__________________________________________________________________________
DATE: April 22, 2010
TO: Seleda Perryman, HHS
FROM: Sandra Hilfiker, Health Communication Advisor, ODPHP
RE: Request for Clearance of Individual Study regarding OMB No. 0990-0281. Formative Research for Spanish-language Quick Guide to Healthy Living, Submission #4
______________________________________________________________________________
Because more than 30 million U.S. residents speak Spanish at home, Spanish is easily the second most common language used in the United States (U.S. Census Bureau). ODPHP has maintained a Spanish version of healthfinder.gov (www.healthfinder.gov/espanol) since 1999. We recognize the importance of providing Spanish language resources that are easy to navigate and use. In the 2008 September launch of the redesigned healthfinder.gov, ODPHP released the new Quick Guide to Healthy Living (QGHL), which provides the public with actionable prevention information that is easy to understand and navigate. Due to limited resources, the Quick Guide includes only English content.
To better serve audiences with limited health literacy and the health professionals and intermediaries who serve them, a Spanish Quick Guide to Healthy Living will be incorporated into the healthfinder.gov Web site. Spanish content will be developed through formative evaluation and iterative design to ensure it is culturally appropriate, understandable and actionable for Spanish-speaking audiences in the U.S.
This request for clearance is to gather the necessary information that will be used to inform the development of an effective Spanish-language QGHL. Our formative research consists of three phases, explained below:
Phase I: Card Sort Exercise (via focus groups) – Inform the organization/structure and priorities of information/content for the Spanish-language QGHL;
Phase II: Paper Prototype Testing ( via focus groups) – Test sample content language and its look and feel (including the tone) to be included in the Spanish-language QGHL; and
Phase III: Usability Testing (via one-on-one interviews) – Test the design, content, and functionality of the Spanish-language QGHL.
IQ Solutions, Inc. (IQ) will conduct the formative research, which includes the card sort, paper prototype testing, and usability testing, and summarize and interpret results in a report. Oversight for this research is provided by Sandra Hilfiker, Health Communication Advisor, ODPHP.
Spanish-speaking participants will be eligible for participation. Participants will be between 18 and 65 years old. All research participants for the three phases of the proposed formative research will meet the following criteria as proxy measures of limited health literacy:
Have a high school education or less,
Report an annual household income below $40,000; and
Have
not searched for health information online in the past year.
Recruitment and screening of participants for focus groups and interviews will be conducted over the telephone, working with recruitment facilities and/or community-based agencies in the Washington, DC, area and Chicago to identify appropriate research participants. The screening of each potential participant is estimated to take 5 minutes. We expect an approximate 25% response rate and will screen 96 individuals to recruit 24 focus group participants (6 participants per focus group, resulting in 4 focus groups in total) Each of the four focus groups will last 2 hours (120 minutes). An incentive fee of $75 will be offered to recruit participants for the focus groups and one-on-one interviews.
Table 1. Card Sort Exercise Description – Burden Hours
Type of Respondent |
Form Name |
No. Of Respondents |
No. of Responses |
Average Burden Per Respondent |
Total Burden Hours |
Focus Group Participant |
Screener |
96 |
1 |
5 minutes |
8 hours |
Focus Group Participant |
Spanish QGHL Card Sort Moderator Guide |
24 |
1 |
120 minutes |
48 hours |
One-on-One Interview Participant |
Screener |
32
|
1 |
5 minutes |
2.67 hours |
Totals |
|
|
|
|
58.67 hours |
Each research participant will sign an informed consent form. The consent form will display the OMB clearance number, expiration date, and burden disclosure statement. The focus group and interview moderators will use the Moderator‘s Guide to facilitate participation and ensure that the data are collected as planned.
The Card Sort Exercise will provide information that will help ODPHP:
Determine target audience-informed ways to appropriately categorize and label multiple QGHL topics.
Determine which QGHL categories interest target audience members most.
Determine how audience members might prefer to rank core prevention content in terms of usefulness.
The Card Sort Exercise (2 hours) will be administered in-person to 24 participants. Twenty-four (24) participants will form four focus groups of six individuals each. Each focus group will break into three teams of two. A moderator will sit with each pair as they sort cards and will record participants’ thoughts (as they talk out loud while they are sorting) and ask questions as the pair makes certain decisions.
The Card Sort Exercise will provide information on organization/structure and priorities of information/ content for the Spanish-language QGHL. The Card Sort Exercise will test several concepts and include the following tasks:
Organization of topics into groups. We will give participants the QGHL topics (pre-translated into Spanish) as they are in the English QGHL then give participants the opportunity to switch around topics in categories, add topics (with blank cards), and change headers. The objective of this task is to identify the groupings that resonate with the target and explore why the groupings were made the way they were made.
Assignment of a category name to each group. We will ask participants to assign an overall or broad name to each of their assembled categories. The objective of this task is to determine the categories that resonate most for the target audience. The moderator will explore the reasons behind the selected category names.
Selection of the top (and bottom) three categories. We will ask participants to rank the 3 categories (of the categories created by participants from the exercise described above) that are most important to them and explain why they are, and ask what categories are their 3 least favorite or important, and why. This will provide insight into ways to organize and prioritize content and information in the Spanish-language QGHL.
Rank core prevention content. We will give each pair of participants a series of cards that briefly describe (in bullet points) the kind of content they might find under an individual topic and ask them how information could best be ranked so it will be most logical and useful to them.
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. IQ Solutions will prepare and submit a top line report describing the findings from the 6 focus group discussions. 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.
Copies of the Participant Screener and Spanish QGHL Card Sort Moderator Guide for the focus groups and one-on-one interviews are appended to this packet.
Recruitment and screening of participants for focus groups will be conducted over the telephone, working with recruitment facilities and/or community-based agencies in the Washington, DC, area and Chicago to identify appropriate research participants. The screening of each potential participant is estimated to take 5 minutes. We expect an approximate 25% response rate and will screen 160 individuals to recruit 40 focus group participants (8 participants per focus group, resulting in 5 focus groups in total). Each of the five focus groups will last 2 hours (120 minutes). An incentive fee of $75 will be offered to recruit participants for the focus groups.
Table 2. Paper Prototype Testing Description – Burden Hours
Type of Respondent |
Form Name |
No. Of Respondents |
No. of Responses |
Average Burden Per Respondent |
Total Burden Hours |
Focus Group Participant |
Screener |
160 |
1 |
5 minutes |
13.33 hours |
Focus Group Participant |
Spanish QGHL Paper Prototype Testing Moderator Guide |
40 |
1 |
120 minutes |
80 hours |
Totals |
|
|
|
|
93.33 hours |
Each research participant will sign an informed consent form. The consent form will display the OMB clearance number, expiration date, and burden disclosure statement. The focus group and moderators will use the Moderator‘s Guide to facilitate participation and ensure that the data are collected as planned.
Paper Prototype Testing will provide information that will help ODPHP:
To get feedback from target audience members on existing QGHL content (specifically the QGHL landing page and one pre-selected QGHL topic);
To seek target audience members’ reactions to different potential formats for the Spanish version of the QGHL;
To seek target audience members’ reactions to popular additional features to the QGHL, as identified by the in-depth interview (IDI) testing; and
To evaluate participants’ levels of engagement, self-efficacy, applicability, and acceptability.
We will fully translate/adapt into Spanish one QGHL topic within one category (“Eat Healthy,” within “Nutrition and Fitness”), develop a mock QGHL landing page for the Spanish version, and produce a paper prototype of these web pages for target audience members’ reactions. The Paper Prototype Testing will test sample content language and its look and feel (including the tone) to be included in the Spanish-language QGHL. The Paper Prototype Testing will test several concepts and include the following:
To assess the appropriateness of the literacy level, terminology, and level of difficulty of the content;
To collect feedback on the tone, style, length, and level of detail of the content;
To identify content format preferences (e.g., number of bullets);
To explore the type of tools and resources that might interest target audience members;
To assess comprehension of the specific topic selected—“Eat Healthy”—by, for instance, asking individual participants to locate specific information and to describe the information in their own words;
To determine how audience members might prefer to “chunk” content within the “Nutrition and Fitness” topic and assess effectiveness of current ways of “chunking”;
To determine preferences for potential format options of the Spanish-language QGHL;
To gain insight into the specific information the target audience expects with regard to photographs/pictures and stories/quotes/testimonials;
To assess interest in receiving health information via mobile/cell phones, as well as to test 2-3 mobile concepts with users (to be developed later);
To identify the target audience’s need and/or desire for these features;
To determine the perceived effectiveness of these features toward motivating the target audience to action; and
To evaluate participants’ levels of engagement, self-efficacy, applicability, and acceptability.
Notes from the focus group discussions will be reviewed and analyzed to explore common and diverse themes with respect to the topics of interest, among participants. IQ Solutions will prepare and submit a top line report describing the findings from the 5 focus group discussions. 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.
Copies of the Participant Screener and Spanish QGHL Paper Prototype Testing Moderator Guide for the focus groups are appended to this packet.
Recruitment and screening of participants for usability testing one-on-one interviews will be conducted over the telephone, working with recruitment facilities and/or community-based agencies in the Washington, DC, area and Chicago to identify appropriate research participants. The screening of each potential participant is estimated to take 5 minutes. We expect an approximate 25% response rate and will screen 96 individuals to recruit 24 individuals to participate in usability testing one-on-one interviews. Each one-on-one interview will last 2 hours (120 minutes). An incentive fee of $75 will be offered to recruit participants.
Table 5. Usability Testing Description – Burden Hours
Type of Respondent |
Form Name |
No. Of Respondents |
No. of Responses |
Average Burden Per Respondent |
Total Burden Hours |
One-on-one Interview Participant |
Screener |
96 |
1 |
5 minutes |
8 hours |
One-on-one Interview Participant |
Spanish QGHL Usability Testing Moderator Guide |
24 |
1 |
120 minutes |
48 hours |
Totals |
|
|
|
|
56 hours |
Each research participant will sign an informed consent form. The consent form will display the OMB clearance number, expiration date, and burden disclosure statement. The focus group and moderators will use the Moderator‘s Guide to facilitate participation and ensure that the data are collected as planned.
Usability Testing will provide information that will help ODPHP:
To determine how target audience members use and navigate a clickable mock Spanish-language QGHL site;
To determine how target audience members use interactive features on the mock Spanish-language QGHL site;
To assess the self-efficacy, engagement, acceptability and applicability of the content for users.
Usability Testing test the design, content, functionality of the Spanish-language QGHL. We will ask participants to “think aloud” while performing the tasks. It will test several concepts and include the following:
The completion of tasks such as browsing, searching, and navigating to specific information;
An evaluation of individual participants’ ability to navigate tabs, buttons, and labels, as well as their ability to view various topics and to use special features of the site;
A walk through test of the individually tailored myhealthfinder tool;
Mobile health concepts (both to gauge interest and to test new concepts that would be interesting, unique, and motivating)
An evaluation of participants’ levels of engagement, self-efficacy, applicability, and acceptability.
Notes from the one-on-one interviews will be reviewed and analyzed to explore common and diverse themes with respect to the topics of interest, among participants. IQ Solutions will prepare and submit a top line report describing the findings from the one-on-one interviews. 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 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.
Copies of the Participant Screener and Spanish QGHL Usability Testing Moderator Guide for the one-on-one interviews are appended to this packet.
An incentive fee of $75 will be offered to recruit participants for all three phases of formative research. This amount is consistent with previously submitted requests under this clearance and is necessary to ensure that the required number of participants fulfill their commitment to participate in the focus groups 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 that ODPHP will not get the information we seek, thereby compromising the integrity and quality of the study. The main problems are:
Recruitment may take longer than anticipated and delay the development of the consumer publication or tool (print and/or electronic), which are required by the fall of 2010;
Research expenses for travel and data collection will be higher if the focus groups or interviews need to be rescheduled; and
Additional focus group and interview facility fees will be incurred, if any of the groups or interviews 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 two-hour focus group session or interview.
The proposed research attempts to answer the following research questions through the conduct of focus group sessions with representatives of the target audience:
RQ1: What content is most useful and how should it be presented in order to be actionable?
As previously mentioned, ODPHP seeks clearance for conducting three phases of formative research:
Phase I: Card Sort Exercise – 4 focus groups (6 participants in each group)
Phase II: Paper Prototype Testing – 5 focus groups (8 participants in each group)
Phase III: Usability Testing – 24 one-on-one interviews
The proposed number of participants, one-on-one interviews, focus groups, and the duration of the interviews and focus groups 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.
Screening of potential focus group participants and interviews is estimated to take 5 minutes per respondent. We estimate a 25% response rate and intend to screen 96 individuals to recruit 24 focus group participants (6 participants per focus group, resulting in 4 focus groups in total). So, the total estimated response burden for recruiting 24 focus group participants is 8 hours.
The focus group sessions and one-on-one interviews are designed to last 120 minutes each, for a total of 120 minutes per participant. Thus, the estimated response burden anticipated for 24 focus group participants is 48 hours.
ESTIMATED TOTAL BURDEN HOURS for Card Sort Exercise = 56 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 160 individuals to recruit 40 focus group participants (8 participants per focus group, resulting in 5 focus groups in total). So, the total estimated response burden for recruiting 40 focus group participants is 13.33 hours.
The focus group sessions are designed to last 120 minutes each, for a total of 120 minutes per participant. Thus, the estimated response burden anticipated for 40 focus group participants and is 80 hours.
ESTIMATED TOTAL BURDEN HOURS for Paper Prototype Testing = 93.33 hours
Phase III: Usability Testing (One-on-one Interviews)
Screening of potential interview participants is estimated to take 5 minutes per respondent. We estimate a 25% response rate and intend to screen 96 individuals to recruit 24 one-on-one interview participants. So, the total estimated response burden for recruiting 24 one-on-one interview participants is 8 hours.
The one-on-one interviews are designed to last 120 minutes each, for a total of 120 minutes per participant. Thus, the estimated response burden anticipated for 24 one-on-one interviews is 48 hours.
ESTIMATED TOTAL BURDEN HOURS for Usability Testing = 56 hours
The cumulative number of hours used under OMB No. 0990-0281 is 597.
APPENDICES [IN SEPARATE FILES]
Spanish QGHL Consent Form
Spanish QGHL Screener
Spanish QGHL Card Sort Moderator Guide
Spanish QGHL Paper Prototype Testing Moderator Guide
Spanish QGHL Usability Testing Moderator Guide
Page
| File Type | application/msword |
| Author | Wai Hsien Cheah |
| Last Modified By | DHHS |
| File Modified | 2010-04-22 |
| File Created | 2010-04-22 |