CDC/NCEH TO21: Outdoor Air Quality Focus Group

Form Approved

OMB No. 0920-0572
Exp. Date 3/31/2018

Appendix A: Moderator’s Guide for At-Risk Adults

CDC estimates the average public reporting burden for this collection of information as 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 Information Collection Review Office, MS D-74; 1600 Clifton Road NE, Atlanta, Ga. 30333; OMB No. 0920-0572.

Welcome/Opening Remarks (5 minutes)

Welcome everyone and thank you for joining us today. My name is [NAME]. We also have [NAME OTHERS] here to listen and take notes. I am here to lead this discussion on behalf of the Centers for Disease Control and Prevention (CDC). I want you to know that I’m not an expert in the topic we’ll be covering. My job today is to guide the discussion. We’re having this focus group discussion to try to understand how CDC can better reach people with recommendations for staying healthy.

The ideas and information you share with us are very important. Before we begin, I’d like to make a few things clear and explain how the discussion will work.

1. We are not trying to sell or promote any product or service to you.
   
   

2. There are no right or wrong answers — we want your opinions.
   
   

3. We will be taking notes and audio recording the discussion. We have to write a report about your suggestions for CDC. Recording the discussion will help us write the report. We will share the audio recording with CDC. We will not use your name in the report and all results will be reported in aggregate. We will only share the report with people working on this project.
   
   

4. In order to make sure that we hear everyone’s thoughts and opinions, it’s important that you only speak one at a time. I may occasionally interrupt you when 2 or more people are talking at once, so we clearly understand what each person has to say.
   
   

5. This discussion will last approximately an hour and a half. I don’t want to keep you here longer than that, so I may occasionally interrupt you to keep the discussion focused.
   
   

[Prior to the focus group, the moderator will have emailed participants the participant information sheet (see Appendix J) and an informed consent form (see Appendix K). Each participant will review, sign, and have an opportunity to ask questions. Participants will then return a signed consent form back to the moderator. The informed consent statement will assure participants that information provided during the discussion group will be kept confidential and will only be used for the development of CDC initiatives. The statement will also contain language explaining that signing the form confers permission to be audio recorded. The Moderator will review the following points below.]

Your participation in this discussion is voluntary. You may discontinue your participation at any time. Your names will not be used in any report. The audio recording is only to be sure that we get all your opinions and ideas.

Do you have any questions before we start?

Warm-up (5 minutes)

First, let’s state our first names and one thing we do to stay healthy. I’ll start and then we’ll go around the room. My name is [NAME] and I [EXAMPLE OF HEALTHY BEHAVIOR].

Knowledge Base: Air Quality (10 minutes)

For this focus group, we will discuss some topics related to health. We’ll start with some general questions.

95.D Have you ever heard of [air quality]?

• PROBE: When you hear the term “air quality,” what comes to mind?

• PROBE: (if participants mention health): How does air quality relate to health?

• PROBE (if participants do not mention health): Can air quality affect someone's health? How?

How often do you think about air pollution in terms of your health?

• PROBE: What do you think about?

[For participants with asthma] How does poor air quality affect your asthma?

130.D How does this concept fit relative to your everyday challenges raising your [family, living with air pollution]?

• PROBE: What can you do to limit how much you or your family come into contact with air pollution?

Have you ever looked for information on air quality?

PROBE: If so, what were you looking for?

69.D Where do you get information about [air quality]?

• PROBE: From television, the internet, newspapers, the radio, or other ways?

If you wanted to find out what the air quality was like today, how would you do that?

• PROBE: If there was a mobile app where you could find out what the air quality is like in your city each day, would you use it? Why or why not?

• PROBE: Describe how you might use an air quality app.

70.D Has your doctor talked with you about [air pollution]?

• PROBE: If so, what did you talk about?

• PROBE: Did the doctor or nurse start the conversation or did you?

• PROBE: What did the doctor say?

• PROBE: Did the doctor mention anything about avoiding certain activities when the air quality is poor? If so, what?

• PROBE: Did you get any takeaways from the conversation, such as a brochure or a link to a website for more information?

Have you talked with a doctor or nurse about how to balance other ways of staying healthy (like being more physically active) with reducing the time you spend outside when the air quality is poor?

• PROBE: What did the doctor or nurse say?

• PROBE: If a doctor or nurse encouraged you to be physically active, did they mention air quality?

Knowledge Base: Air Quality Index (10 minutes)

Now we are going to switch gears and talk about something called the Air Quality Index.

95.D Have you ever heard of the [“Air Quality Index”]?

• PROBE: If so, where?

• PROBE: Who do you think puts out the Air Quality Index?

• PROBE: When you hear the term “Air Quality Index,” what comes to mind?

70.D Has your doctor ever talked with you about [the Air Quality Index]?

• PROBE: What did the doctor or nurse say?

If you wanted to find out what the Air Quality Index forecast was on a particular day, how would you look for that information?

80.D What types of information would you like to receive regarding [air quality/air pollution]? What would be the most effective way or format to provide this information?

• PROBE: Would you look on a website, email, text message, newspaper, or some other way?

Behavioral Intentions (15 minutes)

I’m going to pass around a sheet with some descriptions of actions to take on days when the air quality is poor. On your own, please circle the activities that seem doable to you. Cross out any activities that don’t seem doable.

[Moderator distributes worksheet (Appendix C)]

38.D Which actions, if any, sound doable to you? Why?

• PROBE: Of the activities that you circled, which would you try first? Why?

Which activities did you cross out and why?

• PROBE: Were there any activities that you would never try? Why not?

117.D Did any of the concepts not motivate you at all? Why not?

118.D Did any of the concepts turn you off? What was it about the statement/s that turned you off?

70.D Has your doctor talked with you about [taking any of these steps]? What did he/she tell you?

• PROBE: How did that conversation go?

• PROBE: After your doctor recommended these steps, did you take them?

Stimulus 1: Air Quality and Physical Activity infographic (10 minutes)

Now, we’ll look at a graphic that has information about outdoor air quality.

[Moderator shows Air Quality and Physical Activity infographic (Appendix E)]

6.E What is your general reaction to the way these look?

8.E How do you feel about the colors and graphics? What do you like/dislike about them?

Look at the action steps in the graphic. After the exercise where we circled and crossed out activities, would you be more or less likely to take these steps after seeing this graphic?

• PROBE: Why or why not?

2.E What is the main message of this illustration? What does it tell you?

• PROBE: What do you think about looking at a graphic to get health information?

24.D Who would you say they are trying to reach?

• Does it seem this message is talking to you, and people like you? Or someone else?

• What in the message suggested it was talking to you and people like you or someone else?

Stimulus 2: Weather Channel Breathing Index Webpage (15 minutes)

Next, we’re going to look a website that has information about outdoor air quality.

[Moderator shows Weather Channel Breathing Index, using narrow view to avoid advertisements. (Appendix F)]

Collectively, these images are called the Breathing Index.

6.E What is your general reaction to the way these look?

7.D How would you sum up in just a few words your first impression of this message? Do you like it? Not like it? What makes you say that?

2.E What is the main message of this illustration? What does it tell you?

• PROBE: What do you think about using this website to get information about air quality?

12.E Are there things about the pictures that BOTHER you in any way?

• PROBE: Is there anything confusing or unclear? If so, what?

24.D Who would you say they are trying to reach?

• PROBE: Does it seem this message is talking to you, and people like you? Or someone else?

• PROBE: What in the message suggested it was talking to you and people like you or someone else?

Is this website credible? Why or why not?

1.F Does this message make you want to do anything? Does it motivate you to take action?

• PROBE: If you saw the Breathing Index, would you do anything differently afterwards?

• PROBE: What would you do or not do?

Stimulus 3: AirNow.gov Website (15 minutes)

Now, we’ll look at a different website.

[Moderator shows AirNow.gov. Moderator displays a screenshot of an Air Quality Index Forecast pertaining to participants’ location (Appendix G)]

6.E What is your general reaction to the way these look?

7.D How would you sum up in just a few words your first impression of this message? Do you like it? Not like it? What makes you say that?

2.E What is the main message of this illustration? What does it tell you?

• PROBE: What do you think about using this website to get information about air quality?

• PROBE: Is there anything confusing or unclear? If so, what?

24.D Who would you say they are trying to reach?

• PROBE: Does it seem this message is talking to you, and people like you? Or someone else?

• PROBE: What in the message suggested it was talking to you and people like you or someone else?

Do you think this website is credible? Why or why not?

1.F Does this message make you want to do anything? Does it motivate you to take action?

• PROBE: If you saw the AQI Forecast, would you do anything differently afterwards?

• PROBE: What would you do or not do?

• PROBE: Why?

Thank You and Closing (5 minutes)

That was our final activity for the day.

Before we wrap up, is there anything else you would like to share?

Thank you all for your participation today and for sharing your thoughts and opinions with us. Remember the purpose of today’s discussion was simply to get your opinions about the Air Quality Index. Everything you have said today will be helpful as we make recommendations to CDC.

I’d like to remind each one of you that if you have any questions about outdoor air quality, your health, or anything that has come up today, please make sure to see your doctor or other healthcare provider.