DOI: 10.3886/e120105v2
title: Qualitative Study of Gutka and Paan Masala Use among Bhutanese and Burmese Migrants

description: The interview and focus group data for this study were originally collected as a part of a community program related to substance use prevention among youths from immigrant or refugee backgrounds. The focus groups were conducted at the Center for Pan-Asian Community Services (CPACS), a non-profit organization located in Doraville, GA, and assisted by the Georgia Team Empowerment (GATE) coalition, a substance abuse prevention coalition within CPACS that works with Latino and Asian Pacific Islander (API) communities throughout the greater Atlanta, GA area including the cities of Chamblee, Clarkston, Doraville, and Sandy Springs. Participants were selected at two after-school sites in Clarkston, targeting both youths (aged 9-17) and adults (aged 18+) from Bhutan and Burma. Focus group and interview questions were piloted with community members from late December 2017 to January 2018 (i.e., prior to the start of the study) to evaluate whether the questions were sufficiently culturally sensitive and appropriately understood. After interview questions were piloted and refined, focus groups and interviews were held in January 2018 and continued through April 2018. A total of 122 participants were recruited for the focus groups. Twenty-one focus groups (stratified by ethnicity and age group) were conducted, each with at least four to eight participants, lasting from 15 to 60 minutes. The aim of the focus groups was to explore community members’ knowledge and perceptions of harm of gutka and paan masala, patterns of and reasons for use, availability of and access to gutka and paan masala, and resources for prevention and cessation. The Principal Investigator (ED) served as the only interviewer; she had previous training in qualitative interviews through coursework in her Master’s in Public Health degree. CPACS interpreters who were fluent in English as well as the target language(s) were present during focus groups to assist with translation. The interpreters had been trained in qualitative interviewing and had experiences conducting interviews and focus groups in previous programs and evaluations. During focus groups, CPACS interpreters translated the questions from the interviewer to the target language(s) for focus group participants. Then, interpreters summarized the responses from focus group participants and translated them to English for the interviewer.<br><br>Eleven key informant interviews were conducted in from February 2018 to April 2018. The Principal Investigator (ED) served as the only interviewer. Interviews were held with several community members and leaders, local store and business owners, and local law enforcement officers. Interviews lasted between one-half and one hour each and were conducted in-person. A total of 7 interviews were conducted in English and 4 interviews were conducted in the target language(s). For interviews conducted in the target language(s), CPACS interpreters were present and facilitated translation in a similar manner to the focus groups. Interview questions explored knowledge of risk for each ingredient that is included in gutka and paan masala, personal use, and knowledge of any efforts or policies in the community directed at gutka and paan masala.