown on the boards?
   
   

Probe:

What types of people should be shown in the PSA?

Is there anything you would change about the ideas for graphics that were shown?

8. Does the PSA seem appropriate for the topic?
   
   

Probe:

Does the tone seem appropriate for this topic?

What would you change to make it better or more appealing to you?

• After all storyboards have been presented: Now I want you to consider all 3 of the PSA’s we have discussed so far tonight. [List items on flipchart.]

Which of these three items do you prefer? [Count preferences]

Probe:

What makes you say that?

What could be done to improve the other items?

(B) Evaluation of Radio Spots (20 minutes)

Now we are going to listen to some Public Service Announcements like the ones you may hear on the radio during commercials. Like the TV ads we talked about, these are also just examples of the scripts, not the final version. The final version would sound a little different; for example, it might have background music or other sound effects. As we listen to each ad, I want you to think about what its main message is. Write down what you think the main message is on your notepad.

• Play the spots, rotating the order. Ask the following questions after each spot:

9. If you were listening and this spot came on, how likely is it that it would catch your attention?

Probe:

Do you think you would ignore it and go do something else, or do you think you would listen to part or all of the message?

10. What parts captured your attention? (music, narrative)
    
    

Probe:

What did you like most about it?

11. Did anything strike you as distasteful or inappropriate? What?
    
    

Probe:

How could it be changed to make it less problematic?

12. What did you write as the main message?
    
    

Probe:

What do you think of that?

Was this a new idea, or something that you’ve heard before?

Was the message clear? Was it easy to understand?

13. Is this PSA trying to get you to do something? [If yes] What is it trying to get you to do?
    
    

Probe:

Would you take this action? Why? Why not?

14. Who do you think this PSA is for?
    
    

Probe:

Is it for people like you, or someone else?

15. Does this PSA seem appropriate for the topic?

16. What other comments do you have about the PSA?
    
    

Probe:

What would you change to make it better or more appealing to you?

• After both presented. Which of these two do you prefer? [Count preferences]
  
  

Probe:

What makes you say that?

What could be done to improve the other one?

(C- Part 1) Reactions to Print Material Content (55 minutes)

Objective: Obtain reactions to content about chlamydia and chlamydia screening. Moderators should be aware that the intent of these materials is simply to raise awareness of chlamydia and encourage women 15–25 yrs to talk to their health care provider about chlamydia and screening.

I am now going to hand out two versions of information that explains chlamydia and the importance of screening (Handout A and Handout B, differs by framing, e.g. as fertility issue or STD issue). What’s written here may be used in several different formats (e.g., Internet, brochure, poster, etc). Later, I’ll show you some possible designs that may accompany the information, but for now, we’ll focus on the content.

These versions contain the same major information, but the material is presented differently. All of the information is correct in both of these versions.

I'd like to get your reactions to each one, to determine which one was most effective for you and why. As you read, make the following marks on your handout:

• Write instructions on flip chart.

• Underline phrases or sentences you think are important.

• Circle things that are not clear or you don’t understand.

• X out things you think should be deleted.

• Put an exclamation mark (!) by anything you find offensive or inappropriate

• Hand out first version of the content to each participant. [Rotate order between groups.]

• Allow time for participants to read first version, and then ask if everyone is finished. Once participants are finished reading first version:

Now let’s talk about what you read.

1. What is your initial reaction to the information?

Listen for statements (or lack thereof) that includes: information was useful, important, interesting, easily understood, well written, and relevant for them, motivating.

Probe:

What went through your head as you read this information? Was there something in particular that made you feel that way (e.g., a specific line or phrase)?

Was it too much or too little information?

Was it asking you to do something? What?

Do you think this is written for someone like you, or someone else?

2. What were the main messages for you?

Listen for themes from majority of participants, or probe if they are not mentioned: Chlamydia is among the leading causes of infertility. CT often has no symptoms so infected girls and women may not be aware of their infections. It is important for all sexually active girls/women (<26yrs) to seek annual testing. It can be detected with a simple urine test. It is important to talk with your health care provider and sex partner about testing.

Probe:

What did you underline as important?

For anyone that mentioned other main points: What made the item you picked relevant, interesting, important, etc?

If any of the above points were missed, probe for why the participants did not mention them. Listen for women not perceiving themselves to be at risk.

Did this information address your information needs, as a woman?

3. What did you circle as unclear?

Probe:

What are some reasons you thought that was unclear?

What could make the information more clearly to you?

4. If you received this material, what would you do with it? (Listen for information seeking, screening seeking, partner discussion, call doctor, other.)

Probe:

What additional information would you want after reading this? (Listen for more information on a specific topic covered in the content, testing, etc.)

What did you cross out to be deleted?

What are some reasons this information should be deleted?

• After discussing the first version completely moderator hands out second version.

Now I’d like you to read the second of these carefully, doing the same exercise to indicate words or phrases you think are useful or confusing.

• Allow participants time to read second version. Repeat questions (above) for second version of brochure copy, and probe for common reactions to chlamydia information in both.
  
  

Now that we’ve reviewed both versions of the text, I want you to put a star on the version you think best presented the information in a useful, easy to follow format.

By show of hands, how many people liked Handout A best? How many liked Handout B?

• Count out loud the number preferring each version.
  
  

(C- Part 2) Reactions to Material Designs (20 minutes)

Objective: Obtain reactions to variations of possible designs for print materials about CT. There are three versions of the design.

I) Brochure and Poster Designs

Now I am going to show you several different sets of potential designs for CT print materials to go with the words we just talked about. I have copies on boards that I’ll hold up and some extras for you to pass around to each other, so you can take a closer look and pass them on, but please don’t write on the color copies.

I will give you each a sheet where you can write down your rankings of these designs in order of your preference, from 1 to 3, with 1 being your favorite and 3, your least favorite. You can check off, from a list, some of the responses you may have. Also, feel free to write additional comments about the designs right on this handout. You will need to keep your handout. We will use it again when I show you some other designs a little later.

• Display three “sets” of design options (labeled A, B, C) consisting of a poster and brochure. The materials will be mounted, in color, on boards. Rotate order of materials between groups.

• Distribute 1-2 color copies of the three design options, which participants can pass around to take a closer look.

• Hand out copies of the ranking sheet to each participant. Participants will rank the designs and write any comments on the handout before discussing with the group.

Is everyone through ranking his or her preferences? Let’s talk about the designs and why you liked the ones you did. Who’d like to go first? OK, tell me:

1. Which of the designs was your favorite?
   
   

Probe: (Note: Be sure to probe about both the poster and brochure.)
What do you think about the pictures? Do you prefer pictures of individuals, couples, or groups?

Do you relate to these individuals? Why/why not? If not, how can we make them more relevant to you?

Is it important for you to see a health care provider? Do you prefer the doctor and patient together, or the doctor alone?

What do you think about the colors? Do you prefer bright, muted, or a combination? Why?

What was your initial reaction to the image?

2. Which headline catches your attention most?
   
   

Probe:

What makes you say that?

3. Which headline do you prefer?
   
   

Probe:

What makes you say that?

OK, I’d like to show you one more version of the poster. This is an example with one version of the information you looked at earlier – the words – in one of the designs. Regardless of whether this was your favorite design, now that you see this example with the words in the poster, tell me what you think.

Probe:

Would this catch your eye?

Does this look like something you would read? Does it look easy to read?

Is it the right amount of information, too much, not enough?

4. Who do you think would produce materials like these?
   

Probe:

National organizations? (Listen for specific ones)

Government agencies? (Listen for specific ones, local versus national-level entities, etc.)

Faith-based organizations?

Focus Group Moderator Guide 17