Moderator's Guide

Moderator’s Guide: Project 1: Exploratory Research of Hispanic Women’s Folic Acid Awareness, Knowledge, and Behavior related to Foods Fortified with Folic Acid.

I. INTRODUCTION AND ICEBREAKER (10 minutes)

1. Introduction and purpose

Thank you for coming. Your presence and participation today are very important. My name is ____________ and I will be moderating today’s discussion. This project is being sponsored by the Centers for Disease Control and Prevention, also called CDC.

The goal of this project is to better understand the attitudes that Hispanic women have about health issues. We want to talk to you about your thoughts, feelings, and reactions.

The feedback you will give us today is information we could not get anywhere else. Thank you for your willingness to come and give us your opinions.

2. Procedure

Before we begin, I would like to start with some ground rules for our discussion today:

1. There are no right or wrong answers. Please be completely honest. We’re as interested in learning what you don’t like as we are in learning what you do like.

2. Everyone’s participation is important. Part of my job as moderator is to make sure we get a chance to hear from everyone, so, at times, I may call on you, or ask you to shorten your remarks so someone else has the chance to speak.

3. We want this to be a group discussion, so you don’t need to wait for me to call on you to speak, and please feel free to respond directly to other people’s thoughts and ideas.

4. Our discussion will be kept secure to the extent permitted by law. We will not use your names in any report.

5. Our discussion today is being tape recorded. These recordings allow us to write a more complete report, and to make sure we accurately reflect your opinions. However, please only speak one at a time, so that the tape recorder can pick up all your comments. We will destroy all recordings after we are done writing our report.

6. I am working with some other people on this project, and they will be observing our conversation from the other side of this mirror. They are taking notes and may ask a follow up question at the end. At the end of our discussion, someone will be available to answer your questions.

7. As moderator, my job is to keep the discussion focused on the subject. If I see that we are getting off the topic, I will bring us back to the topic so we can finish on time.

8. If you have a cell phone with you, please turn it off or silence the ringer. Thanks.

1. Introductions

Before we begin, I would like each of you to take a few moments to introduce yourself. Please tell the group:

• Your first name

• How long you have lived in this area

II. DIET AND VITAMINS (25 minutes)

Health

Let’s start by talking about eating healthy.

9. How do you decide what foods you eat? [Probe: taste, other family members like it, is nutritious, brand, cost, ease (ready to eat)]

9. Are there any foods that you think are especially important for women to eat? Which ones? Why?

9. Do you read the labels on the food you eat? What information on the food label do you look at? What information on the label is important to you?

9. Are there any vitamins that you think are especially important for women? Which ones? Why are they important? [Probe: What vitamins, if any, are important for pregnant women? Why? What about when a woman is planning a pregnancy? Why?]

9. Do you think Hispanic women need certain vitamins more or less than non-Hispanic women? Why or why not? Which vitamins?

Great! This has been really helpful.

III. FOLIC ACID (25 minutes)

I would like to talk [MORE] about a vitamin called folic acid. It is also sometimes called Vitamin B9 or folate.

9. What, if anything, have you heard about folic acid? Anything else? [Listen for relationship to birth defects, pregnancy, foods, prenatal vitamins, side effects, fortification of food]

9. How did you learn about folic acid? From what sources? [Probes: television, radio, newspaper, advertising, internet, doctor, friends or family]

9. Have you read anything about folic acid? If so, what was the format? (Probes: brochure, poster, fact sheet, internet)?

9. Who do you think needs folic acid? [Probe: Women? Men? Children? Pregnant women?] How can you get folic acid?

I want to tell you more about folic acid. Folic acid is a B vitamin. The Centers for Disease Control and Prevention (called CDC) recommends that all women who could possibly become pregnant take folic acid every day, whether they are currently planning to have a baby or not. This is because the vitamin folic acid can prevent serious birth defects of the spine such as spina bifida and, of the brain, such as anencephaly, in babies. Women need to start taking folic acid before they are pregnant to reduce these risks. These birth defects happen before most women even know they are pregnant. Because many pregnancies are unplanned, CDC recommends that all women of childbearing age get enough folic acid every day.

9. What do you think about this information? [Probes: Is this information new? Are you surprised?]

9. Do you think you need to take folic acid? Why or why not?

9. Hispanic women have higher rates of babies born with these birth defects than non-Hispanic women. What do you think about this information? [Probes: Is this information new? Are you surprised? Do you believe this is true?]

9. Has your doctor or another healthcare provider ever talked to you about the connection between folic acid and healthy babies? [If yes, what did you hear?]

9. What about friends or family members, have you heard anything from them on this topic? [If yes, what did you hear?]

9. What, if anything, have you heard in the media about this topic? Where did you hear about this? [Probe: radio, television, internet]

9. How do you like to receive new health-related information? (Probe: brochure, poster, fact sheet, radio, television, email messages, instant messaging, internet, doctor?)

9. Who (or what) do you trust most to get health information from? (Probe: doctor, radio, television, brochures, internet?)

IV. PRODUCT FORTIFICATION AND LABELING (25 minutes)

9. What have you heard about fortified foods?

[NOTE: READ SLOWLY] There are different ways to get enough of the vitamin folic acid. Taking a multivitamin every day is one way to do this. Another way to do this is by eating the appropriate amounts of foods that have been fortified with the vitamin folic acid. When a food is fortified with folic acid, it means that folic acid has been added. In the United States, pasta, breakfast cereals, and breads are some examples of foods that have been fortified with folic acid.

9. Have you heard or read anything about adding folic acid to foods, also known as folic acid fortification? If yes, what have you heard or read about this topic? Who did you hear it from? Or where did you read it? [Probe: newspaper, radio, television, website, family members or friends.]

9. What do you think about this information? Do you think fortifying some foods with folic acid is a good idea? A bad idea? Why?

9. What type of information would you like to receive about fortification?
   
   

10. How would you like to receive this information

9. What are some examples of the fortified foods you might find in a grocery store?

9. Where can you find information about whether a specific food is fortified?

9. What are reasons you think some women might choose to eat a fortified product?

9. What are reasons you think some women might choose not to eat a fortified product?

9. Do you think fortified foods are more expensive or less expensive than non-fortified foods?

9. Do you think fortifying a food would make it look different? Taste different?

V. FINAL COMMENTS AND THANK YOU (5 minutes)

Your feedback and thoughts have been very important, and we appreciate your assistance.

9. Finally, do you have any other questions or is there anything else you would like to say?

[____ ] is here to give you additional information about folic acid and to answer any questions you may have. Thank you for coming! Your comments will help CDC promote Hispanic women’s health. As a reminder, all of your comments today will be kept secure to the extent permitted by law.