Asthma Control Communication Materials Field Testing (NCEH)

Attachment 2_Focus Group Discussion Guide Form Approved

OMB No. 0920-0572

Exp. Date 03/31/2018

The Centers for Disease Control and Prevention (CDC) Asthma Communication Messaging and Materials Development:
Focus Group Discussion Guide

Public reporting burden of this collection of information is estimated to average 1.5 hours per focus group, 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0572)

Project Objective: Conduct focus groups with (1) children ages 12 to 18 who are disparately affected by asthma (i.e., have visited the emergency room or had a hospital stay in the past year and have missed at least one day of school/work due to asthma) and (2) caregivers of children with asthma to test key messages for prototype development.

NOTES TO REVIEWER:

This discussion guide is not a script and, therefore, will not be read verbatim. The moderator will use these questions as a roadmap and will probe as needed to maintain the natural flow of the conversation. Secondary question probes are italicized. These are suggestions for the interviewer to follow, and will be used or modified as deemed relevant and necessary in the natural flow of discussion.

Moderator instructions are highlighted in yellow. Materials are highlighted in blue.

Session Overview: Total Time: 90 minutes

SECTION A: Introduction and Icebreaker (5 minutes)

The moderator will explain the purpose of the focus group, present the ground rules, and allow participants to ask any questions.

SECTION B: Asthma Background (5 minutes)

The purpose of this section is to ease into discussion about asthma and start getting them in the mindset of messaging.

SECTION C: Key Message Testing (50 minutes)

The purpose of this section is to examine reactions to the four key messages.

SECTION D: Comparison of Key Messages (10 minutes)

The purpose of this section is to compare the key messages to gain an understanding of which message is most effective.

SECTION E: Comparison of Message Strategies (15 minutes)

The purpose of this section is to compare the four message strategies for the most effective message for each group.

SECTION F: Conclusion (5 minutes)

Moderator ensures that all questions are answered and all comments have been heard.

Section A. Introduction and Icebreaker (5 min)

Thank you for coming to talk to us today, your time is greatly appreciated. My name is _____, and I work for Fors Marsh Group, which is an independent company that conducts hundreds of focus groups like this each year. Focus groups are a type of research used to gather opinions on a specific topic. I’m here to listen to you and what you have to tell me, and it doesn’t matter to me how you answer my questions, I’m interested in hearing your thoughts. Today, we would like to hear from you about how you think and feel about asthma and managing asthma. I am conducting this focus group on behalf of the Centers for Disease Control and Prevention.

We will have about 90 minutes for our discussion. Before we get started, I want to go over a few things:

• There are no wrong answers. Our whole purpose for being here is to hear what you think, so please speak up, especially if what you have to say is different than what someone else is saying. You may represent what a lot of other folks think.

• What we talk about here is confidential. This means that your individual responses will not be reported and your name will not be associated with anything you say in our reports.

• Likewise, we want to respect the privacy of everyone in this room and, therefore, ask that you please not share any of our discussions with others.

• Your participation is voluntary and you have the right to stop participating in this group at any time.

• You don’t have to answer every question, but I do want to hear from everyone, so I might call on you at some point. Please speak one at a time and clearly, so I may hear you.

• You might have already noticed the glass behind me. There are people from my team who are observing and taking notes, so I can focus on our discussion. Even though other people are observing, please speak openly about your opinions and experiences. We want to learn from you, so it is important that you share your honest opinions.

• We are also audio-recording this session. I will be speaking with people across the country for this project, and it will be impossible for me to remember everything. The audio files will be transcribed, but any information that could identify you will be removed from the transcripts. At the end of our discussion, I have to write a report and will refer to the recordings and transcripts when writing the report.

• We’re also streaming this session so some of my team can listen in but not video recording. Is everyone okay with that?

• Please turn your cellphone off or switch to silent mode.

• If you need to go to the restroom during the discussion, please feel free to do so. It is [GIVE DIRECTIONS].

Does anyone have any questions before we begin?

Okay, great. First, I’m going to have everyone introduce themselves. Please tell us your name and something you like to do in your free time. I’ll go first.

[Introductions and Icebreaker] It’s wonderful to meet everyone—let’s get started.

Section B. Asthma Background (5 min)

Each of you shared that you have [asthma/a child with asthma]. I’d like to start our conversation with a few questions about your experience with asthma.

YOUTH

• What triggers your asthma?

• What does it mean to you to manage your asthma?

  • What makes it hard to manage your asthma? [PROBE ON: Barriers]

  • What makes it easier? [PROBE ON: Facilitators]

• What sort of things do you do to manage your asthma?

  • What does managing your asthma look like? [PROBE ON: Steps]

  • Do you have any routine to your asthma management?

    • What does that look like?

  • Does anyone help you to manage your asthma?

    • Who? How so?

  • How involved, if at all, are your parents in managing your asthma?

CAREGIVERS

• What triggers your child’s asthma (e.g., pollen, time of year, etc.)?

• What does it mean to you to manage asthma?

• What makes it hard to manage your child’s asthma? [PROBE ON: Barriers]

• What makes it easier? [PROBE ON: Facilitators]

• What sort of things does your child do to help manage his or her asthma?

  • What does managing your child’s asthma look like?

• What role do you have in your child’s asthma care?

  • What sort of things do you do to help manage your child’s asthma?

Section C. Key Message Testing (50 min)

[MATERIALS: Segment-Specific Message Stimuli (handouts), Key Message Worksheets]

[A total of four key messages will be tested, with the order of messages randomly assigned by group to minimize order effects]

This discussion has been helpful to learn more about your experiences with asthma—it is very useful background for me as we continue talking. Now we’re going to shift the conversation a little bit and talk about messages you might see about managing asthma. I’m going to share a few messages that might be developed into communication and educational materials for youth with asthma. Please keep in mind that the messages I show you today have not been fully developed—they still need a lot of work. Your feedback will help determine which messages we should move forward with, so try not to get caught up in small details since these aren’t final.

[Hand out/show each message in randomized order + probe]

I’m going to read this out loud to you and feel free to follow along on your hand out. We’ll do the same again with the other messages. Later, we will compare the messages together.

[Walk through sheet; allow time for participants to fill out sheet] Take a moment to answer the questions on your worksheet.

Okay, let’s jump in. Remember, there are no wrong answers, and I have no stake in the outcome of this testing. Love it or hate it, it’s all the same to me.

Probes for All Messages
Initial Reactions	What are your initial thoughts about this message? Does this message grab your attention? Why/why not? How does it make you feel? What did you like about this? What did you dislike about this?
Understanding	What do you think this message is trying to say? What is this message telling you to do? Does this message speak to you? Is there anything confusing or unclear about the message?
Engagement	Do you believe what this message is trying to say? Why/why not? What, if anything, would you change or add to make it more believable? Do you feel this message is made for someone like you? How relatable is this message? Does this message make you want to do something? Why/why not? What does this message make you want to do? What, if anything, would you change or add to make this message more persuasive/motivating? Does this message make you want to learn more? CAREGIVERS: Would this message motivate your child to manage their asthma? Why/why not? What would make it more motivating? Does this message make you want to take steps to manage your asthma? Why/why not? What would those steps be? How does this message make you think about asthma management?

Great; I have just a few more questions about this message.

Message Specific Probes
Be Smart. Breathe Smart.	What does “be smart, breathe smart” mean when managing asthma? What is being “smart” in asthma management? [PROBE ON: Education, taking initiative]
Own your Asthma.	What does “owning your asthma” mean? What does taking control of your asthma look like?
Breathe Better Together.	What does “breathe better together” mean for asthma management?
Know Your Zone.	What does it mean to “know your zone” in school? What about when hanging out with friends? When exercising?

Section D. Comparison of Key Messages (10 minutes)

[MATERIALS: Message handouts, Message Ranking Worksheet]

Now think about all the messages I shared with you. I’d like to get your thoughts about all the messages you saw today. [Refer participants to message handouts]

[Walk through ranking sheet; allow time for participants to fill out sheet] Please take a couple minutes to fill out this worksheet about which message is your favorite.

Thinking about everything you’ve seen today and the discussions we’ve had…

• Which message was your favorite?

• Why?

• Which message most makes you want to take steps to manage your asthma? CAREGIVERS: Which message would most motivate your child to self-manage their asthma?

  • Why?

  • What would that management look like?

• Which message seems made for someone like you?

  • Why?

• Which message is going to stick with you tomorrow?

  • Why?

• Which message are you most likely to tell someone else about?

  • Why?

• Which message is most helpful?

  • What parts were most helpful?

• Which message was least helpful?

  • Why?

• Which message makes you want to get more information?

  • What kind of information?

Section E. Comparison of Message Strategies (15 minutes)

[MATERIALS: Message Strategy Handouts for One Message]

Now I’d like to switch topics a bit to talk about how we may take these ideas we just talked about and make them into messages. We’ll walk through the one that the majority said was their favorite and/or most motivating.

[Show examples of the four message strategies for the message that stood out as favorite/most effective during the comparison of key messages]

Take a couple minutes to read these different stories.

• Which message is your favorite?

• Why?

• Which message is your least favorite?

  • Why?

• Which message most makes you want to take steps to manage your asthma? CAREGIVERS: Which message would most motivate your child to self-manage their asthma?

  • Why?

  • What would that management look like?

• Which message most makes you feel like you can manage your asthma on your own? CAREGIVERS: Which message would most make your child feel like they can manage their asthma independently?

  • Why?

  • What would that management look like?

• Which message do you identify with most? CAREGIVERS: Which story would your child identify with most?

  • Why?

• Which message is going to stick with you tomorrow?

  • Why?

• Which message are you most likely to tell someone else about?

  • Why?

• Which message is most helpful?

  • What parts were most helpful?

• Which message makes you want to get more information?

  • What kind of information?

Strategy Specific Probes
Relatable Narratives	How much is this message made for someone like you? What could be done to make it better fit someone like you?
Tips & Tricks	How helpful are these tips and tricks? What could be done to make them more helpful? What other tips and tricks would you want to see?
Finding Balance	What does it mean to find your balance in asthma management?
Social Motivation	How does this message make you feel? How involved are others in managing your/your child’s asthma? [If did not already emerge in discussion] What about when hanging out with friends? Would this story make you want to share your asthma story with others? Why/why not?

Section F. Conclusion (5 minutes)

This has been a very helpful session. Thank you so much for taking the time out of your day to be with me and to share your perspectives and experiences. Before we wrap up, is there anything else that you would like to share or that we might have missed?

We’ve talked about some things today that are sensitive, so please remember not discuss this session with others who did not attend.

[TIME PERMITTING] If you don’t mind, I am going to step out for just a moment to see if my team has any additional follow-up questions for you. [Ask any additional questions.]

Ok, thank you again for your time. Are there any final questions? If not, you are free to go. Please leave behind your worksheets and writing utensils. Have a wonderful evening!