CNPP Message Concept Focus Groups

Generic Clearance to Conduct Formative Research/CNPP

Appendix C-1 Focus Group Moderator's Guide English_may7

CNPP Message Concept Focus Groups

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APPENDIX C-1 CNPP FOCUS GROUP MODERATOR’S GUIDE - ENGLISH

CNPP Focus Group Activity

Moderator’s Guide - English

Focus Group Moderator Guide – Draft 2

Introduction (5 minutes]

Moderator introduces him/herself
No cell phones
Refreshments
Bathrooms
Rules for participation (raise hand, no interruption, all opinion count, no wrong answers)

Warm-Up & Food Decision-Making Discussion (15 minutes)

Tonight, we are going to talk a lot about the foods we eat and the beverages we drink. Before we get into specifics, let’s make a list. [MODERATOR GO TO EASEL] What are some of the things you consider when making decisions about what to eat? In other words, what do you think about when deciding what to eat or drink?:
1. [MODERATOR TO ALLOW UNAIDED RESPONSE]
2. [IF NECESSARY:] Think about what you had for lunch yesterday. How did you decide what to eat?
3. What about things you have eaten earlier in the day? The week? What you are going to eat later? How does that, if at all, impact the decisions for what you eat at a meal? What makes you say that?
4. [IF NOT MENTIONED EARLIER:] What about nutrition? When, if at all, does that factor into your choices?
  1. Let’s get specific. On the sheet of paper in front of you, write down what, if anything you think about when it comes to nutrition, when deciding what to eat. If you typically don’t think about it, keep your page blank. If you think about only one thing or two things, just write those.
  2. [GO AROUND THE TABLE:] What did you write down?
  3. Why those? What about those things makes you think about them when making decisions about what you eat and drink?
  4. What other nutrition-related factors have you considered adding to your decision-making process?

Message Testing (60 minutes)

A. Thanks for that information. Now, we’re going to look at some ideas designed to help people make better decisions about what to eat and drink. These are not ads, and they are not “finished.” [Explore three one-pagers combining top-level messages and supporting recommendations in each group. Rotate order to prevent bias. All one-pagers will be explored across the groups. Each concept will receive a letter to designate it.]

We’re going to look at three different ideas, each on a separate page. Here’s the first one. Please take the next few moments to read the information on this sheet. Circle any word or phrase that you particularly like, and draw a line through any word or phrase that you do not like or do not understand.

Before we discuss the details, what’s your initial reaction to this information? Interesting? Boring? Helpful? Not Helpful?
1. What is it trying to tell you?
2. Does it matter? What makes you say that?
3. On a scale of 1 to 5, where 5 means very likely and 1 means not likely at all, how likely would you be to try to do what this page suggests?
  1. [GO AROUND TABLE]
  2. [BRIEF:] Why did you select the number you chose?
4. How easy or hard is it to do what this page is saying to do? What makes you say that?
5. Looking at the entire page, does this idea sound different from the ways of deciding what to eat and drink that we discussed earlier? If so, what makes it different? If not, what makes it similar?
Let’s focus just on the main statement at the top.
1. [IF NECESSARY:] What’s it trying to tell you?
2. What words or phrases did you circle as ones that you liked? What made those stand out as most appealing?
3. What words or phrases did you cross out as ones you didn’t like? What made those not appealing?
4. Any words or phrases that were confusing?
5. [If not mentioned] What did the phrase _________ mean to you? [Probe to understand reactions to phrases below as relevant to messages discussed].
  1. “plate by plate” [PROBE: Idea of longevity, do respondents think about this notion over time]
  2. “power up your way” [PROBE: What about the word, “power?” Do respondents connect food to fuel, energy?]
  3. “your plates matter”
  4. “find your path” [PROBE: How does “your path” connect with the rest of the page? Are these suggestions optional?]
[IF NOT MENTIONED:] What do you think about the logo or icon on the page?
1. What does it say to you?
2. How well does it “go with” the rest of the information on the page? What makes you say that?
Let’s look at the supporting statements.
1. What words or phrases did you find confusing?
2. Why are these statements on this page? How, if at all, do they connect to the main statement?
[IF NECESSARY:] One of the ideas this information is trying to communicate is that all of the foods and beverages you eat and drink every day over time matters. In other words, it’s not just whether you eat more vegetables at dinner tonight, but the combination of all of the food and drink choices you make over the long haul has the most influence on your health. Did you get that idea when you read this? If not, what could they change or add to make that idea come through more strongly?

B. Let’s look at the next page of information. You’ll see some new statements combined with the same supporting statements we just reviewed. Please take the next few moments to read the information on this sheet. Focusing just on the new statements at the top, circle any word or phrase that you particularly like, and draw a line through any word or phrase that you do not like or do not understand. Then we’ll talk about it. [DISCUSSION OF SUBSEQUENT PAGES IS SHORTER THAN FIRST PAGE.]

What’s your initial reaction to the information on this page? Interesting? Boring? Helpful? Not Helpful?
1. What’s it trying to tell you?
2. How, if at all, does it differ from the first page we read?
  1. Is that good or bad? What makes you say that?
Let’s take a closer look at the main statement at the top.
1. What words or phrases did you circle as ones that you liked? What made those stand out as most appealing?
2. What words or phrases did you cross out as ones you didn’t like? What made those not appealing?
3. Any words or phrases that were confusing?
4. [If not mentioned] What did the phrase _________ mean to you? [Probe to understand reactions to phrases below as relevant to messages discussed].
  1. “plate by plate” [PROBE: Idea of longevity, do respondents think about this notion over time]
  2. “power up your way” [PROBE: What about the word, “power?” Do respondents connect food to fuel, energy?]
  3. “your plates matter”
  4. “find your path” [PROBE: How does “your path” connect with the rest of the page? Are these suggestions optional?]
[IF NOT MENTIONED:] What do you think about the logo or icon on the page?
1. What does it say to you?
2. How well does it “go with” the rest of the information on the page? What makes you say that?
How well do the supporting statements connect to or go with the statement at the top? What makes you say that?

Repeat Section B for third page to be shown.

Now let’s look at all three pages together. Take a moment, and review all of them. I’m going to ask you a series of questions, and I want you to hold up the page that best answers the question.

Of the three pages, which one does the best job of getting you to make better choices when it comes to what you eat and drink? [GO AROUND TABLE, GET LETTER OF EACH PREFERENCE]
1. Why that one?
2. What about that page made a difference to you, compared to the others?
On the flipside, which one did the worst job of getting you to make better choices when it comes to what you eat and drink? [GO AROUND TABLE] What makes you choose that one?
Which one did the best job of communicating that what you eat and drink every day over time matters? [GO AROUND TABLE]
1. Why that one?

Dietary Guidelines Message Drill-Down (20 minutes)

A. Now we are going to talk about some specific words and phrases and ideas. Let’s start with the six statements that appear on every page. We won’t talk about all of them this evening, but take a moment to re-familiarize yourself with them.

Of the six that are listed there, which one would be the hardest for you to do? What makes that one the hardest?
Let’s look at the statement “Make the most of your dairy: move to milk or yogurt – and make them low-fat or fat-free.” What’s your reaction to this statement?
Let’s look at the statement “Eat and drink less when it comes to sources of added sugars, saturated fat and sodium.” What’s your reaction to this statement?

[NOTE TO TEAM FOR SECTIONS IV-A-4 to IV-A-10: WE WILL ROTATE THE PHRASES ACROSS GROUPS. SOME WILL GET EMPTY/POWER CALORIES, OTHERS WILL GET DIETARY PATTERN/DIET STYLE. ALL WILL RECEIVE THE QUESTIONS RE: CHOLESTEROL AND CAFFEINE.]

I am going to give you a word, and I want you to give me your initial reaction. What is the first thing that comes to mind when you hear the word, “calorie”? [BRIEF]
1. Is it a positive or a negative? What makes you say that?
2. What do you associate with the word, “calorie”?
Has anyone heard of the phrase, “empty calories”? [MODERATOR SHOW ON THE FLIP CHART]
1. What does that phrase mean to you?
2. In your own words, what are “empty calories”?
If they used that phrase in this statement so that it read “Eat and drink fewer foods and beverages with empty calories,” how does it change the phrase? What do you need to eat and drink less of?
Let me give you another phrase: “power calories”? [MODERATOR SHOW ON THE FLIP CHART]
1. What does that phrase mean to you?
2. In your own words, what are “power calories”?
3. Where do you get them?
What about calorie balance?
1. What does this mean to you?
2. What can you do to reach or achieve “calorie balance”?
Some people refer to the combination of all of the food and drink choices a person makes over time as a person’s “dietary pattern” [MODERATOR SHOW ON FLIP CHART]?
1. If we were to say “dietary pattern,” what does that mean to you? [Probe to understand reaction to “diet” specifically].
What about the phrase “food routine”? [MODERATOR SHOW ON FLIP CHART]
1. Are you familiar with this term?
2. What does it say to you?
Both of those terms are supposed to communicate the idea of a pattern of healthy food and drink choices over time—or some of the ideas we have discussed this evening.
1. If you had to select one, which of those terms does a better job of communicating this idea? What makes you say that?
2. Is there another phrase that you would use to say the same thing? What is it?
Now I am going to show you additional terms, and I want to get your reactions. Take a look at the FLIP CHART. [TURN TO PAGE WITH THE FOLLOWING TERMS]
1. Diet
  1. What does this mean to you?
  2. What does it bring to mind?
2. Cholesterol
  1. What does this mean to you?
  2. What does it bring to mind?
3. Caffeine
  1. What does this mean to you?
  2. What does this bring to mind?
4. Food and nutrition security?
  1. What does this mean to you?
  2. What does it bring to mind?
  3. [PROBE: What is the timeframe? Now? Long term? Future? Maintenance?]

Dietary Guidelines Tip Review (15 minutes)

A. Thank you for that information. Now, we are going to do something different. So far, none of the materials we read provided any tips on how to do the information on the pages. There were no suggestions about how to make things easier. Now, we are going to look at different types of tips and suggestions. Again, these are not “finished.”

Everyone will have a stack of 12 cards. Each card includes a different tip/suggestion. I want you to read the cards and find the 3 tips that are MOST HELPFUL to you. You can define “most helpful” any way you want. I also want you to find the 3 tips that are LEAST HELPFUL to you. Once you have selected these cards, use Handout 1 to write down the letter that corresponds to the tips you selected. Put the letters of the most helpful tips at the top of the page, and the letters of the least helpful tips at the bottom of the page.

What tips did you find most helpful?
1. What about them made them rise above the others?
2. Were the “most helpful” tips in areas that you found difficult or hard? In other words, when we were talking about the recommendations, we discussed that some were harder than others. Were the “most helpful” tips in that area?
3. Take a look at the 3 “most helpful” tips you selected. What patterns or themes do you see?
What tips did you find the least helpful?
What about them made them fall to the bottom of the list?

Wrap-up/False Close (5 minutes)

Thank you for all of the information you have provided. I am going to check with my colleagues to make sure they do not have any additional questions. While I do, please read Handout 2 and write an answer in the space provided.

Write down up to three changes that you would be most likely to make when it comes to deciding what foods and beverages to eat and drink.

Thanks again! Have a great evening.

List of Tips (Each one will be placed on a different card):

Include fruit at breakfast – At breakfast, top your cereal with bananas, peaches, or strawberries; add blueberries to pancakes; drink 100% orange or grapefruit juice. Or, try a fruit mixed with fat-free or low-fat yogurt.

“Skim” the fat – Drink fat-free (skim) or low-fat (1%) milk. If you currently drink whole milk, gradually switch to lower fat versions. This change cuts calories but doesn’t reduce calcium or other essential nutrients.

Be a good role model for children – Set a good example for children by serving and eating whole grains every day with meals or as snacks.

Know what to look for on the ingredients list – Read the ingredients list and choose products that name a wholegrain ingredient first on the list. Look for “whole wheat,” “brown rice,” “bulgur,” “buckwheat,” “oatmeal,” “whole-grain cornmeal,” “whole oats,” “whole rye,” or “wild rice.”

Pay attention to condiments – Foods like soy sauce, ketchup, pickles, olives, salad dressings, and seasoning packets are high in sodium. Choose low-sodium soy sauce and ketchup. Have a carrot or celery stick instead of olives or pickles. Use only a sprinkling of flavoring packets instead of the entire packet.

Boost your potassium intake – Choose foods with potassium, which may help to lower your blood pressure. Potassium is found in vegetables and fruits, such as potatoes, beet greens, tomato juice and sauce, sweet potatoes, beans (white, lima, kidney), and bananas. Other sources of potassium include yogurt, clams, halibut, orange juice, and milk.

Plan, plan, plan! Before you head to the grocery store, plan your meals for the week. Include meals like stews, casseroles, or stir-fries, which “stretch” expensive items into more portions. Check to see what foods you already have and make a list for what you need to buy.

Build habits that don’t add pounds – Cut calories by skipping foods high in solid fats and added sugar. Limit fatty meats like ribs, bacon, and hot dogs. Cakes, cookies, candies, and ice cream should be just occasional treats. Use smaller plates to adjust the amount of food you eat.

Manage your calories – Drink water with and between your meals. Adults and children take in about 400 calories per day as beverages—drinking water can help you manage your calories.

Keep it tasty and healthy – Try grilling, broiling, roasting, or baking—they don’t add extra fat. Some lean meats need slow, moist cooking to be tender—try a slow cooker for them. Avoid breading meat or poultry, which adds calories.

Maximize with nutrient-packed foods – Give your body the nutrients it needs by eating a variety of nutrient-packed food, including whole grains, lean protein, fruits and vegetables, and low-fat or fat-free dairy. Eat less food high in solid fats, added sugars, and sodium (salt).

Serve small portions – It’s not necessary to get rid of all sweets and desserts. Show kids that a small amount of treats can go a long way. Use smaller bowls and plates for these foods. Have them share a candy bar or split a large cupcake.

First Name: ______________________

Date: _____/_____/15

Group #/Location: ________________

HANDOUT 1

Write down the letters that correspond to the 3 tips you found MOST HELPFUL to you:

_____

Write down the letters that correspond to the 3 tips you found LEAST HELPFUL to you:

_____

First Name: ______________________

Date: _____/_____/15

Group #/Location: ________________

HANDOUT 2

Write down up to three changes that you would be most likely to make when it comes to deciding what foods and beverages to eat and drink.

____________________________________________________________________________

Rotation Order of Materials across Focus Groups

Group #	Concept Order	Phrases
1 & 13	1,2,3	Calorie-related terms
2 & 14	4,5,6	Dietary Pattern/Food Routine
3 & 15	2,4,5	Calorie-related terms
4 & 16	3,1,6	Dietary Pattern/Food Routine
5 & 17	5,3,1	Calorie-related terms
6 & 18	6,4,2	Dietary Pattern/Food Routine
7 & 19	6,2,1	Calorie-related terms
8 & 20	5,6,3	Dietary Pattern/Food Routine
9 & 21	4,1,2	Calorie-related terms
10 & 22	3,5,4	Dietary Pattern/Food Routine
11 & 23	2,3,4	Calorie-related terms
12 & 24	1,6,5	Dietary Pattern/Food Routine

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