QDRL 2012 NIOSH Resp Health 10-day letter 032912hr

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

March 29, 2012

Margo Schwab, Ph.D.

Office of Management and Budget

725 17th Street, N.W.

Washington, DC 20503

Dear Dr. Schwab:

The staff of the NCHS Questionnaire Design Research Laboratory (QDRL) (OMB No. 0920-0222, exp. 03/31/2013) plans to conduct research to evaluate the internet version of the Respiratory Health of Healthcare Workers Questionnaire for CDC’s National Institute of Occupational Safety and Health (NIOSH). The QDRL conducted research to evaluate the paper version of this questionnaire, which was detailed in a letter to you dated October 25, 2011.

We propose to start advertising for volunteer participants as soon as we receive clearance and to start testing as soon as possible after that.

Background Information about Cognitive Testing of Questionnaires

The methodological design of this proposed study is consistent with the design of typical cognitive testing research. As you know, the purpose of cognitive testing is to obtain information about the processes people use to answer survey questions as well as to identify any potential problems in the questions. The analysis will be qualitative.

Proposed project: Respiratory Health of Healthcare Workers Questionnaire – Internet version- Evaluation Study

Healthcare is the largest industry in the United States and performs a vital function in society. Evidence from research indicates that healthcare workers have an elevated risk for work-related asthma. In response to this problem, NIOSH began the project “Research to Inform Prevention of Asthma in Health Care.” The primary objective is to identify modifiable occupational risk factors for asthma in healthcare that will inform strategies for prevention.

The internet version of the Respiratory Health of Healthcare Workers Questionnaire that we are evaluating appears as Attachment 1. The testing procedure will conform to the cognitive interviewing techniques that have been described in our generic OMB clearance package.

The QDRL cognitively tested a paper version of this instrument prior to the development of the internet version. During the evaluation of the paper version of the Respiratory Health of Healthcare Workers Questionnaire the QDRL found many of the questions were misinterpreted, which led to false positive and false negative responses on the part of respondents. As a result several questions were rewritten, new questions were added and sections of the questionnaire where reordered to improve clarity.

As many as twenty-five 60-minute cognitive interviews may be conducted with nurses (registered nurses (RN), licensed practical nurses and licensed vocational nurses (LPN/LVN)), nursing aides or certified nursing aides (CNA), respiratory therapists or respiratory technicians or technologists, dental assistants, lab technicians, central supply or sterilization employees, environmental services, housekeepers, janitors or cleaners. All respondents with the exception of dental assistants are required to be employed at a hospital or nursing home.

We plan to recruit respondents through advertisements/flyers, a flyer through the Service Employees International Union (SEIU), professional organizations or other organizations recommended by the project sponsor and word of mouth (Attachment 2a). Dental assistants may be recruited through flyers distributed to dental offices (Attachment 2b). Individuals will be told that their participation in the study is entirely voluntary.

At NIOSH’s request, the SEIU will inform its Washington, DC area members that the National Center for Health Statistics’ Questionnaire Design Research Laboratory (QDRL) in Hyattsville, Maryland will be conducting research evaluating survey questions on respiratory health of healthcare workers through one hour one-on-one interviews and individuals interested in participating in the study should call the number provided on the flyers (Attachment 2a).

Cognitive interviews will be conducted by QDRL staff members in the QDRL. With the consent of the participants, the interviews will be recorded on videotape or audiotape. Participants will be informed of taping procedures (including observation if applicable) in the process of reviewing the consent forms, and the equipment will be turned on once it is clear that the procedures are understood and agreed upon.

During the interviews respondents will complete the questionnaire on a computer. Upon completion interviewers will probe on respondents’ comprehension of the survey questions and if time allows we will examine the usability of the internet questionnaire.

Individuals participating in the cognitive interview will be paid $50.00 for their participation. Since the recruitment of respondents for this study is specialized, (i.e., nurses (registered nurses (RN), licensed practical nurses and licensed vocational nurses (LPN/LVN)), nursing aides or certified nursing aides (CNA), respiratory therapists or respiratory technicians or technologists, dental assistants, lab technicians, central supply or sterilization employees, environmental services, housekeepers, janitors or cleaners, who are currently employed, working in a hospital or nursing home) the incentive has been slightly increased over and above our normal $40 incentive to increase participation, reduce the number of cancelations, and maximize time and travel in a particular state/location. The $50 remuneration used in the first round of testing proved to be successful in recruiting respondents from this population.

At the end of the interviews, participants will be paid and provided with copies of all papers they signed.

In total, for this project, the maximum respondent burden will be 25 hours of interviewing in addition to travel time. An updated burden table for this project is shown below:

Projects	Number of Participants	Number of Responses/ Participant	Average hours per response	Response burden
QDRL Interviews
2) Other questionnaire testing	25	1	1	25

Attachments (3)

cc:

M. Moien

T. Richardson

DHHS RCO

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