0920-0572 Focus Group Discussion Guide

F orm Approved

OMB No. 0920-0572

Exp. Date 08/31/2021

CDC Enhanced Message Development and Testing to Prevent Excessive Alcohol Use: Message Frame Testing Focus Group Discussion Guide

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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 probe as needed to maintain the natural flow of conversation. Question probes are italicized.

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

Session Overview: Total time—90 minutes

SECTION I: Introduction and Icebreaker (5 min.)

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

SECTION II: Excessive Alcohol Use: Baseline Knowledge and Awareness (10 min)

The purpose of this section is to get participants warmed up and to ease them into discussion of excessive alcohol use, as well as get an understanding of their knowledge and awareness of excessive alcohol use and its definition.

SECTION III: Message Frame Testing (50 min.)

The purpose of this section is to introduce participants to message frames regarding excessive alcohol use. This section will include a rating and ranking worksheet activity in order to facilitate discussion around perceptions of the messages.

SECTION IV: Message Frame Comparison (10 min)

The purpose of this section is for participants to compare and contrast messages in regards to main message effectiveness, memorability, etc.

SECTION V: Imagery Activity and Communication Channel Considerations (15 min.)

In this section, participants will complete a worksheet in which they will select a communication channel they think would best facilitate the dissemination of the message they think is most effective. Additionally, they will write down any words or headlines they think best fit this message, as well as depict any imagery they associate with it.

Section I: Introduction and Icebreaker

Thank you so much for coming today—I appreciate you taking the time to talk to me. My name is _______, and I’ll be moderating this group today. I work for Fors Marsh Group, a private research company based in Arlington, VA. Today, we would like to hear from you about how you think and feel about those times in life when you might have consumed too much alcohol. We will have about 90 minutes for our discussion. Before we get started, I want to go over a few things:

• First, I want to emphasize that we are here today because each of you reported that you drink alcohol. So, it is likely that everyone here has had the experience of drinking too much at some point. There are no wrong answers in this room and we are not here to evaluate or judge each other. Our whole purpose is to hear your perspectives, opinions, and experiences.

• What we talk about here is confidential. That means that you will not be personally identified in any of the summary reports or other materials we might prepare based on our discussions today.

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

• Your participation is voluntary and you have the right to withdraw from the 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 some people from my team who are observing and taking notes so I can be present in our discussion. We are also livestreaming our conversation (audio only) so that individuals who could not be with us behind the glass can observe and take notes. Even though 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.

• 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.

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 you all—let’s get started.

Section II: Excessive Alcohol Use: Baseline Knowledge and Awareness (10 min.)

So to start off our discussion, I’d like to do a brainstorming activity with you on the flip chart. I would like to hear from you about any topics related to “drinking too much.” These could be good or bad things. Right now we’re just going to make a list so feel free to share as many ideas as you can think of. I will write down your responses and then we can talk about them.

Great, thank you! Let’s talk about what [X] is.

• What have you learned or what do you know about [X]?

• Is this a positive thing? Negative? Neither?

That’s a great segue into a few other questions I would like to ask you about drinking too much before we begin our next activity.

• When are you most likely to drink too much?

  • Under what circumstances? With whom?

  • What are the factors that are most likely to affect the amount you drink?

• Thinking about some of those instances:

  • What are the benefits (of drinking too much)?

  • What are the downsides (of drinking too much)?

• How do you weigh the aspects you like about drinking too much with the aspects you dislike about drinking too much?

• Are there any rewards or benefits (not previously mentioned) to drinking too much?

• How easy or difficult is it to abstain from drinking? What about to moderate your drinking?

So that we are all drawing from the same reference point for the rest of today’s discussion, I want to share the CDC’s definitions of binge drinking and heavy drinking with you. If you flip over your pile, you will see these definitions listed here. Binge drinking is defined as: “For women, 4 or more drinks consumed on one occasion. For men, 5 or more drinks consumed on one occasion.” As a note, an occasion is defined as a period of two to three hours. Heavy drinking is defined as “For women, 8 or more drinks per week, and for men, 15 or more drinks per week.”

For the purposes of our conversation today, we’re going to be focusing our discussion on binge and heavy drinking specifically, not just by people who have been diagnosed with an alcohol problem, but by anyone who drinks above these levels.

Section III: Message Frame Testing (50 min.)

Today we are going to be looking at draft messages about drinking too much. To start off, I will show you each draft message and we will talk about them in turn. Please keep in mind that what I am showing you today have not been fully developed – these messages still need a lot of work before you would actually see them anywhere. Since it costs a lot of money to produce an ad, these are draft versions and in their initial form. Once we get your feedback to determine which message ideas to move forward with, we’ll be developing the actual materials. However, they are all a long way from becoming a final product you would see on social media, TV, or a poster or billboard.

After we look at each message, I want you to take a few minutes to complete the Rating Worksheet [Moderator holds up worksheet] on your own before we discuss each message as a group.

• For #1, jot down what you think the main message is – that is, what is the most important thing they are trying to tell you?

• For #2, grade the message. Just like in school, “A” means great job, you really like the message and “F” means it failed, you didn’t like the message at all.

• For #3, select how the message made you feel. If you think there is something missing from the list, you will have the space to write it in.

• For #4, answer a few questions to tell us about your reactions to the message. Just check the box that answers how much you agree or disagree with each statement.

[The moderator will introduce the first message and allow time for participants to complete the Rating Worksheet, at least a couple of minutes. The moderator will then lead a group discussion about the message.]

Initial Reactions	What are your initial thoughts about this message?
Relatable	Does the message speak to you? What did you like about it? What did you dislike about it? How does this message make you feel? Do you feel that this message was created for people like you? IF NO: How could we change it to make it better connect with you?
Main Message	What is this message trying to say? What, if any, benefits are discussed in this message? (e.g., helping health, saving money - probing to understand perceived value of message) Is there anything confusing or unclear about the message?
Believable/Compelling	Do you think what this message is saying is true? Why/why not? What, if anything, would you change or add to make it more believable? Is this message convincing? Why/why not? What, if anything, would you change to make this message more compelling?
Grab Attention/Memorable	If you saw this message somewhere, would it: Grab your attention? How so? How easy would it be for you to not pay attention to this message? Be remembered later? What about it would stick with you?
Frame-Specific Probes (See Appendix A for Frames)	Is this message applicable to you? What are the motivators you see in this message? Does this message motivate you not to drink too much? Does this resonate your with your experience of drinking too much? What risks does this message convey to you?
Intentions	Did this message make you think differently about alcohol? Did this message make you think differently about how much you drink? How so? Did this message make you want to learn more about drinking too much? Where would you go to look for more information? Would you share this message with your friends or family? How would you share it? What would you share?

Section IV: Message Frame Comparison (10 min.)

Now, I’d like for us to compare the different messages that we walked through together. Before we discuss as a group, I’d like to ask you to complete a quick ranking worksheet.

• The first question asks which message you think would be the most relatable or applicable to you.

• The second asks which message would make you pause while scrolling through social media.

• The third asks which message would be most likely to make you think twice about drinking too much.

• And, the fourth question asks which message you would be most likely to share with a family member or friend.

For each question, please select the message and write a brief reason why you selected that message.

[Review Responses] Who would like to share which message they selected for…?

Section V: Imagery Activity and Communication Channel Considerations (15 min.)

As you may have guessed from the messages that we walked through, our goal is to understand how the CDC can better communicate around drinking too much. Specifically, we are interested in developing messages that will inform the public about misperceptions and health risks associated with drinking too much.

To help us with this task of communicating about drinking too much, I’d like your input on how we could bring these messages to life. To help us out, I have a worksheet I would like you to complete. I’d like you to imagine that we are developing these messages to be on social media.

• In the Box #1, you will be asked to write the letter of the message that would make you think twice about drinking too much.

• In the next box, I’d like you to write down on which social media channel you think this message would best fit. Would you see it scrolling through Instagram? On Facebook or Twitter? Another social media platform? Please write that down in Box #2.

• In Box #3, please write down any words/phrases you think would fit well with this message frame. If you were creating a social media post using the frame you selected as your favorite, what would be the caption or headline in the post?

• In Box #4, I’d like you to draw or write down any images that you would expect to see representing this message on your selected social media channel. If you don’t like to draw, feel free to write down what you would expect to see.

Who would like to walk us through what they’ve got on their worksheet? Please remind us which message you used. [Probe as applicable to understand why channel/imagery suggested.]

Section VI: Closing (5 min.)

This has been a very helpful session. Thank you so much for taking time out of your day to be with me and 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 to day that are sensitive so please be reminded to 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 all. [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!

Appendix A: Message Frames

C. There are certain celebrations that are associated with drinking alcohol, such as weddings, sporting events, and birthdays. At a certain point, there must be a line drawn between celebration and risking your health.

S. Drinking is fun until the hangover hits. The effects of a hangover are short-term, and typically people end up drinking again in the near future. At a certain point, there must be a line drawn between enduring the hangover and risking your health.

L. Drinking alcohol raises your risk of getting six kinds of cancer. Drinking might seem fun, but at some point, there must be a line drawn between drinking for fun and risking your health.

P. Going out with friends often involves drinking alcohol, sometimes to excess. At some point, there must be a line drawn between the fear of missing out on the fun and risking your health.

U. Drinking too much can result in loss of memory or doing things you regret. Although you may be able to laugh it off, there comes a time when the line must be drawn between coming up with excuses and risking your health.

E. A good deal can be a good incentive to drink. Happy hours and other specials often encourage people to buy or consume more alcohol than they normally would. At some point, a line must be drawn between a good deal and risking your health.

R. Sometimes, people drink to relive stress or unwind after a long day. Sometimes, drinking in moderation can lead to excess. At some point, a line must be drawn between relaxing and risking your health.

F. There are certain situations where drinking is enjoyment – such as at breweries or wineries. In moderation, these activities may be fine. However, moderation can sometimes lead to excess. At some point, the line must be drawn between enjoyment and risking your health.