0920-0572 Focus Group Moderator Guide - Sexual Health Study for Ga

Form Approved

OMB Control No.: 0920-0572

Expiration date: 08/31/2021

Sexual Health Study for Gay and Bisexual Men

Phase 2 Focus Group Moderator Guide

2^nd FOCUS GROUP MODERATOR GUIDE-Shigellosis among MSM

Moderator: Your instructions for carrying out this focus group are in brackets [*], and are not read to the participants. Anything not in [*] is said out loud to the participants.

FOCUS GROUP INTERVIEW GUIDE

[Before participants arrive, write all ground rules on a flip chart and post in a location visible to all participants during the focus group.]

[As participants arrive, confirm eligibility by asking each person’s age and the other screening questions. Be discrete so that others around will not hear the individual’s response. Have participants sign in using their real names and DOB. Have a place for them to sign for the incentive.]

[Give the participants a name tag and ask them to put a nickname on the name tag. Inform the participants that this is the name that will be used during the focus group to protect their privacy. It’s important they pick a nickname they feel comfortable being referred to as. We encourage them not to use their given name to further protect their identity.]

[Please take time and read the consent forms.]

Welcome and thank you for agreeing to participate in this focus group. My name is ________. My role is to guide the discussion tonight/today. Before we begin today, please silence or turn off your cell phones [pause]. Thank you. Today, I would like to hear your honest opinions about the topics we discuss. There are no right or wrong answers to the questions I’m going to ask. We, myself and the larger research team, want to hear in your own words, your thoughts, experiences and opinions about the topics we’ll be discussing.

You all have been invited to participate because we need your help in a health communication intervention. We will be asking for your reactions to some messages that have been developed to raise awareness about a germ called Shigella. Don’t worry if you have never heard of it. I’m going to read you some information about the germ, show you some messages, and ask for your thoughts and opinions.

Before we get started, there are just a few things we need to cover.

First, I will now read the consent form out loud. Please follow along. Afterwards, you will need to sign your given, or legal name. This form will not be shared outside this group, and we will not link your name to your responses.

[Read aloud the consent form with everyone following along, or give time for everyone to read the consent on their own. Ask them if they have any questions, and address those questions, including, if you don’t know. To build trust, it is important that you are honest with participants. Collect the signed forms.]

Also, we are audio recording this session so I can listen to what you have to say and not worry as much about taking notes. The recording will help us in writing our reports, and are used for this purpose only. In addition, other research staff members may be present to observe and take notes. Everything you say will be kept secure and anything that is reported will be done without your names or identifiers. In other words, no one who reads the final report will know or be able to figure out that any of you participated in this study. Also, please remember that you can choose not to respond to a question at any time, and that your participation in this study is completely voluntary.

Does anyone have any questions?

[Read the ground rules as posted in the room.]

Ground Rules

There are a few ground rules that I would like us to adopt for our discussion:

• You have been asked here to offer your views and opinions.

  • We know that each of you might have different views about this topic. You might hear opinions that you do not agree with, and if this happens, we ask that you respectfully listen and then share your opinion.

• To the extent the law allows, the focus group facilitators will keep all comments secure. For example, in the event a participant discusses an instance of abuse, suicide, etc., we are mandated by law to report the incidence.

• We ask that you not share comments you hear today with anyone outside this room. You should know that there is the possibility that a focus group participant may not honor this request.

• Everyone’s input is important; I may call on you if you are being quiet.

• Avoid side conversations.

• Let one person speak at a time.

• I may need to cut a discussion short to get through all of the questions.

• There are no right or wrong answers.

• All answers will be kept secure and anonymous, so feel free to speak your mind.

• Respect one another at all times.

• It’s okay to disagree.

• As a way to help us, please state your nickname- be careful not to use your given/legal name, when you make a comment.

Do you have any questions before we begin? If there are no more questions, I am going to start recording now. [Turn on audio recorder]

Section I. Warm-up

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

   1. Nickname i.e. the name you want to use today,

   2. Favorite TV show, and

   3. Favorite type of music

[To further build trust] I’ll start. My name is [name], my favorite TV show is [name], and my favorite type of music is [name]. [Ask a specific person] Who would like to go next? [Go around the table until everyone has introduced themselves.]. Thank you.

As mentioned, we would like to develop health messages that educate gay and bisexual men, as well as men who have sex with men about shigellosis. It is ok if you have not heard of shigellosis—that is why we are trying to develop the health messages! We want to know how well or poorly our health communication materials explain what shigellosis is, and help you learn how to prevent it.

Before we begin, I want to provide you with a little information about Shigellosis. First, Shigellosis is an infectious disease caused by a group of bacteria called Shigella. Most who are infected with Shigella develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacteria. Shigellosis usually resolves in 5 to 7 days. Some people who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.

[At this point, the men may have additional questions. Explain that there will be time at the end of the focus group to answer questions about shigellosis, and that we will provide them with a fact sheet with more information on shigellosis.]

In order to help us develop health communication materials, we would like to show you a few different health communication materials in order to find out what you like and don’t like about each one of them.

[Rotate order of messages in each focus group.]

Section II. Message 1 (Lollipop)

This first message is about preventing exposure to Shigella. [Show lollipop poster, and read the text on the poster aloud.]

2. [Impression] What is the main message you get from this ad?

   1. What else are they trying to say?

   2. What do you think they want you to know with this poster?

3. [Content and Wording] How could this message be improved?

   1. How could the tone be improved?

   2. How could the language be improved?

   3. Is it easy to read?

4. [Content and Wording] Is there anything you want to know that this item does not tell you?

5. [Image] What are your reactions to the image?

   1. What do you like?

   2. What do you not like?

6. [Behavior] What action or behavior do you think they want you to do?

7. [Behavior] How likely do you think this ad will influence you to take these actions? Why?

   1. [Behavior] What about this ad works well for the purpose of promoting this action or behavior? Why?

   2. [Behavior] What about this ad doesn’t work well for the purpose of promoting this action or behavior? Why?

Lollipop and Ice Cream Cone Comparison Question

We have a second version of this poster with a different image, and the rest of the content is the same. Here is the image, with the lollipop changed into an ice cream cone.

[Show ice cream cone poster, and read the text on poster out loud]

8. How do you feel about the images used in this concept?

   1. Are they helpful/engaging? Why/why not?

Section III. Message 2 (Blue Announcement (little booty))

This second message is also about preventing exposure to Shigella. [Show blue announcement poster, and read the text on poster aloud.]

9. [Impression] What is the main message you get from this ad?

   1. What else are they trying to say?

   2. What do you think they want you to know with this poster?

10. [Content and Wording] How could this message be improved?

    1. How could the tone be improved?

    2. How could the language be improved?

    3. Is it easy to read?

11. [Content and Wording] Is there anything you want to know that this item does not tell you?

12. [Image] What are your reactions to the image?

    1. What do you like?

    2. What do you not like?

13. [Behavior] What action or behavior do you think they want you to do?

14. [Behavior] How likely do you think this ad will influence you to take these actions? Why?

    1. [Behavior] What about this ad works well for the purpose of promoting this action or behavior? Why?

    2. [Behavior] What about this ad doesn’t work well for the purpose of promoting this action or behavior? Why?

Section IV. Message 3 (Bathroom)

This third message is about the symptoms of a Shigella infection, which can include frequent diarrhea, vomiting, and stomach pain. [Show bathroom poster and read the text on poster aloud.]

15. [Impression] What is the main message you get from this ad?

    1. What else are they trying to say?

    2. What do you think they want you to know with this poster?

16. [Content and Wording] How could this message be improved?

    1. How could the tone be improved?

    2. How could the language be improved?

    3. Is it easy to read?

17. [Content and Wording] Is there anything you want to know that this item does not tell you?

18. [Image] What are your reactions to the image?

    1. What do you like?

    2. What do you not like?

19. [Behavior] What action or behavior do you think they want you to do?

20. [Behavior] How likely do you think this ad will influence you to take these actions? Why?

    1. [Behavior] What about this ad works well for the purpose of promoting this action or behavior? Why?

    2. [Behavior] What about this ad doesn’t work well for the purpose of promoting this action or behavior? Why?

Section V. Comparing Health Messages

Now that you have seen the three different messages, we would like to take some time to have you compare the messages that you have seen today.

21. [Impression] Which of these messages was most inspiring or motivating for you personally?

22. Now, looking at just the top two ads, which one is the most important to you to help you wash your anus and genitals before and after sex, and that you have the greatest likelihood of doing?

1. What makes this message most effective?

2. What about this particular one is most engaging?

23. Which of these is the worst? Why? What, specifically, do you dislike about it? What do you mean by “worst?” What criteria did you use?

1. What could we change in these posters to make it more likely that you would engage in these behaviors?

Section VI. Key Behaviors

All three posters you saw today encouraged you to wash before and after sex. Now we’re going to talk a little bit about those behaviors.

24. What are the things that would make it easy for you to wash your hands before and after sex?

1. What are the things that would make it hard or get in the way of doing that?

25. What are the things that would make it easy for you to wash your anus and genitals before and after sex?

2. What are the things that would make it hard or get in the way of doing that?

[If there is enough time to ask additional questions about the infographic image, then ask the questions below. Explain that you are going to switch from talking about the educational posters to an educational infographic].

OPTIONAL SECTION (CDC Infographic)

We’ve talked about these three posters that have been developed about sexual transmission of shigellosis, now we are going to show you an infographic that was developed as a general communications tool about all modes of transmission. [Show CDC infographic.]

26. [Impression] How would you sum up in just a few words your first impression of this message? a. Do you like it? Not like it? What makes you say that?

27. [Content] Are there any words or phrases that bother you or that you think should be said differently?

28. [Image] Looking at the image, would you say it fits in with what they are trying to convey?

29. [Behavior] What about this ad works well for the purpose of promoting this action or behavior? Why?

30. [Behavior] What about this ad doesn’t work well for the purpose of promoting this action or behavior? Why?

Thank you for your time and your responses. Those are all the questions that I have. We have a few minutes in the session remaining for you to share any thoughts you have about the topics we covered today and for you to ask questions.

[Give them a long pause, and consider asking a particular person if they have something to say.]

Thank you again for taking time out of your day to come talk with us about these topics. Before you go, let’s take care of the incentive payment. I will also give you a flyer with information about shigellosis. Any final thoughts or questions?

[Pause] Have a good evening/day, I’m stopping the recorder. [Stop recorder.]

Public reporting burden of this collection of information is estimated to average 60 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 Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA 0920-0572