VERMONT STRATEGIC PREVENTION FRAMEWORK

FOCUS GROUP GUIDE FOR YOUNG ADULTS AGES 18 Through 25

PIRE 03/19/08

Young Adult Focus Group Guide Some sections of this guide were adapted from Shattuck and Associates, Inc., Program Planning & Evaluation, Mt Airy, MD, September, 2007. Other sections were adapted from focus group materials recently developed for the Vermont Department of Health by Fifth Element Associates.

Young Adult Focus Group Guide

Overview Focus groups and other qualitative research methods can provide useful insights into issues of interest insights that cannot easily be distilled from purely quantitative methods such as closed-ended survey instruments. Because the priorities for Vermonts SPF-SIG community grantees pertain to persons up to age 25 (age 21 for underage drinking), it is important that community grantees learn as much as possible about the perceptions and attitudes of young adults in their communities. This focus group guide has been designed to help grantees capture useful information about this particular age group information that hopefully will help grantees select and implement intervention strategies that will truly make a positive impact on the priority problems they are attempting to address. The questions in this guide focus primarily on obtaining information regarding causal factors (also referred to as intervening variables or risk and protective factors) in the community that lead to or facilitate problem behaviors, specifically: underage drinking, high risk drinking, and marijuana use. Identifying and learning more about what causes, encourages, and/or facilitates these behaviors should help community grantees determine how best to intervene in order to reduce their occurrence. The focus group discussions may also lead to other types of insights and understanding that dont necessarily pertain to directly to causal factors. Thats OK, and encouraged. Community grantees may certainly add additional questions to this guide that they believe are relevant to understanding to problems they are trying to address. Community grantees are asked to conduct at least one focus group with 6 to 10 people aged 18 to 25. A second group, if possible, can often provide additional useful insights and also help confirm (or challenge) impressions gained from the first group. Conducting two focus groups, if possible, also provides the advantage of being able to split the groups by age. In particular, communities planning to ask the high risk drinking questions might have more productive discussions, and elicit more candid responses, if one group was conducted with underage persons (ages 18 through 20) and the other group with legal age persons (ages 21 through 25). That approach would allow relatively more focus on the underage drinking questions with 18-20 age group, and relatively more focus on the high risk drinking questions with the 21 to 25 year group. The decision to conducting separate focus groups for these two sub-groups is left up to each community grantee. We encourage you to consider this option and then select a strategy that you think is both feasible and will be most helpful to your assessment efforts. The remainder of this guide includes recommendations for recruiting participants, scheduling and setting up the discussion, and how to facilitate the discussion. It also

Young Adult Focus Group Guide

includes a set of specific questions and accompanying probes to be used during the session, and a suggested template for summarizing what you learn. The questions that will be used to guide the discussion are organized into three sections: underage drinking, high risk drinking, and marijuana use. At a minimum, the focus group should address the questions that pertain to the communitys two SPF-SIG priorities (if they have already been identified). If the second priority has not been chosen yet, or the coalition would find it helpful, questions that address all three of the states priority areas should be used. It is estimated that the focus group will last around 90 minutes, with approximately 40-45 minutes being devoted to each of the communitys two priorities. If all three priorities will be covered, an extra 30 minutes time should be allotted. Reminders and other considerations All of the VDH Prevention Consultants have completed focus groups on underage drinking with parents within the past year. The PC in your area is a resource for significant technical assistance in planning and conducting your young adult focus group(s). To increase the availability of potential participants, you may want to schedule your focus group(s) during the summer or other college break. This will depend on your community and whether waiting for students to come home from school is likely to make recruitment easier. Keep in mind that the suggested time frame for completing this activity is by the end of June 2008 for Implementation grantees and between April and October 2008 for Capacity Building grantees. You are encouraged to conduct focus groups with participants from other age groups or with different roles in the community if this would suit the needs of you coalition/organization. You are encouraged to use the same questions as those presented below to the extent that it makes sense to do so because this will allow you to directly compare responses from different focus groups. We have been asked about adding questions to the focus group that cover content not specific to risk and contributing factors of the priority problems (e.g., asking participants what type of prevention messages/strategies they think would be effective with their age group). We suggest that questions that stretch the focus group beyond its intended purpose (risk factor assessment) would be best left for a separate focus group (e.g., message testing around the time strategies are being selected), unless there was some time remaining after the question in the guide had all been covered. You may find it helpful to gather contact information from participants and let them know that you will likely contact them to request their participation in future focus groups or related activities.

Young Adult Focus Group Guide

Recruitment Participants can be recruited through a variety of strategies, including: Placing adds in local newspapers Posting flyers in places where young adults can be found Posting a note on public web sites Working with local organizations who have access to this population (including via email)

Sample materials for these methods above may be found in Appendix A. Casting a wide net in terms of where you recruit will be helpful in obtaining a diverse group. Please try to avoid getting all you participants from the same source (e.g. participants in the communitys adult softball league). We strongly suggest that stipends be offered as an incentive for participation a stipend of $20 would be reasonable. Persons who wish to volunteer should be instructed to call or email someone (the screener) in your organization to indicate their interest in participating. They should be told at that time that you are just collecting names, and that they will be notified by a specific date if they have been selected. Volunteers should also be told how long they can expect the discussion to last. You might want to have some tentative dates and times in mind, or you can just wait and see what their time availability is before deciding on a specific date and time. A form for keeping track of volunteers is included in Appendix B. Please be sure that your screener records all the information shown on the form. When you have an adequate number of volunteers to form a diverse group (or two groups, if you decide to have two), you can then select the participants and notify all who applied of their status. For each group, it is recommended that you select two more participants than the number you are targeting, to account for so-shows and cancellations. In selecting the group(s), keep in mind that it would be useful to have an approximately equal number of persons aged 18 to 20 and 21 to 25, and at least one man and one woman in each age group. As mentioned, diversity in terms of where the volunteers were recruited is also desirable. All volunteers should be informed of their status as soon as the groups are selected. In addition, all participants should be sent a letter with the time, place, and other information (see example in Appendix C).

Young Adult Focus Group Guide

Become familiar with the discussion guide and procedures

Consider gathering a small group of coalition members to run through a brief mock focus group to give you a chance to get comfortable with the questions and with phrasing probes. Talk with the PC in your area about their recent experience with running focus groups and solicit their advice on conducting your own. Preparation and Set-up
Identify a place, date, and time (prior to notifying participants) Make sure in advance that the location is available and suitable (e.g., convenient for target participants, reasonably quiet, enough chairs, etc.) Arrive early in case any set-up is needed

Capturing the information You will either need a note-taker or, with the participants permission, audiotape the session. Having an observer (or note-taker) can be helpful even if the discussion will be audio taped Creating a safe environment Allot time for introductions, including yourself (as moderator), the note taker, the goal of the focus group, and how the information will be used Establish ground rules (e.g., respecting what each person says) Begin with an icebreaker question Consider providing drinks and a snack Facilitating the discussion Remain objective / withhold judgment (consider both verbal and nonverbal body language) Listen carefully and occasionally reflect what you are hearing by paraphrasing responses Make eye contact, smile and thank participants for their input periodically throughout the group and at the end Do not let one or two people dominate Encourage feedback from all participants Keep the group on track Let the group know up front that you may need to cut short discussions to ensure that all questions can be asked.

Young Adult Focus Group Guide

Wrapping up With participants, reflect and summarize major themes or areas of the discussion Ask for any remaining comments Ask if there are any questions After the focus group, the moderator and note taker can debrief (reflect on the discussion, coordinate next steps now that this information has been collected, etc.) Complete the template provided in Appendix D for summarizing what you learned Send the completed summary form in Appendix D to Katy Cahill VDH/ADAP 108 Cherry St. Burlington, VT 05401

Young Adult Focus Group Guide

Discussion Guide
Introduction: (The moderator will open the group discussion by briefly explaining to participants the purpose of the focus group and highlighting what will be expected of them. The intent of this section is to make respondents feel relaxed and comfortable.) Hello, my name is __________. I would like to thank you all for coming out to participate in this group. I work with/for __________, and we are conducting this discussion in an effort to get a better understanding of your views related to alcohol use (and marijuana use, if applicable) in your community. Before we get started, there are a few things that I want to tell you. (NOTE: practice and put into your own words): I am going to ask you some questions about alcohol use (and marijuana use, if applicable). You will not be asked questions about your own behavior, but rather your views about issues in your community. I am very interested in everyones point of view. It is ok if you have different opinions; I would like to hear all of them. There are no wrong answers. I simply ask that we respect each others opinions. It is very important that you do not speak at the same time. I would like to be able to hear each of you. So, please take turns and avoid side conversations. I will remain objective. So, I ask that you please say what you think, not what you think I might want to hear. The groups will be audio recorded. This will allow me to go back and listen to each group, take notes, and then write a short summary of the findings. I want to reassure you that all of your comments will remain anonymous. Your names will not be directly linked with anything that you say. Point out restrooms and ask participants to indicate if the room temperature gets too hot or cold during the discussion.

Do you have any questions before we begin?

Young Adult Focus Group Guide Participant Introduction: Lets start off by going around the table with introductions. Please tell me: Your first name Favorite hobby or activity. (Icebreaker example.) Again, thank you for coming. Lets get started. Warm-up Questions: (These are just some suggestions for getting conversation flowing before getting into the more direct questions listed below. Feel free to use some, none, or all of these and to come up with your own open-ended questions to get the conversation started.) You have just seen data indicating that VT has the highest rate in the nation of past month alcohol use and past year and month marijuana use among young adults (18-25 year olds). Is this surprising to you? Why or why not? (show data from http://healthvermont.gov/adap/prevention/SPF/documents/epiprofileexecsummary_final.pdf ) How would you say things have changed with respect to underage drinking, binge drinking, and marijuana use since you were beginning high school? What do you think is different with respect to underage drinking, binge drinking, and marijuana use now than when your parents were 18-25?

Young Adult Focus Group Guide Discussion Questions: The questions contain probes that may be used, if necessary, to stimulate discussion or to ask for additional information. Begin by asking only the question and then use probes as necessary. SECTION 1: UNDERAGE DRINKING Introduction: Now I would like to ask you some questions about underage drinking. 1. How acceptable is it for people under the age of 21 in this community to drink alcohol? How acceptable is underage drinking to people your age? To parents and other adults? To the community in general? Probe: Tell me whether there are situations in which it is seen as OK for people under the age of 21 to drink. What are some reasons it is seen as OK for people under the age of 21 in this community to drink alcohol? Family acceptance / Parents allow Right of passage Youth perceive it as cool, something to do

2. What risks do you think people under the age of 21 in this community associate with drinking alcohol? Probe: What are some possible reasons that people under the age of 21 may perceive alcohol use to not be very risky? (listen for responses to this general questions, and further probe with some of the following possible reasons if necessary) They dont think they will get cited or arrested They dont think there will be serious consequences (from legal system) even if they are cited or arrested They dont think there will be serious consequences (from parents) even if they are cited or arrested They are not aware of the potential risks of alcohol use to their health and safety Even if they are aware of the risks, they dont think those consequences will happen to them 10

Young Adult Focus Group Guide They dont care even if there will be negative consequences If this community identified high risk drinking as its second priority, skip the following question (Q.3.) for now because it is included in the next section of questions. 3. How is alcohol promoted (or advertised) in this community and which types of promotion do you see or hear most often? Probe: Advertising (e.g., on the radio or TV, on billboards, in the newspaper, at events) Through discount prices or drink specials (e.g., happy hours) Availability at community events

4. Where do you think people under the age of 21 in this community get alcohol? Probe: Retail Access liquor store? grocery store? bar? restaurant? Social Access friends? parents? Older brothers and sisters strangers? parties other social events?

5.

Is it easy for people under the age of 21 in this community to get alcohol from those sources? Probe: What are some reasons it is easy for people under the age of 21 in this community to get alcohol? Retail Access Bars, stores, and restaurants dont check ids Social Access Adults are unaware of penalties for providing alcohol to minors 11

Young Adult Focus Group Guide Lack of monitoring at social events Lack of parental monitoring

6. Where do you think people under the age of 21 in this community drink alcohol?

7. If people under the age of 21 in this community who live with their parents drink alcohol, how likely do you think it would be that their parents would find out and what happens when they do? 8. How effective do you think this community is at enforcing laws against underage drinking? Probe: If someone under the age of 21 was drinking, how likely is it that the police would find out? How likely are police in this community to find out about and break up parties where underage people are drinking? How likely is it that people would be arrested (and convicted) in these cases? What are some reasons this community may not be effective at enforcing laws against underage drinking? Lack of resources (e.g., personnel, training) Inconsistent application of laws Not a priority

9. Can you think of any other things that influence alcohol use among people under the age of 21 in this community? Probe: How strong are these influences relative to the things weve already discussed?

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Young Adult Focus Group Guide SECTION 2: HIGH RISK DRINKING Note: This section may be skipped if this community did not identify high risk drinking as a priority. Explain: Now, I would like to ask some questions about different patterns of alcohol use. 1. How acceptable is it in this community for people your age to have 5 drinks or more within an hour or two? This is also referred to as binge drinking. How acceptable is it to people your age? To parents and other adults? To the community in general? Probe: What are some reasons it is seen OK for people your age in this community to binge drink? Lack of knowledge of health and safety consequences Perception that negative consequences wont happen to them (perceived invulnerability) Youth perceive it as cool

2. How acceptable is it for people your age in this community to drink and drive? How acceptable is it to people your age? To parents and other adults? To the community in general? Probe: What are some reasons it is seen as OK for people your age in this community to drink and drive? 3. What risks do you think people in this community associate with binge drinking? Probe: What are some reasons people your age in this community may not perceive drinking until they are drunk to be risky? Lack of knowledge of health and safety consequences Perception that negative consequences wont happen to them (perceived invulnerability) Low perception of getting cited or arrested 13

Young Adult Focus Group Guide Low perception of being punished (by legal system or parents)

4. What risks do you think people in this community associate with drinking and driving? Probe: What are some reasons people your age in this community may not perceive drinking and driving to be risky? Lack of knowledge of health and safety consequences Perception that negative consequences wont happen to them (perceived invulnerability) Low perception of getting cited or arrested Low perception of being punished (by legal system or parents)

5. Where do you think people age 21 through 25 in this community drink alcohol?

6. How is alcohol promoted in this community and which types of promotions do you see or hear the most? Probe: Advertising (e.g., on the radio or TV, on billboards, in the newspaper, at events) Through discount prices or drink specials (e.g., happy hours) Availability at community events

7. How effective do you think this community is at enforcing laws against drinking and driving? Probe: If someone your age was driving after having too much to drink, how likely is it that they would be stopped by police? How likely is it that the person would be arrested (and convicted) in this case? What are some reasons this community may not be effective at enforcing laws against drinking and driving? Lack of resources (e.g., personnel, training) Inconsistent application of laws 14

Young Adult Focus Group Guide Not a priority

8. How effective do you think this community is at enforcing laws against serving someone who is obviously intoxicated? Probe: How likely is it that an obviously intoxicated adult, with proper ID, would be sold alcohol at a bar, restaurant, or store in this community? What are some reasons this community may not be effective at enforcing laws against serving people who are intoxicated? Lack of resources (e.g., personnel, training) Inconsistent application of laws Not a priority

9. Can you think of any other things that influence risky patterns of alcohol use, such as binge drinking and driving after drinking, among people your age in this community? Probe: How strong are these influences relative to the things weve already discussed?

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Young Adult Focus Group Guide

SECTION 3: MARIJUANA USE Note: This section may be skipped if this community did not identify marijuana use as a priority. Explain: Now, I would like to ask some questions about marijuana use. 1. How acceptable is it for people your age in this community to use marijuana? How acceptable is it to people your age? To parents and other adults? To the community in general? Probe: What are some reasons it is seen as OK for people your age in this community to use marijuana? Perceived as OK / Parents allow Perceived as cool, something to do Perceived as not harmful

2. What risks do you think people your age in this community associate with using marijuana? Probe: What are some reasons people your age in this community may not perceive marijuana use to be risky? Lack of knowledge of health and safety consequences Perception that negative consequences wont happen to them (perceived invulnerability) Low perception of getting cited or arrested Low perception of being punished (by legal system or parents)

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Young Adult Focus Group Guide 3. Where do you think people your age in this community get marijuana?

4. How easy is it for people your age in this community to get marijuana from those sources? Probe: What are some reasons it is easy for people your age in this community to get marijuana? Lack of monitoring at social events Distribution and/or sale of marijuana is not a priority for law enforcement

5. Where do you think people your age in this community use marijuana?

6. If people your age in this community who live with their parents use marijuana, how likely do you think it would be that their parents would find out and what happens when they do?

7. How effective do you think this community is at enforcing laws against marijuana use? Probe: What are some reasons this community may not be effective at enforcing laws against marijuana use? Lack of resources (e.g., personnel, training) Inconsistent application of laws Not a priority

8. What are other things that influence the use of marijuana in this community?

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Young Adult Focus Group Guide

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Young Adult Focus Group Guide

Appendix A Example Recruitment Materials

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Young Adult Focus Group Guide Sample Ad

Looking for Young Adults

Are you between the ages of 18 and 25? Then we need your input. The (name of your coalition/organization) is hosting a discussion group with young adults to gather local opinions about alcohol [and other drug] use. [If offering a stipend: Each attendee will receive $20 for their time.] Please call [insert first name] at [insert phone number] for more information. (org name or logo here)

Sample Flyer (half-page)

Are you between the ages of 18 and 25?

Then we need your input and experience. The (name of your organization) is hosting a discussion group with young adults to gather local opinions about alcohol [and other drug] use. [If offering a stipend: Each attendee will receive $20 for their time.]

Please call [insert first name] at [insert phone number] for more information.
(org name or logo here)

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Young Adult Focus Group Guide Sample Copy for Web Page Persons between the ages of 18 and 25 We Need Your Opinions! The (name of your organization) is hosting a discussion group with young adults to gather local opinions about alcohol [and other drug] use. We would like to hear from you about your attitudes and perceptions on these issues. [If offering a stipend: Each attendee will receive $20 for their time.] Please contact [insert name] by e-mailing [insert e-mail address and make link] or calling [insert phone number] for more information.

Sample Copy for E-mail SUBJECT LINE: Are you between the ages of 18 and 25? Then we need you. The (name of organization) is hosting a discussion group with young adults to gather local opinions about alcohol [and other drug] use. We would like to hear from you about your attitudes and perceptions on these issues. [If offering a stipend: Each attendee will receive $20 for their time.] Please contact [insert name] by e-mailing [insert e-mail address and make link] or calling [insert phone number] for more information.

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Young Adult Focus Group Guide

Appendix B Volunteer Roster

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Young Adult Focus Group Volunteer Roster

Name 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. Address Phone or email Times available Gender Age Where recruited

Appendix C Sample Letter to Participants

Month xx, 2007 Name Address City, ST zip Dear [insert name]: Thank you for agreeing to participate in our focus group. The purpose of the group is to better understand your views about alcohol [and marijuana] use among persons your age. The information collected will help us work with other organizations in our community to reduce problems associated alcohol [and marijuana] use. Everything you say within the context of the group will remain confidential. Nothing you say will be linked directly with you. Also, this is not a sales presentation of any type and will not result in one. It is purely to gather your valuable views and opinions. The group will be conducted by [insert name].

The group will be held on: Day of Week, Month xx from ___PM to ___ PM at [insert location]

We only plan for a certain number of people for the group, so please dont bring anyone not invited to the group with you. They will not be able to participate or observe it. If you wear contacts lens, glasses or anything else to be able to read, please remember to bring them with you. Also, we are not able to provide childcare or transportation to or from the group. We ask that you arrive at [time time minutes before start time] as the group will start promptly at [time]. [If offering a stipend insert: You will receive a check or cash for participating in this group.] We anticipate the group will last approximately 90 [or 120] minutes. [If providing food insert: A beverage and snack will be provided.] We are enclosing directions to [insert location], for your reference. Thank you again for your help with this project. If you have any questions, please feel free to contact me at [insert telephone number]. Best regards, Name Title e-mail address

Appendix D Focus Group Summary Template

Vermont SPF-SIG Focus Group Summary

Community Grantee: Date of focus group: Age range of participants:

1. What are the three most significant things you learned (or confirmed) from this activity?

2. Did you learn anything that was a surprise to you?

3. What useful information did you obtain about causal factors for underage drinking? a Low perceived risk b Social norms that accept or encourage c Low enforcement of laws d Easy access to alcohol e Lack of parental monitoring f Promotion and pricing g Other causal factors not listed above 4. What useful information did you obtain about causal factors for high risk alcohol use by persons under age 26 (if this priority was addressed)? a Low perceived risk b c d e f g Social norms that accept or encourage Low enforcement of laws Easy access to alcohol Lack of parental monitoring Promotion and pricing Other causal factors

not listed above 5. What useful information did you obtain about causal factors for marijuana use by persons under age 26 (if this priority was addressed)? a Low perceived risk b Social norms that accept or encourage c Low enforcement of laws d Easy access to alcohol e Lack of parental monitoring f Other causal factors not listed above 6. Were any insights gained on promising strategies or ideas on how best to address important causal factors?

7. Do you have any other summary observations or comments on what was learned and/or the usefulness of the focus group to your planning and capacity building efforts?

8. What follow-up activities related to this effort (if any) were identified?