Focus Group Discussion Guide for African American Women

Form Approved

OMB No. 0920-0572

Exp. Date 03/31/2018

Attachment B1: Discussion Guide for Focus Groups with African American Women

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Discussion Guide: African American Women

Section One: Welcome, Background, and Informed Consent (10 minutes)

Thank you for taking the time to join us today. My name is _______ from _______, a research organization. Our discussion today is being sponsored by the United States Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC). Our purpose in talking with you today is to hear from you on your thoughts and opinions about protecting your skin and related messages CDC has developed for women. Our discussion will last for about 120 minutes.

Before we begin, I would like to remind you that your participation in this discussion is voluntary and you may end it at any time. If you do not wish to participate, you may stop at any time. The risks associated with participating in this focus group are the same as those you would experience talking in a group of people you do not know. Taking part in this focus group is your agreement to participate.

I would also like to let you know that I am an independent consultant hired to moderate these discussions. Therefore, I don’t have a vested interest in receiving any particular point of view. I simply want to have an active and lively discussion with all of you. Also, I am not an expert about the topics we are going to discuss today. Therefore, I won’t be able to answer any questions about the topics which we discuss.

To ensure accuracy, our discussion today is being audio recorded. At no time will your name, address, or phone number appear in any reports or presentations that result from this work. Do you give your permission to be audio recorded today? (If participant says no, thank and terminate participation)

Also, some of my research team is observing our session to help me prepare my report. Ok? (If participant says no, thank and terminate the interview)

I have a few other “house-keeping” matters to discuss.

1. Have all of you checked in with the front desk? (If participant says no, please tell them to check in with the front desk promptly)

2. Did you return a copy of the Informed Consent? (If participant says no, please tell them to return to the front desk promptly and complete the informed consent before returning to the group)

Lastly, before we begin, I would like to remind you that:

1. Anyone can speak out; you don’t need to wait for me to call on you. However, I would request that only one person speak at a time. Please keep in mind that we have a lot to talk about and materials to review, so it’s important that I hear from everyone and that we discuss all of the topics. Eliminating side conversations will help us accomplish this goal.

2. There are no right or wrong answers. If you disagree with something that is said, I want to hear about it.

3. Lastly, please set your cell phones to vibrate or turn them completely off. If you need to use the restroom, please feel free to step out and join us once you are done.

Thank you. Do you have any questions before we begin our discussion?

Section Two: Participant Introductions (5 minutes)

To begin, I would like to have you go around the table and introduce yourselves. Please tell me:

1. Your first name, your favorite outdoor activity and the last time you did this.

Section Three: Sources of Information/Communication (20 minutes)

1. Let’s talk about health information and where you get it. What websites do you visit to get your health information?

   • Generally speaking, what prompts the search? Are you looking up a particular symptom you were experiencing or were you looking for more general information? [PROBE FOR EXAMPLES]

   • What about these sites makes them appealing to you?

   • Did you trust or believe the messages? Did it prompt you to take any action?

   • How frequently would you say you look for health information online each month?

2. At any point in the past, have you sought out any information on skin cancer or protecting your skin from the sun online?

   • Where from? What did you find?

   • Were you satisfied with the information you found?

3. Have you ever seen messages about sun protection on social media, such as Facebook or Twitter?

• What kind of messages do you see? [PROBE FOR A DESCRIPTION, SOCIAL MEDIA SITE, WHETHER CONTENT WAS SHARED OR AN ADVERTISEMENT]

4. Who, or what organizations, have you ever trusted to provide you with information about sun protection?

• [PROBE IF NEEDED: government, churches, doctors?]

• What websites would you trust?

5. What have been effective ways or formats you have received information about sun protection?

• Printed pamphlets, internet or digital media including ads, websites or social media, television, billboards, radio?

6. Are there some places in particular that you have been more likely to notice and pay attention to messages about sun protection?

Thank you for sharing information about your online search habits and how you receive information. It’s helpful for me to understand how you generally get your information. Now, I’d like to ask you specifically about health information related to sun exposure and skin cancer prevention.

Section Four: Knowledge About Sun Exposure And Skin Cancer Prevention (25 MINUTES)

1. (TAKE A HAND COUNT) Before going outside, how many of you ever take steps to protect yourself from the sun? Who just goes out and does nothing? Sometimes? How many of you do this every time?

   • What kinds of things do you do before going out in the sun?

2. What have you heard about the health risks associated with sun exposure for [AFRICAN AMERICANS]?

• Where did you hear this?

• How likely do you think it is that African Americans will experience health risks associated with sun exposure?

  • Tell me about that.

3. What have you heard about the health risks associated with using a tanning bed?

• What have you heard about the health risks associated with using a tanning bed for [AFRICAN AMERICANS]?

• Where did you hear this?

• How likely do you think it is that African Americans will experience health risks associated with using a tanning bed?

  • Tell me about that.

4. How likely do you personally think you are to get skin cancer?

• Very likely/Not at all likely [SHOW OF HANDS]

  • Tell me about that.

• Who is most likely to get skin cancer?

  • Where did you get this information?

5. What are some signs or symptoms of skin cancer that you know of? What might cause someone to suspect they have skin cancer?

6. What are some things people can do to reduce their risk of skin cancer?

• [IF NEEDED] Is there anything people can do to avoid getting sunburned?

7. Can you think of any conversations you’ve had with friends, co-workers, or others about skin cancer, tanning, or protecting your skin from the sun in the past year?

• What prompted the conversation?

• What was discussed or shared?

• Did it influence your thoughts on your own risk?

• Did it make you consider taking any actions?

8. When you were growing up as a child or teenager, did you ever have any conversations with your family members (mother, father, parents, etc.) about skin cancer, tanning or protecting your skin from the sun?

• What was discussed and with whom?

• When did you have those conversations? How frequently?

9. We’ve talked a little bit about sun protection and skin cancer. I’d like to hear, what questions do you have at this point about skin cancer, tanning, or protecting your skin from the sun?

Section Five: Reaction to Messages and Materials [55 MINUTES]

Now, I would like to get your reactions to some information presented in factsheets and infographics. about skin cancer prevention and safe sun practices. [DISTRIBUTE MATERIALS ONE AT A TIME BASED ON INSTRUCTIONS LISTED BELOW]. For each material discussed, please take a couple of minutes to review. We will go through each material one at a time and I will ask some questions about them. As you review, I’d like you to underline phrases or sentences you think are important, circle things that are not clear or you don’t understand, and X-out things you think should be deleted or removed. [INSTRUCTIONS ON EASEL]

There are five materials which will be tested during this section of the focus group. Approximately 10 minutes will be spent reviewing and discussing each item, including its content messages.

MODERATOR INSTRUCTIONS:

African-American women will provide feedback on the following materials.

Materials will be rotated across groups using the Materials Rotation Matrix below. As the moderator hands out each material, she will state the name and identifying code of the material out loud for documentation in the focus groups notes.

African American Women – Ad Rotation
	LOW RISK	ELEVATED RISK
Age 18-29	1 group	1 group
Materials Testing Order	Infographic: Controlled tanning Infographic: Base tan Infographic: Not healthy skin Factsheet: Family Factsheet: Skin You’re In	Factsheet: Skin You’re In Factsheet: Family Infographic: Base tan Infographic: Controlled tanning Infographic: Not healthy skin
Age 30-44	1 group	1 group
Materials Testing Order	Factsheet: Family Factsheet: Skin You’re In Infographic: Not healthy skin Infographic: Controlled tanning Infographic: Base tan	Infographic: Base tan Infographic: Not healthy skin Infographic: Controlled tanning Factsheet: Family Factsheet: Skin You’re In

Fact Sheets

The moderator will give each participant a copy of a fact sheet that presents general information about protecting your skin. The moderator will provide participants the following instructions (which will also be written on a flip chart at the front of the room):

• Underline phrases or sentences you think are important

• Circle things that are not clear or you don’t understand

• X-out things you think should be deleted or removed

The moderator will allow participants to read and mark the fact sheet before beginning a discussion about it. At the end of the discussion each marked up material will be collected and saved for the research team.

1. First impressions? How does this information make you feel?

• What about the design of the fact sheet—does it work for you? Is it eye-catching?

2. Who do you think this fact sheet is for?

3. What did you underline as important?

• What makes this important?

4. What did you circle as unclear or confusing?

• What makes this area confusing or hard to understand?

• How could it be changed to be clearer?

5. What did you cross out as something to delete?

• What makes this something to remove?

6. Is it asking the reader to do anything? What action would you take after reading this?

7. What social media outlets or websites should this be available on for you to read it?

8. After reading this, what questions do you have?

One-Pager/Infographics

The moderator will give each participant a copy of a one-pager about skin cancer or protecting your skin that might be seen on a website or as a call-out box on a fact sheet or brochure. Components of this text-based piece include information about tanning. The moderator will provide participants the following instructions (which will also be written on a flip chart at the front of the room):

• Underline phrases or sentences you think are important

• Circle things that are not clear or you don’t understand

• X-out things you think should be deleted or removed

The moderator will allow participants to read and mark the one-pager before beginning a discussion about it. At the end of the discussion each marked up material will be collected and saved for the research team.

1. First impressions? How does this information make you feel?

   • What about the design of the one-pager—does it work for you? Is it eye-catching?

2. Who do you think this one-pager is for?

3. What did you underline as important?

• What makes this important?

4. What did you circle as unclear or confusing?

• What makes this area confusing or hard to understand?

• How could it be changed to be clearer?

5. What did you cross out as something to delete?

• What makes this something to remove?

6. Is it asking the reader to do anything? What action would you take after reading this?

7. What social media outlets or websites should this be available on for you to read it?

8. After reading this, what questions do you have?

Section Six: Wrap Up (5 Minutes)

1. CHECK WITH OBSERVERS FOR ADDITIONAL QUESTIONS [5 minutes]
   
   
   

[If needed, remind participants that you are not an expert about any of the topics we are discussing tonight and therefore can’t answer their questions. However, we are very interested in learning their questions to help develop answers in the future and what they might do/who they will ask in the meantime to find answers.]

Section Seven: Conclusion

Thank you for your participation. The information you provided and questions you raised will be very helpful for improving how CDC provides information about skin cancer prevention.

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