Diaper Distribution Demonstration and Research Pilot (DDDRP) Assessment

Instrument 3. DDDRP participant focus group protocol

This protocol provides a guide for facilitators leading a DDDRP participant focus group during the implementation assessment site visits.

Facilitators need to request participants’ permission to audiorecord the focus group.

Facilitator: ________________________ Date: ___________

Additional assessment team members: __________________________________________________

Other attendees (not including focus group participants): _______________________________________

Grant Recipient: ______________________________

Location: _________________________________ Time: __________________________________

Language: ____English ____ Spanish

Getting Started

As participants enter, introduce yourself, check them in, and give them a name tag or notecard for the table. Please ask the participant to put their first name (or however they want to be referred to) on the name tag or notecard.

Hello, everyone. My name is [facilitator] and my colleague is [colleague]. We work for an independent research firm, Westat, which is supporting the federal government by evaluating its Diaper Distribution Demonstration and Research Pilot. We want to thank you for coming to talk with us today. Today, we will spend about an hour together. The plan is for all of us to get to know one another a little and then walk through a list of questions we’re asking folks who participate in diaper programs across the country. This focus group is a way for the program and its funders to better know you and your community. We also want to learn how not having enough diapers has affected you and your family and your initial thoughts about the diaper services at [local diaper program name]. At the end of the session, we’ll take a few minutes to discuss an opportunity for you to share some photos with our team.

Our group today meets in the spirit of learning and improvement. We want to hear your opinions and beliefs. There are no wrong answers. We recognize you could have been anywhere else right now, and we appreciate the effort you've made to meet with us. Some of these questions can be a difficult reminder of some really challenging experiences with diaper need. We are not here to judge your experiences. We welcome everything you are able to share to help other parents who may have been in very similar experiences and had similar challenges. We hope that your answers will help other parents and caregivers in the future.

Before we get started, I need to go over this informed consent form with you (hold up form) to make sure you know you can choose not to participate in this focus group discussion, and if you do decide to participate, you know exactly what you are agreeing to, and you can skip any question you don’t want to answer for any reason.

You should have received a copy of the consent form for this project either by email or directly from the program. I have some copies here for anyone who doesn’t have one. Does anyone need one?

Distribute to any participants who do not have a copy of the consent form.

Review consent form with participants.

Ground Rules and Expectations

Thank you for agreeing to participate in today’s focus group. We know from experience these conversations are better if the group agrees to a set of guidelines or rules. I want to offer some guidelines that other groups have developed and get your reactions. I’ll go through a few ideas, and then I’m hoping you will share whether these sound about right, or if any need to be changed or added.

First, we respect one another through active listening and by avoiding interrupting others when they are speaking; in other words, please avoid talking when others are talking. We don’t all need to agree with one another, but let’s not judge anyone for having different opinions. It is okay to react to or build on another person’s statement.

We’d like you to be honest and open, and we know that’s more likely if we all agree that whatever is said here in this group stays here with the group. We request you don’t share anything we talk about outside our group. We also ask that you make sure everyone gets a chance to share. If you feel you are speaking a lot, pause to give others a chance to share. If you are quiet, I might check in with you at some point to see if there’s anything you’d like to add.

Finally, we ask that you “be present.” That is, the success of this activity depends on each of you bringing your whole self and giving your attention to the group. So, we ask that you put away your phones and other distractions, and just be here for the next hour. That said, we know you’re all parents or caregivers and things come up. If you need to take an urgent call, just step outside into the next room. You should also feel free to get up to use the bathroom, to pump or nurse, or otherwise take care of your children. Also, if anything we discuss becomes too hard for you to hear, please feel free to step out of the room.

Is there anything anyone would like to add to help make this a safe space for you?

Are there any questions before we get started? (Respond to any participant questions.)

Ice Breaker

Before we start going through the questions, let’s get to know one another a little. I’d love for us to go around the room and introduce ourselves. Let’s each say our name, how old your children in the diaper program are, how long you’ve been receiving diapers from [local diaper program name], and one word you would use to describe your youngest child.

I’ll go first.

Facilitator note: It’s helpful to kick off this activity by introducing yourself. If you aren’t a parent or caregiver, think of a cousin/niece or nephew/or other child you’ve spent time with. Sample descriptions include curious, energetic, mischievous, cuddly, tiny, etc.

Diaper Need

That was really fun. Thank you! Now we want to shift our conversation to talk about your experiences with diapers.

1. Sometimes people who don’t have young kids in their lives don’t understand why diapers are so important. How would you explain why diapers are important?

2. Can anyone share an example of how not having enough diapers affects your daily life?

   1. How has not having enough diapers changed where you go or what you do with your children? [Probes: Has it prevented you from leaving your home? For example, were you not able to go to story time at the library because your child was undiapered?]

   2. How, if at all, does not having diapers affect your relationship with your child or children?

   3. Does not having diapers affect your relationship with other adults?

   4. How, if at all, does not having diapers affect your stress level or worries you have?

Strategies for Dealing with Diaper Need

3. Caregivers and parents are really inventive when they need to be. We know that many caregivers and parents have used creative diaper-stretching strategies when they’re running low on diapers or run out completely because they don’t have any other choice. When you realize that you’re running low on diapers, how do you stretch your supply? [Probes: makeshift diapers, undiapered, diaper use tracking, keeping wet diapers on for a bit, potty training/sit on potty]

   1. Sometimes families have to go without something else they need to get diapers instead. What have you had to go without so that you could have enough diapers? [Probes: food, medicine, gas, clothes, period products, cleaning supplies]

   2. Have you used any other strategies to get diapers or money for diapers?

   3. What strategies other than using a diaper bank have you used?

   4. What diaper strategies have worked best for you? Why?

   5. What has not worked? Why? 

4. If you realize your diaper supply is really low, is there a person or organization you can turn to for help getting more diapers? This is in addition to [local diaper program name]’s help. This can be now or in the past.

5. Where do you typically buy diapers? What strategies, if any, do you use to make them cost less? [Possible probes: split packages with friends, look for sales, use coupons, use subscription services, buy generic] 

Experiences with Diaper Distribution Program

Now I’d like to ask you about your experiences with [local diaper program name] here.

6. How, if at all, has [local diaper program name] helped you and your family? 

   1. [Probes: Has it helped you meet your diaper need? Has it changed how often you change your children’s diapers? Has it helped you afford other things you need? Has it helped you change any of the problems we talked about earlier such as (facilitator will need to be reflective)? Has it helped you connect to other organizations or individuals?]

   2. Another part of the program is helping families get access to other programs or services that might address needs or challenges you have. Did [local diaper program name] meet with you to discuss any additional needs or challenges you’re facing or provide recommendations for other programs, such as childcare, medical care, housing, training, job support, parenting education, or other programs?

      1. [If yes] Were you able to connect with those services?

         1. [If yes] Have they been helpful? Why or why not?

         2. [If no] Why weren’t you able to connect with those services?

7. If you were in charge, how would you improve [local diaper program name]? [Possible probes: add services, take away services, change the way diapers are distributed, change the number you can get, change enrollment, change how long you can be on the program, change how many people can get services, change the staff or staff training, change the location, reduce how long you wait at the office to get your diaper packet]

8. Thinking back to when you first started receiving diapers through the program ... What concerns, if any, did you have about receiving diapers from [local diaper program name]? [Probes: stigma, judging, difficulty physically getting there, proper documentation]

9. How did those concerns compare with your actual experiences receiving diapers? In other words, how was your experience like or not like how you worried it might be?

10. How does it feel when you visit the agency? [Probes: do you feel welcome or unwelcome, do you feel respected by staff or not respected, do you feel safe or unsafe, are children welcome or not welcome?] 

11. Tell me about the quality of the diapers [local diaper program name] provides. [Probes: Are they absorbent? Do they fit/can you get the sizes you need each time? Can [local diaper program name] get you specific types or brands if your kid is allergic? Are they brand name? Do you like those brands? How do you feel about how the diapers are packaged (e.g., are they marked or packaged in a way that shows they are from a diaper bank?)]

Wrap-Up

This discussion has been so helpful. I have a few final questions before we wrap up.

12. Are there any other services or programs or strategies that would help you get enough diapers for your child(ren)? [Probes: diapers being tax free, vouchers for diapers, money/cash for diapers through other programs, such as WIC/SNAP/TANF subsidies, coupons, diapers included in daycare, free cloth diaper service] Would you prefer any of those to the diaper program? Why or why not? 

13. Is there anything that we haven’t talked about today that you’d like to share related to diaper need?

Focus Group Close and Opportunity to Share Photos

Notetaker begins to prepare the gift cards.

Thanks so much to all of you for participating. This was a very helpful discussion. We have two last pieces of business. First, [colleague] will have a gift card available for you as you leave. Please make sure you stop by to get the card from [colleague].

As we end our session, I also wanted to tell you all about another voluntary opportunity to participate in our project. We are collecting photos from parents and caregivers that help us show how parents feel when they’re worried about diaper supply, how having sufficient diaper supply helps parents, and what your experience with the diaper program looks like. We will use these photos in project reports to help share the stories of diaper program clients. At this time, we are not providing payment for these photos.

If you are interested, stay after I close this session, and we can talk more. Otherwise, this is the end of the focus group, so feel free to leave at any time. Have a great rest of the day!

Photo Instructions and Release

We write reports for many audiences: organizations that fund diaper banks, Congress, funders of this diaper program, policymakers, and other diaper program staff. Sometimes these reports are pretty technical, and while they share important calculations such as the average number of diapers clients receive, they can miss sharing real and relatable stories about people who are served by these programs. We’re trying something a little new to help us better show families’ stories, not just tell them.

We’d like to add photos taken by caregivers or parents participating in this diaper program in our reports to better share your experiences. This is a totally voluntary option to contribute to our assessment, so if you don’t want to share more, or don’t enjoy taking photos, you don’t have to. But if you are creative, want to share a bit more about your experiences with diapers, and maybe have a photo included in our public reports, we hope you’ll participate.

We are asking for your photos that have to do with (1) how needing diapers has affected you and your family, (2) how you and your family feel when you do have a good supply of diapers, or (3) your experiences with the diaper program.

It’s really up to you how you choose to use the photos to talk about your experiences. This is your story. You can share the happy parts of your story or the hard parts. This is your opportunity to share your story with pictures. If you would rather not take a photo but want to draw a picture or do some art, others have done that before, and we would be happy to include that as well.

Hand out photo release.

This handout provides more detail on our request and how to email your photos to us. These photos might be published in public, online forums, so please don’t share anything you wouldn’t put on social media for everyone to see. Please keep in mind we are not allowed to share photos of any children’s faces, even your own children. We ask that in addition to a photo, you also write a short caption (one or two sentences) that explains what we’re looking at or how the picture makes you feel. For example, if you submit a photo of your diaper bag full of diapers your caption might be: “When I have a good supply of diapers, I can relax a little bit and not worry whether I’m doing everything I need for my daughter.” We also want to know whether you want to be credited for the photo. If you don’t want credit, we will just add to our report that the image was taken by a program participant. If you do, we’ll say something like “credit: Molly Smith, program participant.” We can also do first name and initial or first initial and last name.

Please do not share photos that include people’s faces, including infants and children. When in doubt, ask permission to take pictures on private property. Generally speaking, if a photographer is shooting within a public space, they have the right to take photographs without asking permission. In most cases, this is true for photographing buildings, sites, and people. But also consider asking people if it’s okay to take their pictures. You might want to try to avoid taking pictures with people in them. We do not recommend a physical address or people’s names. Lastly, please don’t take pictures of anything illegal or that could suggest anyone, child or adult, is in danger.

This handout provides all the guidance I just went over, and also talks about how by sending an image to us, you are releasing it for public distribution. That means you’re giving us the right to take your art and share it with the world. We are asking you to email us the photos. We will reply to your email asking you to agree for us to use the photo. We may not use all photos that we receive.

Review photo release language

We would like to receive images from you by [date 3 weeks after focus group]. Please take a minute to read the document and let us know if you have any questions. You can also contact us based on the information on the document.

Answer questions, thank group for their time, and say goodbye.

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to help the federal program team understand diaper need in communities across the country. Public reporting burden for this collection of information is estimated to average 1.5 hours per respondent, including the time for reviewing instructions, gathering the information needed, and submitting the information to the evaluation team. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0531 and the expiration date is 9/30/2025. If you have any comments on this collection of information, please contact Erin Cannon at erin.cannon@acf.hhs.gov

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