DC Public Schools Student Perspectives on Access to Recommended Adolescent Preventive Health Services

Form Approved

OMB No. 0920-1235

Exp. Date 06/30/2019

Attachment 3: Student Focus Group Guide

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Welcome and Overview

Thank you again for coming to our discussion today. We are __________ & __________from ICF, a research and evaluation company that is helping your school district learn more about how students access health services at your school. We appreciate you agreeing to talk openly with us. We know that everyone has different experiences and opinions so we would like to encourage everyone to respect each other. For us, that means (1) give everyone in the group a chance to speak, (2) do not judge other people or their ideas, and (3) keep everything we discuss private (do not tell other students or teachers what your classmates may have said during this discussion as well as not sharing the names of people in the group).

During the group discussion today, I will be asking the group different questions about health services offered in your school. You are really the experts so we would like to hear from all of you. We want to hear your opinions but will not be asking about your personal experience receiving health services. We will be recording the discussion and _________ will be taking notes to help me remember what we discussed. No one will be able to put your name with any of the comments you make, so what you say will stay private. The group will last about an hour and a half.

At the end of our discussion, you will receive _______as a thank you for your time.

Ground Rules

Before we get started, let’s go over a few ground rules.

[Note to moderator: Refer to pre-written ground rules (on flip chart or board) and go over aloud with group.]

• Give your complete attention to the group (e.g., no cell phone use, no side conversations)

• Participate as much or as little as you want

• Allow everyone to participate

• Don’t judge other people’s comments – they may have a different experience than you did

• Try to speak up, speak clearly, and speak one at a time

• Keep things private – what is said in the group stays in the group. Please do not share what is said with others outside of the group or the names of the people in the group.

• Please do not use the real names of other students in our discussion

OK, before we start, do you have any questions?

[Note to moderator: Answer any questions posed by participants.]

Great, I will now turn on the recorder and we will get started.

[Note to Moderator: Start audio recorder.]

Discussion

Ice Breaker

So, how many of you know the game “hot potato”? To warm up, we are going to play a quick game. I am going to pass the ball to someone and I want you to tell me one thing that someone your age can do to stay healthy. After you answer, I want you to pass the ball to someone else. Remember, you must answer and toss the ball quickly so that your hand does not burn up from the hot potato!

Let’s begin…. [Note to Moderator: Begin game and allow group to play for a few minutes. Remind participants to answer quickly and that there are no wrong answers if they are holding the ball for too long. If possible, try to incorporate answers students gave throughout discussion where there is a natural fit. ]

Excellent, you gave some really good answers. Those were all great examples of things that young people can do to stay healthy.

Student Needs

Today we are going to talk about sexual health services. Sometimes people engage in behaviors that put them at risk for certain health effects, such as HIV, STD, and pregnancy. [Note to moderator: Refer to handouts and posted quick glossary as appropriate.] Sexual health services include services and information that help reduce that risk and help you stay healthy. We want to know about activities and programs connected to your school that you feel are beneficial to help students stay healthy.

1. What do you think students at your school think about the most when it comes to their sexual health?

Probes: birth control, STD/HIV prevention, STD/HIV testing and treatment, condoms, pregnancy testing, counseling, information, sexual orientation and attraction

2. Thinking about this list of things that [insert school name] students think about related to sexual health (repeat list), what types of health or counseling services are available through your school to help students?

(write down responses on flipchart to refer back to as you continue focus group discussion- be sure to include)

Probes

• School Based Health Center (SBHC) or School Clinic- family planning, pregnancy testing, STD and HIV testing and treatment

• Condom availability program

• STD/HIV school-wide testing (done once a year by the Department of Health)

• Sexual identity or gender identity support services (ex. Gay, lesbian, bisexual, transgender)

3. How do students in your school learn about available services such as ____________?

[Note to moderator: Restate answers from Q2. here.]

4. What sexual health services (SEXUAL HEALTH SERVICES) are there that students might need and can’t get through school?

[Note to moderator: State sexual health services for sexual health services throughout session]

5. If services are not available at school, where do you think students might go for those services? How do students learn about where to go for those services?
   
   
   

6. What would make it easy for students to get sexual health services outside of school? (What are the benefits of receiving sexual health services outside of school?)

6. What kinds of things would keep students from getting services outside of school? (What are the challenges/barriers of receiving sexual health services outside of school?)

Probes: time, location, confidentiality, environment, staff

Resource People at School for Sexual Health Services

You mentioned earlier the sexual health services that are available at school (refer to list). Now I would like to ask you about specific people or groups of people and whether or not students in your school would go to these people for information about the sexual health services available at your school or off campus.

6. Who are some of the main people students might ask if they had questions about how or where to get sexual health services in the school?
   Probes:

• Sexual health liaisons

• LGBTQ liaison

• Teachers or other school staff

• Peers, peer educators

• SBHC staff

[Note to Moderator: Ask questions 9-12 about each person or group named by students as someone students would go to]

6. Why do you think students would ask _____ about sexual health services available in the school?

7. How do students know to ask ______ about sexual health services offered in the school?

8. What makes it easy to talk to ______ about sexual health services?

9. What makes it difficult or hard to talk to ______ about sexual health services?

Probes: relationship/caring person/personality, time, location, confidentiality, environment

On Campus Sexual health Services

6. 

   Probes Q13-Q16

   • Time

   • Location

   • Confidentiality

   • Environment

   • Staff

   What are some reasons a student would or wouldn’t use sexual health services (SBHC, CAP, STD testing)?

   If you were to guess, would you say students use sexual health services at the SBHC, condom availability program, STD and/or HIV testing, offered through the school a lot, sometimes, or not very much? [NOTE: Ask about each sexual health services separately]

7. What do you think it’s like for students who use the SBHC for sexual health services?

Probes:

1. What are the benefits/good things about receiving sexual health services at the school-based health center?

2. What are the challenges/hard things about receiving sexual health services in the school clinic (school-based health center).

6. What do you think it’s like for students to get condoms at school?

[Note to Moderator: Condoms are available through Wrap MC program but students may not be familiar with the name]

Probes

1. What are the benefits/good things about getting condoms at school?

2. What are the challenges/hard things about getting condoms at school?

6. Describe what it is like when the school offers STD testing to all students at the school (School-wide STD testing).

   1. Do you think students are interested in getting tested/using this service? Why or why not?

   2. What are the benefits/good things about participating in the school-wide STD screening?

   3. What makes it hard to participate in the school-wide STD screening?

7. What efforts have been made to make sexual health services welcoming to lesbian, gay, bisexual, transgender, and questioning (LGBTQ) students at school?

[Note to Moderator: Questions in blue text are for focus group for LGBTQ students]

Probe for cultural competence, physical environment, and awareness

1. Tell me about how staff talk to students ( non-judgmental, use of inclusive and accurate language)

2. How do posters, educational materials reflect LGBTQ student experiences?

3. How do the patient forms (paperwork you complete at the SBHC) make LGBTQ students feel welcome and included?

4. How does the school show respect for student privacy/confidentiality?

5. What does the school do to make the physical space welcoming/safe space for LGBTQ students (restrooms, waiting area)?

6. What efforts has the school made to market sexual health services to LGBTQ students (posters, materials)?

7. How does the school make sure sexual health services referrals are inclusive of LGBTQ students?

Student Perceptions and Recommendations

6. How do you think LGBTQ students view the sexual health services offered at your school?

Probe: When it comes to sexual health services at school, what barriers do you think LGBTQ students face compared to students who are not LGBT?

6. What do you think would encourage more students to take advantage of getting sexual health services at school?

Closing

Thanks so much for spending your time with us today and sharing all your ideas and experiences. This wraps up our focus group discussion. As a reminder, we ask that you keep what we discussed today private. Do you have any questions or anything extra you would like to share?

[Note to Moderator: Allow sufficient time/pause for participants to answer.]

We appreciate your time and input. It has been extremely valuable.

[Note to Moderator: Turn off audio recorder and provide incentives.]

Quick Glossary

Birth Control	Birth control, sometimes called contraception, is a general term for ways to prevent pregnancy. Some types of contraception prevent ovulation (releasing of an egg), fertilization (meeting of egg and sperm), or the implantation of a pre-embryo in the uterus. Some ways are permanent and others let a woman get pregnant when she or her partner stops using them. Birth control pills, spermicide, diaphragms, sterilization and condoms are some examples of contraception. Not all contraception stops people from getting HIV and other STIs. Only latex condoms stop pregnancy and HIV from happening. Abstinence is the only 100 percent method for preventing both STIs and pregnancy.1
Condom (male)	A cover for a male’s penis. It can be made out of thin latex (rubber), polyurethane (soft plastic) or natural membranes (animal skin). Condoms are used to prevent pregnancy and to prevent sexually transmitted diseases (STDs), although natural membrane condoms do not prevent STDs.1
Sexually Transmitted Diseases (STDs)	STDs are diseases that are passed from one person to another through sexual contact. These include chlamydia, gonorrhea, genital herpes, human papillomavirus (HPV), syphilis, and HIV. Many of these STDs do not show symptoms for a long time. Even without symptoms, they can still be harmful and passed on during sex.2

1 http://www.iwannaknow.org/teens/sexualhealth/sexual-health-glossary.html

2 https://www.cdc.gov/std/life-stages-populations/stdfact-teens.htm