Understanding Physical Activity-Related Information Needs and Communication Preferences among Consumers and Professionals

Prevention Communication Formative Research

Att-C_OMB_PAG_2017.1.9

Understanding Physical Activity-Related Information Needs and Communication Preferences among Consumers and Professionals

OMB: 0990-0281

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Attachment C:

ODPHP Physical Activity Guidelines, 2^nd Edition

Consumer Focus Group Protocol

(English)

OMB Control Number: 0990-0281

January 9, 2017

Submitted to:

Sherrette Funn

Office of the Chief Information Officer

U.S. Department of Health and Human Services

Submitted by:

Frances Bevington

Strategic Communication and Public Affairs Advisor

Office of Disease Prevention and Health Promotion

U.S. Department of Health and Human Services

Table of Contents

Objectives 1

Participants and Recruitment 2

Methods 4

Appendix A: Recruitment Email 5

Appendix B: Participant Information Sheet 6

Appendix C: Informed Consent Form 7

Appendix D: Consumer Focus Group Moderator’s Guide 8

Appendix E: Incentive Receipt Form 15

Objectives

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0281. The time required to complete this information collection is estimated to average 1 hour and 30 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

The Office of Disease Prevention and Health Promotion (ODPHP) will be releasing the second edition of the Physical Activity Guidelines in 2018. In preparation for this, ODPHP aims to conduct formative research to inform a comprehensive communication plan to promote physical activity and the Physical Activity Guidelines resource. This research will also inform the development of effective iconography that relays key messages about physical activity.

CommunicateHealth (CH) will conduct focus groups with adults ages 35 to 64, including parents of adolescents ages 12 to 17 and Spanish-speaking adults. We will conduct 12 in-person, 90-minute focus groups to investigate the following research questions:

What beliefs, attitudes, and motivations influence consumers’ engagement in physical activity?
What are consumers’ current physical activity behaviors? What individual- and structural-level barriers and facilitators exist related to consumers following the Physical Activity Guidelines?
What differences exist between consumers’ physical activity goals and their actual physical activity behaviors? Why?
How familiar are consumers with the Physical Activity Guidelines?
What are consumers’ preferences for physical activity communication channels, images, and branding?
What mobile health tools and technologies do consumers use to support physical activity? What mobile health tools and technologies have consumers used in the past, and what tools would they like to use in the future?

Participants and Recruitment

We will conduct 3 focus groups in 4 greater metropolitan areas: Baltimore, MD; Jackson, MS; Indianapolis, IN; and Las Vegas, NV. The states in which we will conduct the focus groups have among the highest percentage of adults who report no leisure-time physical activity.¹ These cities were chosen for regional diversity — each is located in a different HHS region.²

We will aim to conduct at least 3 focus groups in a rural settings outside one of these greater metropolitan areas. These rural groups will be contingent upon the ability to recruit enough participants who can travel to a central location.

We will conduct all focus groups with adults ages 35–64. We will aim to recruit up to 8 participants for each group (96 participants total). Specifically, we will conduct focus groups with each of the following audiences:

Adults (general, i.e. either parents or non-parents) — 6 focus groups total
Parents of adolescents — 6 focus groups total

For each of these audiences, we will aim conduct focus groups in the following languages:

English — 2 focus groups per metro area (4 with general adults, 4 with parents; 8 total)
Spanish — 1 focus group per metro area (2 with general adults, 2 with parents; 4 total)

	Baltimore, MD	Jackson, MS	Indianapolis, IN	Las Vegas, NV	Total
Location
Urban	3		3	3	9
Rural		3			3
Adults (General)
English	2	2			4
Spanish			1	1
Parents of Adolescents
English			2	2	4
Spanish	1	1			2
Total FG	3	3	3	3	12

CH will use a professional recruitment firm to identify, screen, and recruit prospective participants. The recruitment firm will use the approved Recruitment Email (Appendix A) and Phone Screener for Consumer Focus Groups (OMB Packet — Attachment A) provided by CH to identify and screen potential participants from their databases.

We will aim to recruit a participant pool with diverse:

Races and ethnicities
Education levels
Income levels
Physical activity levels

Using the Stages of Change³ theory, we will recruit participants in the contemplation and planning stages (i.e. people motivated to improve physical activity levels for themselves or their children). We will exclude participants who are currently meeting or exceeding key PAG recommendations, such as adults who get 150 minutes per week of moderate-intensity aerobic physical activity and parents of children who get 60 minutes per day of physical activity.

Participants will be offered a $75 cash incentive for participation. Whenever possible, focus groups will take place in locations that can be accessed by public transportation.

Methods

We will conduct 12 focus groups with up to 8 participants each (for a total of up to 96 participants). At the beginning of each focus group, the moderator will provide participants with the Participant Information Sheet (Appendix B) and Informed Consent Form (Appendix C). Participants will review and sign the form, and have an opportunity to ask questions about any aspect of the study before the focus group begins.

The informed consent statement assures the participant that information provided during the discussion group will be kept confidential and will only be used to inform ODPHP’s efforts to promote physical activity. The statement also contains language explaining that signing the form confers permission to be audio recorded.

Each focus group will each last approximately 90 minutes and will include a moderator and a note taker.

Testing Procedures

The moderator will follow a standard protocol for each focus group that includes the following (see Consumer Focus Group Moderator’s Guide in Appendix D for details):

Welcome, opening remarks, ground rules, and introductions
Explanation of the purpose of the focus group
Informed consent
Warm-up discussion
Main focus group discussion
Quick association exercise (OMB Packet — Attachment G)
Collage activity exercise (OMB Packet — Attachment H)
Closing discussion
Participant remuneration

Summary Report

CH will analyze feedback from focus group participants to identify important themes, commonalities, and preferences, which will guide the development of the physical activity iconography and communication plan. CH will deliver a summary report highlighting key findings and recommendations.

Appendix A: Recruitment Email

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0281. The time required to complete this information collection is estimated to average 10 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

To: Consumers

From: Recruiter

Email Subject: Opportunity to participate in a physical activity focus group

Email Body:

Dear [FIRST NAME],

My name is [RECRUITER FIRST NAME AND LAST NAME] and I’m reaching out from [RECRUITMENT COMPANY] to invite you to participate in a focus group about physical activity. The U.S. Department of Health and Human Services is working closely with a company called CommunicateHealth to figure out how to help people be more physically active.

We are looking for people to share their ideas and opinions about physical activity. Your input will help us make sure we create physical activity-related information and tools that meet the needs of people like you.

If you’re eligible, you will receive a $75 incentive as a thank you for your time and participation. The focus group will be held in person in [LOCATION]. It will last 90 minutes and take place [TIME FRAME].

If you are interested in participating, please reply to this email with your phone number and the best time to reach you. I will follow up by phone to make sure you qualify to participate in the focus group and to discuss scheduling.

Thanks in advance for your help!

All the best,

[RECRUITER FIRST NAME]

Appendix B: Participant Information Sheet

Please review the following information about this project. Feel free to ask us any questions you may have.

Who is working on this project?

This project is being coordinated by CommunicateHealth, a health communication consulting firm, on behalf of the Office of Disease Prevention and Health Promotion (ODPHP), which is part of the U.S. Department of Health and Human Services (HHS).

What is the goal of this project?

We are working to identify the best way to communicate about physical activity. Our goal is to develop information and tools that help people be more physically active.

How can I help?

We are interested in learning from your experiences. Your feedback in this focus group will help us make sure we create physical activity-related information and tools that meet the needs of people like you.

Do I have to participate in this project?

No. It is your choice whether to participate or not. You can stop at any time, and you don’t have to answer any questions you don’t want to answer. If you don’t want to participate or decide to stop, that’s okay.

How will you protect my privacy?

We will keep your identity and all of your personal information confidential — that means we will not share it with ODPHP or anyone outside of our project staff. We will not collect or store any of your personal information. Also, your responses will not be linked with your name.

For more information:

If you have questions about the project, contact Project Manager Jaya Mathur at [email protected] or (413) 582-0425.

Appendix C: Informed Consent Form

I, _________________________________________, agree to take part in this focus group study.

I understand that I do not have to be in this study. I can leave at any time without penalty. I can agree to be in the study and then change my mind later.

I allow the Office of Disease Prevention and Health Promotion (ODPHP) — which is part of the U.S. Department of Health and Human Services — to use the information from this study. I understand that the information is for research only, and that my name will not be shared with anyone else.

I agree to ask questions about the study if I don't understand something. If I have questions after the study is over, I can contact Jaya Mathur at [email protected] or at 413-582-0425.

Audio Recording Release

I understand that I will be audio recorded during this study. I allow ODPHP to use the recordings of me for research purposes only. I understand that my name will not be used for any other purpose.

I give up any rights to the recording and understand the recording may be copied and used by ODPHP without my permission.

Summary

I have read and understood this consent form. I understand that I will get a copy of this form.

Print Name: _________________________________________

Signature: _________________________________________

Date: _________________________________________

Appendix D: Consumer Focus Group Moderator’s Guide

Welcome/Opening Remarks (10 minutes)

[The moderator will greet everyone as people join the focus group discussion.]

Thank you for joining us today. My name is _____, and I will be facilitating this discussion group on behalf of the Office of Disease Prevention and Health Promotion (also known as ODPHP), which is part of the U.S. Department of Health and Human Services (HHS).

The ideas and information you share with us are very important. What you tell us today will help us better understand what information and tools would help people be more physically active. With your help, we hope to help ODPHP develop effective graphics and messages that will help people be physically active.

Before we begin, I’d like to make a few things very clear and explain how the discussion will work.

We are not trying to sell or promote any product or service to you.
There are no right or wrong answers — we want your opinions.
____ will be taking notes and audio recording the discussion. We will be writing a report on your suggestions. Audio recording the discussion will help us write the report. We will not use your names in the report. We will only share the report with people working on this project.

In order to make sure everyone’s thoughts and opinions are heard, it is important that you only speak one at a time. I may occasionally interrupt you when 2 or more people are talking at once in order to be sure we hear everyone’s suggestions and opinions.
This discussion will last approximately 90 minutes. I want to be sure not to keep you here much longer, so I may occasionally interrupt you to keep the discussion focused.
Please turn off your cell phones and other electronic devices.

[The Moderator will provide participants with the consent form and obtain informed consent. The Moderator will provide ample time for participants to review and sign their informed consent form and answer any questions they might have.]

To remind you, your participation in this discussion is voluntary. You may stop the discussion at any time. Your name will NOT be used in any report.

[The moderator will collect all informed consent forms.]

Introduction and Warm-up (5 minutes)

First, I’d like to thank you all for making yourselves available today. And thank you in advance for sharing honest answers about the role physical activity plays in your life. I’m sure we’ll hear a variety of experiences and ideas today. Again, there are no right or wrong answers, and no one is judging your responses.

Let’s go around and introduce ourselves. Please say your first name and one thing you do to stay healthy. I’ll start and then we’ll go around the room. Again my name is _______ and to stay healthy I _______.

Thank you.

Discussion of Physical Activity, Barriers and Facilitators, and the Physical Activity Guidelines (30 minutes)

For Adults 35–64

Now, we’re going to start with a warm-up question.

We all have different understandings about what it means to be physically active. What comes to mind when you hear the phrase physical activity?
- PROBE for both formal and informal understandings of physical activity.

Getting enough physical activity can help you stay healthy. But it can be tough to stay motivated.

What kinds of physical activity do you do, if any?
- PROBE: How much physical activity do you do?
- PROBE: How often do you do this physical activity?
- PROBE: How has your physical activity changed over time? Why?
What motivates you to be or want to be more physically active?
What are your physical activity goals (if any)?
- PROBE: How much physical activity do you think you should do each week?
- PROBE: How are you doing at meeting these goals?
- PROBE: What are the top 1 or 2 things that make meeting your goals challenging?
- PROBE: If you aren’t setting physical activity goals, why not?

What are 1 or 2 strategies that you have used in the past or have thought about using to make it easier to be physically active?
- PROBE: What has worked? Why?
- PROBE: What hasn’t worked? Why?

Have you used mobile health tools (like mobile phone apps or pedometers) to help be more physically active?
- IF NECESSARY PROVIDE EXAMPLES: FitBit, MapMyRun, MyFitnessPal
- PROBE: What have you used in the past?
- PROBE: How did it work for you?
Looking ahead, what kinds of mobile health tools would be helpful to you? Why?

Next, I would like to discuss how you get health information.

Where do you typically get information on how to stay healthy?

PROBE for all channels of communication including web, social media, friends and family, etc.
PROBE for any specific resources.
PROBE: What do you like/dislike about these resources?

Where do your ideas about how much and how often to be physically active come from? Where do your ideas about how much effort to put in when you’re physically active come from?
- PROBE: Where do you get this information?
- PROBE for any differences in sources of general health information.
- PROBE for any specific resources.
- PROBE: What do you like/dislike about these resources?
- PROBE: Which sources do you trust for information on being active?

What’s the best way to reach you with information and tips about being active? Why?

Finally, before we switch gears and do an activity, I would like to discuss the Physical Activity Guidelines with you. The Physical Activity Guidelines is a set of national, evidence-based recommendations for physical activity. The Physical Activity Guidelines recommends Americans get certain amounts and kinds of physical activity to live a healthy life.

Have you heard of the Physical Activity Guidelines before today?
- PROBE: What do you know about the Physical Activity Guidelines (if anything)?
- PROBE: Who develops the Guidelines?
- PROBE: Where did you hear about it?

For Parents of Adolescents

Now, we’re going to start with a warm-up question.

We all have different understandings about what it means to be physically active. What comes to mind when you hear the phrase physical activity?
- PROBE for both formal and informal understandings of physical activity.

Getting enough physical activity can help you stay healthy. But it can be tough to stay motivated.

What kinds of physical activity do you do, if any?
- PROBE: How much physical activity do you do?
- PROBE: How often do you do this physical activity?
- PROBE: How has your physical activity changed as you’ve gotten older? Why?
What motivates you to be or want to be more physically active today?
Are there any physical activities that you and your children do together?

Now we’re going to talk about your kids and how they get physical activity. We’re particularly interested in the physical activity of your kids ages 12 to 17, but if you have younger children, please feel free to share information about their habits, too.

Describe the kinds of physical activity that your children do, if any.
- PROBE: How much physical activity do they do?
- PROBE: How often do they do this physical activity?
What do you think motivates your children to be or want to be more physically active?
What are your physical activity goals for your children? Do they have their own goals, too?
- PROBE: How are your children doing in meeting these goals?
- PROBE: What are the top 1 or 2 things that make meeting these goals challenging?

What are 1 or 2 strategies that you have used in the past or would like to use to encourage your kids to be more active?
- PROBE: What has worked? Why?
- PROBE: What hasn’t worked? Why?

Have you or your children used mobile health tools (like mobile phone apps or pedometers) to help be more physically active?
- IF NECESSARY PROVIDE EXAMPLES: FitBit, MapMyRun, MyFitnessPal
- PROBE: What have you/they used in the past?
- PROBE: How did it work for you/them?
Looking ahead, what kinds of mobile health tools would be helpful to you and/or your children? Why?

Next, I would like to discuss how you get health information for your child.

Where do you typically get information on how to keep your children healthy?

PROBE for all channels of communication including web, social media, friends and family, etc.
PROBE for any specific resources.
PROBE: What do you like/dislike about these resources?

Do you look for information about how to help your children get more physical activity? If so, where do you find that information?
- PROBE for any differences in sources of general health information.
- PROBE for any specific resources.
- PROBE: What do you like/dislike about these resources?

What’s the best way to reach you with information and tips for keeping your child active? Why?

Have you heard of the Physical Activity Guidelines before today?
- PROBE: What do you know about the Physical Activity Guidelines (if anything)?
- PROBE: Who develops the Guidelines?
- PROBE: Where did you hear about it?

Quick Association Exercise (20 minutes)

Now we’re going to do an exercise. I will pass around a sheet numbered 1 through 7. I will then show you a series of 7 slides, each with an image or message related to physical activity. You will have 20 seconds to quickly jot down your first impressions about each slide on the sheet. Focus on what you like or don’t like about each image or message. Remember, you will only have 20 seconds until we move on to the next slide.

[The Moderator hands each participant the numbered assessment sheet. The Moderator begins the slide deck of images and messages for testing. On each slide, the corresponding number is clear. Each slide advances after 20 seconds.]

Think about the images and messages that you liked. What did you like about them?
Think about the images and messages that you didn’t like. Why didn’t you like them?

Next, I would like to go back to each slide and hear your thoughts. [This provides an opportunity to get feedback on images, messages, and taglines.]

What were your first impressions about this slide?
- PROBE: What did or didn’t you like? Why?
- PROBE: What was or wasn’t effective? Why?

[Repeat this line of questioning for specific images or messages in slide deck. At the end of the exercise, the Moderator will collect participants’ assessment sheets for analysis and report writing.]

Collage Activity Exercise (20 minutes)

[For this exercise, the moderator will ask participants to pick 2 or 3 pictures that represent qualities they would want in information and tools to help them be more physically active and 2 or 3 pictures that represent qualities they would not want. Moderator hands each participant the 25 picture set.]

We’re going to do a short activity now. As we’ve discussed, the goal of this project is to create information and tools — like graphics or web content — to help people be more physically active. I would like you to circle 2 or 3 pictures that represents qualities you would like to see in physical activity information and tools. Then I would like you to cross out 2 or 3 pictures that represent qualities you would NOT like to see.

Under each picture you circle or cross out, please briefly write why you chose that picture.

Remember that the pictures you choose are symbolic and represent qualities about physical activity information and tools. [Moderator demonstrates the activity.]

I’ll give you a few minutes to choose and once you are done we will discuss why you chose each picture. [Wait for everyone to complete their collage.]

Let’s talk about which pictures you each chose and why.

Is there anything else you would like to share before we end the group discussion?

Thank You and Closing (5 minutes)

The Moderator will conclude each session by thanking participants for offering their opinions and suggestions.

Appendix E: Incentive Receipt Form

I have received $75 for participating in a focus group for CommunicateHealth and the Office of Disease Prevention and Health Promotion.

Name (print):

Name (sign):

Date:

1 http://www.cdc.gov/physicalactivity/downloads/pa_state_indicator_report_2014.pdf

2 http://www.hhs.gov/about/agencies/iea/regional-offices/

3 Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology 51(3): 390–395, 1983.

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