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Hepatitis C: Intervention Programming for Youth at Risk - Final Consolidated Report

Appendix C - Facilitators' Guide - Focus Groups

Introductions (15 minutes)

Introduce yourself and your colleague and explain the role of facilitator and reporter.

• Stress using our first names, and that it's OK to ask a question any time you want to.

Diana/Ellie and I are consultants for Health Canada. We've been hired to find out what the best ways might be to inform the youth who are most at-risk of hepatitis C about those risks and how to deal with them. What we're going to do today is to get your opinions and your advice on that. At the end of the session, we're going to ask you what you would do if you were in charge of designing a program to prevent the spread of hepatitis C. My job is to ask the questions, and Diana's job is to make notes about your answers and write a report that will go to Health Canada. No one will be identified in any part of the report, so feel free to say whatever you would like to.

• Explain participants roles:

Your job for the next two hours is just to be open and honest. You don't have to know anything about hepatitis C, and you don't have to be concerned about getting flak for anything you say. We just want honest responses to the questions we'll ask you. There are no right or wrong answers.

• Explain how the session will be conducted, and the ground rules:

I'll ask a question. But this is not like school where you have to raise your hand - we want this to be more like a conversation than a question and answer period. So if you want to talk - go ahead. I'll referee if we have a couple of people talking at once.
 
I've got a flipchart here, and might make notes while you talk. This is just a memory aid for me.
 
You should feel free to speak freely, and to express yourself the way you want to, and interact with me and with the others in whatever way you're most comfortable.
 
Any questions?

• Orchestrate introductions:

We're going to be talking together for the next couple of hours. That's generally easier to do when you know a little bit about the people you're talking to. So let' s take a minute for you to each introduce yourselves.

• Name
• Where you live.
• and just for fun, if you had a million dollars, how would you spend it?

Question 1:
What's important to you? What stresses you out? What about health issues? (15 minutes)

What kinds of things stress you out? What concerns do you have?

Are any health issues important to you? If so, what are they and why are they important to you? And listen - when I say "any health issue" - I really mean ANY issue, whether it's kind of mainstream, like safe sex, or mainline, like what are the safest injection practices.

Be ready to prompt if they want to know what a health issue is: SARS, AIDS, vegetarianism, cloning, genetically-engineered food, drug abuse, methadone programs, etc.

Do you take any actions, - do you DO anything, or NOT do some things, because of your concern? What?

If they have no health issues, ask them:

What about personal safety? Are there any things that you go out of your way to do, or not to do, related to safety?

Question 2:
What Do You Know About Hepatitis C? How important is it? (15 minutes)

No one mentioned hepatitis C as a health concern. Have you ever heard of it? What have you heard?

OR

A couple of people mentioned hepatitis C. Can you tell me what you guys know about hepatitis C?

Use pre-printed flipchart to give them key facts about hepatitis C.

No lectures, I swear. But I need to give you a couple of key facts to get some feedback from you. Here are some key facts about hepatitis C.

Review flipcharted info.

After covering how the virus is transmitted:

I talked earlier about youth who are most at risk of contracting hepatitis C. It's youth who are involved in this stuff that are most at risk. That means that many youth who live on the streets are at risk. But so are other youth who engage in these practices, regardless of where they live.

Complete the review of the flipcharted information.

Now that you have this information - what's your take on this? Would you go out of your way to take steps to avoid getting hepatitis C? Why, or why not?

Question 3:
Good Messengers? (15 minutes)

For this and all sorts of other projects, Health Canada needs to know who youth at risk are most likely to listen to, trust, and respect, so that they can get those people involved in getting health messages out to others. Can you tell us who those people are likely to be? And this could be ANYONE youth at risk are likely to come into contact with, like:

• other youth
• staff at public health clinics
• people at food banks or soup kitchens
• staff at drop-in centres
• tattoo artists
• used music dealers
• ANYONE

So: Who is both cool and trusted?

If they say they can't generalize this to a "class of person" get some of them to describe the people they DO trust, and what it is that makes them trustworthy.

Question 4:
Best Way to Package the Message? (30 minutes)

Admin instruction:

On a table to the rear or side of the room, arrange printed materials. If a video or videos are available, have that set up.

Health Canada may decide to develop some information products for youth at-risk. We'd like you to give us some advice about the kind of products they are most likely to consider.

So what I want you to do now, is just take a few minutes to look at the material we've displayed here. Feel free to talk to each other, or to grab something to eat or drink while you do this. We want to know if there's anything you see that you really like or really hate, and any insights you can give us on why you like or dislike something would be appreciated. You don't have to do a lot of note-taking, but if you could just make notes about the titles of stuff you like or dislike it would be helpful.

I'll give you about 10 minutes to schmooze through this stuff, and then we'll talk about it.

Give them 10 - 15 minutes, then reconvene.

Ask: Did any of you see anything you liked? Promote a general discussion, and probe as required to elicit this kind of information:

• Might you actually take this product if it was available to you?
• Any particular type of size, graphic design, or style of language, that works better than others?
• Note that you will probably also encounter significant information about products youth disliked during this discussion.

Ask: Did you see anything you found particularly bad? Promote the same sort of general discussion as above.

Question 5:
Best Way to Carry the Message? (15 minutes)

There are a couple of ways Health Canada could use to get information about hepatitis C to youth at risk. They could: (show 4 pre-flipcharted options):

• make sure that people that you trust and respect know about hepatitis C, and trust them to kind of informally educate youth. These people could be youth themselves.
• make information products, like brochures, pamphlets, videos, websites available at places where youth at-risk hang out, and hope they pick up on the information.
• use both of these approaches: enlist the people you trust, and give them information they can turn the youth on to.
• use other approaches like street theatre, puppet shows, comic books, etc.

Which of these approaches do you think would work best, and why? Or can you think of another approach you think might be better than any of these?

Question 6:
Pulling it All Together (15 minutes)

Health Canada wants to design a program for youth at-risk, on hepatitis C. They'll be factoring your opinions into any program they design. But here's your shot at giving them even more direct guidance. If you were designing a program to create awareness of and help prevent the spread of hepatitis C among youth at-risk, what would your program include? How would it work?

As ideas arise, cross-reference as appropriate to clarify other opinions voiced throughout the session. Example:

• a couple of people really liked the idea of installing computers at drop-in centres, so that some key websites could be visited. But you haven't mentioned it here. Why is that?

Closing

OK guys - we've now asked all the questions we wanted to put to you.

Are there any questions you want to ask us, before we wrap up?

Many thanks to participants, and then give them whatever admin information is required.

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