Supporting Statement B

Screen for Life: National Colorectal Cancer Action Campaign

2015 Focus Group Testing with the General Public

Submitted Under OMB No. 0920-0800

Focus Group Testing to Effectively Plan and Tailor

Cancer Prevention and Control Communication Campaigns

Generic Information Collection

Expiration date December 31, 2017

Supporting Statement Part B

June 22, 2015

Contracting Officer Representative:

Cynthia A. Gelb

Division of Cancer Prevention and Control

Phone: 770-488-4708

Fax: 770-488-3040

E-mail: [email protected]

Supported by:

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

Division of Cancer Prevention and Control

4770 Buford Highway, NE, Mailstop F-76

Atlanta, GA 30341

TABLE OF CONTENTS

B. Data Collection & Statistical Methods ………………………………………….

B1. Respondent Universe……………………………………………………………

B2. Procedures for Information Collection………………………………………….

B3. Methods to Maximize Response Rates………………………………………….

B4. Tests or Procedures or Methods to be Undertaken……………………………...

B5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or

Analyzing Data…………………………………………………………………..

List of Tables

Table B1-A. Focus Group Locations

Table B1-B Racial and Ethnicity Characteristics of Focus Group Areas

List of Attachments

Attachment A-1. Focus Group Discussion Guide (English)

Attachment A-2. Focus Group Discussion Guide (Spanish)

Attachment B-1. Screening and Recruitment Form (English)

Attachment B-2. Screening and Recruitment Form (Spanish)

Attachment C-1. Consent Form (English).

Attachment C-2. Consent Form (Spanish)

Attachment D. Creative Concepts Brief

B. DATA COLLECTION & STATISTICAL METHODS

Data collection will consist of a focus group methodology. Focus groups are widely used in stages 1 and 2 of the Health Communication Process (National Cancer Institute, 2002). In a focus group, a small group of people (typically 8-12 individuals) engage in a discussion of selected topics of interest typically directed by a moderator who guides the discussion in order to obtain the group’s opinions (Edmunds, 1999; Krueger & Casey, 2000). Focus groups capture the collective insight of a group while preserving individual preferences. In this setting, participants can describe their experiences and preferences without the limitations of preset response categories. Furthermore, focus groups produce rich data complete with nuances that often may be obscured in quantitative data collection techniques.

Qualitative information will be collected to provide insights about respondents’ knowledge, attitudes, beliefs, and behaviors related to colorectal cancer and screening. CDC will also assess efficacy and appeal of creative concepts for public service advertisements among the target audiences of men and women nearing or older than 50 years, the age at which screening is recommended to begin. Qualitative findings from this information collection will be used to inform development of future messages and materials for the Screen for life: National Colorectal Cancer Action Campaign.

B1. Respondent Universe

The target audience for the Screen for Life campaign is men and women nearing or older than 50 years. Respondents will include members of the general public who are non-incarcerated, non-institutionalized adults. They will be men and women in the U.S., aged 48 – 72 years, who have never been screened for colorectal cancer or have not been screened appropriately.

The recruitment and screening process is designed to identify respondents who are in the target age range; speak English or Spanish; have not been previously diagnosed with colorectal cancer or other diseases of the bowel; and have not been screened for colorectal cancer or have not been screened according to recommended guidelines. Other demographic questions will be asked to ensure that focus groups include a mix of respondents.

Recruiters will ask respondents a limited number of questions for information only, such as: whether they have health insurance – which will help CDC understand if having health insurance promotes appropriate screening or, conversely, if lack of insurance is a barrier to colorectal cancer screening. Recruiters will also ask whether respondents have had other cancer screening tests – breast cancer and prostate cancer screening tests – to help CDC understand whether respondents generally have appropriate screening tests.

Table B1-A. Focus Group Locations

Focus Group Location	Number of Focus Groups in English	Number of Focus Groups in Spanish
Chicago, Illinois	4	3
Houston, Texas	0	3
Los Angeles, California	4	3
Miami, Florida	4	3
New York, New York	4	0
Total	16	12

CDC plans to conduct 28 in-person focus groups – 16 in English and 12 in Spanish. General population groups in English will be held in Chicago, Los Angeles, Miami, and New York City. Spanish groups will be conducted in Chicago, Houston, Los Angeles, and Miami. These cities were chosen as they provide geographic, ethnic and racial diversity. A summary of these characteristics in each city (U.S. Census Bureau 2013) is in Table B1-A.

Table B1-B . Race and Ethnicity Characteristics of Focus Group Areas

U.S. City	Race: Asian, or Native Hawaiian or Other Pacific Islander	Race: Black or African American	Ethnicity: Hispanic	Race: Non-Hispanic White
Chicago, IL	5.5%	32.9%	28.9%	31.7%
Houston, TX	--	-	48.3%	-
Los Angeles, CA	11.4%	9.6%	48.5%	28.7%
Miami, FL	1%	19.2%	70%	11.9%
New York, NY	12.8%	25.5%	28.6%	33.3%

Four English groups will be held in each of these cities: Chicago, IL; Los Angeles, CA; Miami, FL; and New York, NY. Three Spanish groups will be conducted in each of these cities: Chicago, Houston, Los Angeles, and Miami. A maximum of nine men and women aged 48-72 will participate in each group, resulting in an estimated total of 252 focus group participants (9 respondents/group x 28 groups = 252 respondents). Based on previous experience with focus group recruitment, we estimate that 504 individuals (252 x 2 = 504) must be screened through telephone interviews to yield 252 completed responses.

B2. Procedures for Information Collection

In order to elicit focus group responses to effectively plan for the development of new, targeted materials and refine existing materials for the Screen for Life campaign, the following steps will occur.

Participants will be identified and recruited using a Screening and Recruitment Form (Attachment B-1 {English} and B-2 {Spanish}). No personal identifying information used in the recruitment process will be linked to information collected in the focus group discussions. Thus, no personal information in identifiable form will be collected by CDC. Each focus group participant will be advised that all information he or she provides during the focus group will be treated in a secure manner and will not be disclosed, unless compelled by law (see Consent Form, Attachment C-1 and C-2).

Participants will be recruited using public information (e.g. telephone directory), public venues (e.g. city parks), as well as proprietary lists (e.g. lists maintained by focus group facilities and professional focus group recruitment consultants).

Focus group discussions will be conducted under the direction of a professionally trained moderator, who will use the Discussion Guide (Attachment A). The estimated burden per response is two hours. The information collected will be used by DCPC to appropriately plan for development of new Screen for Life public service announcements (PSAs) and materials and also refinement of existing materials. Focus group questions will be the same regardless of the geographic area of the focus group, and the focus group guide will be utilized in every focus group. The focus group moderator will ask a series of questions to assess knowledge, attitudes, and beliefs related to colorectal cancer screening. The moderator will also show television and print PSA creative concepts to participants, to assess the appeal and understandability of the concepts. Information derived from discussion of the concepts will guide CDC planning for new PSA production and possible refinement to existing materials.

B3. Methods to Maximize Response Rates

To maximize the response rates, and to minimize the possibility of having too few appropriate focus group participants (thereby forcing group cancellation), as many as 25% more participants are invited to each group than are needed. In the event that too many participants report, excess participants will receive a token of appreciation and will be dismissed.

B4.Tests or Procedures or Methods to be Undertaken

All DCPC communication campaigns are guided by the Health Communication Process (National Cancer Institute, 2002) which involves four stages: (stage 1) planning and strategy development; (stage 2) developing and pretesting concepts, messages, and materials; (stage 3) implementing the program; and (stage 4) assessing effectiveness and making refinements. The Health Communication Process is not linear, but rather is a circular model in which stages are revisited in a continuous loop of planning, development, implementation, and refinement. DCPC campaign staff carefully record all aspects of campaign development, operation, and evaluation. Innovations and improvements are incorporated into subsequent campaign cycles and periodically published in the peer-review literature (Cooper et al., 2011, Cooper et al., 2013). The use of focus group methodology to inform the development and refinement of communication campaigns has been well documented throughout the literature (Bull, et al., 2002; Edmunds, 1999; Krueger, 1994; Krueger & Casey, 2000; Cooper et al., 2011). Thus, the formative and materials-testing methods currently used by DCPC campaigns have been refined in 14 years of campaign operations.

B5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

The following individuals have been consulted on the design of this qualitative information collection. DCPC, Ogilvy Public Relations, And Soltera Center for Health Communication Research staff identified below will participate in analysis of the data, campaign planning and/or material refinement, as well as development of scientific manuscripts.

Individuals consulted	Key Roles
Cynthia A. Gelb, BSJ Division of Cancer Prevention and Control Centers for Disease Control and Prevention (770) 488-4708 [email protected]	data analysis, campaign planning, material refinement, manuscript development
Jennifer Chu, MPH Ogilvy Public Relations, Washington, DC 202-729-4157 [email protected]	data analysis, campaign planning, material refinement, manuscript development
Sherri Stewart, PhD Division of Cancer Prevention and Control Centers for Disease Control and Prevention 770-488-4616 [email protected]	study design consultation
Crystale Purvis Cooper, PhD Soltera Center for Health Communication Research Oro Valley, AZ 520-797-1392 [email protected]	Study design consultation, data analysis, campaign planning, manuscript development
Wendy Child Focus Group Consultant, Washington DC 301-864-2474 [email protected]	study design consultant and moderator for English focus groups
Carlos Ribero Inteligencia Qualitative Research Miami FL (305) 444-2456 [email protected]	study design consultant and moderator for Spanish focus groups
Jackeline Fernández Inteligencia Qualitative Research Miami FL (305) 444-2456 [email protected]	study design consultant and moderator for Spanish focus groups

References

Bull, S. A., Cohen, J., Ortiz, C. & Evans, T. (2002). The POWER Campaign for Promotion of Female and Male Condoms: Audience Research and Campaign Development. Health Communication, 14 (4), 475-491.

Centers for Disease Control and Prevention. Screen for Life: National Colorectal Cancer Campaign Web site. www.cdc.gov/screenforlife.

Edmunds H. (1999). The Focus Group Research Handbook. Chicago: NTC Business Books.

Krueger, R.A. (1994). Focus Groups: A Practical Guide for Applied Research. 2nd ed. Thousand Oaks, CA: Sage Publications.

Krueger R.A., Casey M.A. (2000). Focus Groups: A Practical Guide for Applied Research. 3rd ed. Thousand Oaks, CA: Sage Publications.

National Cancer Institute. (2002). Making Health Communication Programs Work (NIH Publication No. 02-5145). Bethesda, MD: Department of Health and Human Services.

U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2007 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2010.

U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2011 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2014.

U.S. Census Bureau. Quick Facts. http://quickfacts.census.gov/qfd/index.html. Accessed May 5, 2014.

Cooper CP, Gelb CA, Chu J. Life cycle of television public service announcements disseminated through donated airtime. Preventive Medicine Reports 2015;2:202–205.

Cooper CP, Gelb CA, Lobb K. Celebrity appeal: Reaching women to promote colorectal cancer screening. Journal of Women’s Health 2015;24(3):169–173.

Ekwueme DU, Howard DH, Gelb CA, Rim SH, Cooper CP. Analysis of the benefits and costs of a national campaign to promote colorectal cancer screening: CDC’s Screen for Life National Colorectal Cancer Action Campaign. Health Promotion Practice 2014; 15(5):750–758.

Cooper CP, Gelb CA, Hawkins NA. How many “get screened” messages does it take? Evidence from colorectal cancer screening promotion in the United States, 2012. Preventive Medicine 2013;60:27–32.

Ekwueme DU, Howard D, Gelb C, Rim SH, Cooper C. An exploratory analysis of the benefits and costs of a national campaign to promote colorectal cancer screening: CDC’s Screen for Life: National Colorectal Cancer Action Campaign. Value in Health 2013;16(3):A142.

Cooper CP, Gelb CA, Jameson H, Macario E, Jorgensen CM, Seeff L. Developing English and Spanish television public service announcements to promote colorectal cancer screening. Health Promotion Practice 2005;6(4):385–393.

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