Focus Group Discussion with Community Leaders in Puerto

Form Approved

OMB No. 0920-0572

Expires 03/31/2018

Focus Group Discussion with Community Leaders in Puerto Rico

to Assess Possible Actions for Preventing Zika

Moderator – before participants enter room:

• Write on flip chart “Topic of Discussion: Ways to protect pregnant women and their babies from Zika virus: What actions best address community leaders’ needs and concerns?”

• Write all ground rules on flip chart and post in a location visible to all participants. Refer to these in your introduction.

Ground Rules:

1. You have been invited to be here to offer your views and opinions, so don’t hesitate to do so. There are no right or wrong answers!

2. Everyone’s input is important, so I may call on you if you are being quiet.

3. Avoid side conversations.

4. Respect one another at all times; we shouldn’t judge or evaluate anyone’s opinions.

5. Let one person speak at a time.

6. I may need to cut a discussion short to get through the whole guide.

7. Please turn off all cell phones!

8. All answers are confidential, so feel free to speak your mind. Only the researchers involved in this project will have access to this information and all identifying information, like your names, will be removed.

9. It’s perfectly fine to disagree; please do so respectfully.

Introduction

Welcome and thank you very much for agreeing to participate in this focus group. My name is ___________________, and my role is to guide the discussion. I’m not an expert in the topic we’ll be discussing, so I have no particular agenda or point of view. I want to hear your honest and frank opinions about the ideas we discuss tonight. There are no right or wrong answers to the questions I’m going to ask, please relax and enjoy the discussion. If you need to go to the restroom, it is located _____________. Please try to slip out and return quietly.

Today, we’ll be discussing actions that are being considered for helping to stop the spread of Zika virus here in Puerto Rico. You are here because you are a leader in your community. The purpose of this discussion is to get your opinions about a variety of actions in terms of how desirable, acceptable and do-able each action would be for you and the people in your community. We are conducting focus groups across the island and the information we gather will be used by the Puerto Rico Department of Health and the Centers for Disease Control and Prevention in the development of plans for stopping the spread of Zika virus in Puerto Rico. What we learn will also help us educate the community about the actions that can be taken to protect everyone, but especially pregnant women and their babies, from Zika virus.

Before we get started, I’d like to point a few things out. We are taping this discussion simply to ensure that we capture all the information that is provided and so I can listen to what you have to say and not worry about taking notes. The tapes help us in writing our reports and are used for this purpose only. Everything you have to say is confidential and any identifying indicators are removed from the reports and other data before submitting them to the Puerto Rico Department of Health and the CDC. Also, please remember, you can choose not to answer a question at any time and that your participation in this project is completely voluntary.

Please, let’s also quickly review the Ground Rules (refer to chart and read each rule out loud). Do you have any questions before we begin?

Warm-Up

1. Let’s begin by finding out a little bit about each of you. Please tell us your:

   1. First name,

   2. What you appreciate most about your community

1. Discussion Questions

Current knowledge about Zika and trusted information sources

1. Have you heard about Zika? (HMTS 16c)

Probe: What have you heard? How is it spread? How dangerous is it?

2. What can you tell me about Zika? (HMTS 17c)

Probe: Any concerns or fears? What are they?

3. Where do you get your information about Zika? (HMTS 69d)

Probe for sources such as media, family, friends, and church

4. What types of information would you like to receive regarding Zika? What would be the most effective way or format to provide this information? (HMTS 80d)

Probes: Video? Educational pamphlets? Community/public meetings? Internet?

5. When it comes to Zika, are there any organizations that you would really trust as a reliable source of information? (HMTS 74d)

6. What makes them a trusted source of Zika information? (HMTS 75d)

7. If you are trying to put together a group of people in your community to deal with Zika in a comprehensive fashion, who are the people you want at the table? (HMTS 83d)

Probe: Community based organizations, health care practitioners, policy makers

Probe: Religious leaders/faith based organizations

Probe: What is it about these people that makes you want them there?

Probe: Once you get these people in the room, what is the conversation going to sound like?

Reactions to possible actions

There are many ways to stop the spread of Zika virus in Puerto Rico. If they have mentioned some of the actions (e.g., repellent use, etc.), acknowledge the ones that they have identified. Many decisions have to be made by many people about what to do. Stopping the spread of the Zika virus will require action by everyone. Some actions can be done by individuals, while other actions can be done by communities. I will show you a card that briefly describes an action that could be taken and how it could help. Then I will ask you a series of questions to get your opinion about that action.

Devote about 10 minutes on each concept, showing up to 7 concepts

SHOW ACTION/CONCEPT #1

For each action/concept ask:

1. What do you think of this idea? (HMTS 45d)

2. How appealing is it to you as a way to control Zika? (HMTS 46d)

3. How does it make you feel? (HMTS 11d)

4. Do you strongly agree with any part of this message? If so, what? (HMTS 13d)

5. Do you strongly disagree with anything in this message? If so, what? (HMTS 14d)

6. Was this a new idea or something you’ve heard before? (HMTS 12d)

7. Is this message believable or not? Why or why not? (HMTS 15d)

8. What additional information would you need in order to more strongly believe this message? (17d)

9. Who do you believe would benefit most from (insert action/concept topic)? (HMTS 27d)

10. Which descriptions, if any, sound do-able? Why? Why not? (HMTS 43d)

11. What are the good things about trying this tactic? (HMTS 56d)

12. If you were trying to influence a friend to (insert action/concept topic), what would you say? (HMTS 94d)

Probe for benefits and ways to overcome barriers

13. If you were trying to make up your mind about (insert action/concept topic), who would influence you? (HMTS 93d)

14. Who do you think would be a good spokesperson to use to convince you and your friends to (insert action/concept topic)? (HMTS 91d)

15. What if the CDC was to say something like this? Would that change the way you look at these statements? Would it make any of them more or less believable? More or less appealing? Motivating? (HMTS 102d)

For action/concepts that they personally could do, ask

16. Would you consider doing this behavior? (HMTS 40d)

17. What makes it hard to do this? (HMTS 41d)

18. What would make it easier for you to do? (HMTS 51d)

Repeat for action/concept #2-7 using same questions above

COMPARING AND PRIORITIZING ACTIONS/CONCEPTS

19. I’m going to pass around a sheet that gives you some descriptions of Zika prevention actions. Please review these descriptions silently, and circle those that seem most doable. Cross out any that don’t seem do-able. (HMTS 59d)

• After all tactics have been discussed, the moderator asks participants to identify the two or three tactics that they think are most important and that they have the greatest likelihood of doing. (Moderator takes hand count).

• From the two or three top tactics, the participants are asked to choose the single tactic that they think is most important and that they have the greatest likelihood of implementing. The moderator explores some of the participants’ choices and their reasons for choosing.

• As you look at these strategies, does any one of the three stand out as the one that you would try first? Which one? Why?

• What are the one or two things we have discussed today—if any—that seem most feasible to implement in your household?

• Is there any more information or tools that you would need that would help you implement some of these strategies?

• What are some of the things that would make it difficult for people in your area to (insert behavior)?

• What could, or has, been done in the local area to make it easier—to overcome some of the barriers you described?

Thank you so much for your participation.

Public reporting burden of this collection of information is estimated to average 120 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74,  Atlanta, Georgia 30333; ATTN:  PRA (0920-0572).