Supporting Statement B
for
Assessing Knowledge, Attitudes and Perceptions (KAPs) of Hispanic/Latina Women of Reproductive Age about Folic Acid Fortification and Supplementation
New
Jennifer Farramola
Health Communication Specialist
Centers for Disease Control and Prevention
Email: [email protected]
Phone: 404.498.2262
Kara Polen
Lead Health Scientist
Centers for Disease Control and Prevention
Email: [email protected]
Phone: 404.498.3914
September 29, 2023
B. Collections of Information Employing Statistical Methods
The intended population for this overall project is less acculturated, Spanish-dominant Mexican and Central American women capable of becoming pregnant whose staple diet includes products made with corn masa flour. The U.S. Hispanic population reached 62.5 million in 2021, up from 50.5 million in 2010, representing approximately 19% of the U.S. population. This 23% increase in the Hispanic population was faster than the nation’s 7% growth rate. [1] In 2021, Hispanic people made up nearly one-in-five people in the U.S. and people of Mexican origin accounted for nearly 60% of the nation’s overall Hispanic population. Six other Hispanic origin groups in the U.S. have 1 million or more people in each: Salvadorans, Cubans, Dominicans, Guatemalans, Colombians, and Hondurans. The Hispanic population is projected to grow to 111 million people by 2060, which will comprise approximately 30% of the total U.S. population.[2] CDC has contracted EurekaFacts, LLC to conduct formative research with Hispanic/Latina women of reproductive age to examine folic acid and fortified food awareness, food and supplement use practices, as well as messaging and channels to reach Hispanic/Latina women.
EurekaFacts currently has 216,342 individuals in their online recruitment panel within Salesforce, an integrated Customer Relationship Management (CRM) tool. Specifically, within the panel EurekaFacts has 6,044 individuals who are Hispanic/Latina women with a subset of 3,063 who are Hispanic/Latina women between the ages of 18 to 44. We will invite all that meet our inclusion criteria, but since we cannot survey all individuals, we will screen (Attachments 20, 21, 22, 23, 35, 36) for individuals who are Spanish speaking, were born outside of the United States, and have lived in the United States for less than 7 years as eligible.
A total of 9 focus groups will be conducted with up to 9 participants
each, which will include one pilot focus group, for a total of 81
total participants in the sample. This sample accounts for
over-recruitment by two (2) and scheduling of at least seven (7)
participants for each focus group to account for last minute
cancellations and no-shows.
[1] Jones, N., Marks, R., Ramirez, R., & Ríos-Vargas, M. 202 Census Illuminates Racial and Ethnic Composition of the Country. August 12, 2021. https://www.census.gov/library/stories/2021/08/improved-race-ethnicity-measures-reveal-united-states-population-much-more-multiracial.html (accessed August 15, 2023).
[2] United States Census Bureau. Hispanic Population to Reach 111 Million by 2060. October 9, 2018. https://www.census.gov/library/visualizations/2018/comm/hispanic-projected-pop.html (accessed March 8, 2023).
Nine focus groups will be conducted, using a combination of both in-person and online formats. Online focus groups, in addition to in-person focus groups, will yield the most diverse sample as priority audience members in remote locations (e.g., outside heavily populated cities in Texas and California) will be able to participate and have their voices heard. All focus groups will be planned to be conducted in Spanish with a mix of women of reproductive age (WRA) of Mexican and Central American descent who are less acculturated or bi-cultural. Each focus group’s duration will be 90 minutes. We plan to over-recruit and schedule at least 7 participants for each focus group to account for last-minute cancellations and no-shows. All participants will be directed to fill out the self-administered screener (Attachment 20 and 21) to see if they are eligible. Participants will be given the option of calling and a bilingual EurekaFacts staff member will screen the participant via phone call (Attachment 22 and 23). If eligible, participants will be given a unique identification number to protect their privacy.
All focus groups will include a mix of Hispanic WRA participants who are currently not pregnant and not trying to get pregnant, currently trying to get pregnant, planning to get pregnant in the future, as well as those who currently have children and those who do not currently have children. We will not recruit currently pregnant women. While focus groups may include a mix of Hispanic women of different races (e.g., white, black, indigenous, Asian) and different countries of origin/national backgrounds, this will not be a focal point in recruitment. An online participant screening tool (Attachments 35 and 36) and telephone screener (Attachments 22 and 23) has been created that gathers needed data to ensure a demographically diverse mix of participants—this includes collecting participants’ primary language (must be Spanish); countries of origin/national backgrounds (Mexico and countries in Central America preferred); races; time in the U.S. (must be less than 7 years; recent immigrants); geographic location in the U.S.; geographic setting (rural, urban, suburban); age; pregnancy status (cannot be currently pregnant); and consumption of corn masa flour food products (must be a yes).
After scheduling an in-person focus group, participants will receive a confirmation email (Attachments 18 and 19) with details about the focus group meeting, which will include instructions, directions to facility, and what, if anything, to bring with them to the meeting (e.g., eyeglasses). After scheduling an online focus group, participants will receive a confirmation email with a unique link to the interview or focus group meeting, which will be conducted via a web conferencing platform, with detailed instructions and screenshots on how to connect to the meeting.
During the session, a trained and experienced bilingual moderator will facilitate all sessions and a notetaker will take notes during the focus groups. The bilingual moderator will facilitate the session using the moderator guide (Attachment 30 and 31) and present visual aids (Attachment 32) during the session. All focus groups will be confidential, audio-recorded, and transcribed for data analysis purposes.
Participants who meet the requirements (woman, age 18-44, Hispanic/Latina) within the EurekaFacts panel will be sent an invitation email/letter (Attachment 8 and 9). EurekaFacts staff waits a week for responses to compile and sends out the invitation email/letter in batches, if needed, in the case that there is a large number to be reached. If there are not enough responses from the initial invitation, a follow-up invitation (Attachment 10 and 11) will be sent at least a week after the initial invitation letter. Afterwards, if needed, a final follow-up email will be sent to participants two and a half weeks after the initial email to participants that did not respond (Attachment 12 and 13). The invitation emails will lead the participants to the self-administered screener (Attachment 20 and 21). Please see Attachment 35 and 36 for the screenshots of how the self-administered screener will be presented.
Due to the nature of the study, EurekaFacts will also email (Attachment 14 and 15) a list of community-based organizations (CBOs) that work with this population and supply flyers (Attachment 33) and an FAQ (Attachment 26 and 27), as needed. The support of CBOs will aid in the recruitment of in-person sessions. In addition, EurekaFacts has prepared social media advertisements (Attachment 34) that will be used in rotation, which will target the specific demographics of this study using platforms such as Instagram and Facebook. Social media postings are the third option for recruitment, casting a wider net to reach participants in remote locations. The metrics from ads will be monitored twice a week.
Once an agreed upon date and time has been determined, EurekaFacts staff will send a scheduling email to confirm attendance (Attachment 16 and 17). Upon response to the scheduling email, participants will then be sent a confirmation email (Attachment 18 and 19) with more details of the session. In addition, a reminder email (Attachment 39 and 40) will be sent. A bilingual EurekaFacts staff member will also give the participants a telephone call and/or text reminder (Attachment 41 and 42) a day before the session to remind participants of their session to assure participation. The day of the scheduled session, a bilingual EurekaFacts staff gives reminder call for verbal confirmation and assure participation.
The focus group moderator guide (Attachment 30 and 31) was developed using information learned from an environmental scan and a handful of subject matter expert interviews. An initial pilot focus group will first be hosted with the intended population virtually with participants within the surrounding area of the EurekaFacts facility (Maryland, Virginia, and District of Columbia). EurekaFacts will then host other virtual focus groups to reach participants in remote places. Further, with the support of subject matter experts and community-based organizations, EurekaFacts will conduct up to four (4) focus groups in person in California, Texas, and/or Oregon.
Name |
Role |
Phone Number |
|
Cecilia Teal |
Research Program Director |
202-794-6427 |
|
Esther Cortez |
Research Analyst (Lead) |
202-794-8199 |
|
Cora Trelles Cartagena |
Moderator |
|
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | fvs1 |
| File Modified | 0000-00-00 |
| File Created | 2023-11-15 |