Developing Strategic Concepts Designed to Prevent AI/AN Youth Tobacco Use

Moderator Guide
Reviewer Note: Moderator instructions are in brackets. Probes are italicized. The
Moderator Guide consists of questions that researchers anticipate are relevant to ask.
However, this does not mean that every question listed will definitely be asked. As per
standard protocol for focus group research, researchers will allow the conversation to
unfold naturally. Certain questions listed may not need to be asked because they may not
be relevant to a particular discussion.
I.

STUDY INTRODUCTION (5 Min)

[As participants arrive, they may receive the study introduction in groups so that
participants may begin on the initial activities without having to wait for all participants to
arrive.]
Welcome and thank you for coming. My name is [insert moderator/research
assistant name] and I am helping with the discussion group today. We also have
[insert names of research assistants] who will be helping out today. We are going to
do some individual activities and then have a group discussion where we will talk
about what teens are like here. Then we are going to watch some videos and talk
about them. At the end, you will each receive $25. How does that sound?
We also want to remind you that no one outside of the group will know what you
said during the discussions. It is completely up to you whether or not you take part
today, and you have the right to leave the group at any time.
Before we begin, we have a few ground rules for the group:
1. We want you to share what you are thinking, so please don’t be shy to
tell us your opinion! If you do not have an opinion on something, that’s ok
too. There are no right or wrong answers!
2. Make sure to let everyone get a chance to talk. We want to hear from
each person. So if you are talking a lot, let others talk for a little while.
3. Be nice to each other. Don’t make fun of others for their answers. But we
also want you to be honest when you disagree—we need to hear your
opinions. Our goal is not to get everyone to agree or disagree. It is about
hearing each person’s unique opinion.
4. Feel free to share openly and honestly, but please do not share any
personal information, like your name. Please also respect the privacy of
everyone here by not sharing what is said in this discussion outside of
the group.
5. Please silence your cell phones, put your headphones away, etc. If your
parents call, you can step out and quickly talk to them, but other than
your parents, please don’t text or answer calls or texts from other people
during the discussion group.

Moderator Guide

Page 1 of 8

Verbal Confirmation to Audio Record
Also, I would like to double check that we have your permission to audio record this
discussion group. As I mentioned, all information from the group will be kept private
and protected, including the audio recording or any transcripts made from the audio
recordings. So, is it ok with you if we audio record the group?
[If not everyone in the room confirms, then do not audio record group activities;
research assistants should take notes instead.]
To keep things private, please do not mention people’s names during the
discussion.
The first thing you are going to do is an activity with pictures OR take a survey.
When you are finished with one of the activities you will then switch and complete
the other activity.

II.

PARTS A & B: (PART A) INDIVIDUAL PICTURE SORT & (PART B) CHECK-IN
SURVEY (35 Min Total for Both Parts)

[For 14-17 year olds the Individual Picture Sort (Part A) and Check-In Survey (Part B) will
occur concurrently and procedures for both activities are described below. For 12-13 year
olds, Part A will not be conducted and all participants will complete Part B simultaneously.]
[Moderator assigns half the participants to begin with the Individual Picture Sort (Part A)
and the other half to begin with the Check-In Survey (Part B). Those assigned to begin
with Part A will be directed to one side of the room, while participants assigned to Part B
can remain in their seats to complete the Check-In Survey.]
Part A - Individual Picture Sort (20 min)
[Moderator/assistant will instruct participants to be seated a desk with a set of pictures.
The following direction will be addressed to participants starting Part A.]
1. On this table is a bunch of pictures. We would like you to pretend that all of the
people in these pictures go to your school. Looking at all of the pictures, I want you
to think about who would hang out with whom. Which people would be friends with
each other and hang out on the weekend? For this activity, you’re going to put the
pictures into groups, based on who would hang out with each other. Please make at
least two groups but no more than ten groups. Remember, you are grouping people
that would hang out with each other, not people that you would personally hang out
with. While you are making your groups, if any picture looks like someone that you
cannot imagine at your school or that doesn’t fit into any of the groups, please set
those pictures aside. After you make the groups, we are going to talk about them.
Please take about 10 minutes to put the pictures into groups and let me know when
you’re done. Do you have any questions?
Moderator Guide

Page 2 of 8

[Participant begins making groups on their own. Moderator/assistants continue to
facilitate the activity by checking in on each participant’s progress until picture
sorting is finished, for no longer than 10 minutes.]
2. [When an individual is finished sorting pictures, the moderator/assistant will
interview the participant individually about their responses and fill out the Individual
Sort Form. Moderator/assistant will state the participant’s Unique ID for the
recording].
This is Part A for Participant [Unique ID #]. OK, I want to talk about each of these
groups. First, I’m going to give our groups numbers just so we can keep track of
what we’re talking about.
[Moderator/assistant labels each group with a Post-It Note.]
3. Now, let’s begin with the first group. I am going to spread out the pictures for Group
1 so we can see everything:
a. First, I would like you to think about how you would describe this group.
[Example probes:]
1. What would you call this group?
2. What are three words or phrases that best describe this group? For
example, what are they like?
3. What kind of music do they listen to?
4. What clothing brands do they wear?
5. Where do they hang out on the weekends?
[Moderator/Assistant records responses for Group 1 in the ‘Descriptors’
column of the Individual Picture Sort Form. Process is repeated for all
groups.]
b. Before we move on, I want to find out if there are any pictures missing.
Think about your school, your friends, the people you see at lunch. Are
there any pictures missing that would represent a group?
1. What can you tell me about missing groups?
2. Are there 1 or 2 photos that are somewhat similar to someone from
that group?
3. What is different about them?
[Moderator/Assistant records any additional groups on back of Individual
Picture Sort Form (blank side).]
c. Now, out of the groups you made, pick the one group you are most likely
to hang out with

Moderator Guide

Page 3 of 8

[Moderator/Assistant writes an ‘X’ in the corresponding ‘Group Member’
column of the Individual Picture Sort Form]
d. Now, think about all of the groups here. Which is the largest group at
your school? What about second largest? Third largest?
[Moderator/Assistant records top 3 rankings in the ‘Group Size’ column of the
Individual Picture Sort Form; must select 3 groups].
e. Next, I want you to think of all the teens at your school who use
tobacco like cigarettes, cigars, cigarillos, chew, hookah, or e-cigs.
Which of these groups uses the most tobacco? What about second
most? Third?
[Moderator/Assistant records top 3 rankings in the ‘Tobacco Use’ column of the
Individual Picture Sort Form]; must select 3 groups. After participant provides their
top 3 rankings, ask the following questions of the top 3 groups.]
4. What is the main type of tobacco this group uses?
[Moderator/Assistant does not read any response options out loud to participant,
rather the Moderator/Assistant selects only 1 response that best matches
participant’s answer, including “Don’t Know,” under “Main Tobacco Type” column on
the Individual Picture Sort Form. If Moderator/Assistant does not recognize product
type based on brand name, Moderator/Assistant should record response in the
Notes row to be re-coded at a later time.]
5. Are there any other types of tobacco products that this group uses? Which
ones?
[Moderator/Assistant does not read any response options out loud to participant,
rather the Moderator/Assistant selects only 1 response that best matches
participant’s answer, including “Don’t Know,” under “Other Tobacco Type” column
on the Individual Picture Sort Form. If Moderator/Assistant does not recognize
product type based on brand name, record response in the margins to be recoded
at a later time].
[Moderator/Assistant will instruct participants who started with Part A to switch
activities and complete Part B, the Check-In Survey. Participants who completed
Part B and then Part A will be instructed to return to their seat for the general
discussion.]
Great, we are now finished with this activity and you can now [complete the CheckIn Survey that is in your folder OR go back to your seat for the group discussion.]
Part B - Check-In Survey (15 min)

Moderator Guide

Page 4 of 8

1. In the folder you were given, there is a survey called the Check-In Survey that you
can start filing out now. Please do not write your name anywhere on the survey. Let
me know if you have any questions. Otherwise, just let one of us know when you’re
done.
[After each participant completes the Check-In Survey, Moderator/Assistant should
circulate and instruct participants to insert the completed survey upside down in the
bottom of their Participant Folder.]
[Moderator/Assistant will instruct participants who started with Part B to switch
activities and complete Part A, the Individual Picture Sort. Participants who
completed Part A and then Part B will be instructed to return to their seat for the
general discussion.]
Great, thanks for finishing [this activity]. You can now [go find a seat on the other
side of the room to do the picture sort activity OR go back to your seat for the group
discussion.]

III.

RAPID ID PROJECTION (5 Min) or ID PROJECTION (25 mins)

[Moderator will instruct participants to come back together as a group. For 14-17 year olds,
Rapid ID Projection will occur as a brief activity taking no more than 5 minutes, following
the completion of both Parts A and B, above. For 12-13 year olds who completed Part B
(the Check-In Survey) only, additional behavioral risk questions will be asked about the
pictures, lasting up to 25 minutes.]
Now I’ll be showing you some pictures of people on the screen and we’ll talk about
them. Just like the activity each of you did earlier, the pictures feature unknown
individuals. You do not need to write anything down. Let’s begin.
[Moderator shows a slide with numbered pictures of unknown youth. Moderator will
ask the following questions for 3 to 4 pictures.]
First let’s look at Picture 1.
1. [For all participants] Thinking about the picture sorting activity we did earlier,
which group did you think this person belongs with?
a. What did you call this group? Did anyone else call this group
something else?
b. What are their hobbies? Interests?
c. Where do they hang out?
d. What kind of clothes do they wear?
e. What kind of music do they listen to?
2. [For 12-13 year olds]
a. Do you think this person uses tobacco? Why or why not?

Moderator Guide

Page 5 of 8

b. If yes, what type of tobacco do you think they use?
[Moderator follows process for a few pictures and then asks participants to compare
pictures.]
3. Let’s compare the person in Picture [insert number] with the person in Picture
[insert number].
a. How are they different?
b. Do they care about any of the same things?
c. [if in different groups] Are there any events or activities where these
groups would hang out together? Which groups would hang out together?

IV.

STIMULUS-DRIVEN DISCUSSION (45 Min)

[Campaign ads will be revealed one at a time, followed by discussion for that ad before
moving on to the next ad.]
Now we’re going to watch some videos and ask you to give your opinions.
After I play each video we will discuss as a group. We will talk about each of the ads
individually and then compare them to each other at the end.
1. [Repeat for every ad.]
We’re going to watch the first concept. This is Ad# [1-6]
[Research assistant should play video.]
Great. So, let’s talk about your thoughts about the ad you just saw.
1. What is the message this ad is trying to convey?
a. Is this message interesting? Why/why not?
b. Is this message realistic or believable? Why/why not?
2. How did this ad make you feel?
3. What do you like about this ad?
4. What don’t you like about this ad?
a. What would make it better?
5. Did you learn anything from this ad?
a. If yes, what did you learn?
6. Is this ad relevant to you?
7. What do you think about the setting or situation in this ad?
8. Did this ad catch your attention?
a. If yes, what about it?
b. If not, why not?
9. What did you think about the tone or feeling of the ad?
10. Was there anything that was confusing or didn’t make sense?
Moderator Guide

Page 6 of 8

11. How does this ad make you feel about [tobacco / smoking cigarettes / using
electronic cigarettes, hookah pens, or vape pens]?
a. Is that different than how you felt before viewing the concept?
12. Do you think this ad would convince people your age to not use tobacco?
13. Do you think you would talk about this ad with friends?
a. Would you share this concept with your friends if it was available
online?
14. Do you think this ad is directed to you and your friends?
a. Why/why not?
2. [Stimulus-specific questions to ask depending on themes in the ads]
1. What does it mean to be “healthy?” Is living a healthy life important to you
and your family? Why?
a. What are some examples of things you do to live a healthy life?
b. If overall wellness and happiness do not come up in the way health is
conceptualized, ask: Is the way you feel and your emotions part of
being healthy, or is that something different? Why or why not?
2. Do you agree or disagree that cigarettes are addictive? Why or why not?
a. Do you think it’s possible for someone your age to become addicted to
tobacco? Why or why not?
3. What does it mean to be “controlled” by tobacco? Do you agree or disagree
that someone can be controlled by tobacco?
4. What are some of your goals? Do you think that tobacco could stop you from
reaching your goals? Why or why not?
5. Are traditional events or customs important to you? Why or why not?
a. What are some of the traditions you participate in?
b. Which ones do you enjoy most? Why?
c. Who do you learn about traditional customs from?
6. What did you think of the people that were shown in this ad?
a. Do they look like people you might see around here?
b. If not, where do you think they are from?
c. What did you notice about their clothing and style? Would you or your
friends dress like that?
d. Would people dress like that every day or just for special cultural
events?
[Play ad a second time after getting initial reaction, as needed.]
Okay, that’s great feedback! Let’s move on to the next ad.
[Moderator follows process for the remaining ads.]
[After playing all ads, moderator will engage participants in discussion about their
overall favorite and least favorite ad.]
3. Now that we’ve watched all the ads, I want to ask what you thought about them
overall.
Moderator Guide

Page 7 of 8

a. Which ad did you like the most? Why?
b. Which ad did you like the least? Why?
V.

CHECK OUT
Thank you for your time today. We appreciate you sharing your thoughts with us.
Make sure that you collect all of your belongings and turn in your folder containing
all of your completed worksheets from today. You can walk back to where you
signed in to check out. Thanks again!

[Have each participant check out by turning in their folder; make sure that all necessary
documents are in the folder. Participant will initial the Participant Check Out Form
indicating that they have received their $25 incentive and the adult who provided
transportation for the participant will initial the Adult Check Out Form indicating that they
have received their $25 payment. For each discussion group, there should only be one
Participant Check Out Form and one Adult Check Out Form for administrative purposes.
Upon completion of group, organize all completed documents. The team should have a
complete folder for each participant.]

Moderator Guide

Page 8 of 8