HIC Revolving CS Survey Supporting Statement B 071409

The National Heart, Lung, and Blood Institute (NHLBI) is requesting clearance to collect data using a survey. The purpose is to evaluate customers’ perceptions of the NHLBI Health Information Center’s (HIC’s) quality of service.

The total population of customers who contacted the HIC by telephone and e-mail from January 1, 2008, to December 31, 2008, is 13,094. This total breaks down as follows: The number of customers who contacted the HIC by telephone is 9,041, or an average of 753 each month, and the number who contacted the HIC by e-mail is 4,053, or about 338 per month. NHLBI contractor American Institutes for Research (AIR) has captured this information in its inquiry management system, Nortel Networks Symposium Express Call Center, and Microsoft Dynamics applications CRM (a customer relationship management software package) and Great Plains (an enterprise resource planning software package). HIC staff manually enter public inquiries and orders into CRM and Great Plains from customers who contact the HIC by telephone, e-mail, postal mail, and fax.

We have based our estimates of the distribution of the type of customer and volume of inquiries on the population of customers who contacted the HIC during the 2008 calendar year.

Information on the distribution of customers by type—patient, health professional, private sector organization, public sector organization—is collected by the NHLBI wherever possible. The trend for the distribution of customers contacting the HIC, based on data collected over 2008, is as follows:

Customer Type	Percentage	n
General Public	43.9%	5,748
Private Companies	16.5%	2,160
Public Sector Groups	10.6%	1,388
Health Professionals	29.0%	3,797

The NHLBI believes that inviting the total population of approximately 1,091 customers who contact the HIC via telephone or e-mail each month to participate in this survey is a valid method to obtain meaningful and representative data for the entire population of HIC customers.

A sample of 99 respondents will produce 95 percent confidence intervals of no more than +/‑ 7.48 percent for percentage estimates. (This estimate employs a finite population correction.)

For this survey, a 100 percent sample (census) of the HIC inquirers will be invited to participate.

Although every measure possible will be taken to maximize response rates (see next section), the NHLBI estimates conservatively that it will achieve a response rate of between 10 percent and 12 percent of the total population. Our estimate takes into account people who choose not to complete the survey or only partially complete the survey, as defined by not answering any of the questions.

Based on an anticipated response rate of 10 percent, the original sample size needed to generate a random sample of 99 respondents is: 99/.1 = 990.

B.2. Procedures for Collection of Information

The NHLBI will use two types of technology—a Web-based survey tool reached via an e-mail–embedded link and a telephone-based survey tool—to conduct the survey and capture respondent data. We will invite customers who e-mail or call the NHLBI HIC during the collection period to participate in the survey.

Soliciting Responses by E-Mail

To capture survey responses from customers who contact the HIC by e-mail, we will provide an embedded link to the survey in our e-mail response to their original inquiry. We believe this is an efficient and less invasive way to invite customers to participate. During the data collection period, then, e-mail responses from the HIC will provide each customer with a tailored answer to his/her original inquiry and an invitation to participate in the survey (for invitation language, see Attachment B, Solicitation E-Mail and Telephone Menu Greeting for HIC Revolving Customer Satisfaction Survey). The e-mail response template used by health information specialists during the collection period will include the invitation text and also the embedded link to the survey. The embedded link will take customers to a Web-based survey (WebSurveyor software) that consists of six questions to measure customers’ level of satisfaction with the HIC. Customers can complete the survey online; no special equipment or software is required to access and complete the survey beyond an Internet connection and Web browser. WebSurveyor will check all responses for completion and accuracy, registering the data only for those completed surveys that pass the system’s requirements.

Soliciting Responses by Telephone

To capture survey responses from inbound callers, we will use an interactive voice response (IVR) system that enables callers to provide not only touch-tone responses to the survey but also voice answers to open questions. During the collection period, the greeting on the HIC general telephone menu will notify callers that a customer satisfaction survey is under way and will invite them to participate following their contact with a health information specialist. At the end of the call, the health information specialist will ask the customer whether he/she would like to participate in the survey. If the customer agrees, then he/she will be transferred directly to the telephone-based survey menu. For callers who wish to complete the survey at another time, a toll-free number will be provided for them to call at their convenience. If a customer declines to participate, the health information specialist will thank him/her for contacting the HIC.

Data Collection and Analysis

Both the Web-based and telephone-based survey instruments will be active during the data collection period but will be closed to participants during off months. The survey will be implemented twice a year, with each data collection cycle lasting 1 month, during rotating months (initially April and October) to help reduce possible seasonal variance bias.

We do not anticipate any unusual problems requiring specialized sampling procedures.

The WebSurveyor software package and telephone IVR system will collect survey response data, which then will be combined into a single database for analysis. The data will be made available to data analysts at AIR for analysis. Data analysis reports, containing collated data, will be provided to relevant NHLBI staff and Consumer Services Team (CST) members. Survey respondents will remain anonymous, and no personal or identifying information will be collected.

B.3. Methods To Maximize Response Rates and Deal With Nonresponse

This survey will employ best practices for Web-based and telephone surveys, as outlined in the following publications:

Telephone Survey Methodology. Robert M. Groves, Paul P. Biemer (American Association for Public Opinion Research, American Statistical Association), and Lars E. Lyberg (International Association of Survey Statisticians). New York: John Wiley and Sons. 2001.
Survey Research Methods. Floyd J. Fowler. Thousand Oaks, CA: SAGE Publications. 2008.
Mail and Internet Surveys: The Tailored Design Approach, 2007 Update. Donald Dillman. New York: Jon Wiley and Sons. 2007.
Introduction to Survey Methodology and Design. James K. Doyle. Chapter 10 from Handbook for IQP Advisors and Students, by Douglas W. Woods. Worcester, MA: Worcester Polytechnic Institute. 2006.

The NHLBI estimates conservatively that it will achieve a response rate of between 10 percent and 12 percent of the sampled population. To ensure that respondents are receptive to completing the survey, the survey has been designed to eliminate as many obstacles as possible to completing it.

The survey has been pretested for clarity and ease of response by a group of eight people. Adjustments were made on the basis of feedback collected at the pretests.
The survey is quick, with an average completion time of around 3 minutes.
No personal information is collected.
For the Web-based survey:

The questions are brief and written in language at a ninth-grade level.
The final question asks for broader input from respondents, providing space for them to write in their comments.

For the telephone-based survey:

Instructions and questions are spoken clearly at an optimum speed by a professional, trained voice narrator.
The response system interacts with the caller if an incorrect option is selected or too much time is taken to answer, e.g., “I’m sorry, I didn’t understand your answer. Please say or key your answer again.”
Customers can replay questions by speaking a designated number or pressing the number on the telephone keypad.
The final question asks for broader input from respondents, allowing them to provide their comments in a voice message.

B.4. Test of Procedures or Methods To Be Undertaken

Both the Web-based and telephone survey instruments have been pilot-tested with eight individuals who have experience using NHLBI health information materials, but no prior knowledge of or exposure to the survey instrument, to ensure that the questions, instructions, and response options are clear and straightforward.

The Office of Human Subjects Research (OHSR) has determined that this survey activity is exempt from Institutional Review Board (IRB) review.

B.5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

The following individuals were consulted on the statistical aspects of the proposed survey:

Roger Levine, Ph.D., Managing Research Scientist, American Institutes for Research, 650–843–8160
Christine Paulsen, Ph.D., Principal Research Scientist, American Institutes for Research, 978–302–5543

The following individuals will direct the collection and analysis of data for this survey:

Lawrence Thomas, Project Director, American Institutes for Research, 240–629–3232
Justin Gray, Inquiry Response Manager, American Institutes for Research, 240–629–3238

File Type	application/msword
Author	American Institutes for Research
Last Modified By	Lisa Knight
File Modified	2009-07-14
File Created	2009-03-19

HIC Revolving CS Survey Supporting Statement B 071409