Consent form-guide Consent form-guide-scripts

OMB No. 0930-0196

Expiration Date: 09/30/16

Public Burden Statement: 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. The OMB control number for this project is 0930-0196. Public reporting burden for this collection of information is estimated to average 90 minutes per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 2-1057, Rockville, Maryland, 20857.

PART A:

National Recovery Month

1 Choke Cherry Road, Rockville, Maryland 20857

240-276-2750 (phone) – 240-276-2710 (fax)

Authorization and Release

The undersigned hereby authorizes the U.S. Department of Health and Human Services (DHHS), Substance Abuse and Mental Health Services Administration (SAMHSA) to use the information, feedback, and opinions I provided through a focus group in the development and editing of concepts for Public Service Announcements (PSAs) and in their production and post-productions stages.

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Full Name of Adult of Minor Subject

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Signature of Adult Date

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Signature of Parent of Guardian of Minor Subject Date

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Address

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Phone Number

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Witness Date

Project Description: National Recovery Month (Recovery Month) National Recovery Month (Recovery Month) is a national observance that educates Americans on the fact that addiction treatment and mental health services can enable those with a mental and/or substance use disorder to live a healthy and rewarding life. The observance’s main focus is to laud the gains made by those in recovery from these conditions, just as we would those who are managing other health conditions such as hypertension, diabetes, asthma and heart disease. Recovery Month spreads the positive message that behavioral health is essential to overall health,

that prevention works, treatment is effective and people can and do recover.

Visit www.recoverymonth.gov for more information.

Note: Be advised that these PSAs will be in the public domain and may be reproduced in their entirety or excerpt pieces in official agency future publications without further permission.

PART B:

MODERATOR’S GUIDE

ROADMAP OF PLANNED ACTIVITIES

Intro, disclosures, guidelines, self-intros	10 minutes
Opening Discussion	20 minutes
Non-comparative evaluation	75 minutes
Comparative evaluation	5 minutes
TOTAL TIME AVAILABLE	110 minutes

Show PSAs in the following order by group:

Group 1: A, B, C – Bethesda, English

Group 2: B, C, A – Bethesda, Spanish

Group 3: C, A, B – Atlanta, GA, English

Group 4: A, B, C –Atlanta, GA, Spanish

A = Portraits B = Generations C = Stories from Home

INTRODUCTION

Hello, My Name is (Name of Moderator) and I’m the moderator for today’s discussion. The main purpose of the discussion is to get your opinions about some TV public service announcements, otherwise known as PSAs, commercials or spots, currently in development.

The PSAs are designed to inform people about the effectiveness of treatment and support for mental and substance use disorders and the important contributions that people in recovery make to themselves, their family and friends, workplace and community.

We will not be seeing the final TV spots. We will show you some ‘animatics’. Animatic is a preliminary form of TV spot consisting of a series of filmed drawings with voiceovers, which were prepared to obtain feedback about the PSA. These spots are sponsored by a U.S. Federal government agency that promotes the quality and availability of community-based mental and substance use disorder treatment and recovery support services for individuals and families who need them.

We’ll be doing several things tonight:

1. Participating in a group discussion.

2. Looking at some TV commercial concepts (not final spots, but storyboards)

3. Occasionally doing some private writing

I have nothing to sell today. This is a consumer-opinion project. I work for a research company located in Washington, DC.

Feel free to make negative or positive comments about any of the things we’ll be discussing today. This is a free-flowing discussion and there are no wrong or right answers. All of your responses are confidential.

DISCLOSURES

As we’ve mentioned before, this is a discussion-group setting. There are microphones on the table, mirrors on this side of the room, and observers behind that wall. The observers are listening to make sure I cover everything we need to discuss. Before we end for the day, they’ll let me know if I have missed anything. The session is being taped so I can write an accurate report not of “who said what,” but “what was said.” Your name will not be used in the report. As you have been told previously, your participation here and everything you say is totally confidential.

GUIDELINES

In order to make this work as a research session, there are some guidelines to follow:

• Please talk one at a time and in a voice at least as loud as mine.

• Avoid side conversations with your neighbors.

• I need to hear from everyone in the course of the conversation and to the degree
  possible, let’s have equal “air time,” so that everybody talks about the same amount – nobody talks too much and nobody talks too little.

• There are no right or wrong answers to the questions I ask – there are different points of view. It’s valuable for me to hear all points of view, so it’s especially important to speak up when you disagree with what someone else has said. Also please remember that I did not develop the spots you’re going to see so I won’t be hurt or penalized by any criticism you might have.

• I may need to move on to another area of discussion sooner than you are ready, and may have to cut a conversation short in the interest of time. If I interrupt you, it is not personal; I just want to get everything covered on the agenda that is planned. You’re welcome to speak to me after the group so that I can be sure I get all your thoughts and comments.

• I’d like to remind you not to smoke in this room. At any time, you can excuse yourself to go to the restroom or to get more food or beverages. I ask that only one person should be up or about at a time.

SELF-INTRODUCTIONS

Before we get started, let’s introduce ourselves to each other. Let’s go around the room and tell us: (TAKE NOTES!!!)

• Your first name

• Who else lives in your household

• Something fun you like to do

INTRODUCTION

We will be talking tonight about ways to communicate to the public about recovery from mental and substance use disorders. Some of you may know people who are addicted to drugs or alcohol or individuals suffering from mental health problems, others may know people who are in recovery, or you may even have your own experiences. Others may only know about these things from reading or the media.

MODERATOR REVEALS FLIPCHART WITH THE WORDS, BEHAVIORAL HEALTH; MENTAL HEALTH; MENTAL DISORDERS; ALCOHOL AND DRUG ADDICTION; ALCOHOL AND DRUG PROBLEMS; RECOVERY

• What comes to mind when you hear the words:

  • Behavioral Health?

  • Mental health?

  • Mental disorders?

  • Alcohol/drug addiction?

  • Alcohol/drug problems?

  • Substance Use Disorder

• What are the differences between alcohol or drug addiction and alcohol or drug problems? What words pop into your mind? How do you relate to each?

• What comes to your mind when you hear recovery? What does recovery mean to you? [Flip chart]

• Are there other words or terms that you would use besides “recovery?”

• Who plays a role in recovery? What kind of role?

PSA REVIEW

As discussed earlier, you are going to review ideas for television public service announcements, or PSAs. A PSA is an announcement developed for radio and/or TV designed to raise awareness of a particular issue – they are not selling a product or service. The PSAs all depict an aspect of recovery: the strength one feels when part of a group, the importance of teamwork and support in one’s journey, and how support and being able to rely on others is vital to one’s recovery process.

What are some PSAs that you’ve seen on television? (Probe: texting and driving, drinking and driving, anti-drug, recycling, other?)

I would like to start out by showing you animatics of three TV spots about recovery from mental and/or substance use disorders. We will discuss each spot individually.

Please keep in mind that:

• These are just filmed drawings of what might be filmed and what you might see on TV if these were real spots. These are not the actual, final images.

• I would like to know about your thoughts on the spots, but not on the little things. For instance, please don’t be distracted if you don’t like a person’s clothes or expression. The final commercial will be shot in color with professional actors and in a location that we design and develop, which is specific for the ad’s story.

• The final commercial will feature a diversity of individuals.

• Keep in mind that the final PSAs are very brief and last :30 seconds or less.

For each PSA, we will follow this order:

• I will describe the visual elements of the PSAs.

• Next, I will read what the narrator says. I will read this twice.

• Before we say anything about the PSA, I will hand out a worksheet and give you a couple of minutes to fill it out.

• After you complete the brief worksheet, we will have a group discussion about the PSA.

• If you think of questions or comments during the review, please jot them down in your copy of the storyboard. We can discuss them after you complete the worksheet.

SHOWCASE EACH ANIMATIC IN THE ORDER DRESCIBED ABOVE. PRESENT TWICE IF NECESSARY.

Main Theme/Point Exercise

Before we say anything about this animatic/storyboard, let me hand out a worksheet [Worksheet 1: Theme Worksheet]. Please write down what you think the main message is of this ad.

WAIT A FEW MINUTES TO COMPLETE EXERCISE

Initial Reactions/Message

• What do you think about the animatic/storyboard (called - name of the PSA) we looked at?

• What did you write in your sheet for the main idea/message of this animatic/storyboard?

• What do you like about it? What do you dislike?

• Were there any elements that stood out from the story? Something that catches your attention? What is it? Was there anything in the animatic/storyboard that was confusing or not clear? Anything that would make the spots more interesting?

• How would you describe the ad’s story to a friend, who has not seen it?

Audience

• Who do you think this ad is for?
  PROBE: Is it talking to people who are in recovery, family members or friends of people in recovery, anybody else who interacts with people in recovery, people who are still living with a disorder and not in recovery, the general public?

• What makes you think that?

• How do you think (the main audience) would react?

• (For 2^nd and 3^rd spot): Is the audience different from the audience for the previous ads?

Call to Action

• Why do you think the sponsors made this spot? What are they trying to achieve with it?

• Do you think this ad is trying to get the audience to do something? If yes, what is it?

• How persuasive was this spot? Would you do what it was asking you to?

(Refer To Call to Action As Respondents Stated, Not True Call To Action)

Accuracy

• Was there anything else in the animatic/storyboard (called - name of the PSA) that is especially realistic?

• Was there anything else in the animatic/storyboard (called - name of the PSA) that isn’t realistic?

(If Execution Issues Arise, Remind Respondents That These Are Not Final Spots)

• Was there anything in the animatic/storyboard (called - name of the PSA) that troubled you in any way?

PROBE: Any particular words or phrases?

SHOWCASE AND DISCUSS THE OTHER TWO ANIMATICS IN THE SAME WAY

MODERATOR COLLECTS COMPLETED WORKSHEETS

EVALUATION BY CRITERIA (AFTER INDIVIDUAL STORYBOARD DISCUSSIONS)

• Let’s analyze and evaluate all three spots. REVIEW EACH SPOT BY NAME SO PARTICIPANTS CAN CORRECTLY IDENTIFY EACH SPOT BY NAME. PASS OUT EVALUATION WORKSHEET [Worksheet 2].

• There is only enough funding to produce two of the three spots. If you were the agency, which two of these three spots would you fund? Please vote on the form and write a short reason why you think the spots you choose are the best. Use “1” for your top or favorite choice, “2” for your second choice, and “3” for the spot you think is least effective.

DISCUSS IF TIME ALLOWS: IF CALLING TOLL-FREE NUMBER NOT MENTIONED WHEN DISCUSSING ANIMATICS, MENTION HERE:

• (If they don’t understand the call to action) – Did you notice there was a phone number at the end of every spot?

• Why would anyone call that number? Under what circumstances would you call?

• If you called that number, what would you expect?

PROBE: Would you expect a recording? Would you expect a live person?

• What kind of help, if any, would you expect to get from that number?

• What kind of help would be more helpful? What would you want to hear?

Inform participants:
The number that you have seen in these spots tonight is an actual working number. It is the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Helpline. The Helpline is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish. The Helpline provides free information and publications on prevention, treatment and recovery for substance use and mental disorders as well as referrals to local treatment facilities, support groups, and community-based organizations. Here is a sheet with additional information on the Helpline. Please feel free to take extra if you would like to pass them on to anyone in your family, workplace, place of worship or community.

HAND OUT INFORMATION ON THE SAMHSA NATIONAL HELPLINE AND FACTS ABOUT MENTAL AND SUBSTANCE USE DISORDERS.

(MODERATOR EXCUSES HERSELF AND LEAVES THE ROOM TO TALK TO OBSERVERS)

Thanks for coming tonight and providing your opinions. Your comments have been very helpful and insightful. Goodnight and have a great day tomorrow.

PART C:

PSA CONCEPT - GENERATIONS

CONCEPT DESCRIPTION FROM PITCH BOOK:

We open on the close-up of a family photo. The camera pulls out slightly to reveal a frame around the photo and begins a slow slide to the right, revealing other framed family photos on a long credenza—celebrating birthdays, holidays, community gatherings, support group gatherings, formal pictures —the full spectrum of family sharing stories and life through the generations. As the camera reaches the end of the family gallery, we widen our view to see in the background a big dining room table with our family gathered around sharing dinner.

Location: Interior of an urban home Look & Feel: Warm light, amber tones, fluid, macro shot with pull back and slide, fluid dolly camera movement to reveal final shot. Actors: Multi-generational family of 4, unidentifiable race…Grandfather, 30’s-early 40’s single mother, one teenage daughter and younger son.	Music: Traditional, medium paced, hopeful
CU of a family photo with multi generations represented. Camera dollys out slightly to reveal a frame around the photo and other framed photos on the table.	Music: Low and under.
The camera begins a slow slide to the right, (MS) revealing other framed photos on a long credenza. The pictures show birthday celebrations, holidays, gatherings, support groups	Narrator VO: For generations our family has overcome mental and substance use disorders
The camera reaches the end of the family gallery, a gathering in the background is revealed, a dining room table with a family gathered around sharing a meal.	We listen, and support each other
Final WS shot continues	and so can you…
Final WS shot continues	Narrator VO: Join the Voices for Recovery: Our Families, Our Stories, Our Recovery!
(:07) FADE UP/ LAST SHOT BLURS: Phone Graphic. (:03) FADE UP: Logo Graphic.	Tag VO: For confidential information on mental and substance use disorders including prevention and treatment referral for you or someone you know, call 1-800-662-HELP Brought to you by the U.S. Department of Health & Human Services.
FADE OUT.	MUSIC OUT.

PSA CONCEPT - PORTRAITS

CONCEPT DESCRIPTION FROM PITCH BOOK:

We see a sequence of portraits of faces – close-ups, lit beautifully with a soft light, against a gradient grey background. We are introduced to each face as a still image that comes to life, transitioning to video, as each person smiles, beaming with pride. Our portraits represent the range of our target audience reach using clothing or other visual cues. We close on a montage of our portraits (“Brady Bunch” style).

Location: Studio with backdrop Look & Feel: Bright, happy, slight mottling with ring light and filters for softness. Dolly move, extreme shallow depth of field, classic straightforward shooting style. Actors: 5 total spanning different demographics. Our target audiences include the following if we can work them in using clothing or other visual cues: Military, veterans, and military families; LGBT community; Victims of trauma; and Families, with discussion of generational issues	Music: Light, uplifting, piano *there will be two VO talent total – 1 male, 1 female
	Music: Low and under
Full screen MS of a 30 year old unidentifiable FEMALE in patterned shift dress, professionally dressed - still transitions to video as she smiles.	Female Narrator: My story is yours. Female Narrator: I am a mother
Dissolve to a MS of a 60 year old, African American MALE, clean shaven, professional, with blue polo shirt- still transitions to video as she smiles.	Male Narrator: I’m a father, a son
Dissolve to MS of 40 year old, Caucasian FEMALE in a t-shirt, short hair, nose ring- still transitions to video as she smiles.	Female Narrator: a daughter. Female Narrator: I am in recovery from a mental illness,
Dissolve to a MS of a 30-40 year old Caucasian MALE in plaid flannel shirt- still transitions to video as he smiles.	Male Narrator: a substance use disorder.
Dissolve to a MS of an African American 25 year old FEMALE in military uniform Still transitions to video as she smiles.	Female Narrator: With support from family and community,
Dissolve to a FS shot with 5 images of smiling faces.	Both Narrators: we are victorious.
Final shot continues	Male Narrator: Join the Voices for Recovery: Our Families, Our Stories, Our Recovery!
(:07) FADE UP/ LAST SHOT BLURS: Phone Graphic (:03) FADE UP: Logo Graphic	Tag VO (Female Narrator): For confidential information on mental and substance use disorders including prevention and treatment referral for you or someone you know, call 1-800-662-HELP Brought to you by the U.S. Department of Health & Human Services.
FADE OUT.	MUSIC OUT.

PSA CONCEPT - STORIES

CONCEPT DESCRIPTION FROM PITCH BOOK:

A veteran who is traveling on business sits on a couch or bed peering at his computer/laptop screen. We see a veteran hat next to him and/or he can be wearing a veteran ring that is seen while he types. The location suggests a hotel room since he is traveling and away from home. We see his gaze intently focused on the email open on-screen, featuring photos of family/friends. A second window is open alongside as he chats with friends from a support group. As a third window opens overtaking the screen with a live video call, we see the soldier relax, smile and laugh as he engages in conversation with his family, sharing support long distance.

Location: Interior hotel room Look & Feel: Realistic, bright lighting, hand-held camera with slight movement, edgy, sharp focus. Cuts between series of close-ups, POV and wide shots. Actors: late 40’s Caucasian male, 40 yr old Hispanic Female, late teens daughter.	Music: Strong background beat, promising and positive.
	Music: Low and under.
WS of a man sitting at a hotel room work desk on a computer. We see a suitcase and a veteran hat in the background. Cut to a CU shot of his face as he looks at the computer screen with a pleasant expression Cut to CU of his hand on keyboard (veteran ring on finger) Cut to a MS of the screen showing multiple window’s open (email & support chat group)	Narrator VO: My family and friends are always with me no matter where I may be
Cut to a CU of the man’s face.
Cut back to MS of screen where we see a third window opening, taking over the screen with a live video chat with three family members smiling/greeting our hero. Cut to MS of smiling/ beaming hero as he chats with his family and is happy and relaxed. Cut to WS showing hero and his family on screen.	(Nats up full) Sharing stories from home helps me sustain my recovery from my mental and substance use disorder.
Final shot continues	Narrator VO: Join the Voices for Recovery: Our Families, Our Stories, Our Recovery!
(:07) FADE UP/ LAST SHOT BLURS: Phone Graphic (03) FADE UP: Logo Graphic.	Tag VO: For confidential information on mental and substance use disorders including prevention and treatment referral for you or someone you know, call 1-800-662-HELP Brought to you by the U.S. Department of Health & Human Services.
FADE OUT.	MUSIC OUT.

Group Code

WORKSHEET 1

What is the main theme/point of the PSA?

Portraits

Generations

Stories from home

Group Code

WORKSHEET 2

Evaluation of PSAs

Please rank the PSA’s in the order in which you think they should be produced, i.e. rank #1 = highest priority for production, #2 = second priority for production and #3 = lowest priority for production. Write a sentence explaining why you chose the rank that you did for each one.

______ Portraits

Because:

______ Generations

Because:

______ Stories from home

Because:

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