Audience Research to Inform Physical Activity Guidelines Strategic Communication

Prevention Communication Formative Research

Att-B_OMB_PAG_Protocol-English_2017.06.21

Audience Research to Inform Physical Activity Guidelines Strategic Communication

OMB: 0990-0281

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OMB Control Number: 0990-0281

ODPHP Generic Information Collection Request: Prevention Communication and Formative Research

Audience Research to Inform Physical Activity Guidelines Strategic Communication

Attachment B:

ODPHP Physical Activity Guidelines, 2^nd Edition

Focus Group Protocol (English)

Research Instrument

June 21, 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 13

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 has developed preliminary messages and iconography to promote the guidelines. This research is intended to serve as a process check and gauge whether consumers understand the messages and find the graphics relatable and persuasive.

CommunicateHealth (CH) will conduct 9 in-person, 90-minute focus groups to investigate the following research questions:

What are consumers’ perceptions and opinions of PAG graphics?
To what extent do consumers understand the messages?
What messages and visuals do consumers find appealing?
What messages and visuals do consumers find persuasive, motivating, and doable?
What factors influence the effectiveness and acceptability of messages and graphics?

Participants and Recruitment

We will conduct 9 focus groups in 3 metropolitan areas: Baltimore, MD; Chicago, IL; 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 conduct all 9 focus groups with adults ages 35–64. At least one group per location will be conducted with parents of adolescents (ages 12-17). We will aim to recruit up to 8 participants for each group (72 participants total). Focus groups will be conducted in English and Spanish, and audiences will be segmented as follows:

	Baltimore, MD	Chicago, IL	Las Vegas, NV	Total
Adults (General)
English	1	1	2	4
Spanish	1	1		2
Parents of Adolescents
English	1	1	1	1
Total FG	3	3	3	9

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 Focus Groups in English (OMB Packet — Attachment A) and Spanish (OMB Packet — Attachment D) 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

Testing Procedures

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.

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
Rating exercise in English (OMB Packet — Attachment C) and Spanish (OMB Packet — Attachment F)
Closing discussion
Participant remuneration

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

Summary Report

CH will analyze feedback from focus group participants to identify important themes, commonalities, and preferences, which will guide revisions to the physical activity iconography and messages. 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 focus group about physical activity

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 provide feedback on some materials related to physical activity. Your input will be very helpful in shaping what the final materials look like.

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.

Thank you 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 about your preferences for physical activity messages and graphics. 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

Session Overview: Total time — 90 minutes

Section A: Welcome and Opening Remarks (10 mins)

The moderator will explain the purpose of the session, present the ground rules, and allow for questions.

Section B: Creative Concept Testing (40 mins)

The purpose of this section is to gauge participants’ reactions to 3 PAG campaign strategies, included in Graphics and Taglines in English (OMB Packet — Attachment G). The order of campaign presentation will be randomized across sessions. Participants will provide feedback on up to 3 graphic executions for each campaign (for a total of 9) and a few campaign-specific messages. Individual- and group-level feedback will be collected.

Section C: General Message Testing (25 mins)

This section will focus on gauging reactions to general messages, included in Messages in English (OMB Packet — Attachment H). It will focus on specific themes, including benefits/barriers, dosage, and intensity. Parent groups will be shown parent/child specific messages.

Section D: Concept Comparison and Rating (10 mins)

The purpose of this section is to revisit all campaign executions together to compare and rate them. The moderator will probe for consumer preferences for one campaign over another. Individual- and group-level feedback will be collected via Rating Exercise in English (OMB Packet — Attachment C).

Section E: Closing and Thank you (5 mins)

The moderator will thank participants for their involvement and provide a final opportunity for questions or comments.

Note 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 conversation.

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 purpose of our discussion today is to share some preliminary graphics and messages about being physically active. We are interested in getting your feedback to help improve them.

A few things to keep in mind as we start our discussion:

Your participation is voluntary

This means you have the right to stop at any time. You do not have to answer every question, but I would like to hear from everyone, so I might call on you at some point.

There are no wrong answers

I’ve come here today to learn from you and get your opinions.
I did not create anything I am going to show you today — so love it or hate it, it is all the same to me.

We are not trying to come to consensus

It’s okay for there to be disagreement and, in fact, I welcome different points of view. Please share what is true for you.

What happens in this room stays in this room

I am interested in what you say but not in who said it. That means your name will not be associated with anything you say in my report. I will only share the report with people working on this project.
Likewise, we want to respect everyone’s privacy in this room and not share any of our discussion from today with others who were not here.

Speak up, speak clearly, and share the space

We are recording this session for notetaking purposes. I will have to write a report later and the recordings will allow me to be present with you now and revisit our conversation at a later time.
Please speak one at a time and as loudly and clearly as possible.

Can we all agree to these ground rules? [Seek verbal confirmation from participants.]

A few other logistics…

This discussion will last approximately 90 minutes and we have a lot to cover — so I may occasionally interrupt to keep us moving.
Please turn off your cell phones and other electronic devices.
If you need to step out for any reason, please feel free to do so one at a time.

[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.]

[The moderator will collect all informed consent forms.]

Now, the only time we will go around the room one by one is right now so I will know who I am talking to.

I would like for each of you to tell me 3 things:

Your first name
How long you have lived in the area
A physical activity you enjoy

[Moderator can write bullets on easel for cues to participants. Introduce self last.]

Creative Concept Testing (40 mins)

[Graphics and Taglines in English (OMB Packet — Attachment G). Allow 5 minutes per graphic. Questions and activities will be repeated and sequence of graphics shown will be randomized across groups.]

Over the next 40 minutes, I am going to show you 8 different concepts. They each have images and messages that I would like your feedback on. You will have an opportunity at the end of our session to compare them to each other, so for now we’re going to look at each one individually.

Please keep in mind that all graphics are currently in black and white and will eventually have color.

Okay. Our first image is called _____[read ID]______. [Moderator shows first execution.]

[Quick association]

Before we share thoughts as a group, I’d like you to grab a notecard, write THIS number [point to execution ID#], and then write in just a few words about what this means to you.

[Brief pause]

Okay thanks. Tell me briefly what you wrote?

Did anyone have a similar or different takeaway?

[Seek feedback from a few participants then collect cards.]

Please pass me your cards. Alright, so let’s discuss this icon:

What is your general impression?
- What do you like about it?
- What do you NOT like about it?
What do you think about the pictures or people shown here?
What do you think about the words in the icon?

[Uncover the tagline under the icon.]

[Point to message.] What do you think about these words?
How similar or different is this message to what you wrote on your notecard?

Here is another example…

[Repeat procedure until all executions for each campaign have been shown.]

[Approximately 5 mins for each execution.]

General Message Testing (25 minutes)

Next we’re going to look at some longer messages — no pictures this time! I am going to share 3 sets with you and we’ll follow the same process for each set.

[Messages in English (OMB Packet — Attachment H)]

[For Adult Groups – Show General Adult Messages only]

[For Parent Groups – Show Parent Messages only]

[Show only one message set at a time. Complete activity and discussion and then repeat]

Step 1 — I want you to read through and highlight in PINK any words or phrases that you find motivating (or that you really like).

Step 2 — Now I want you to read through these again and highlight in GREEN any words or phrases you think are NOT motivating (or that you do not like).

[After completed ask participants to share.]

Tell me some words or phrases you highlighted in pink. What do you like about them? What makes those motivating for you?
Tell me some words or phrases you highlighted in green. What is it about those that you don’t like? Or what makes those not motivating for you?

[Probe particularly if participants indicate something is not feasible or realistic.]

[Repeat process until all 3 sets have been tested have been tested.]

Concept Comparison and Rating (10 minutes)

Okay we’re in the home stretch! Now, I am going to pull up all 9 boards we saw before and compare. Before we discuss as a group, please complete the rating sheet in front of you. I’ll give you a couple of minutes.

[Participants fill out rating sheet: Rating Exercise in English (OMB Packet — Attachment C).]

Let’s discuss how you all rated these.

[Probe on the following questions as time allows]

Which 1 one did you rate as most attention grabbing?
- What is it that catches your attention?
Which 1 did you rate as most motivating?
- What makes it motivating for you?
Which 1 did you rate as your overall favorite? Why?
Which 1 did you rate as your least favorite overall? Why?

[The Moderator will collect participants’ rating sheets.]

Thank You and Closing (5 minutes)

We are about at our time. Thank you all so much for your thoughtful feedback. Is there anything else you would like to share before we conclude?

[Allow for final comments.]

Great! Thank you for coming and please stop by and see ___ on your way out to receive your incentive.

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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