Focus Group Moderator's Guide

CDC and ATSDR Health Message Testing System

Attachment 3_Focus Group Moderator Guide_19July2019

A Tailored Communications Campaign to Reduce Pregnancy-related Complications and Death

OMB: 0920-0572

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A Tailored Communications Campaign to Reduce Pregnancy-Related Complications and Death

Attachment 3: Focus Group Moderator Guide

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OMB No.: 0920-0572

Exp. Date: 08/31/2021

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FOCUS GROUP MODERATOR GUIDE: Messaging about pregnancy-related complications and death among pregnant and postpartum women

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.

INTRODUCTION (5 minutes)

[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, have them sign in with you using their real names for the incentive. Participants should not see each other’s real names. ]

[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.]

[If a CDC or MarketVision representative is in the room to answer questions, please introduce them.]

Welcome and thank you for agreeing to participate in this focus group. My name is ________ and I will be guiding the discussion for today’s focus group.

You all have been invited to participate because we need your help in creating a health communications campaign. We will be asking for your reactions to some messages that have been developed to raise awareness about the topic of pregnancy-related complications and death. I’m going to read you some information about pregnancy-related complications and death, show you some messages, and ask for your thoughts and opinions.

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. I want to hear in your own words your thoughts, experiences and opinions about the topics we’ll be discussing.

Before we get started, there are just a few things we need to cover. First, I will pass out a consent form that describes our project, what your participation involves, and the steps we will take to protect your privacy to the extent permitted by law. I will read this aloud and then ask you to sign if you agree to participate.

[Pass out the consent form and read aloud. Ask them if they have any questions, address those questions, and tell them you will follow-up with them on answers to questions you don’t know. Collect the forms after everyone has signed.]

Also, we are audio recording this session. It helps me listen to what you have to say and not worry about taking notes. The recording will help us review what you said as we write reports focused on how to improve the messages for the health communication campaign. Everything you say will be kept secure and anything that is reported will be done without your name or identifying information. In other words, no one who reads the final report will know or be able to figure out that any of you participated in the focus group discussion today. Also, please remember that you may choose not to respond to a question at any time, and that your participation today is 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 child abuse we are mandated by law in the state of Georgia to report the incident.
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, but we hope that everyone will be respectful of 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 to the extent permitted by law, 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 when you make a comment - be careful not to use your given/legal name.

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 (10 minutes)

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

I’ll start. My name is [name], my favorite TV show is [name], and my favorite type of music is [name]. Who would like to go next? [Go around the table until everyone has introduced himself or herself.]. Thank you.

As mentioned, we would like to develop health messages that educate pregnant and postpartum women about conditions that could lead to death or severe complications related to pregnancy. Pregnancy-related deaths—or maternal deaths--remain relatively rare and will never affect many women. However, in order to prevent as many of the deaths as possible that do continue to occur every year, it’s critical that we develop health messages that can help women, their partners, family members, and others to reduce the risk of pregnancy-related complications and death. We want to know how well or poorly our messages frame the issue, and help you learn how to find resources that may help to prevent negative outcomes.

Before we begin, I want to provide you with a little information about pregnancy-related deaths and complications. As I mentioned, these deaths don’t happen that often; however, 700 women do die in the U.S. each year because of pregnancy-related complications and 50,000 more experience severe maternal morbidity – that is, unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health. Some of these deaths happen after pregnancy and delivery. Women of all walks of life are affected, but some women are at more risk than others. For example, African American women are three to four times more likely to die of pregnancy-related complications than white women. There is research to suggest that more than half – 60%, in fact – of maternal deaths are preventable. That’s the gap we’re trying to fill – we’re trying to help women and their support system to find resources to help them identify common causes and get the help they need.

[At this point, ask the participants if they have questions and answer them. Explain that there will also be time at the end of the focus group to ask additional questions.]

To help us develop health communication messages about this topic, we would like to show you a few different pictures with messages 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.]

[30 min. for each concept]

Section II. Message 1 (Hear Her)

This message is about listening to pregnant or postpartum women who express concerns when they know something is wrong. [Show message, and read the text aloud.]

1d. [Comprehension] What is the main idea that this message is trying to get across, in your own words?

2d. [Comprehension] How well do you think the main ideas come across?

6d. [Content and Wording] Is there anything confusing, unclear, or hard to understand?

28d. [Content and Wording] Do you like the way it is written? [Probe: tone, language/style, etc.] Is it easy to read?

30d. [Content and Wording] If you saw or heard this message, would it get your attention? Why or why not?

33d. [Content and Wording] How could this message be improved? [Probe: tone, language/style, etc.]

29d. [Content and Wording] Is there anything you want to know that this item does not tell you?

6e. [Testing Images/Visuals/Illustrations] What is your general reaction to the way these look?

5e. [Testing Images/Visuals/Illustrations] How do you feel about the images used in this concept? Are they helpful/engaging? Why/why not?

12e. [Testing Images/Visuals/Illustrations] Are there things about the pictures that BOTHER you in any way?

3d. [Comprehension] Is it trying to get people to do something?

What action would the message prompt you to take?

39d. [Efficacy] How feasible is it that you would try to do this? Please explain.

40d. [Efficacy] Would you consider doing this behavior?

41d. [Efficacy] What makes it hard to do this?

51d. [Efficacy] What would make this easier for you to do?

Section III. Message 2 (Moments Matter)

This message shows the importance of mothers to families and depicts special moments in a family’s life when a mother either is or isn’t present due to pregnancy-related complications or death. [Show message, and read the text aloud.]