Fish Consumption Focus Group

Fish Consumption Focus Groups

Moderator’s Guide

2/17/14

Welcome

Thank you for taking the time to join us today. I am _______ from [name of contractor], a research organization. The purpose of this group is to get your thoughts related to your food choices. Your feedback is very important to us and may ultimately be used to [insert goal]. Our discussion will last about 90 minutes.

I am an independent consultant hired to moderate these discussions. Therefore, I don’t have a vested interest in receiving any particular point of view. I simply want to have an active and lively discussion with all of you. Also, I am not an expert about the topics we are going to discuss today. Therefore, you may have questions that I can’t answer.

Have you all had the opportunity to read and sign the informed consent notice?

Ground Rules

1. You have been asked here to offer your views and opinions; everyone’s participation is important

2. Audio/video/observers

3. Speak one at a time

4. No side conversations

5. No right or wrong answers

6. It is OK to be critical. If you dislike something or disagree with something that is said, I want to hear about it.

7. All answers will be kept private to the extent provided by law, so feel free to speak your mind

8. Please respect one another’s confidentiality.

Participant Introductions

To begin, I would like to have you go around the table and introduce yourselves. Please tell me:

1. Your first name only.

2. Tell me about your favorite food and when was the last time you ate it.

Food to Eat While Pregnant (Warm-Up)

1. What foods do you try to include in your diet? [Probe for reasons]

2. (For the pregnant women with children group) What foods did/do you try to eat more of while pregnant? [Probe for reasons]

3. (For the women that plan to become pregnant) What foods do you think you should try to eat more of while pregnant? [Probe for reasons]

4. What foods do you try to limit in your diet? [Probe for reasons]

5. (For the pregnant women with children group) What foods did you/do you try to eat less of while pregnant? What foods did/do you try to avoid? [Probe for reasons]

6. (For the women who plan to become pregnant) What foods to you think you should try to eat less of while pregnant? What foods do you think you should avoid? [Probe for reasons]

Knowledge about Fish Benefits and Risks and Fish Consumption Habits

1. Do you eat fish or shellfish (or seafood)?

2. How often do you eat fish?

3. What kinds do you eat? (Probe for: varieties of fish and also if it is fresh, canned, or frozen)

4. When do you usually eat fish (Probe for: times of year, days of week, certain meals?)

5. What about your children/family? Do they also eat the same types of fish?

6. Did you eat fish or shellfish when you were growing up? When did you first start eating fish? [Don’t spend too much time on this.]

7. Where do you usually buy or eat fish? (Probe: supermarket, at a restaurant, specialized seafood store, catch it themselves, get it from friends or family members.)

8. What determines how often and what kinds of fish you eat? [Probe: Taste, cost of fish, preparation ease, environmental concerns, sustainability, health benefits, risks]

9. About how much fish would you say you generally eat per serving/ meal? How did you figure out this amount?

10. Have you heard of any benefits from eating fish and/or seafood? If so, what benefits?

11. Have you heard of any risks from eating fish and/or seafood? If so, what risks? [MODERATOR: Wait until mercury comes up in the group. Then probe about what they have heard about mercury as a problem in fish. ]

12. Has knowing about these benefits and risks changed how much fish you eat? What about the types of fish you eat? In what ways?

13. Are there any fish that you try to include in your diet? Which ones? Why?

14. Are there any fish that you avoid eating? Which ones? Why?

15. Are there any fish that you limit how much you eat of? Which ones? Why?

16. What about for your family?

17. Where are you getting information about the health and safety of eating fish? [Probe: news media, web (which sites), physician, friends, family, others.]

18. Which sources are the most helpful for you?

    1. [Probe about government sources of information, if not mentioned—ask whether they would like to see more information from the government about the health and safety aspects of fish and seafood, or what information would be most helpful for the government to provide.]

Responses to Messages about Eating Fish

Current dietary guidelines suggest that fish consumption is very nutritious and may be particularly beneficial during pregnancy for the development of the unborn child and during adulthood for heart health. Today, we’ve talked about different factors that can influence how much fish people eat. We’ve also talked about types of foods that some women try to eat or limit during pregnancy.

[MODERATOR: Before the group start, please write out the following on subsequent flip chart pages:

• Page 1. Women who are or might become pregnant and nursing mothers should try to eat between 8 and 12 ounces (about 2 or 3 servings) of a variety of fish lower in mercury each week for their nutritional benefits.

  • For young children, give them 2 or 3 servings of fish a week with the portion that is right for the child’s age and calorie needs.

• Page 2. Choose fish lower in mercury. Many of the most commonly eaten fish are lower in mercury. These include salmon, shrimp, pollock, tuna (light canned), tilapia, catfish, and cod.

• Page 3. Avoid 4 types of fish: tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel.

  • These fish are highest in mercury.

  • Limit white (albacore) tuna to 6 ounces a week.

• Page 4. If you eat fish you have caught from local streams, rivers, and lakes, pay attention to local fish advisories.

  • If advice isn't available, limit fish to 6 ounces a week and don't eat other fish that week.

• Page 5. When adding more fish to your diet, be sure to stay within your calorie needs.]

1. [Refer to page 1of the chart.]Suppose you heard or read that nutrition experts, including those in the federal government, recommend that pregnant women, women who might become pregnant, and nursing mothers should try to eat between 8 and 12 ounces (about 2 or 3 servings) of a variety of fish lower in mercury each week for their nutritional benefits.

a. What would you think of this information?

b. What questions would you have?

c. How easy or hard would it be to eat this amount of fish each week (probe for reasons)?

d. Is this new information?

2. [Refer to page 2]Suppose you heard that many of the most commonly eaten fish such as salmon, shrimp, Pollock, tuna (light canned), tilapia, catfish, and cod were lower in mercury.

   1. What questions would you have about this list?

   2. Are you familiar with these types of lower mercury fish?

   3. Are there any fish here that you don’t know?

   4. Are there other fish that you would want to know about?

3. [Refer to page 3]Suppose you heard that pregnant women (etc.) should avoid 4 types of fish – tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel which are the highest in mercury and limit white (albacore) tuna to 6 ounces a week.

   1. What questions would you have about this list?

   2. What is new information?

   3. Are you familiar with these fish?

   4. Would it be hard to avoid eating them?

4. [Refer to page 4.]If you were told to pay attention to local fish advisories before eating fish caught from local streams, rivers, or lakes, what would you think/do?

   1. What questions would you have? Have you seen local advisories/how would you find this information?

   2. If no local advisory is available, and you were advised to limit locally caught fish to 6 ounces per week, and not to eat any other fish that week, would this make sense to you? Be easy or difficult to do? Other thoughts?

5. [Refer to page 5.]What if you heard that when adding more fish to your diet, you should be sure to stay within your calorie needs?

   1. What does this mean to you? Do you know what your calorie needs are?

Now that we’ve gone over some messages about eating fish:

6. Is anything surprising? Are there differences between this information and what you’ve heard before? (Probe for discrepancies and sources of discrepant information.) What information is new to you?

7. How would this information affect the amount of fish you would eat? [Probe if they would eat more, less, or about the same as what they currently eat; probe reasons.]

8. What questions about the benefits and risk of eating fish do you have? Where would you go to look for answers to these questions?

Check with observers to see if they have any other questions.

MODERATOR: If needed, remind participants that you are not an expert about any of the topics we are discussing tonight and therefore can’t answer their questions. However, we are very interested in learning their questions to help develop answers in the future and what they might do/who they will ask in the meantime to find answers.

Conclusion:

Thank you for your participation. The information you provided and questions you raised will be very helpful for improving how FDA provides information about fish consumption for pregnant women. For your reference, please take home a copy of this information from the 2010 US Dietary Guidelines.

MODERATOR: Hand out the information from the U.S. Dietary Guidelines.