0920-25BP Focus Group Discussion Guide

Form Approved

OMB Control No.: 0920-1154

Expiration date: 03/31/2026

CDC Division of Vector-Borne Diseases

Discussion Guide for Oropouche Communications Among At-Risk Audiences

Updated October 4, 2024

I. Background and Moderator Introduction 10 minutes

Welcome! Thank you for joining today’s discussion. My name is NAME. I’m an independent researcher and moderator with KRC Research. The sole sponsor of today’s focus group discussion is the Centers for Disease Control and Prevention, or CDC.

Our conversation today will focus on a health topic. I’m a professional researcher, not a CDC employee or subject matter expert on health topics. My role is to facilitate our conversation for the next 90 minutes. Let me tell you a bit about it:

• There are no wrong answers. You may have different opinions. That’s fine—all your experiences and opinions are important, and we want to hear from all of you.

• Since we are having these groups online, we will need to talk one at a time and let everyone have time to speak. Not everyone has to answer each question, but it’s important that everyone participates throughout this conversation.

• We will be showing you information on your screen to look at and respond to. If at any time you can’t see the screen well or have difficulty hearing, let me know. We have a technician here who can help us.

• Please silence your cell phones and put away portable devices.

• If you need to step away from our discussion for any reason, you don’t have to ask for my permission—just step away and come back as soon as you can.

Because privacy is important, I’m going to show you our Privacy Policy. SHOW ON SCREEN AND READ

We will protect your privacy for today’s discussion, and nothing you say will be reported in association with your name.

• We will use first names only during this conversation. You may choose to use a nickname or any other name you prefer.

• Your participation is voluntary. You do not have to answer anything you are uncomfortable with.

• Like our technician who is with us virtually but whom you do not see, a few colleagues are also with me virtually to watch quietly and take notes.

• We are audio and video recording today’s discussion for transcribing purposes. Because we are speaking with other groups like this one, it is important for me to have an accurate record of today’s conversation.

• We ask that you do not share any information, comments, or participants’ identities with others outside of this group.

II. Participant Introductions 5 minutes

Let’s start with introductions. The first thing to know about this group is that you’re all pregnant or planning to become pregnant! With that in mind, please share with us:

• Your first or preferred name

• The state you live in

• An activity you look forward to doing with your child

III. Context Setting 7 minutes

As I said before, we’re going to focus on health topics today. We’re going to start by talking about something many people have experience with: bug bites.

• How often do you get bug bites, particularly when you’re outside?

• How much of a concern are bug bites to you?

  • What’s concerning? LISTEN FOR INFECTIOUS DISEASES, PROBE AS NEEDED FOR BUGS i.e. midges, mosquitoes

  • Do you think that you are (or will be) more or less concerned about bug bites when you are pregnant? Why is that?

• What do you typically do to prevent bug bites? PROBE: insect repellent, long-sleeve shirts and pants, treating clothes with permethrin, mosquito nets, etc.

  • How often do you take these actions?

  • In what situations? OFFER AS NEEDED: Every time you go outside, just during muggy weather, just when doing activities in nature, when you travel, etc.

  • Why do you / don’t you take actions like the ones we’re talking about?

  • Are you or will be more or less likely to take actions to prevent bug bites when you are pregnant? Why or why not?

• What’s challenging or frustrating about trying to prevent bug bites? PROBE: Inconvenience, product availability, skin sensitivity, difficulty in applying products, environmental concerns, cost, and product safety

  • PROBE concern of chemicals affecting the health of the baby

  • PROBE: Reference if needed -when used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women.

• What would make it easier for you to take actions to prevent bug bites more frequently? PROBE: Easier application, product availability, more effective or safe methods

IV. Bug Bite Prevention When Traveling 7 minutes

Another thing you share in common is that you all travel to SPECIFIC COUNTRIES often or at least occasionally. I want you to think about your travel to just those countries now.

• Do you or would you consult with a doctor before traveling to COUNTRIES while pregnant?

• What resources, if any, would be helpful for your doctor to share about traveling when pregnant?

• Thinking about your most recent trip to COUNTRIES, how often did you experience bug bites?

  • In what situations? OFFER AS NEEDED: Every time you go outside, just during muggy weather, just when doing activities in nature, when you travel, etc.

• Compared to when you are at home, are you more or less concerned about bug bites when you travel to COUNTRIES? Why?

• When traveling to SPECIFIC COUNTRIES, do your precautions for bug bites differ from when you are at home?

• What challenges have you experiences about preventing bug bites specifically when traveling to COUNTRIES?

  • PROBE on traveling with prevention, size of product, inconvenience, product availability, skin sensitivity, difficulty in applying products, environmental concerns, cost, and product safety

V. VBDs 5 minutes

I’d like to focus on a related topic, which we’ll learn more about later. We’re going to be discussing vector-borne diseases, or VBDs for short.

• How familiar are you with vector-borne disease or VBDs, if at all?

  • What examples come to mind?

  • IF AWARE OF ANY: What do you know about VBDs?

I’m going to share information about VBDs. I’d like you to read this information, then we’ll talk about it. SHARE ON SCREEN

Mosquitoes, ticks, fleas, and midges (often called no-see-ums) can spread germs like viruses when they bite people. The germs can make people sick. These bugs are called vectors. A person who gets bitten by a vector and gets sick could have a vector-borne disease (VBD).

Examples of VBDs are dengue, West Nile, Lyme disease, and Rocky Mountain spotted fever. VBDs are major causes of death and illness around the world. The number of people with VBDs in the United States alone has doubled in the last two decades..

• Do you have any questions about this information?

• Have you had any experience with VBDs before?

  • What happened? What was it like?

• What preventative measures are best for VBDs? How do people protect themselves?

V. Oropouche Reaction 15 minutes

We’re now going to talk about a specific vector-borne disease called Oropouche. It can be pronounced different ways, pronounced “o-ro-push” or “o-ro-pooch”, and I am going to say it this way moving forward.

• Have you heard of Oropouche before today? SHOW OF HANDS

  • IF AWARE: What do you know about it?

  • IF AWARE: When and where did you learn about Oropouche? PROBE FOR SPECIFIC SOURCES

• IF AWARE: Based on what you know, who’s at risk for Oropouche?

  • What kind of people?

  • Where do they live?

• What preventative measures are best for Oropouche? How do people protect themselves?

I’d like you to read this information about Oropouche, then we’ll talk about it. SHARE ON SCREEN

Oropouche virus is spread to people primarily by the bite of infected biting midges. Some mosquitoes can also spread the virus. Common symptoms include sudden onset of fever, severe headache, chills, muscle aches, and joint pain. Most infected people will develop symptoms that can often reoccur.

There are no vaccines to prevent or medicines to treat Oropouche. The best way to protect yourself from Oropouche is to prevent bites from biting midges and mosquitoes.

There is no evidence that Oropouche virus has been spread in the United States. Oropouche virus has been found in South America, Central America, and the Caribbean.

• What are your first reactions to what you’ve seen here?

  • What stands out? Why? PROBE ON TOPIC

• Does this seem… IF YES TO ANY, PROBE ON WHY AND WHAT ABOUT IT

  • Concerning?

  • Scary?

  • Noteworthy?

• What questions do you have about Oropouche, or anything you read here?

  • What do you want to know? PROBE ON TOPIC

• FOR THOSE AWARE: Does what you already heard about Oropouche match what you see here? Did you learn anything new?

• What is unclear or confusing about Oropouche?

  • Is it clear how someone gets Oropouche?

• This says Oropouche is spread through infected biting midges. Do you know what a midge is?

  • PROBE on terms, midge vs. no-see-um

VI. Oropouche Prevention 7 minutes

Now let’s talk about prevention.

• Do you think Oropouche would require the same or additional precautions compared to other VBDs?

• Do you feel like Oropouche is something you need to be mindful of? Why or why not?

• Would you do anything differently about preventing bug bites because of Oropouche?

  • At home or abroad? Why or why not?

VII. Oropouche and Pregnancy 5 minutes

Now I’m going to share a bit more information. Please read it and then we’ll talk about it.

Oropouche virus can be passed from a pregnant person to their fetus. Oropouche infection during pregnancy has been linked to poor pregnancy outcomes such as stillbirth and birth defects.

Pregnant travelers should reconsider non-essential travel to areas with an Oropouche Level 2 Travel Health Notice. If you must travel, strictly follow recommendations to prevent bug bites.

• What’s your reaction to this information?

• Does this make you any more or less likely to take protective measures for Oropouche? Why?

• Does this cause you to think any differently about bug bites and risks from bug bites?

• Does this cause you to think any differently about your travels to COUNTRIES? How?

VII. Oropouche Information Needs and Sources 7 minutes

Now let’s talk about information and resources related to Oropouche.

• If you wanted to find out more about Oropouche, where would you turn, or what would you do? Why? PROBE: people you’d talk to, health care providers, specific platforms, portals, sites, etc.

• What information would you most like to have about Oropouche, if any? PROBE Level 2 Travel Health notice

  • What format would you like to receive that information in?

  • How would you like that information to come to you?

• What resources, tools, or data would you most like to have on this subject? PROBE: fact sheets, web tools, data on prevalence or locations with the highest number of infections, etc.

  • What format would you like to receive that information in?

  • How would you like that information to come to you?

• Who would you want to hear from about Oropouche?

  • Who would you trust? Tell me about why.

• Would you prefer information about Oropouche be in English, Spanish, or another language? Why?

VIII. Oropouche Messages and Testing 20 minutes

In the final part of our conversation, we’ll be looking at some information about Oropouche that CDC might use to communicate. These are draft materials; they’re not finalized. I’m going to share them on the screen and ask you to read them silently. Once everyone has had a chance to read, we’ll talk about them together.

SHARE fact sheet #1 focused on what travelers need to know about Oropouche that will include a travel checklist

• What’s your reaction to this?

• What stands out? Can you point to anything specific?

  • What do you like about this? What words, phrases, or ideas?

  • What don’t you like?

  • PROBE Trust in CDC providing this information

• How clear is this information?

  • Is there anything you don’t quite understand? What?

  • Is there anything confusing or awkward? Why?

• What is main point? What does it want you to do?

• How likely are you to follow the steps on the travel checklist? Which ones? Why or why not?

• Does this seem relevant personally? How so?

  • IF NO: Who is this fact sheet relevant for?

• What questions do you have?

SHARE fact sheet #2 focused on the midge – where midges are located, different types of midges and not all spread diseases like Oropouche, environments midges prefer, etc.

• What’s your reaction to this?

• What stands out? Can you point to anything specific?

  • What do you like about this? What words, phrases, or ideas?

  • What don’t you like?

  • PROBE on terms, midge vs. no-see-um

• How clear is this information?

  • Is there anything you don’t quite understand? What?

  • Is there anything confusing or awkward? Why?

• What is main point? What does it want you to do?

• How likely are you to take steps to prevent Oropouche?

• Does this seem relevant personally? How so?

  • IF NO: Who is this fact sheet relevant for?

• What questions do you have?

AFTER REVIEWING BOTH FACT SHEETS

• Given all that you’ve read here, what information from the fact sheets…

  • Is most useful for you to know or read?

  • Is best at conveying the seriousness of the topic?

  • Does the best job communicating prevention strategies?

• In your own words, what the most important thing to take away? Why?

• Is there any other information you’d want to see in a fact sheet on this subject that would make you more likely to take preventive action to prevent bug bites?

Lastly, we’re going to be reviewing a graphic about Oropouche. I am going to share on the screen and then we will discuss after everyone has had a chance to review.

SHARE graphic on the Oropouche transmission cycle.

• What’s your reaction to what you’ve seen?

  • What is interesting?

• What stands out? Can you point to anything specific?

  • What do you like about this? What visuals, words, phrases, or ideas?

  • What don’t you like?

• How clear is this visual?

  • Is there anything you don’t quite understand? What?

  • Is there anything that’s confusing or awkward? Why?

• What questions do you have?

• How would you improve this or make it better?

• Is there any other information you’d want to see on the Oropouche transmission cycle?

IX. Wrap U 2 minutes

Thanks for all your thoughtful comments. We are going to wrap up. As we do, just a couple of closing questions.

• What advice would you give to CDC as it continues to work toward building awareness of Oropouche among people who are or planning to become pregnant and travel frequently ?

Thank you again for your time.

MODERATOR TO DISMISS

Public reporting burden of this collection of information is estimated to average 90 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS H21-8, Atlanta, Georgia 30333; ATTN: PRA 0920-1154

Oropouche – Discussion Guide – At-Risk Audiences Focus Groups 1