0920-0800 Discussion Guide for Hispanic (no fam hist) Eng

Form Approved

OMB No. 0920-0800

Exp. Date 10/31/2021

Attachment B3: Discussion Guide for Focus Groups with Hispanic Young Women

(With No Family History of Breast Cancer), English

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Discussion Guide: Hispanic Young Women With No Family History of Breast or Ovarian Cancer

Section 1: Welcome and Introductions (10 minutes)

Introduction and Informed Consent

Welcome to our focus group discussion and thank you for coming. My name is ___________________, and I’m excited to be here to guide this discussion. Our discussion today is being sponsored by the United States Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC). Our purpose in talking with you today is to hear from you on your thoughts and opinions about breast health and breast cancer. What we hear from you today will help CDC develop messages for young Hispanic women.

Focus Group Process and General Rules

Before we begin, I would like to remind you that your participation in this discussion is voluntary and you may end it at any time or feel free to skip questions you feel uncomfortable answering.

This is meant to be an open discussion. We are taping the discussion, so I can write a report and get what you say exactly right, and this recording will be kept private and only be shared with my colleagues. At no time will your name appear in any reports or presentations that result from this work. Do you give permission to be audio recorded today?

My job is to keep us on the right track and moving along so that we’re done in an hour and a half. I’d like to share a few ground rules before we get started:

• There are some interested colleagues observing our discussion.

• There are no right or wrong answers.

• All comments, positive and negative, what you know and don’t know, are important.

• It is important to hear what everyone thinks, so please speak up and please let others do the same.

• Respect each other and personal opinions; you may not always agree, but we will be respectful of each other.

• Don’t wait for me to call on you, but please speak one at a time.

• Respond to each other as well as to me.

• If I ask a question that you’re not comfortable answering, feel free not to answer.

• If you need to go to the restroom or need a break, feel free to leave the room, but please come back as soon as possible because all opinions are important.

• Please turn off all of your mobile devices. You may put it on vibrate, but please do not disturb others during our discussion by checking your phone or leaving it on the table.

Do you have any questions before we get started?

Great! Let’s start with a quick introduction. Please tell me your first name ONLY and your favorite family activity.

Section 2: Sources of Information/Communication (25 minutes)

1. Thinking about an average week, what are some of the websites you visit most often?

   • What content on those websites is most interesting or appealing to you?

   • How much time would you estimate you spend on those sites?

2. Thinking back, have you noticed any online ads or messages related to health recently? Please tell me about those ads.

   • What about that particular ad was interesting to you?

   • Why do you think you noticed that particular ad (i.e., color, placement, content, image)?

   • Did you trust or believe the message? Did it prompt you to take any action?

   • Did you learn anything new?

3. What websites do you visit to get your health information?

   • How frequently would you say you look for health information online each month?

   • What prompted the search? Were you looking up a particular symptom you were experiencing or were you looking for more general information?

   • Was it easy or difficult to find the health information you were looking for?

What made it easy or difficult?

4. Are you an active member of any Hispanic or Latina organizations? Do you regularly receive information online or from other media outlets (e.g. newspaper, TV) specifically for Hispanic or Latina audiences?

Thank you for sharing information about your online search habits and how you receive information. It’s helpful for me to understand how you generally get your information. Now, I’d like to ask you specifically about health information related to breast or ovarian cancer.

5. Do you consume any media that is specifically intended for [women interested in breast and ovarian health issues]?

   • If so, which ones?

   • What made you start following/reading that information?

   • What topics do they cover that most interest you?

   • Do you follow them on social media?

   • What do you like about them?

   • Have you seen any online media sources for [women interested in breast and ovarian health issues] that you do not like?

   • If so, what do you dislike about those sources?

6. At any point in the past, have you sought out any information on breast or ovarian cancer online?

   • Where from? What did you find?

   • Were you satisfied with the information you found?

7. Do you have any affiliation with, regularly receive information from, or participate in any activities/fundraisers with organizations that are specifically intended for [women interested in breast and ovarian health issues]?

   • If so, which ones?

   • What made you want to get involved with those organizations?

   • Do you follow them on social media?

8. Have you heard of the Bring Your Brave campaign?

   • If so, what have you heard/seen?

   • How, if at all, have you engaged with the campaign?

Section 3: Awareness of Risk Factors for Breast and Ovarian Cancer (30 minutes)

9. Have you heard of any risk factors for breast cancer? If so, what risks are you aware of?

   • Where did you learn about this risk information?

10. When you think about breast or ovarian cancer, who do you think is most likely to get these cancers? Do you think of any groups as being at risk of getting these cancers?

• Why do you think those groups seem to be at risk?

11. Are you aware of things that might make some young women more likely to get breast cancer than others?

Probe:

• If so, what have you heard?

• Where have you heard this information? Do you consider this a trusted source? Explain.

• Why do you think those groups seem to be at risk?

• What would you like to know? What questions do you have?

12. Have you heard anything specifically about Latinas and breast cancer?

    • What have you heard?

13. What are some signs or symptoms of breast cancer that you know of? What might cause a woman to suspect she has breast cancer?

14. Can you think of any conversations you’ve had with friends, co-workers, or others about breast cancer in the past 6 months?

• What prompted the conversation?

• What was discussed or shared?

• Did it influence your thoughts on your own risk?

• Did it make you consider taking any actions?

15. Have you ever talked with a doctor or other provider about breast and ovarian cancer?

Probe:

• If yes,

  • What type of doctor? (PCP, OB/GYN, other)

  • Explain the circumstances – was this part of routine care, during a visit regarding another issue or specifically about your breast or ovarian cancer concerns?

  • In your opinion, what might have made the conversation more productive or helpful for you?

  • Did you take any actions after this conversation? Why or why not? What were they?

• If no,

  • Did your provider ask about your family medical history?

  • Did you want to talk to your doctor about breast and ovarian cancer? Why or why not?

  • What might have helped you initiate this conversation with your doctor?

16. Within your family, have you had conversations about your family’s medical history?

• Who initiated the conversations and why?

• Who has been involved in those conversations? Do conversations include family members on both your mother’s and father’s side? Do conversations include family members across generations?

• Are there family members who choose not to participate? Why?

• When did you have those conversations? How frequently?

• How would you characterize the tone and content of most of those conversations?

• Did these conversations influence how you think about your own health? If so, in what way?

17. Have you ever heard of the BRCA (moderator note: say B-R-C-A and Bra-Ca the first time it’s mentioned) gene?

• If so, what have you heard?

• When did you first hear of the BRCA gene?

• Where have you heard this information? What is the source? Do you consider this a trusted source? Explain.

• What is significant about the BRCA gene?

18. Have you ever heard of genetic testing for breast and ovarian cancer?

Probe:

• If so, what have you heard? (Probe on both direct-to-consumer testing and physician-referred testing)

• What are your thoughts about it?

• What would you like to know? What questions do you have?

• Where have you heard this information? What is the source? Do you consider this a trusted source? Explain.

19. Have you heard about genetic testing specifically to help a young woman find out if she is at high risk for breast and ovarian cancer?

• If so, what have you heard?

• What are your thoughts about it?

• What would you like to know? What questions do you have?

• Where have you heard this information? What is the source? Do you consider this a trusted source? Explain.

20. Have you ever heard of anything women can do to reduce their risk of breast cancer?

    • What have you heard?

    • What might motivate someone to take action to reduce their risk of breast cancer?

21. Regarding genetic testing or breast cancer, what do you wish you knew more about? Do you have any questions or confusion?

Section 4: Wrap Up (10 Minutes)

22. Since we started talking today, how have your feelings about breast cancer and young women changed from before this discussion?

23. Is there more information you would like to know?

24. That’s all of my questions. Do you have any final comments on anything we’ve talked about?

Thank you so much; your help has been invaluable.

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