0920-0572 Attachment 3 consumer IDI Guide_l1_13

OMB No. 0920-0572

Expiration Date 3/31/2018

Submission under

0920-0572 Health Message Testing System

Attachment 3: Consumer Message Testing for Zika Domestic Readiness

In-Depth Interview Guide

Public reporting burden of this collection of information is estimated to average 1 hour 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 D-74, Atlanta, Georgia 30333; ATTN: OMB-PRA (0920-0572).

Consumer Message Testing for Zika Domestic Readiness

In-Depth Interview Guide

Welcome

Welcome and thank you very much for agreeing to participate in this interview. Your participation is very important. I’m __________ [INSERT NAME] and I work for Abt Associates, a private research organization. The Centers for Disease Control and Prevention (CDC) is sponsoring this health education initiative.

The purpose of this interview is to hear your views and opinions on important health topics concerning Zika virus. I’m not an expert in the topic we’ll be discussing, so I have no particular agenda or point of view. We will have about 60 minutes for our discussion.

The purpose of this discussion is to get your opinions on [INSERT MATERIAL TYPE] for a Zika Prevention Initiative in [INSERT LOCATION] for [INSERT TARGET POPULATION].  What we learn will help us raise awareness about the actions people can take to protect themselves and their babies from the Zika virus.

Before we get started, I’d like to point a few things out:

I will be asking for your opinions only; not for personal information. There are no costs to you for being in this initiative and your participation is completely voluntary. This interview will take about one hour to complete. The initiative is funded by the Center for Disease Control and Prevention. Also, please remember, choose not to answer a question at any time and may choose to quit the interview at any time. You may refuse to answer any questions. The risks to you for participating in this initiative are minimal. You may experience some discomfort when answering some of the more personal questions.

We can assure you that procedures to protect the privacy of your data will be strictly followed, with your answers kept in a secure database only accessible to the researchers working on this initiative. Everything you have to say is privacy and any identifying information will be removed from reports and other data. 

You have probably noticed the recorder [INSERT DEVICE TYPE] in the room. It is here because we are recording the interview. I want to give you my full attention and not have to take a lot of notes. At the end of our discussion, I have to write a report and may refer to the recording when writing the report. As a reminder, some of the project staff from Abt and CDC are observing or listening. [At the end, there will be a few minutes to address questions you may have about Zika with the people observing this interview.]

Please see Attachment C for full consent language

Would you like to continue with the interview?

Yes [CONTINUE]

No [THANK/END]

Do you have any questions before we begin?

I. Zika Virus Knowledge and Beliefs

First I am going to ask a few questions about Zika virus.

1. I’d like to ask you about what you have seen or heard about the Zika virus. What comes to mind when thinking about “Zika?”

PROBE:

• How is it spread?

• What are people saying about sexual transmission of Zika?

• Who have you heard about Zika from?

• What have you heard happens to someone who has been bitten by a mosquito that carries the Zika virus?

• What have you heard happens to someone who has been infected with Zika virus through sex?

• Is Zika in your area?

• What are the symptoms of Zika?

• Who should be tested?

• How can Zika be treated?

• [Other probes]

1. How is Zika virus spread from person to person?

PROBE:

• What are common ways Zika virus is transmitted?

• What are less common ways Zika virus is transmitted?

3. Considering what you have heard about Zika, how serious do you think Zika is?

   • If considers Zika to be Not Serious, ask: What are some reasons you don’t think Zika is serious?

   • Probe for all other participants: Do you consider Zika a threat?

4. What are some of the things that may be confusing to you about the Zika virus?

PROBE:

• How is it transmitted?

• Who should get tested?

• What are the symptoms?

• Mosquito control methods?

• [Other probes]

5. What questions do you have about Zika virus? What would you like to know more about?

PROBE:

• How it is transmitted

• How to prevent transmission

• How it affects your body

• How it affects unborn babies

• How it can be treated

• Who should be tested

• Mosquito control methods

• [Other probes]

II. Perceived Zika Virus Risk

6. Who do you think is at risk for Zika virus?

7. Do you feel like you are at risk for Zika virus? Have you ever been at risk? Why/why not?

8. Where do you go if you want to learn about the risk of getting Zika virus?

9. Do you think the information you find on Zika virus risk is trustworthy? Why or why not?

PROBE:

• What are some of the reasons you think this information is trustworthy?

• What are some of the reasons you think this information is not trustworthy?

10. What websites or social media, if any, would you go to for Zika virus information?

PROBE:

• What are some of the reasons you obtain information from [ADD SPECIFIC SOURCES]?

• What makes the information on these websites or social media helpful?

11. How much do you worry about Zika virus?

PROBE:

• What are some of the reasons you worry about Zika?

12. What changes, if any, have you made in your life because you were worried about getting Zika virus?

13. What steps, if any, can someone take to prevent from getting or transmitting Zika virus?

PROBE:

• Prevent mosquito bites by wearing long-sleeved shirts and pants to cover bare skin

• Prevent mosquito bites by using mosquito repellent

• Removing standing water, covering garbage cans and rain/water barrels

• Using condoms during sex or abstaining from having sex

• Installing or replacing screens to cover windows and doors

14. How would you describe your role in protecting yourself/ your developing baby from Zika virus?

15. Who else do you think is responsible for preventing Zika virus? What should he/she/they be doing about it?

PROBE:

• You?

• Your partner?

• Your family?

• The community?

• The government?

• [Other probes]

16. [IF PARTNER IS MENTIONED IN 15] How about your partner’s role in protecting himself/herself?

17. [IF PARTNER IS MENTIONED IN 15] How about your partner’s role in protecting you/your developing baby?

18. [IF COMMUNITY IS MENTIONED IN 15[How can the community help protect pregnant women in particular?

19. Zika can be spread through unprotected sex. Does this information make you more likely to use condoms during sex? [IF NO, ASK THE PROBES BELOW]

PROBE:

• What would motivate you to use a condom when having sex?

• What are some reasons you would NOT use a condom when having sex?

• What prevents you from using condoms?

III. Materials

Now I would like to show you some [INSERT MATERIAL TYPES] that CDC might use to [insert Zika virus topic here].

There are [INSERT NUMBER] [INSERT MATERIAL TYPE] that I am going to share with you. Each [INSERT MATERIAL TYPE] has supporting words. I’ll show you the [INSERT MATERIAL TYPE] and then we’ll discuss it/them. We’ll repeat this same process with each of the [INSERT NUMBER] [INSERT MATERIAL TYPE]. For now, I would like us to avoid comparing the [INSERT MATERIAL TYPE]. Instead, let’s consider each [INSERT MATERIAL TYPE] on its own first.

[METHODS FOR RECORDING INFORMATION TO BE ADAPTED OR READ ALOUD TO PARTICIPANTS WHEN NECESSARY OR WHEN COLLECTING DATA ONLINE]

NOTE TO INTERVIEWER: REPEAT QUESTIONS 19-41 FOR EACH [INSERT MATERIAL TYPE].

20. What are your initial reactions to the [INSERT MATERIAL TYPE]?

PROBE:

• What do you like about this [INSERT MATERIAL TYPE]?

• What do you dislike?

• What would you say are the strengths of the [INSERT MATERIAL TYPE]? Weaknesses?

21. What is this section telling you [INTERVIEWER WILL POINT TO OR READ SECTION INDICATED. REPEAT IF NEEDED.]?

22. What is meant by [INSERT PHRASE OR WORDING HERE]?

23. What feelings do you have in reaction to this [INSERT MATERIAL TYPE]? How does this [INSERT MATERIAL TYPE] make you feel?

24. What are the words or phrases that you think work well in this [INSERT MATERIAL TYPE]?

PROBE:

• Are there any words or phrases that you like?

• Are there any words or phrases that you don’t like?

• What other words can be used in their place?

25. What is the main idea that this [INSERT MATERIAL TYPE] is trying to get across, in your own words?

26. How well do you think the main ideas come across?

27. Was this a new idea or something that you’ve heard before? Where have you heard it before?

28. Is there anything confusing, unclear, or hard to understand about the message?

PROBE:

• What makes it confusing or hard to understand?

29. What do you think about using the term [INSERT TERM FROM MATERIAL] to describe [INSERT TERM DEFINITION]?

PROBE:

• What other term or terms could be used instead of [INSERT TERM FROM MATERIAL]?

[QUESTION 30 WILL NOT BE USED FOR LOW-LITERACY AUDIENCES.]

30. Please [UNDERLINE/CIRCLE/HIGHLIGHT/CROSS OUT] phrases or sentences that you think are [IMPORTANT/CONFUSING/UNCLEAR/INAPPROPRIATE/OFFENSIVE/SHOULD BE DELETED]. METHODS FOR RECORDING INFORMATION TO BE ADAPTED OR READ ALOUD TO PARTICIPANTS WHEN NECESSARY OR WHEN COLLECTING DATA ONLINE]

PROBE – INCLUDING PROBES ON WHAT WAS MARKED:

• What are the main reasons the phrases or sentences [WERE/WERE NOT] important?

• Is there anything confusing or unclear about the phrases or sentences? If so, what?

• Is there anything inappropriate or offensive? If so, what?

• Is there anything that should be deleted? If so, what?

• What phrases or sentences were unusual or unfamiliar?

• What other phrases or sentences can be used in their place?

31. In your opinion, do you believe this overall [INSERT MATERIAL TYPE]?

PROBE:

• What makes it believable (or unbelievable)?

• What information would you need in order to more strongly believe this [INSERT MATERIAL TYPE]?

32. Who do you think the [INSERT MATERIAL TYPE] is trying to reach?

33. Does the [INSERT MATERIAL TYPE] give you a clear call to action or idea of what to do next?

34. What is this [INSERT MATERIAL TYPE] trying to get people to do?

35. What action would this [INSERT MATERIAL TYPE] prompt you to take?

36. To what extent does this [INSERT MATERIAL TYPE] make [INSERT ZIKA VIRUS PREVENTION STRATEGY] sound easy or complicated?

37. Because of the information presented in this [INSERT MATERIAL TYPE], how likely is that you will [INSERT BEHAVIOR]?

38. Is there anything you would add to or change about this [INSERT MATERIAL TYPE] to make it stronger or more motivating?

Images

39. What do you think about the images in this [INSERT MATERIAL TYPE]?

PROBE:

• Is there anything about the images in this [INSERT MATERIAL TYPE] that could make you feel badly or ashamed about yourself – or make other men/women like you feel ashamed of themselves?

• Is there anything about the images in this [INSERT MATERIAL TYPE] that would bother or upset you [INSERT TARGET AUDIENCE] like you?

• Is there anything that is offensive about these images?

40. Please [UNDERLINE/CIRCLE/HIGHLIGHT/CROSS OUT] images that you think are [IMPORTANT/CONFUSING/UNCLEAR/INAPPROPRIATE/OFFENSIVE/SHOULD BE DELETED].

PROBE – INCLUDING PROBES ON WHAT WAS MARKED:

• What are the main reasons the image [was/was not] important?

• Is there anything confusing or unclear about the images? If so, what?

• Is there anything inappropriate or offensive? If so, what?

• Is there anything that should be deleted? If so, what?

• What words or images were unusual or unfamiliar?

• What other images can be used in their place?

41. Do the images help you understand the message?

42. How appealing are the images to you personally?

PROBE:

• Can you relate to the images in this flyer?

• Can you relate to the images of the people?

IV. Messages

Please see Attachments E for materials to be tested with consumers

[METHODS FOR RECORDING INFORMATION TO BE ADAPTED OR READ ALOUD TO PARTICIPANTS WHEN NECESSARY OR WHEN COLLECTING DATA ONLINE]

Now, I’m going to ask you to review some [INSERT MATERIAL TYPES] I have shown you.

INTERVIEWER SHOW [INSERT MATERIAL TYPE] WITH BUNDLED/ALL MESSAGES AND [INSERT MATERIAL TYPE] WITH SINGLE/INDIVIDUAL MESSAGES.

43. Thinking about these different [INSERT MATERIAL TYPES], which of these formats do you most prefer to receive?

PROBE:

• What do you think about the single/individual messages?

• What do you think about the bundled/group messages?

44. Please indicate whether the individual/single or bundled/all message format of [INSERT MATERIAL TYPE] would most inspire or motivate you to [INSERT BEHAVIOR HERE]?

PROBE:

• What made you choose that [INSERT MATERIAL TYPE]?

• Images

• Easy to understand

• The [ACTION/MESSAGE] in the [INSERT MATERIAL TYPE] seem easy to do

• Do you feel you know how to protect yourself/your family?

45. When you see this [INDIVIDUAL/SINGLE MESSAGE], how motivated are you to [INSERT BEHAVIOR HERE]?

46. When you see this [BUNDLED/GROUP MESSAGE], how motivated are you to [INSERT BEHAVIOR HERE]?

PROBE:

• What are the specific reasons that this format is motivating?

• Are some of the ACTION/MESSAGE in this [INSERT MATERIAL TYPE] easier to do? [DESCRIBE]

• Are some of the ACTION/MESSAGE in this [INSERT MATERIAL TYPE] harder to do? [DESCRIBE]

47. Which of these [INDIVIDUAL/SINGLE MESSAGE OR BUNDLED/GROUP MESSAGE] is more motivating to [INSERT BEHAVIOR HERE]?

PROBE:

• What are the specific reasons this format is motivating?

48. Can you think of an idea or [INSERT MATERIAL TYPE] that we did not present that might motivate you to [INSERT BEHAVIOR/STRATEGY/ACTIVITY HERE]? What is it?

Exploring Communication Strategies

Now, let’s talk a little about how we can best deliver information on Zika virus.

[THESE QUESTIONS CAN ALSO BE ADAPTED AS FOLLOW-UP QUESTIONS TO THE SECTIONS ABOVE.]

49. Where would you expect to see [INSERT MATERIAL TYPE] like these?

50. Where are some other places you might notice [INSERT MATERIAL TYPE] like these?

PROBE:

• Where would they need to be so that you would pay attention to them?

51. Is Zika virus a topic on which you seek out information? If so, how?

PROBE:

• What type of information are you seeking?

• Where would you turn first for information?

52. Where might you seek out information?

PROBE:

• Physicians, clinics

• What mass media (e.g. television stations, radio, billboards, news sources)

• What websites do you go to for Zika virus information? Why?

• What social media do you go to for Zika virus information? Why?

• What other ways do you like to get Zika virus information? Why?

• [OTHER PROBES]

53. What sources of information do you trust for Zika virus information? Why?

PROBE:

• Places – clinics, hospitals, schools, churches, other public places

• Influential Persons – your doctor or health care provider, teachers, religious leaders, community leaders, public/elected officials, celebrities like musicians, actors and sports figures, friends and family

• Friends and family

• Media – both website/online and mass media sources

• Other sources like health departments, government agencies, universities

54. Besides work and home, where do you spend most of your free time?

PROBE:

• Where are these places located (e.g., in what neighborhoods, areas of town, on what streets)?

55. Would you go to a website that helped you decide how often you needed to [INSERT TOPIC HERE]?

56. Would you go to social media that helped you decide how often you needed to [INSERT TOPIC HERE]?

57. If you could sign up to be reminded to [INSERT TOPIC HERE] would you?

PROBE:

• What kinds of reminders would work best for you (e.g., text, email, phone calls, apps)?

58. Would you be willing to share your ideas about Zika virus on a website or social media site?

PROBE:

• If yes, what are some of the ideas or information you would share?

• If yes, what websites or social media would you share the ideas and information?

V. Comparing Risk Format

[METHODS FOR RECORDING INFORMATION TO BE ADAPTED OR READ ALOUD TO PARTICIPANTS WHEN NECESSARY OR WHEN COLLECTING DATA ONLINE]

Please take a look at [show number format or risk format] and can you tell me:

59. What are your first impressions of the information?

PROBE:

• What do these numbers or words mean?

60. What are your first impressions of the images?

PROBE:

• What do these images mean?

• Which image do you prefer/understand better?

61. Which number/risk do you prefer/understand better?

62. Based on the [NUMBER OR RISK] format shown, how risky would you say is this [BEHAVIOR/ACTIVITY]?

63. What does [RISK RELATED TERM] mean in [INSERT MATERIAL TYPE]?

64. What do the words “should/may consider postponing travel [OR INSERT RISK/BEHAVIOR]” mean to you?

PROBE:

• What does the message mean?

• What is the message telling you to do/not do?

65. What do the words “delaying pregnancy [OR INSERT RISK/BEHAVIOR]” mean to you?

PROBE:

• What does the message mean?

• What is the message telling you to do/not do?

66. How would you compare these [INSERT NUMBER] [BEHAVIORS/ACTIVITIES]?

PROBE:

• Is [BEHAVIOR/ACTIVITY] [MODIFIER] risky for getting/transmitting Zika virus than Y? [BEHAVIOR/ACTIVITY] will increase risk of getting/transmitting Zika virus: [X%] of the time; [BEHAVIOR/ACTIVITY] will increase risk of getting/transmitting Zika virus [COMPARISON] times

67. Based on the [NUMBER OR RISK] format shown, how effective is [STRATEGY] at preventing Zika virus?

68. What does [RISK RELATED TERM] mean in [INSERT MATERIAL TYPE]?

69. How would you compare these [INSERT NUMBER] strategies?

PROBE:

• Is [STRATEGY] more effective at preventing Zika virus than Y? [STRATEGY] will help prevent getting Zika virus: [X%] of the time; [STRATEGY] will prevent getting/transmitting Zika virus [COMPARISON] times

70. Do you believe what it is saying?

1. If so, what makes you believe it?

2. If not, what makes you not believe it?

71. What is the main idea this message is trying to get across, in your own words?

PROBE:

• Thinking specifically of the risk for getting Zika virus, are these large or small numbers?

Now I’m going to ask you to rate the [INSERT MATERIAL TYPE] on a scale from 1-10 for how likely is it that the [INSERT MATERIAL TYPE] will [INSERT DESCRIPTOR HERE].

[METHODS FOR RECORDING INFORMATION TO BE ADAPTED OR READ ALOUD TO PARTICIPANTS WHEN NECESSARY OR WHEN COLLECTING DATA ONLINE]

72. With one (1) being not likely at all to get your attention and 10 being very likely to get your attention, how would you rate this [INSERT MATERIAL TYPE]? Please mark your rating on the paper.

73. Now I’m going to have you rate the [INSERT MATERIAL TYPE] on a scale from 1-10, with 1 being not effective and 10 being effective, how would you rate this [INSERT MATERIAL TYPE]? Please mark your rating on the paper.

74. Are there any that you strongly dislike? If yes, which materials? For each one, tell me what it is about the [INSERT MATERIAL TYPE] that you like or don’t like. Please mark those down on the paper in the box next to the frowning face.

75. Are there any that you strongly favor? If yes, which materials? For each one, tell me what it is about the [INSERT MATERIAL TYPE] that you really like. Please mark those down on the paper in the box next to the smiley face.

V. Wrap-Up

After all that we have talked about today, I have a few final questions.

76. Are you more or less likely now to [INSERT ACTION]? What makes you say that?

77. What would motivate you to want to [INSERT ACTION]?

In-Depth Interview Closing

Okay, we are pretty much out of time. Excuse me for one moment while I see if the people observing have any questions that I have not asked. I will be right back.

[PLACEHOLDER FOR QUESTIONS FROM OBSERVERS]

78. Those are all of the questions I have, but before we end, do you have any closing thoughts or opinions you would like to share? Any questions?

. [Now the people who observed this interview will take a few minutes to address any questions you may have about Zika virus.]

Thank you for your participation. Have a good day/evening

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