SATIS-PHI/CRC Postintervention Practice Focus Group Guide
Hello. My name is ______________________ and I am the moderator for today's 30-minute group discussion. My colleague, ______________________, is here to take notes and help the session run smoothly. Our main purpose today is to discuss colorectal cancer screening in your practice.
[INSERT HERE: INFORMATION ON WHY YOU ARE CONDUCTING THIS FOCUS GROUP]
Your practice participated in this intervention, and we would like to talk with you about the intervention and how you think it may have affected you, this practice, and the practice's patients. Your input is important to help us understand how the intervention functioned and what we can do to improve it.
I want to thank you for coming in today to talk with us and for fitting this session into your already busy schedules.
The session is being recorded in audio to make sure our notes accurately reflect our discussion with you. It doesn't matter who says what; I only care what gets said. Does anyone have concerns about taping this session?
Notes will also be taken during the discussion today, but they will not include any identifying information about the group's participants.
Your decision to participate is voluntary. Before we begin, I would like to hand out this consent form for you all to sign, if you still would like to participate in our discussion. [Hand out informed consent, and collect after obtaining signatures]
- Are there any questions about your participation?
- If you do not want to participate, please take this time to gather your things and leave the room. We appreciate your interest.
A few guidelines before we start:
- What you say in this room stays in this room. As I mentioned, all information discussed today will be held in confidence. So please feel comfortable in speaking openly and candidly with us.
- Please talk one at a time.
- Talk in a voice as loud as mine.
- Avoid side conversations with your neighbors, but it is okay to "piggy back" on comments others have made. Just be sure to talk loud enough so the whole group can participate.
- Make sure everyone has a chance to talk.
- There is no one point of view, so please allow all points of view to be heard.
- Say what you believe. It doesn't matter whether anyone agrees with you.
Are there any other questions before we begin?
Before we begin, does everyone know each other? [If not, do self-intros with first names only]
Theme 1: Overall Impression of/Satisfaction With the Intervention
- Describe to me your overall impression and level of satisfaction with this colorectal cancer screening intervention?
- What do you understand this intervention to be? [NOTE: Briefly describe the intervention if it appears subjects don't have a good understanding of it]
- What do you think worked well?
- What do you think didn't work well?
Theme 2: Perceived Impact of the Intervention on You (especially targeted to clinicians)
- How, if at all, would you say the intervention affected you or your behavior regarding CRC screening and followup?
- Has this intervention affected your understanding of CRC screening guidelines?
- Has this intervention affected your understanding of appropriate CRC screening followup procedures?
- Has this intervention affected which patients you recommend CRC screening to or how you recommend it or talk with them about it [the nature or content of your discussions]?
- Has this intervention affected which patients you recommend a CDE followup to or how you recommend it or talk with them about it [the nature or content of your discussions]?
- Has the intervention affected how often you recommend CRC screening or CDE?
- Are there any other ways this intervention affected you or your behavior regarding CRC screening and followup?
Theme 3: Perceived Impact on Patients
- As part of the intervention we conducted, we sent your eligible patients information on CRC screening and an invitation to be screened.*
- Did patients contact you or the practice about the intervention or any of the materials we sent them? Also, did patients talk with you about the intervention or materials during any office visits?
- If yes, what did they ask about or want to know?
- What did you tell them?
- How, if at all, did the intervention appear to influence your patients' awareness of or attitude toward CRC and screening for it?
- How, if at all, did the intervention appear to influence their behavior?
- Do you think either the intervention or the new 2008 Colorectal Cancer Screening Guidelines played a role in their decision about getting screened?
- What do you think your patients thought of the intervention material and the screening invitation? How satisfied or dissatisfied did they appear to be with it?
Theme 4: Perceived Impact on the Practice
- In general, how, if at all, did the intervention affect this practice?
- Who, if anyone, in this practice did it affect? How did it affect them?
- How, if at all, do you see this intervention benefiting or having positive effects on this practice? [Probe for economic, reputational, efficiency, or other types of benefits]
- How, if at all, do you see this intervention negatively affecting this practice? [Probe for economic impact, reputation, interference with processes, overuse of providers' or staff's time, or other types of negative effects]
Theme 5: Process Improvement and Maintenance
- Describe to me what it was like to adopt and implement this intervention in your practice.
- What were the interventions' strengths?
- What were the interventions' weaknesses?
- Based on your experience, if we wanted to introduce this CRC screening intervention into other practices:
- What, if anything, would you suggest we do differently and why?
- What, if anything, would you suggest we do the same and why?
- What, if anything, would you suggest we do to improve the way this screening intervention affects:
- Practitioners/clinicians? Practice staff?
- The practice overall?
- The practice's patients?
- How, if at all, do you see this intervention and your experience with it having changed your and this practice's approach to CRC screening and followup? [Probe: What, if anything, from the intervention have you or this practice adopted to use on your own? If nothing was already adopted, what would be required for you and your practice to adopt this intervention approach on your own in the future?]
- If we were to come to you in a year or so and ask you and this practice to once again participate in a screening effort using this intervention approach, would you or would you not agree to participate again? Why?
- Would you encourage other primary care practices or other organizations that work with practices to adopt this intervention approach on their own? Why?
- Would you encourage other primary care practices to participate in screening programs that use this intervention approach? Why?
* If anyone asks, eligibility criteria were: average-risk patients (no known personal or family risk factors for CRC), age 50-79, with no evidence of up-to-date screening (as defined by current screening guidelines for CRC), a known mailing address, and a visit to the practice within 2 years.
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