Form #4 Form #4 Clinician Focus Group Guide

Attachment F

Clinician Focus Group Guide

Moderator’s Topic Guide –Clinicians

ROAD MAP of Discussion

Warm-Up explanation	10
General Information Seeking	5
Awareness and Understanding of PCOR and of EHCP	10
Use of PCOR results	15
Assistance interpreting survey surprise findings	10
False Close	5
Close	5
Total	60

I. Introduction (5 minutes)

(a) Introduction and Consent Disclosures

(i) Thanks for being willing to participate in our phone discussion.

(ii) Your participation is important.

(iii) Describe what a focus group is – like an opinion survey, but very general, broad questions.

(iv) Confidentiality – Your responses will be kept confidential to the extent permitted by law, including AHRQ’s confidentiality statute, 42 USC 299c-3(c); won’t use name in report; combined with all responses

(v) Observers – from IMPAQ/Battelle team; from AHRQ

(vi) Audiotaping – for report writing purposes.

(b) Purpose

(i) We will be discussing your experiences in recommending courses of treatment for your patients. We are trying to understand what information you draw on, how you learned about that information, and what the important features of the information are to you.

(ii) You have already participated in a mail survey XX months ago. We want to share some of the results of the survey with you and get your opinions. This will help us better understand the findings from the survey.

(iii) Ground Rules

1. I am interested in all your ideas, comments, and suggestions.

2. Please avoid side conversations.

3. There are no right or wrong answers.

4. All comments, both positive and negative, are welcome.

5. Please feel free to disagree with one another. We would like to have many points of view.

6. Please turn off cell phones.

7. Please use your first name only.

8. TELEPHONE CONFERENCE HELP OPTIONS

(c) Procedure

(i) Explain the use of videotape. All comments are confidential, used for research purposes only.

(ii) We have a lot of ground to cover, so I may change the subject or move ahead. Please stop me if you want to add something.

Warm-up

Let’s go around the table, and please introduce yourself, first name only.

• Tell us your first name, type of healthcare practice, # of years in practice

General Information Seeking Behaviors (5 minutes)

We are interested in learning what types of information you use to help you decide among different treatment options for your patients.

1. What factors do you consider before (choosing/recommending) one treatment or another for your patients? (SPECIFY TYPE OF TREATMENT/CONDITION)

   1. How do you typically learn about these options? (PROBE: )

      1. From colleagues?

      2. The news?

      3. Medical journals?

      4. Pharmaceutical representatives?

      5. Government representatives?

      6. Continuing education courses?

      7. Professional Medical Association meetings?

      8. Meetings at your place of work?

2. How often do you review medical research to help you make these decisions?

   1. What type of medical research do you review?

      1. Does it matter who sponsored the research?

      2. How to you judge if the research is objective? Unbiased? Neutral?

      3. What makes you trust research and use it to help you decide which treatment to recommend (prescribe) to your patients?

   2. LISTEN FOR MENTION OF PCOR; IF MENTIONED PROBE. IF NOT, DO NOT INTRODUCE PCOR UNTIL NEXT SECTION.

Awareness and Understanding of PCOR (10 minutes)

3. What have you heard lately about (INSERT CER REVIEW TOPIC)?

   1. Where did you hear this information? (PROBE FOR SOURCES OF INFORMATION)

   2. What did you think about this information?

   3. Was this information based on research? Who sponsored the research?

4. Have you heard about research that is designed to help you make healthcare decisions by comparing the benefits and harm of different treatment options? (IF YES) What is that research called? (Open ended) (IF YES) Was it for a specific medical condition? (Y/N) (IF YES) What medical condition? (open ended)

5. Have you heard of Patient Centered Outcome Research? (Y/N) (How many of you have heard about PCOR?)

   1. What have you heard?

      1. Who conducts it?

      2. How is it conducted?

      3. Who sponsors the research?

      4. Do you think it is better, the same, or not as good as than other medical research available?

   2. Have you ever used patient centered outcome research in your clinical practice? How have you used it?

6. Have you heard of the Effective Healthcare Program? (Y/N) (How many of you have heard about EHCP?)

   1. What is if for? What does it include?

   2. Who sponsors it?

      1. Is it sponsored by a federal agency, private company, academic institution, pharmaceutical firm, or some other type of organization?

   3. What types of materials/information does it provide? Who is their information for?

      1. PROBE FOR TYPES OF MATERIALS

   4. Have you ever gotten information from the Effective Health Care Program?

      1. How?

         1. Through the web?

         2. Brochures?

         3. Continuing Education courses?

         4. Emails from professional associations?

         5. Visits in my place of work by professionals talking about it?

      2. What are your reactions to the Effective Healthcare Program?

         1. Were they positive? Negative? Neutral?

      3. Have you reviewed any of their materials?

         1. Which ones?

         2. What did you think?

         3. Have you used their findings with your patients? Why or why not?

         4. How do these materials compare to other materials out there?

Use of PCOR (15 minutes)

7. Have you ever used any of the PCOR results in making treatment and management decisions?

   1. Why have you?

   2. Why haven’t you?

8. What do you see as the benefits of PCOR results? What do you see as the drawbacks?

9. What would encourage you to use PCOR results in making treatment and management decisions for your patients?

10. Would you want to hear about PCOR results on a regular basis? What would be the best way(s) to reach you to tell you about PCOR results?

    1. Email

    2. In person

    3. At meetings

    4. At the office

    5. Through continuing education

    6. Through professional associations newsletters

    7. Through other channels

11. Do you think using PCOR results would improve your clinical practice? Would it help you provide better medical treatment and management to your patients?

Surprising Findings (10 minutes)

Thank you so much. As I mentioned before, everyone on the call had participated in the survey. I’d like to share with you some findings from the survey and see your reactions. (REPEAT FOR FINDINGS; UP TO 5 DIFFERENT SURPRISING FINDINGS REQUIRING INTERPRETATION; START WITH % SAYING THEY USE/DON’T USE CER RESULTS; QUESTION WORDING DIFFERS SLIGHTLY IF IT’S A STRAIGHT PERCENTAGE OR CORRELATIONAL RESULT; CHOOSE QUESTION STEMS ACCORDINGLY)

First, we surveyed #### clinicians in the US and found that % say they (use/don’t use) PCOR findings in their clinical practice.

1. Does this percentage surprise you? (Too high, too low)

2. Why do you think (so few? So many?) clinicians use PCOR results?

3. What do you think it would take to increase this number?

Second, (STRAIGHT PERCENTAGE/SINGLE ITEM) (SURPRISING RESULT #2)

1. What are your reactions when you hear that X% of clinicians said (INSERT RESPONSE TO SURVEY QUESTION)?

2. Why do you think (so many/so few) said (INSERT RESPONSE TO SURVEY QUESTION)?

3. What do you think it would take to (INCREASE/DECREASE) (INSERT RESPONSE TO SURVEY QUESTION)?

Third, (CROSS-TABBED; CORRELATIONAL RESULTS) (SURPRISING RESULTS #3)

1. What are your reactions to hearing that clinicians who (INSERT CHARACTERISTIC) are (MORE/LESS LIKELY) to (INSERT RESPONSE TO SURVEY QUESTION)?

2. Why do you think that is?

3. What do you think it would take to (IMPROVE/CHANGE/DECREASE/AFFECT) this behavior?

4. Would need to happen if we wanted to see (INSERT OPPOSITE FINDING) instead of what we saw? How would that change come about?

5. How could comparative effectiveness research help change this? Would it change this?

False Close (5 minutes)

Before we end, I’m going to check with the observers to see if there are any follow up questions; meanwhile, please think about if there’s anything else you’d like to say about the discussion we had that has not yet been shared.

Closing

Ask questions from back

Does anyone have any comments?

Thank you so much for coming today. Your time is very much appreciated, and your insights have been very helpful.

Incentives will be mailed to you by X date. Call X if you haven’t received it by XX.

If you want to get more information about the Effective Healthcare Program, you can visit (WEBSITE; URL; AND PHONE NUMBER; PROVIDE CAMPAIGN RESOURCES)

Thank you.

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