Table 3.
Focus group themes, subthemes, and quotes, CV Health and Needs Assessment Qualitative Study.
| Themes and subthemes | Illustrative quotes | |
|---|---|---|
| 1. Question improvement | ||
| Questions on physical activity | “. . . Page 4, Question 16, ‘How much time do you usually spend sitting. . .’ It’s a fine question but I think it should be broken up between work and non-work time, which may be a little clearer for folks, some other people that are going to take the survey. . .” (Male, 55) | |
| “. . . of the things on the exercise part that was confusing to me was it said “Does your work involve moderate intensity activity such as brisk walking?. . . walking to and from is part of my commute. . . I don’t see any place where that goes. . .” (Male, 49) | ||
| Questions on eating | “[Question reads] ‘During the past month, how often did you eat the following? Please fill the number of times per day, per week, per month’. . . I thought that once you start getting down to the itemized items [types of foods] that they were grouped too much together. . .” (Female, 59) | |
| “[One question asks about] ‘foods prepared outside of the home’, then you talked about breakfast, lunch and dinner [in] places such as McDonalds [in another question]. . . I didn’t understand why some [fast food] restaurants are listed but are not part of the previous question [about foods prepared outside of the home]. . .” (Male, 49) | ||
| Questions on drinking | “. . . [the question on drinking] ‘regular soda’, there is nothing about coffee on here, If I’m a coffee drinker, would that go under any of these categories as far as drinks on the first page?” (Male, 49) | |
| “. . . I see soda and pop [consumption are asked about] in here and those are typically caffeinated so we might want to add coffee and then specify, categorize it as caffeine drinks, to see how much caffeine people are [drinking]. . .” (Female, 43) | ||
| Formatting scales/responses | “Page 10 question 47 and when I take surveys, I like to have the survey broken up a little bit and I think 47 is a great place for you to consider using a. . . scale. . . sometimes people may have difficulty saying well, the overall healthcare you receive, I could give it a grade” (Male, 55) | |
| “And on page 14, 62, and 65, it was confusing to me. . . not clear if you want one answer or multiple. . . indicate what more. . . ”How did you try to lose weight?”. . .” (Female, 59) | ||
| “Question 52 in the weight history, where it had the pictures of the men and the women; that was a little confusing for me. . . pictures when it asks me if I want to look like. . . I don’t want to look like any of them. . . I’m just not sure how to judge these pictures. . .” (Male, 49) | ||
| “I think it’s about the graphics at the end of the day. . . giving them more a real picture of an actual person. . .” (Male, 28) | ||
| Consistency/timing of questions | “Well the first sentence just confused me, because it said the past month, I wasn’t sure if that was inclusive of today, the last thirty days or previous month. . .” (Male, 49) | |
| “Well some of the questions later on said the “the last 30 days” and you know, you could put the word inclusive or not you know ‘the last 30 days including today, or the last 30 days not including today’” (Male, 49) | ||
| Clarifications of definitions | “And with the drinking [alcohol] piece. . . that might be one you want to add “Elect not to answer”, just add that in and you’ll know that there’s some issue with answering the question, rather than somebody just saying “No” when they may be a drinker and because this is being conducted in a church. . . may elect not to answer. . .” (Female, 59) | |
| 2. Suggestions for additional questions | ||
| Health behavior–related questions | “. . . you don’t ask any questions about sexual activity, and if it is. . . if you have some cardiovascular issues, is that important or not?. . . but you don’t address it for a person who’s taking a medication or maybe taking something for erectile dysfunction or, is that, I think those things, when I heard, affect your heart. . . ” (Male, 55) | |
| “I would like to see questions related to, on the survey, how often, if you are on Lipitor for cholesterol or blood pressure meds, if people are. . . I mean how consistent you are with taking your meds. . . I know for myself. . . [I]was in denial. . . and I elected not to take the meds. . . if I increase my exercise and modify my diet, I don’t have to take these pills. . . other than just saying “I’m hopeless; I just have to take these pills, there is no other alternative”. . . so I don’t want to feel hopeless like “I have to take these meds to live”, there’s ways, things that I can do, to offset that, until such time as that doesn’t work anymore and I have to take the meds. . .” (Female, 59) | ||
| “You ask about cigarettes and drinking but you don’t ask about marijuana or electronic cigarettes or other products. . . crack or cocaine use or things like that. . . and I think, you know, narcotics and other substances should be covered. . .” (Male, 49) | ||
| Complementary alternative medicine (CAM)–related Questions | “You know, I think because like [says names] can be an in-class example of how people tend to think about their circumstances when they’ve been diagnosed with high cholesterol or diabetes and high blood pressure, and the list starts mounting up of things that you’re getting as you’re getting older, I think questions in there that gear towards holistic alternatives and other things that you can do to offset, I think those questions being built would help. . . ” (Female, 59) | |
| “But you should ask what alternative meds we are taking. . . because you should track what kind of vitamins, how many aspirins, like, I would take a daily aspirin even though the doctor hasn’t told me to be on an aspirin regimen, I might do my own little aspirin regimen just because. . . those are the kind of things you probably want to track. . .” (Male, 49) | ||
| Questions on self-efficacy | “But the reason I’m doing it is because I’m trying not to take medicine. . . she makes a good point in that we’ve been prescribed medicine but we don’t want to take it and we’re taking alternatives so we don’t have to take it. . .” (Male, 49) | |
| “. . . I feel hopeless [when] I’m stuck on taking something the doctor has prescribed because [I think] there is no other alternative when. . . there is” (Female, 59) | ||
| 3. Community-specific issues | ||
| Potentially sensitive topics | “I did have a comment. . . under 19 tobacco and only because. . . that your target audience would be churches and, even though the survey is confidential, you pose the risk of not getting a true answer. . .” (Female, 43) | |
| “Well I think it. . . again, if this survey is going to be put before the church you typically targeting the church, you will fall into what [says name] talked about in terms of drinking, if people aren’t married and that kind of thing, you may not get a true answer [when asking about sexual activity]. . .” (Female, 59) | ||
| Suggestions for tailoring to the community | “I don’t think [the questions were too long]. . . I think those were solid questions. . . in this case, longer may be better because you want to get as much info from them as possible. . .” (Male, 55) | |
| 4. Skip logic of questions | ||
| “. . . when you asked the question. . . and you answer no and it says go to question 20, well I went immediately to question 20 and didn’t think I should have answered all the other questions in between. . . but then as I started reading back [and realized], some of the other [questions], like question 4 addresses a different level of activity. . .” (Female, 43) | ||
| “I have one [says name]. . . Question 44 and 45, if you answer 44 positively “If you do go to a clinic or health center regularly” then 45 is not applicable; 45 says “What’s the main reason you do not have a usual source of medical care?” well if you answer “I do have a source” in 44, then 45 is not applicable.” (Male, 70) | ||