HHS/ASPA Opioids Strategic Communication Plan and Messaging

Form Approved

OMB No. 0990-0459

Exp. Date 03/30/2021

Appendix D. Moderator’s Guide:

HHS Prescription Opioid Misuse Education Efforts

Focus Group: Adults Between 18 and 25 Years of Age

A. Introduction (6 minutes)

Welcome, and thank you very much for agreeing to participate in this focus group. My name is _________, and I will guide this discussion. I work for ICF, a research and consulting firm. We are conducting research on behalf of the U.S. Department of Health and Human Services, a federal public health agency, also known as HHS. The main purpose of our discussion is to hear your opinions about prescription opioids and your thoughts on some messages designed to prevent prescription opioid use and misuse among young adults. Please know that I am not an expert on the topic we will be discussing. Your feedback will be used to help plan and develop materials about preventing and reducing prescription opioid misuse among young adults.

Before we start, is there anyone who has not signed the consent form? [Note to moderator: All participants must submit a signed consent form prior to beginning the group discussion.] I need to go over the following things mentioned in the consent form before we start:

• Participation in this focus group is voluntary.

• You may choose to leave the group at any time.

• You may choose not to answer any question.

• All of your answers are private. We will only use your first name during this discussion.

• The information you share will not be linked to your name in our report. We will record the conversation to ensure that we capture all of your ideas. Once the report has been completed, the recording will be deleted.

• People from HHS, and my company are also listening to our discussion. All those listening will protect all information shared unless compelled by law.

• The questions in our discussion are not sensitive and we will not be asking questions about your personal use or activities with opioids. So, please exercise discretion with the information you share.

• The group discussion will last approximately 1 hour.

• You will receive a $25 gift card in appreciation for your participation in the group.

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 0990-0459. The time required to complete this information collection is estimated to about one (1) hours, including the time to review instructions, search existing data resources, gather the data needed, to review and complete 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

Ground Rules

To make our discussion more comfortable and run smoothly for everyone, please keep in mind that: [Note to moderator: Read the ground rules.]

• Everyone’s input is important, so please show respect for one another and share the floor space. It is okay to disagree with another’s opinion or perspective. There are no right or wrong answers. If you dislike something or disagree with something that is said, I want to hear about it; however, please avoid trying to sway the opinion of others. We would like to hear as many different opinions and experiences as possible.

• Everything discussed today is confidential. Please do not share information we discuss with others outside this group.

• At times, I may need to cut a discussion short because of the limited time we have, so please don’t take it personally if I have to move us along.

• Please speak one at a time and at about the same volume as I do. If you are talking softly, I may ask you to speak up to ensure that your comments are captured.

• And last, please silence or turn off your cell phones.

B. Warm-Up (4 minutes)

Let’s begin by finding out a little bit about each of you. Please tell us your first name only and what you like to do for fun. I’ll start. [Icebreaker: Note to moderator: Start by restating your name and mention one of the activities you like to engage in.]

Great, thanks, let’s get started on our discussion. First, I am going to ask you some general questions about prescription opioids.

C. Knowledge, Attitudes, and Beliefs of Prescription Opioid Use and Misuse (23 minutes)

1. What have you heard, or what do you know about prescription opioids (also known as prescription pain pills)?

[MODERATOR: Participants may have a misunderstanding of what prescription opioids are. Clear up any confusion before moving forward by giving a clear definition of prescription opioids. Here is the definition, if needed:

Opioids are chemicals that bind to places in your brain or body, and can be used to treat moderate-to-severe pain. Prescription opioids are often prescribed following surgery or injury, or for painful health conditions such as cancer. Common prescription opioids include pain relievers such as oxycodone, hydrocodone, morphine, Percocet and methadone. Prescription opioids can come in tablets, capsules, or liquids, and are sometimes called by different street names such as Oxy, Vikes, Percs, Tabs, and Demmies. For the remainder of our discussion, we will only be talking about prescription opioids designed to be prescribed for pain relief —not illicit opioids, which are opioids that are illegal and are not prescribed by a doctor, such as [mention the names of illicit drugs participants may have named, such as heroin].

2. Where have you heard about prescription opioids?

   1. Have you ever looked for information about prescription opioids?

3. What do you think about taking prescription opioids in general?

   1. [If they need explanation]: Is it safe/not safe, smart/not smart, neutral? Why?

4. Do you think misusing prescription opioids, such as taking more than prescribed to you or taking someone else’s prescription, is a problem for people your age, people around 18-25?

5. What do you think about misusing prescription opioids?

   1. Is it safe/unsafe? Worth it? Risky?

   2. Not a big deal, why?

   3. If risky, why? What do you think the risks are?

6. What do you think prompts people your age to misuse prescription opioids?

   1. Where do they get the prescription opioids they misuse?

   2. In what types of settings do 18-25 year olds misuse prescription opioids?

   3. What else influences their decisions to misuse prescription opioids?

7. What does it mean to be addicted to prescription opioids?

   1. Do you think addiction to prescription opioids is a problem for 18-25 year olds?

   2. How big of a risk is addiction for people your age who take prescription opioids?

   3. What are the reasons that people your age become addicted to prescription opioids? How does becoming addicted affect people your age?

8. Do you think overdose from prescription opioids is a problem for people your age, people 18-25?

   1. How big of a risk is overdosing for people your age who take prescription opioids?

   2. Do you think death from overdose from prescription opioids is a concern for people your age?

9. What are some of the reasons why people your age choose not to misuse prescription opioids?

10. What would make people your age stop misusing prescription opioids?

11. How hard is it to recover from opioid addiction? What helps people stop misusing prescription opioids?

12. Have you seen any ads about prescription opioids?

    1. In general, what do you think about this information? Anything good/bad about prescription opioids? Why?

    2. Where did you see them shared?

    3. Would you prefer to see these ads shared in other places or channels? If so, where?

This feedback you all are providing is really helpful. Now, I’d like to shift gears and discuss some messages that have been created to help prevent prescription opioid misuse among young adults. I’m going to show five messages, one at a time. I’ll give you a few moments to think about them, and then ask you some questions.

[Note to Moderator: Rotate order of messages across groups. Show each message separately and after each message is shown, ask questions 13 through 19. Repeat these activities for the remaining five messages. After all six messages have been reviewed, move on to the ranking section.]

Message A: The dead-on reality: prescription opioids can take away everything. Even your life.

Message B: Prescription opioids can make your life spiral out of control.

Message C: Your future will thank you for not using opioids.

Message D: Prescription opioid misuse can lead to addiction.

Message E: Your individuality is worth everything. Don’t let prescription opioids take that away.

Message F: Most people don’t use prescription opioids. And for good reason.

D. Message Testing (20 minutes)

13. What do you think is the main point of this message? What idea is this message trying to get across?

14. Are there any words or phrases that aren’t familiar to you or are confusing? Which ones? Are there other words/phrases that should be used?

15. If this message came on your television at home, or showed up in your social media feed, would it get your attention? Why or why not?

1. Are there any words that don’t make sense?

16. Is the message convincing or believable?

17. How does this message make you feel? [Probe: shamed; encouraged; lectured; motivated; concerned; energized; afraid.]

18. What action, if any, might young adults like you take after seeing this message? What do you think the message is trying to get people to do?

19. Do you think this message would make prescription opioid use more appealing to young people? Why or why not?

E. Ranking (5 minutes)

Thinking about the messages you just saw, I would like for each of you to tell me which one you think will be the best or most effective in preventing people your age from misusing prescription opioids. I am going to first show you all six messages, next give you a moment to think about them, and then ask each of you to tell me which message you like the best, and why. Each message is labelled with an alphabet letter, so you can just tell me, for example, A, E, D, etc.

[MODERATOR: Show all six messages on screen at once.]

20. From the six messages shown, I want you to tell me which message you like the best, and why. Let’s start with [participant name].

F. Conclusion (2 minutes)

Thank you. Before we end our discussion, I have just two more questions.

21. What is the most important information you think people your age need to understand about prescription opioids?

22. What do you want to know about prescription opioids that you have not yet learned?

False Close

[Note to Moderator: Confirm if there are any additional probes from observers.]

Closing

Thank you very much for participating this evening, and for sharing your ideas with us—we really appreciate your time. Your gift card will be e-mailed to you.

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