BRANY nonvaccinated discussion guide nonvaccinated

HHS COVID-19 PUBLIC EDUCATION CAMPAIGN
IRB APPROVED
04/22/2021

A campaign to increase vaccine confidence while reinforcing basic prevention measures

Foundational Focus Group Discussion Guide
Research Objective: Examine attitudes, perceptions, and behaviors related to
preventive measures (e.g., mask wearing, social distancing, avoiding crowds) and
vaccine confidence for those who have not yet received a COVID-19 vaccine.
NOTE TO REVIEWERS: The discussion guide is written in a purposefully colloquial
style to better engage with participants. Question probes are below some main
questions and may change. These are suggestions for the moderator to follow and will
be used as deemed relevant and necessary in the natural flow of discussion. The
discussion guide is developed for a 90-minute session. Moderator instructions are
highlighted in yellow and bracketed.
Guidelines and Introductions
Preventive Measures
Personal Risk Perceptions
Measures Taken to Slow the Spread
Sources of Information
Vaccines
Intent
Convenience
Choice/Options
Safety and Effectiveness
Side Effects
Post-Vaccination
Wrap-Up
TOTAL TIME

10 MINUTES
30 MINUTES
5 minutes
15 minutes
10 minutes
45 MINUTES
10 minutes
10 minutes
5 minutes
10 minutes
5 minutes
5 minutes
5 MINUTES
90 MINUTES

GUIDELINES AND INTRODUCTIONS (10 MIN)
Guidelines
Thank you for speaking with me today. My name is _________, and I work for a private
research company. Today we want to get your thoughts and opinions about COVID-19
and how it is affecting life in the United States. We would also like to better understand
what precautions you and your family take when it comes to avoiding infection from the
virus.
Before we begin, I want to go over a couple of things:


There are no wrong answers. Our whole purpose for being here is to hear
what you think, so please speak up, especially if what you have to say is

For internal communications only

IRB APPROVED
04/22/2021

different than what someone else is saying. You may represent what a lot of
other folks think.


There may be times I ask you to clarify or ask you to tell more about what you
just said. This is simply to make sure I understood and accurately capture
what you think, not because I’m challenging your point of view.



Your participation is voluntary. If I ask any questions you do not wish to
answer, you do not have to answer them.



We want to hear from everyone, but I ask that you speak one at a time,
although I understand it can be difficult, especially online. I simply want to
make sure I hear everything that everyone says.



Nothing you say will be tied back to you. Your name and any identifying
information will not be used in any of our reports.



There are some other people listening in who are helping me take notes so
that I can fully focus on our conversation and be respectful of your time. At
the end of the group, they might have a couple of clarifying questions for us.



I’ll be video recording our conversation; it will only be used to confirm our
notes. Only the research staff will have access to this taping and no
personally identifiable information will be used in connection with the
recording. Does everyone agree to be recorded? [ASK FOR AGREEMENT
THROUGH A SHOW OF HANDS OR HEAD NOD] I am going to start the
recording now.



Our discussion should take no more than 90 minutes. I appreciate the time
that you carved out to be here, and I want to be respectful of that, so I may
interrupt us so that we stay on track.

Do you have any questions before we begin?

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Introductions/Ice Breaker
I’d like to start by getting to know each of you a bit better. So, I’m going to have
everyone go around and share their first name, where you live, and your favorite type of
food to make at home. [FOR AMERICAN INDIAN/ALASKA NATIVE GROUPS, ALSO
ASK ABOUT TRIBAL AFFILIATION.]
I can go ahead and get us started.
[MODERATOR INTRODUCES SELF, ANSWERS THE QUESTIONS, AND THEN HAS
EACH PARTICIPANT INTRODUCE THEMSELVES AND RESPOND TO THE
ICEBREAKER QUESTIONS.]
[MODERATOR TO PROBE AS NEEDED TO GET PARTICIPANTS COMFORTABLE
AND TO ESTABLISH RAPPORT.]
[MODERATOR: FOCUS ON THE BOLDED QUESTIONS. QUESTIONS IDENTIFIED
AS PROBES SHOULD BE USED AS NEEDED TO OBTAIN/CLARIFY
INFORMATION. SUBQUESTIONS NOT IDENTIFIED AS PROBES SHOULD BE
ASKED AS TIME PERMITS.]
PREVENTIVE MEASURES (30 MIN)
Thank you. To start off, I want everyone to think about COVID-19.


What is the top thing on your mind today when it comes to the COVID-19
pandemic?

Personal Risk Perceptions (5 minutes)


Have you or anyone you know personally ever been diagnosed with COVID19? [IF YES, PROBE LIGHTLY FOR WHO THEY KNOW WHO HAS BEEN
DIAGNOSED WITH COVID-19—SELF? FAMILY MEMBER? FRIEND? ETC.]



How concerned are you personally about getting COVID-19? [PROBE ON
REASONS WHY CONCERNED OR NOT.]
o How concerned are you about family getting COVID-19? Friends?
Community members?



How have your concerns about getting COVID-19 changed since the
beginning of the pandemic, if at all?

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o Have your concerns about getting COVID-19 changed since learning
about new variants of the virus? [PROBE]: What have you heard about
the variants?


[If previously had COVID-19] Have your concerns about COVID-19 changed
since getting the virus?

Measures Taken to Slow the Spread (15 minutes)


Let’s talk a bit more about different types of preventive measures, starting
with mask wearing. Thinking about the past few weeks, can you describe a
situation where you wore a mask?
o What are the reasons that people wear masks during the COVID-19
pandemic?
o What are some reasons why someone wouldn’t wear a mask when they
were out in public?
o For those of you who wear masks regularly, how long do you plan to
continue wearing a mask in public?



Next, social distancing. Thinking about the past few weeks, can you give
me an example of how you have socially distanced?
o How well does it work at preventing the spread of COVID-19?
o How difficult is it for you to socially distance?
o For those of you who practice social distancing, how long do you plan to
continue doing so?



How often do you attend large gatherings or social events?
o [PROBE]: What kinds of gatherings or social events are you thinking of?
o What precautions do you take when attending these events?
o Is your behavior different based on whether the gathering is outdoors or
indoors?



How important do you think it is to take precautions to slow the spread of
COVID-19?



What are your thoughts about state governments or the federal
government relaxing mandates for preventive measures, such as mask
wearing or social distancing?
o [PROBE]: If you are in a state where mandates have been relaxed, what
are your thoughts? Do you feel comfortable with mandates being relaxed?
Safe?

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IRB APPROVED
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o How do you think mandates in your community or state impact how often
people practice measures like mask wearing?
Sources of Information (10 minutes)


Where do you turn for information about COVID-19?



What resources do you think provide the best information about COVID19?



I’m going to show a list of sources on the screen, and I want everyone to
tell me which sources you find most trustworthy in providing information
about COVID-19 and which sources you find least trustworthy. [SHOW LIST
OF SOURCES: Your State Government; The U.S. Department of Health and
Human Services (HHS); The Centers for Disease Control and Prevention (CDC);
U.S. Federal public health officials; The U.S. Food and Drug Administration
(FDA); Pharmaceutical companies; Local public health officials (e.g. state,
county, city, or town); The American Medical Association; Medical websites, like
WebMD or the Mayo Clinic; Your local hospital leadership (e.g., Chief Medical
Officer); President Biden; Vice President Harris. [PROBE ON REASONS WHY
SOURCES ARE MOST OR LEAST TRUSTWORTHY, AS NEEDED.
MODERATOR MAY USE THE WHITE BOARD TO JOT DOWN THOUGHTS.]



Here’s another list of sources. Again, I want everyone to tell me which
sources you find most trustworthy and which sources you find least
trustworthy. [SHOW LIST OF SOURCES: My family physician; Friends;
Immediate family members; Extended family members; Neighbors in my
community; Local schools; My employer; My local government; My place of
worship; Tribal leaders (AI/AN focus groups only)]. [PROBE ON REASONS
WHY SOURCES ARE MOST OR LEAST TRUSTWORTHY, AS NEEDED.
MODERATOR MAY USE THE WHITE BOARD TO JOT DOWN THOUGHTS.]



How often do you visit social media platforms to get information about
COVID-19?
o Which platforms?
o How trustworthy do you find information about COVID-19 to be on these
platforms?
 [PROBE]: How does this vary based on who is posting the
information?



What advertisements have you seen about COVID-19, if any? Where have
you seen or heard these ads? [PROBE IF NEEDED]: Television,
radio/podcasts, print, social media?

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o How trustworthy do you find information about COVID-19 to be in these
media sources?
VACCINES (45 MINUTES)
Now I’d like to talk more about vaccines.
Intent (10 minutes)


FDA-authorized vaccines to prevent COVID-19 are now available at no cost.
You were all asked to participate in this group because you indicated you
had not received a COVID-19 vaccine. Is that still true? [MODERATOR: YOU
MAY NEED TO ADJUST QUESTIONS SLIGHTLY FOR ANYONE WHO HAS
ALREADY RECEIVED A VACCINE.]



Now that you are eligible for a vaccine and assuming you could schedule
an appointment immediately, how soon would you get vaccinated?
o What are some of the things on your mind when you’re deciding if and
when to get vaccinated?
o For those of you who are waiting to get a vaccine:
 What are some of the reasons why?
 Is there certain information, or a certain milestone, that you’re
waiting for?
 Is there anything that would motivate you to get a vaccine sooner?
[PROBE IF NEEDED]: Coupons? Incentives? Mobile vaccine unit
(van/truck) in your home or neighborhood?
o [For those who had COVID previously] How did getting COVID-19
affect your thoughts about getting a COVID-19 vaccine?



What questions or concerns do you have about getting a COVID-19
vaccine?
o What kinds of information would you look for to better understand if you
should take a COVID-19 vaccine when it is available?
o Where would you look for information about COVID-19 vaccines?
o Would recommendations from certain individuals or groups impact your
decision; for example, your personal doctor or public health officials?



How have your cultural beliefs or traditions informed your views of COVID19 and COVID-19 vaccines, if at all?
o How has history informed your understanding?

Convenience (10 minutes)

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

Where would you prefer to go to get a COVID-19 vaccine?
o What are some of the main reasons you would prefer going to that
location?
o What are your concerns, if any, about going to a vaccination site to
receive a COVID-19 vaccine?
o How does the location of the vaccination impact your intent to get a
COVID-19 vaccine, if at all?



What have you heard about any costs for a COVID-19 vaccine?
o Do you have any concerns about potential costs for you to get the
vaccine?
o Are there other costs for you associated with getting the vaccine; for
example, transportation costs, taking time off work, childcare?



What have you heard about showing an ID or health insurance card when
you receive a vaccine?



What issues, if any, have you experienced when trying to schedule or go to
a COVID-19 vaccination appointment?
o [PROBE IF NEEDED]: Issues with technology/Internet, language,
transportation to/from vaccine sites, availability or accessibility of
vaccines, work commitments, childcare, etc.

Choice/Options (5 minutes)


What have you heard about the different COVID-19 vaccines that have been
authorized for use in the United States?
o What have you heard about how the different vaccines are administered?
o About the availability of different vaccines?



Based on what you know about the different COVID-19 vaccines that have
been authorized for use in the United States, do you have a preference for
one or more of the authorized vaccines? [PROBE ON REASONS WHY THEY
HAVE PREFERRED VACCINES OR NOT.]

Safety and Effectiveness (10 minutes)


What have you heard about the process for developing COVID-19
vaccines?
o What is your level of confidence in this process? [PROBE ON ANY
CONCERNS.]

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

What have you heard about the process for authorizing COVID-19 vaccines
in the United States?
o What is your level of confidence in this process? [PROBE ON ANY
CONCERNS.]



How effective do you feel the currently authorized COVID-19 vaccines are
at preventing infection from COVID-19?
o Thinking about all the authorized vaccines available, do you feel differently
about the effectiveness of any of them in preventing COVID-19?



How effective do you feel the vaccines are at preventing severe cases of
COVID-19 (if a vaccinated person is infected)?
o Thinking about all the authorized vaccines available, do you feel differently
about the effectiveness of any of them in preventing severe COVID-19?



How effective do you feel the vaccines are at preventing infection from the
new variants of COVID-19?
o Thinking about all the authorized vaccines available, do you feel differently
about the effectiveness of any of them in preventing infection from new
variants?



How safe do you feel the currently authorized COVID-19 vaccines are to
get?
o How safe are they to get for those with underlying health conditions?
o How safe are they to get for people in your community?

Vaccine Side Effects (5 minutes)


What have you heard about side effects after receiving a COVID-19
vaccine? [PROBE IF NECESSARY TO GET PERCEPTIONS ON SHORT OR
LONG TERM SIDE EFFECTS, SPECIFIC VACCINE INGREDIENTS, ETC.]
o How do these vary by vaccine type?



How concerned are you about experiencing side effects after you receive a
COVID-19 vaccine?
o What, if anything, would lessen your concerns about side effects?

Post-Vaccination (5 minutes)


What does it mean to be “fully vaccinated” against COVID-19?

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o When is someone considered “fully vaccinated” from COVID-19?
[PROBE IF NEEDED ON NUMBER OF DAYS OR WEEKS, HOW MANY
DOSES.]
o If you choose to receive a COVID-19 vaccine, when will you feel protected
from COVID-19?


If you choose to receive a COVID-19 vaccine, how likely will you be to
practice preventive measures, such as mask wearing and social distancing,
after you receive a vaccine?
o What factors would play into your decision to wear a mask or social
distance? [PROBE IF NEEDED AROUND LOCAL MANDATES,
CDC/FEDERAL GUIDANCE, BEHAVIORS OF OTHERS, TYPE OF
EVENT/OUTING],
o For those who plan to continue preventive measures after receiving a
vaccine, how long do you plan to continue? [PROBE FOR A
PARTICULAR CIRCUMSTANCE OR NUMBER OF DAYS/WEEKS,
WHETHER THIS IS AFTER FIRST DOSE OR SECOND DOSE, IF
APPLICABLE.]

WRAP-UP (5 MIN)


Those are all the questions I have for you. I just want to check to see if any of my
colleagues have any final questions.



Is there anything you would like to share that you have not had the chance to
before we wrap up?



Thank you very much for participating in this discussion. I appreciate your time,
and your feedback has been extremely helpful. Please remember not to share
anything we’ve discussed here today.

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