Reframing How We Talk About Alcohol

Form Approved

OMB No. 0920-1154

Exp. Date: 01/31/2020

CDC Alcohol Reframing Study

Phase 2: Descriptive Research Moderator Guide

The Phase 2 interviews and group discussion will be comprised of the following steps:

1. Welcome (5 mins)

   1. Welcome - The moderator will welcome the participant(s) and explain the purpose of the interview/group discussion.

   2. Permission to audio record – The moderator will ask permission to audio record the session

   3. Ground rules -The moderator will clarify rights as a participant, and for group discussions provide guidance to ensure that participants are allowed to speak without interruption by other participants.

2. Warm-up: [For Group Discussions] Participants will introduce themselves and provide a little information about themselves. (5 mins)

3. Discussion: In the design, participants will discuss the following topics: (75 mins)

   1. Sources of Alcohol Information (5 mins)

   2. Frequency vs. Amount (25 mins)

   3. Explaining Drinking Recommendations (25 mins)

   4. Receiving Drinking Information (20 minutes)

4. Closing (5 mins)

Welcome (5 min)

Thank you for coming today. I’m _____, and I’m from RTI International, a non-profit research organization based in Durham, North Carolina. This is _____ who will be helping me with today’s discussion. Today’s discussion is part of a research study that is being sponsored by the Centers for Disease Control and Prevention (CDC).

The purpose of today’s session is to discuss your thoughts about alcohol use. We are not necessarily interested in your personal use of alcohol, though you can feel free to share your experiences as we are talking. We are more interested in understanding how you think about alcohol use and the things you have learned or observed about how others drink. This information will be used to improve communication efforts and programs about alcohol use.

Before we get started with the discussion, you should have received a consent form for today’s discussion when you checked in. Do you/does anyone have any questions or concerns? Just a few highlights…

• Participation. Your participation is voluntary and you can stop participating at any time. If at any time you are uncomfortable with any question, you can choose not to answer.

• Privacy. Your name and contact information will not be given to anyone else and no one will contact you after this session is over. As part of this study, we will write a report for the CDC summarizing what we learned from these discussions. The report will not identify individuals or what a specific person said by name.

• Audio Taping. We would like to record today’s discussion. At the end of all our sessions, we want to summarize what everyone has to say. I want to give you my full attention and not take a lot of notes, so I will refer to the recording when writing the summary. Do I have your permission to audio record today’s session?

Finally, I want to review a few ground rules for our discussion:

1. There are no right or wrong answers. We want to hear what you have to share.

[For Group Discussions] We recognize people may have different ideas or opinions about a topic. This is fine. We want to know what each of you thinks about the issues we discuss.

2. [For Group Discussions] Speaking. Please try to speak one at a time. I may occasionally interrupt you when two or more people are talking in order to be sure everyone gets a chance to talk and that responses are accurately recorded.

3. [For Group Discussions] We would also ask that you protect each other’s privacy by not discussing what you hear in the discussions today.

4. Cell Phones. As a courtesy to everyone, please silence or turn off your cell phones, PDAs, and pagers.

5. Restrooms. If you need to go to the restroom during the discussion, please feel free to leave.

[For Group Discussions] However, I’d appreciate it if you would go one at a time.

6. Do you/does anyone have any questions before we begin?

Warm up (5 min) [For Group Discussions]

I would like to begin our discussion by asking you to introduce yourself. Please tell us:

• Your first name

• Where you grew up

• Since the topic of our discussion today is the use of alcohol and everyone here indicated that they periodically consume alcohol, I am going to ask what your number reason is for personally consuming alcohol. In saying alcohol, I am referring to beer, wine, mixed-drinks or spirits. For example, a wine cooler or a drink mixed with vodka or gin.

Sources of Alcohol Information (5 mins)

During today’s discussion we’re going to be talking about alcohol use. When I say alcohol I am talking about beer, wine, mixed drinks or spirits.

I want to start our conversation by asking…

Questions		Prompts/Probes
What are your current sources for information on health and medicine?
[For each source listed, ask the following question] What kinds of messages do you get from these sources about alcohol use? Just to clarify, when I say alcohol I am referring to all kinds of alcohol—beer, wine, mixed drinks or spirits		[If not listed, probe on the following] Your physicians or health care provider Alcohol industry Social media Friends, family, and coworkers
Has that information influenced how you drink? If so, in what ways?		Which sources of information are you more likely to believe?

Frequency vs Amount (25 mins)

Now I want to turn our discussion to different patterns of alcohol use.

Questions		Prompts/Probes
When it comes to drinking alcohol, how much would you say is drinking too much at one time, such as in a single evening [or a single day]?		Is there a number of drinks that is too much? Does it matter what kind of alcohol is being drunk? How does this differ from person to person? How does one know how much they can drink at one time?
What kinds of things can happen to people who drink too much at one time?		What else? What amount do you think one would need to drink before it may affect their health?
Tell me what would be considered drinking too often?		What number of times is too much in a week? Is there an amount they have to drink each day before it is a problem? How often does one need to drink to be labeled dependent on alcohol or alcoholic?
What kinds of things can happen to people who drink too much at one time?		What else? What are the ways drinking too often can affect a person’s health? [Ask about short and long-term effects]

Explaining Drinking Limits (25 mins)

For the next part of our discussion, we are going to talk about how people increase their risks when they drink over the recommended limits.

But first, let me ask you about risks from drinking alcohol.

Questions		Prompts/Probes
What do you see as some of the risks people face when they drink alcohol?		Anything else

I am now going to share with you a few examples of ways to explain the risks from consuming too much alcohol. After I share each one, I want you to give me your feedback. Let me know what it makes you think, how it makes you feel.

Ask the following set of questions for each description.

Questions		Prompts/Probes
What are your first thoughts after seeing this?		What words came to your mind?
In your own words, what was its main message?		What do you think is its message about risk from alcohol? Do you think this message is clear? Was it easy to understand?
What do you think it says about the risk from drinking alcohol?		Did it make you think about risk from drinking in a different way? How? How is this different from other information you have seen about risks from consuming alcohol? What does it make you want to do?
What did you like about it?		Why was this appealing to you?
What didn’t you like about it?
Was anything confusing or unclear? What questions do you have after reading this? How could it be made better?		What else?

After sharing the sample risk statements, ask the following set of questions about each both.

Questions		Prompts/Probes
Which of these descriptions of risks from alcohol do you think is most effective?		What do you think was better about that one?
Where would you imagine receiving this kind of information?		Who do you think might share this kind of information?
Is there a term or label you think best describes the type of drinking and its risk described in these two descriptions?		[Moderator can also share drinking limit guidelines, to see if that helps with this conversation]

Receiving Drinking Information (20 mins)

Let’s talk now about receiving information related to risks from alcohol. I want you to imagine you are at your doctor’s office to get a routine physical. Don’t worry if you do not have a regular health care provider at this time, we are just imagining a visit.

Questions		Prompts/Probes
Walk me through a routine visit. What are some of the things that happen?		What happens when you first come in? Who are the different people you see or encounter? What other things do you have to do?
Thanks for sharing. At which points in this process do you think people could be provided information about alcohol use, including possibly questions and feedback about their drinking behaviors?		What do you think would be the best point or time to receive information?
You shared encountering a number of people as part of a visit. Who among them would you want talking to you or providing information about your alcohol use?		Who do you think would be best to provide this information? Who do you think should not be providing this information?
How do you think you would feel if asked about your alcohol use while at the doctor’s office? Would you be open to this?		What do you think could be done to make you or other people feel more comfortable about being asked about their alcohol use? What would you not want be asked?
How might this information be delivered?		How would you feel about receiving information via an electronic device (e.g., phone, email, online tools/apps)? What if you received information or questions before your visit? Or through your health insurance company?
How do you think you would feel if you received information suggesting that you should drink less?		How would you want to receive this information? [i.e., what source] How do you think such a conversation should go? What questions do you think you would have? What else should be done?

Closing (5 min)

Is there anything else we should know that we didn’t discuss today?

Thank you for participating. Your input was extremely valuable, and we really appreciate your time.

Also, if you have any questions about the guidelines for alcohol consumption, we have a resource available here for you. Please feel free to come take one.

Public reporting burden of this collection of information is estimated to average 90 minutes, 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:  PRA (0920-1154).