Statement of Need

______________________________________________________________________________

DATE: December 11, 2009

TO: Seleda Perryman, HHS

FROM: Sean Arayasirikul, ODPHP

RE: Request for Clearance of Individual Study regarding OMB No. 0990-0281. Healthy People 2020 Consortium Member Assessment to Support the US Department of Health and Human Services (DHHS) Healthy People 2020 Initiative, Submission #2

______________________________________________________________________________

Statement of Need

Healthy People is the ten-year prevention agenda for the Nation. The initiative has been ongoing for 30 years and serves as a tool that identifies the most significant, preventable threats to health and focuses federal, public and private sector efforts to address them. Healthy People 2020 is the fourth in the series of Healthy People agendas. This proposed study is essential to the formative planning process for the overall development of a Healthy People 2020 communication strategy – including a website – that is tailored, appropriate and effective.

The Healthy People Consortium (Consortium) has been the public and private sector voice for Healthy People for the past two decades. It is currently made up of over 1,200 agencies and organizations who are partnering with DHHS to help achieve the goals and objectives of Healthy People 2020. The Consortium is an asset to DHHS by helping to expand the reach of Healthy People’s information and activities to the state, county, community, tribal and territorial levels. To provide Consortium members with the information and resources they need for effective networking and communication, ODPHP must hear from them to fully understand what their unique needs are related to Healthy People 2020. This assessment is an important step in our formative planning process that will allow ODPHP to gather information that can be used to develop an effective communication plan. This survey is formative, solely to inform the Healthy People 2020 communication strategy. No generalizations will be made to a larger population.

The Healthy People 2020 web site will play an integral role in the communication strategy of Healthy People 2020. The Healthy People 2020 website will be a central hub to share resources, tools, information and relevant public health data with the public at-large. The Healthy People web site design will be a user-centered process. Because of the diversity of Healthy People stakeholders, it is important to gather input early on in the web site design process to assess the accessibility, feasibility and appropriateness of the how the web site is configured and what functions are useful. Focus group sessions with state, local and community-based health professionals will explore participants’ reactions to the overall web site’s format and design, the perceived value of organizational elements, functionality, accessibility and usability of content. Gathering feedback will ensure that the web site, and the information contained within it, is as accessible, usable and valuable as possible in helping community professionals and organizations to work together to improve the health status of their residents.

Intended Use of Information

The information collected will be used to:

• Identify the different sectors represented by Consortium members – areas where membership is strong as well as gaps where membership is lacking or not well represented.

• Determine the appropriate resources ODPHP needs to provide to Consortium members to help them effectively network and communicate with their partners, other Consortium members, and ODPHP.

• Share aggregate findings with the Outreach Subgroup of the HHS Federal Interagency Workgroup who will assist in developing the Consortium networking and communication plan.

• Provide feedback to website developers and to ODPHP on the appearance, format, utility, functionality, ease of use, clarity and content of the Healthy People web site.

• Share findings with ODPHP on their target audiences’ use of existing web sites and web-based information and their current use and perceived value of the Healthy People web site strategy. This information will be used in the overall redesign of the web site and its tools and resources.

Description of Participants

Consortium Member Assessment: Currently, there are approximately 1,200 Consortium members with representation from various levels and sectors. These include agencies and organizations from the federal, state, county, local/community, tribe and territorial levels across the U.S. Sectors represented include professional organizations, health departments, academia, government, corporate/business, non-profit organizations, community-based organizations and a catch-all category of “other.” Participants will be adult men and women who work in these agencies or organizations. All races and ethnicities will be eligible for participation. English should be their primary language.

Healthy People 2020 Web Site Design: We will conduct 6 focus groups and 12 interviews with health professionals and consumers who work at the State, Local and Community levels. Thirty participants will be involved in a total of 6 focus group sessions (5 participants per focus group session) and 12 participants will be interviewed. A total of 42 people will be participating in providing formative data to help design the Healthy People web site. Participants will be recruited from existing ODPHP contacts with stakeholders and their professional organizations. This includes organizations representing State, local and community-based health professionals. The screening instrument will include questions regarding their urban/rural status, as well as characteristics about the organization they represent and their specific job title and responsibilities. The focus groups and interviews will be segmented by whether the professional works at the state, local or community level (see Tables 1 and 2). For clarification purposes, state level refers to professionals planning for statewide activities, local professionals would work in organizations that are funded and connected to the state Health Departments, and community professionals would work in community based organizations. Each group would include a mix of professionals, from diverse geographic regions, and diverse urbanicity. All participants will have access to the internet through their place of employment. Assignment to the audience segments and the corresponding focus groups will also be accomplished during the recruitment and screening process. Participants will be adult men and women who work in these agencies or organizations. All races and ethnicities will be eligible for participation. English should be their primary language.

Table 1. Focus Group Segmentation

Level	Number of Focus Groups	Number of Participants per Focus Group	Total Number of Participants
State	2	5	10
Local	2	5	10
Community	2	5	10
Total			30

Table 2. Face-to-Face Interviews Segmentation

Level	Number of Participants
State	4
Local	4
Community	4
Total	12

Information Collection Procedures

Consortium Member Assessment: The Consortium Member Assessment will be designed, and information collected and analyzed using the Survey Monkey software. Information about Survey Monkey can be found at http://www.surveymonkey.com/. This software is an online survey tool that enables people to create their own surveys quickly and easily. It provides ODPHP flexibility in the creation and management of the Consortium member assessment.

ODPHP will work with Survey Monkey staff to design the assessment in a format that is user-friendly, easy and quick for Consortium members to complete. Survey Monkey’s expertise in designing surveys will save ODPHP time and money from the iterative nature of survey design. The assessment consists of eleven questions that should take members no more than 10 minutes to complete. We expect an approximate 50% response rate. Members will be informed that completion of the survey is voluntary and that only aggregate results will be collected. Once the assessment is designed, a link will be created and sent to Consortium members via the Healthy People Consortium listserv which has been established through the National Institute’s of Health Listerv services. Consortium members will click on the link which will take them directly to the survey.

Survey Monkey ensures data security and confidentiality. According to their website, “We employ multiple layers of security to make sure that your account and your data will be kept private to the extent allowed by law. We employ a third-party firm to conduct daily audits of our security, and your data resides behind the latest in firewall and intrusion prevention technology.”

The Consortium Coordinator will collect analyzed results and prepare a report describing the findings. The report will be shared with the Outreach Subgroup of the HHS Federal Interagency Workgroup who will assist in developing the Consortium networking and communication plan.

A copy of the Consortium assessment is appended to this packet.

Table 3. Consortium Member Assessment Description-Burden Hours

Type of Respondent	Form Name	No. Of Respondents	No. of Responses	Average Burden Per Respondent	Total Burden Hours
Consortium Members	Consortium Member Assessment	600	1	10 minutes	100 hours
Totals					100 hours

Healthy People 2020 Web Site Design: Recruitment and screening of participants for focus groups and interviews will be conducted over the telephone using lists of potentially eligible participants. Prior to the screening calls, the lists will already be segmented by organization level, geographic region, urbanicity and in many cases type of organization and target audience. During the screening calls, potential participants will be asked to confirm the information already gathered, and to provide answers to specific questions regarding their job titles and responsibilities and the target audience they serve. Those interested in participating will be asked to commit to a specific time for participation in telephone/online focus group or interview. They will be required to have access to the internet during the focus group and interview. We expect an approximate 25% response rate.

The focus groups and interviews will be conducted online allowing for the inclusion of people from diverse geographic locations. The term online focus group refers to groups that are conducted over the telephone (conference call style) while using computer-assisted technology (via the Internet) to enhance the discussion with visual displays. At a designated time participants call a telephone number that connects them to the group. Simultaneously, if there is a need to review any written material, a computer program is logged onto by each participant. The viewing of materials is controlled by the focus group leader which helps ensure that participants don’t get distracted by the materials. The focus groups and interviews will be conducted by a trained focus group moderator or interviewer. A consent form including a confidentiality statement will be signed and submitted by all participants. The consent form will display the OMB clearance number, expiration date, and burden disclosure statement. The focus group and interview moderators and will use the Moderator‘s Guide to facilitate participation and ensure that the data are collected as planned. The guide will be reviewed and approved by the ODPHP along with the consent forms and any other data collection materials.

Focus groups and interviews will test several concepts and cover the following topics:

• Use and perceived value of health information Web sites for community planning.

• Use and perceived value of Healthy People objectives for community planning.

• Feedback on format, accessibility and content of Healthy People Web site.

Each focus group will last approximately 120 minutes, and each interview will last approximately 60 minutes. Notes from the focus group discussions and interviews will be reviewed and analyzed to explore common and diverse themes with respect to the topics of interest, among participants from different organizational structures (state, local and community). IQ Solutions will prepare and submit a top line report describing the findings from the 6 focus group discussions and 12 interviews, including recommendations for the changes to the Web site or any of its components.

Information that could be used to identify individual participants will not be provided to ODPHP. No names will be associated with individuals’ comments in the top line reports. All information individually identifying regarding participants in the focus groups and interviews will be stored in a password-protected secure computer server at IQ Solutions. These files will be deleted one year after the end of the project, along with any printed participant lists used for the groups.

Copies of the focus group Participant Screener and Moderator’s Guide for the focus groups are appended to this packet.

Table 4. Web site Feedback, Focus Group Description-Burden Hours

Type of Respondent	Form Name	No. Of Respondents	No. of Responses	Average Burden Per Respondent	Total Burden Hours
Health Professionals	Screener	120	1	5 minutes	10 hours
Health Professionals	Focus Group Moderator’s Guide	30	1	120 minutes	60 hours
Totals					70 hours

Table 5. Web site Feedback, Interviews Description-Burden Hours

Type of Respondent	Form Name	No. Of Respondents	No. of Responses	Average Burden Per Respondent	Total Burden Hours
Health Professionals	Screener	48	1	5 minutes	4 hours
Health Professionals	Interviewer’s Guide	12	1	60 minutes	12 hours
Totals					16 hours

Incentive Justification

Consortium Member Assessment: No incentive will be offered for participation.

Healthy People 2020 Web Site Design: An incentive fee of $75.00 will be offered to recruit participants for the focus groups. An incentive fee of $50.00 will be offered to recruit participants for interviews. This amount is consistent with previously submitted requests under this clearance and is necessary to ensure that the required number of participants fulfills their commitment to participate in the focus groups and interviews, within the timeframe of the research study. If incentives of this amount are not offered, it will be difficult to secure a recruitment firm willing to collaborate and/or to secure individuals willing to participate. This would create significant risks to the budget and schedule associated with the study. The main problems are:

• Recruitment may take longer than anticipated and delay the study

• Research expenses for travel and data collection are higher if the focus groups need to be rescheduled

• Additional focus group costs will be incurred, if any of the groups have to be rescheduled due to an insufficient number of participants

To avoid these risks, ODPHP requests OMB approval to remunerate participants at the rate of $75.00 per focus group session and $50.00 per interview.

Justification for Proposed Collection Methodology

The proposed study attempts to determine how to best utilize the Consortium and web site in the overall communication strategy of Healthy People 2020. Broadly, the following formative research questions are aimed to determine the needs of the Healthy People audience and stakeholder. These research questions are:

• RQ1: How will Consortium organizations hope to benefit as a member of the Consortium?

• RQ2: How will Consortium organizations plan to use or implement Healthy People 2020?

• RQ3: How will Consortium organizations help increase visibility of Healthy People 2020?

• RQ4: What tools/resources would help Consortium organization network and communicate with other Consortium members, partners and DHHS?

• RQ5: How do users look for health information web sites, what types of media do they use, and which do they consider the most believable and trustworthy?

• RQ6: What is the perceived value of the Healthy People for users and how are they actually used?

• RQ7: How do users respond to the format of the Healthy People Web site, including its site map, search functionality, navigation, resources and tools?

As previously mentioned, ODPHP seeks clearance for conducting:

• A Consortium Member Assessment with 600 members, consisting of 11 questions that should take members no more than 10 minutes to complete.

• 6 focus group sessions, 5 participants per group, with a total of 30 participants; and

• 12 individual interviews.

Focus groups and interviews will be segmented by level of the represented organization. A mix of various health professionals from different types of communities will be invited to participate. Focus groups will be conducted online to include a geographically diverse group of professionals and to reduce the anticipated time and travel burden. The proposed number of participants and length of focus groups (2.0 hours each) and interviews (1.0 hour each) will maximize the use of available resources to ensure that sufficient data is gathered to form actionable conclusions for the proposed use of the information collected.

Estimated Response Burden

There is no screening for participants of the Consortium Member Assessment. Consortium members will receive an email and if they would like to participate at that point, they can immediately complete the assessment. The assessment of 11 questions should take no more than 10 minutes to complete. Of 1,200 Consortium members, we expect half or 600 members to complete the survey. So, the total estimated response burden for 600 members is 100 hours.

ESTIMATED TOTAL BURDEN HOURS for completion of the Consortium Member Assessment = 100 hours

Screening of potential focus group participants is estimated to take 5 minutes per respondent. We estimate a 25% response rate and intend to screen 120 participants in order to recruit 30 to participate in the focus group sessions. So, the total estimated response burden for recruiting 30 participants is 10 hours. The focus group sessions are designed to last 2 hours, for a total of 120 minutes per participant. Thus, the estimated response burden anticipated for 30 focus group research participants is 60 hours.

ESTIMATED TOTAL BURDEN HOURS for completion of the Focus Groups = 70 hours

Screening of potential interview participants is estimated to take 5 minutes per respondent. We estimate a 25% response rate and intend to screen 48 participants in order to recruit 12 to participate in the focus group sessions. So, the total estimated response burden for recruiting 12 participants is 4 hours. The interviews are designed to last 1 hour, for a total of 60 minutes per participant. Thus, the estimated response burden anticipated for 12 interview research participants is 12 hours.

ESTIMATED TOTAL BURDEN HOURS for completion of the Interviews = 16 hours

The cumulative number of hours used under OMB No. 0990-0281 is 203 hours.

APPENDICES [IN A SEPARATE FILE]

1. Healthy People 2020 Consortium Member Assessment

2. Focus Group and Interview Participant Screener

3. Focus Group Moderator’s Guide

4. Interviewer’s Guide

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