Supplement to the HMTS Template - Narrative Project Description

Message Testing for CDC’s Division of Nutrition, Physical Activity, and Obesity

Supplement to the HMTS Expedited Review Form

	Page Number
Project Summary	1
Background	1
Methodology	2
Modes for Testing	2
Overview of Data Collection	3
Incentives	4
Duration of Survey and Focus Groups	4
Burden	4

Appendices

Appendix A: Messages to be Tested

Appendix B: Materials for Online Survey with Mothers

1. Survey Screener

2. Online Survey (including consent language)

3. Screenshots of Screener and Survey Questions/Messages to be Shown on Screen (as will be seen on the online survey platform by participants)

Appendix C: Materials for Focus Groups with Mothers

1. Focus Group Screener

2. Consent Form

3. Moderator Guide

4. Messages to be tested (as will be seen in-person by participants)

Project Summary

Goal: To conduct message testing to help inform the communication efforts across DNPAO with identified key audiences and around key obesity-related topics.

How Information Will Be Used: Findings from this message testing effort will be used by DNPAO to inform how to best communicate with key audiences for DNPAO obesity prevention efforts. This work will help increase the likelihood that messages will resonate and be understood as intended.

Methods: Messages will be tested via 2,000 online surveys. A total of 16 focus groups will be conducted to validate the findings from the survey. The focus groups will be coordinated by a professional market research firm. The online panel survey will be conducted remotely through an online survey platform.

Respondent Population: The target audiences are mothers, segmented as follows:

• Mothers with children ages 1-8 – recruited to include a mix by race/ethnicity and income

  • Segmented by weight status: healthy weight (BMI= 18.5-24.9), overweight/obesity (BMI= 25-34.9; only class 1 obesity will be included)

  • Segmented by type of location (focus groups): mid-size city and suburbs, small city/town and outlying areas. Specifically,

    • Mid-size city and small city/towns and outlying areas in 2 regions: Mid-Atlantic/Midwest and Southern regions.

    • 8 groups will be conducted in the Midwest/Mid-Atlantic region and 8 groups in the Southern region (with up to 4 locations per region).

Analysis Techniques: Focus group notes will be analyzed to identify major themes. Survey data will be analyzed using qualitative analysis software (e.g., SPSS, SASS). The themes and details will additionally be explored to identify similarities and differences regarding reactions to the messages tested overall as well as across the aforementioned segmented groups among mothers.

Background

The Division of Nutrition, Physical Activity, and Obesity (DNPAO) at the Centers for Disease Control and Prevention (CDC) is conducting audience research to better understand how to most effectively communicate with key stakeholders of DNPAO’s obesity prevention efforts. The proposed approach for this data collection effort will help inform the communication efforts across DNPAO with identified key audiences and around key obesity-related topics.

See Appendix A for the messages to be tested.

Methodology

Through a combination of surveys and focus groups, data will be collected from mothers of children ages 1-8. Specifically, an online survey will be conducted with a national sample of 2000 mothers. Survey findings will be validated through sixteen (16) focus groups. Focus groups will be segmented by type of location. Half will be conducted in mid-size cities and suburbs and half in small cities/towns and outlying areas. They will be conducted in two 2 regions: Mid-Atlantic/Midwest and Southern regions. Eight (8) groups will be conducted in the Midwest/Mid-Atlantic region and eight (8) groups in the Southern region (with up to 4 locations per region).

Mothers have been identified as a key audience for message testing because DNPAO’s efforts ultimately seek to benefit the public, and mothers are a segment of the public among the most likely to be in a position of influence in their families and communities. Testing messages with this audience will provide valuable insight regarding how this audience understands and reacts to the messages. Specifically, messages testing will be conducted with mothers of children ages 1-8 as this is a stage in which parents may be more likely to be able to influence obesity-related behaviors in their children.

The online survey and focus groups will be segmented by maternal BMI status. Research suggests that having parents who are overweight or have obesity is associated with greater risk of child obesity—and that the association is stronger for maternal weight compared to paternal weight.¹ Therefore, segmenting based on maternal weight—specifically overweight/obesity in mothers versus healthy weight—will allow for exploring the potential similarities and differences in reactions to obesity messages between these groups and whether distinct messages may be needed to influence intended attitudes and behaviors.

Modes for Testing

DNPAO is proposing data collection using two modes: an online survey and focus groups.

The online survey will be conducted remotely through an online survey platform. Standard procedures will be used by the online survey company to contact likely eligible online panel participants to confirm they meet the study criteria. Potentially eligible participants will complete an online screening questionnaire to confirm their eligibility prior to taking the survey. Once confirmed, participants will continue to the survey questions. Before taking the survey, the first screen will include consent language. Proceeding to take the survey will be confirmation that they have read the consent language and agree to participate. See Appendix B for instruments and other documentation for the online survey— including the eligibility screener, online survey, and screenshots of how the survey and messages will be viewed online by participants.

The focus groups with mothers will be completed in-person at a professional research facility. Before being scheduled for the focus groups, participants will be screened by the research facility recruiters for eligibility. The focus groups will be conducted with a sample of mothers of children ages 1-8. During the focus group, individual messages will be presented on separate sheets of paper to the participants. A moderator’s guide will be used to facilitate the focus groups with mothers. Participants will review and sign a consent form prior to beginning the focus groups. See Appendix C for instruments and other documentation for the focus groups with mothers— including the screener, moderator’s guide, consent form, and individual sheets with the messages to be tested.

Overview of Data Collection

Audience	Data Collection Methodology	Participants	Type of Location				Totals
			National Sample (approximately 250 in each of the following U.S. Regions: Northeast, West, South, Midwest)
Mothers of Children Ages 1-8	Online Survey	Mothers with Overweight/Obesity	1000 surveys				1,000 Surveys
		Healthy Weight Mothers	1000 surveys				1,000 Surveys
		Total	1,000 surveys		1,000 surveys		2,000 Surveys
	Focus Groups		Mid-Size City and Suburbs (100-250K people)		Small City/Town and Outlying Areas (100K people or less)
			Midwest/ Mid-Atlantic Locations	Southern Locations	Midwest/ Mid-Atlantic Locations	Southern Locations
		Mothers with Overweight/Obesity	2 focus groups	2 focus groups	2 focus groups	2 focus groups	8 FGs
		Healthy Weight Mothers	2 focus groups	2 focus groups	2 focus groups	2 focus groups	8 FGs
		Total	4 FGs	4 FGs	4 FGs	4 FGs	16 FGs

Incentives

Mothers, a segment of the general population, have competing demands (e.g., childcare) that can make it challenging to take part in in-person focus groups. All mothers who participate in the in-person focus groups will receive $75 to show appreciation for their participation.

Appropriate incentives are key to the success of research efforts and to preventing over-burdening the public. In other words, even when individuals agree to participate, insufficient incentive may result in a greater likelihood of participants not showing up to participate in the discussion (i.e., “no-shows”). This may not only negatively impact the ability to gather the necessary data but, additionally, the time that would have already been spent in the recruitment of these participants would therefore translate into unnecessary burden to the public. Additionally, because there are costs associated with recruiting each participant (even for no-shows), when participants are no-shows it involves expenditures that could otherwise be avoided.

Online survey participants will receive reward points valued at approximately $0.50 to $1.50 from the survey company. Participants will be recruited from an existing online panel of potential participants who have agreed to receive points for completing surveys which they can accumulate and exchange for rewards.

Duration of Survey and Focus Groups

• The online survey will take approximately 10 minutes to complete.

• Each focus group with mothers will last approximately 90 minutes.

The focus groups will be held at a convenient time of day for working people – e.g., at noon or in the late afternoon and evening. All discussions will be conducted by an experienced moderator.

Burden

Type of Respondents	Form Name	Number of Respondents	Number of Responses per Respondent	Burden per Response (in hr)	Total Burden (in hr)
Mothers	Focus Group Recruitment Screener	160	1	10/60	27
	Focus Group Moderator’s Guide	160	1	90/60	240
	Eligibility Screener for Online Survey	2,000	1	3/60	100
	Online Survey	2,000	1	12/60	400
Total: 767 HOURS

1 Whitaker KL, Jarvis MJ, Beeken RJ, Boniface D, Wardle J. Comparing maternal and paternal intergenerational transmission of obesity risk in a large population-based sample. Am J Clin Nutr. 2010 [epub]. Epub 2010/04/09