1 #6_REV_Justif Memo and Attach 6B 6C 6E 6F 6G_HINTS

Questionnaire Cognitive Interviewing and Pretesting (NCI)

#6_REV_Justif Memo and Attach 6B 6C 6E 6F 6G_HINTS

#6, #7, and #8 Bundled Sub-studies for HINTS, MDC and NExT

OMB: 0925-0589

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0925-0589 can be found here:

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Date:

January 12, 2011 (Revised)

To:

Office of Management and Budget (OMB)

Through:

Seleda Perryman, DHHS Report Clearance Officer
Marilyn Tuttleman, NIH Project Clearance Officer, OPERA
Vivian Horovitch-Kelley, NCI OMB Project Clearance Liaison, OMAA

From:

Bradford Hesse, Project Officer
Health Information National Trends Survey (HINTS),
Division of Cancer Control and Population Sciences,
National Cancer Institute/NIH

Subject:

Health Information National Trends Survey 4 (HINTS 4) Advance Materials
Focus Groups
Generic Sub-Study under “Questionnaire Cognitive Interviewing and
Pretesting,” OMB No. 0925-0589-06, Expiration Date: 5/31/2011

The National Cancer Institute’s (NCI) Division of Cancer Control and Population Sciences
(DCCPS), Behavior Research Program (BRP) proposes conducting formative research prior to
the fourth iteration of the Health Information National Trends Survey (HINTS 4) (OMB No.
0925-0538). Specifically, NCI proposes conducting focus group research for the purpose of
obtaining feedback on alternative message content included in the survey mailing materials.
Conducting this research is critical to successful recruitment efforts and to gaining the
cooperation of thousands of household respondents for HINTS 4. Results will be used to inform
the development of the content for the following correspondence with sampled households: the
advance letter, the cover letters sent along with the HINTS 4 questionnaires, the reminder
postcard sent to households who do not initially respond to the survey request, and the Questions
and Answers (Q&A) document included with the questionnaire mailing packages.
Background, Need and Use of Information. The HINTS data collection program addresses
many critical health research and programmatic needs. The HINTS program monitors changes
in the rapidly evolving field of health communication. Survey researchers are using the data to
understand how adults 18 years and older use different communication channels, including the
Internet, to obtain vital health information for themselves and their loved ones. Program planners
are using the data to understand and address barriers to health information usage across
populations, and to create more effective communication strategies. Finally, social scientists are
using the data to refine their theories of health communication in the information age and to offer
new and better recommendations for reducing the burden of cancer throughout the population.
HINTS creates and publishes HINTS Briefs showcasing results to ensure that findings from
HINTS research can be used to develop evidence-based policies, programs, and practices
relevant to health communication at the national, state, and local level.
These important scientific and program functions require that the HINTS program engage in
efforts to develop and improve data collection protocols that will result in high data quality.
Based on experimentally controlled methods research conducted as part of the previous round of

Office of Management and Budget (OMB) - November 29, 2010
Page 2
HINTS, HINTS 4 will use an entirely mail-based data collection procedure that collects data in 4
cycles with 4 independent samples. Thus, the proposed formative research seeks to identify the
most effective messages to use with the HINTS 4 mailing materials to encourage the
participation of all sampled households, improving overall response rate and diminishing the
chances of systematic nonresponse specific to certain subpopulations.
Participants and Recruitment. Focus group participants will be recruited from the noninstitutionalized adult household population. Neither Westat nor NCI employees will be eligible
to participate in the focus groups. Two of the four focus groups will be conducted with adults
who speak primarily Spanish at home. HINTS 4 will include a Spanish-language questionnaire
and supporting materials so evaluative information about the effectiveness and clarity of those
materials for the Spanish speaking population is needed. The English-speaking focus groups will
recruit a racially diverse population. Both the English- and Spanish-speaking focus groups will
recruit participation from adults representing a variety of educational attainment levels.
Westat, along with their subcontractor EurekaFacts, will recruit participants for the focus groups.
Recruiters will place advertisements on Internet sources such as Craig’s List, and will print
advertisements in local community papers around the Washington DC metropolitan area. In
addition, local adult education programs will be contacted to seek permission to distribute flyers
at one or more classes that cater to populations with less than a college education. All
advertisements will include a toll-free phone number for those interested in finding out more
about participation.
EurekaFacts will handle recruitment of the Spanish-speaking participants. As a professional
focus group and market research firm specializing in Spanish-speaking and other hard-to-reach
populations, EurekaFacts will advertise for participants in Spanish-market papers and locations
for which they have had prior success in recruiting focus group and one-on-one interview
participants. Additionally, EurekaFacts may draw from eligible Spanish-speaking respondents
within their established recruitment database, providing individuals have not participated in a
similar focus group in the last 12 months. All advertisements will include a toll-free number
dedicated to Spanish language calls.
When interested individuals call either toll-free number, recruitment staff will explain the
purpose of the project, eligibility criteria, and what is involved in participating. Recruitment staff
will screen individuals for participation in the focus groups (see Attachment 6A). One week
before the focus group session, recruitment staff will send individuals who have agreed to
participate a reminder letter (see Attachment 6B), and directions to the Westat facility.
Recruitment staff will attempt to contact all participants by phone 1–2 days prior to the focus
group to remind them of their appointment.
Data Collection Methods. The focus groups will be conducted in the focus group facilities at
Westat in Rockville, MD. All the focus groups will be conducted by professionally trained
moderators. Two of the four total focus groups will be conducted by a bilingual
(Spanish/English) moderator and the other two conducted by an English-speaking moderator.
In addition to the moderator, each focus group will include an assistant who will take notes,
gather informed consent forms, distribute respondent payments and manage other administrative
details. Each focus group will last up-to 90 minutes, and all participants will be asked to arrive a

Office of Management and Budget (OMB) - November 29, 2010
Page 3
few minutes early to review and sign the consent form. All focus groups will be video and audio
recorded with the consent of participants. Focus group moderators will use the session notes and
recordings to summarize the sessions. The Spanish speaking moderator will do the initial
summary in Spanish, and then translate to English for NCI and other project staff. Participants
of the focus groups will receive $50.00 as a thank you for their participation. The amount of this
incentive is slightly higher than average to account for time spent in screening and reviewing the
consent form, travel time (the amount of time required by participants for a 1.5 hour focus group
is close to 2 hours when travel is counted), and travel expenses (Westat is not located on the
Metro) .
Focus Group Moderator Materials. Westat will test the following materials as part of the focus
groups (see Attachment 6C for the full set of materials):
• two versions of the cover letter mailed with the questionnaire packets, plus the version
used in the 2007 HINTS mail sample,
• two versions of a refusal conversion letter mailed to households who don’t initially
respond
• a set of Frequently Asked Questions, and
• alternative facts that could replace or add to the relevant content of the letters under
consideration.
The Spanish-language materials will reflect the same content as the English language materials,
but will be fully translated into Spanish. The moderator will follow a semi-structured moderator
guide for the focus groups (see Attachment 6D) and consent form (see Attachment 6E). The
guides address the following research objectives:
• What information about the HINTS program do participants:
find most relevant to his/her own life, if any?
consider important to them, their families or their community more
generally?
think really encourage their interest and participation in HINTS 4?
• Are there possible differences between the English and Spanish speaking groups in what
messages seem most relevant, important or encouraging?
• Do participants understand the specific language used in the proposed materials in the
intended manner? If not, what is the source and impact of the confusion?
• Do participants view any of the content in the proposed materials negatively or think the
content is likely to diminish participation in the survey? If so, why?
• Does the format or style of the letter affect the level to which participants read and attend
to the content of the letters?
Data Analysis. Westat will analyze the data using qualitative analysis methods. Consistent
themes occurring in the focus groups summaries addressing the research questions will guide the
development of the final survey letters, reminder postcard and Question & Answer information
planned for HINTS 4 data collection.
Other Considerations. The focus group activities and materials outlined in this memo have been
approved by Westat’s IRB (see Attachment 6F) and is currently under review at NCI’s IRB.
Approval or exemption from both IRBs will be provided to OMB once received and prior to the
initiation of any testing.

Office of Management and Budget (OMB) - November 29, 2010
Page 4

No personally identifying information (PII) will be retained for this submission, however PII will
be collected in the full HINTS questionnaire. Additionally, the advance materials included in
this submission are in preparation for fielding the first HINTS questionnaire in 2011 which does
include PII. The information collection has been reviewed by the NIH Privacy Act Officer and it
was determined that the Privacy Act does apply to the first HINTS questionnaire (see
Attachment 6G).
Respondent Burden and Costs. The table below displays the burden estimates for this data
collection effort. We anticipate screening up to 80 individuals and retaining 40 to participate
across both the English- and Spanish-language focus groups. Each focus group session will last
up to 90 minutes. The total respondent burden for this effort is estimated to be 67 hours. This
effort will account for less than 4 percent of the total burden hours (1800) granted in OMB No.
0925-0589 approved package.
Estimates of Hour Burden and Respondent Cost
Maximum
Types of
Frequency
Instrument
Number of
Respondents
of Response
Respondents
General
Public
Total

Screening Questionnaire
(Attach 6A)

Focus Group/Moderator
Guide (Attach 6C and 6D)

120

Estimated
Burden
(Min/Hours)
5/60
(0.083)
90/60
(1.5)

Annual Burden
Hours
7
60
67

Thank you for your consideration of this proposed sub-study.
List of Attachments (Attached Below)
6B:
English and Spanish1 Reminder Letter
1

SPANISH DOCUMENTS
For all advance materials and data collection instruments, HINTS is using the TRAPD method of translation (see
citation below). This method involves two main steps in order to get the best translation possible:
1. Documents are independently translated by two different translators that are not in contact with each
other. In the case of HINTS, there are two separate subcontractors, each doing their own independent
translations of the documents. The translators both have been provided with a way to track places
where they are unsure of an appropriate translation or where they feel translations are awkward.
2. Both translations and tracking sheets are provided to a third translator who acts as an adjudicator
between the two translations. This translator determines the best Spanish version of the document
based on the two translations received. Where there are questions or inconsistencies, the adjudicator is
in contact with the two translators to discuss the issues and come to a resolution.
Only once all issues have been resolved are the letters and data collection instruments considered final.
This process is time consuming. Two to three weeks are provided to the subcontractors for the initial translations of
documents depending on the complexity of the documents (with instruments taking longer than letters). Then, an
additional two to three weeks are provided for the adjudication process. It therefore takes approximately four to six
weeks from the time that the translators receive the initial English documents to the time that a Spanish translation is
finalized. We are currently in the middle of this process for the advance materials.

Office of Management and Budget (OMB) - November 29, 2010
Page 5
6C:
6E:
6F:
6G:

Test Materials – English and Spanish Letters, FAQs, and Alternative Facts
English and Spanish Consent Form
Westat IRB Approval
Privacy Act Memo

List of Attachments (Attached in a Separate File)
6A:
English and Spanish Screening Questionnaire
6D:
English and Spanish Moderator Guide

The version of the letters attached here is one copy of an initial translation. They have not yet been through the
adjudication process. We anticipate there will be some changes to the translations through adjudication, but these
changes should be very minor in nature (selecting one word over a similar word, for example). It should be noted
that the attached translations were completed before the addition of the sentence about safeguarding information and
the change in wording related to the Privacy Act, so those are not included in this Spanish version but are being
added during adjudication.
Items such as moderator guides (for focus groups and cognitive testing) are not undergoing the TRAPD process.
Because these items are not seen by respondents and are only used as guides by trained professionals, they are
undergoing just one translation and that translation has not yet taken place. The translated moderator guide can be
submitted once it is complete.
CITATION:
Harkness, Janet A., Ana Villar and Brad Edwards (2010) “Translation, Adaptation, and Design” in Survey Methods
in Multinational, Multiregional, and Multicultural Contexts J. Harkness, M. Braun, B. Edwards, T. Johnson, L.
Lyberg, P. Mohler, B. Pennell, and T. Smith (eds), Chapter 7, pgs 117-140.

Attachment 6B: English and Spanish Reminder Letter
[Date]
Dear [name],
Thank you for agreeing to participate in our study on health-related topics. Here are
details to remind you where and when to appear for the focus group session. The
session will take about an hour and a half. You will receive $50 as a token of gratitude
for your participation in the study.

DATE: XX/XX/XXXX
TIME:

LOCATION: Westat
Conference Center
1600 Research Boulevard
Rockville, MD 20820

Directions and a map are enclosed.
Kindly allow enough time for travel as we would like to begin on time. There will be
parking spaces marked “(Study)” in the Conference Center Parking lot. Someone will
meet you in the lobby of the 1600 building.
If you need further information, please call me at the office (301) XXX-XXXX.
We look forward to seeing you and thank you in advance for your assistance.

Sincerely,

[Westat staff]

[Date]
Estimado [name],
Gracias por aceptar participar en nuestro estudio sobre temas relacionados con la
salud. Aquí están los detalles para recordarle donde y cuando aparecer para la sesión
de grupo de enfoque. La sesión durará aproximadamente una hora y media. Usted
recibirá $50 como muestra de gratitud por su participación en el estudio.

FECHA: XX/XX/XXXX
HORA:

LOCALIDAD: EurekaFacts LLC
451 Hungerford Drive (Rockville Pike) Suite 515
Rockville, MD 20850

Direcciones y un mapa está incluido.
Por favor permita el tiempo suficiente para el viaje como nos gustaría comenzar a
tiempo.
Si necesita más información, por favor, llámenos a la oficina al (301) XXX-XXXX.
Esperamos su visita y gracias de antemano por su ayuda.

Sinceramente,

[Eureka Facts staff]

Attachment 6C – 1: Cover letter 1 and Frequently Asked Questions – English and
Spanish

Dear Sir or Madam:
You’ve been selected to take part in an important national survey sponsored by the U.S.
Department of Health and Human Services, the Health Information National Trends Survey (HINTS).
HINTS has interviewed over 10,000 people since 2003. From those interviews we’ve learned
that:
•

The number of Americans using email to talk with a doctor or doctor’s office doubled
between 2003 and 2007.

•

In the past several years, as health information becomes more available on-line, American’s
trust in the health information they get on-line has decreased.

•

During the same time period, public trust in doctors as a source of health information
increased.

By completing this questionnaire, you can help health professionals use HINTS to find
out how you and other Americans get health information now and what needs done to make that
information easier to find and understand.
We ask that each adult in this household complete a questionnaire and return it to us in
the postage-paid envelope within the next two weeks. We’ve enclosed $2 as a token of our
appreciation for your participation. Of course, your participation is voluntary. You can keep the
money even if you decide not to take part in the survey.
Westat, a research firm under contract with us, is administering the survey. Your answers will
be kept private under the Privacy Act. More information about the study is provided on the other side
of this letter. You can also go to www.HINTS.cancer.gov to find out more about HINTS.
Thank you in advance for your cooperation. If you have any questions about the study or you
would like to request more questionnaires, please call Westat toll-free at 1–888–636-6540.

Sincerely,

Bradford W. Hesse, Ph.D.
HINTS Project Officer
Chief, Health Communication and Informatics
Research Branch
National Institutes of Health
U.S. Dept of Health and Human Services
www.HINTS.gov
Si prefiere recibir la encuesta en Español, por favor llame 1-888-636-6536.
The Health Information National Trends Survey is authorized under 42 USC, Section 285a

Some Frequently Asked Questions
about the
Health Information National Trends Survey

What is the study about? What kind of questions do you ask?
A:

Where can I find out more about HINTS?

About 20 to 30 minutes.

Who is sponsoring the study? Is this study approved by the Federal Government?
A:

Yes. Your answers cannot be connected to your name or any other information that could identify
you or your household, to the extent provided by law. The completed questionnaires will be stored
in a separate file with restricted access. Both the paper and electronic versions of the information
will be destroyed shortly after the research is finalized.

How long will it take to answer the questions?
A:

Your participation is voluntary, and you may refuse to answer any questions or withdraw from the
study at any time. However, your answers are very important to the success of this study and will
represent thousands of others. Getting an answer from all the households chosen for the study is
the best way to make sure the study results reflect the thoughts and opinions of all Americans.

Will my answers to the survey be kept private?
A:

Your address was randomly selected from among all of the known home addresses in the nation.
It was selected using scientific sampling methods.

Why should I take part in this study? Do I have to do this?
A:

Findings will help the U.S. Department of Health and Human Services promote good health and
prevent disease by determining ways of better communicating accurate health information to
Americans.

How did you get my address?
A:

If you have any questions about the study or you would like to request more questionnaires,
please call Westat toll-free at 1–888–636-6540,or you can go to www.HINTS.gov

How will the study results be used? What will be done with my information?
A:

The study concerns health and how people receive health information. For example, we will ask
how you usually get information about how to stay healthy, the sources of information you most
trust, and how you might like to get such information in the future. We will also ask about your
beliefs on what contributes to good health, how best to prevent cancer, your participation in various
health-related activities, and related topics.

The study is sponsored by the U.S. Department of Health and Human Services. The study has
been approved by the Office of Management and Budget (OMB), the office that reviews all
federally-sponsored surveys. The OMB approval number assigned to this study is 0925-0538.

Who is Westat?
A:

Westat is a research company located in Rockville, Maryland. Westat is conducting this
survey under contract to the U.S. Department of Health and Human Services.

Estimado Señor o Señora:
Usted ha sido seleccionado para participar en una importante encuesta nacional patrocinada por el
Departamento de Salud y Servicios Humanos de los Estados Unidos, La Encuesta de Tendencias
Nacionales de Información Sobre La Salud (HINTS por su siglas en inglés).
HINTS ha entrevistado más de 10.000 personas desde 2003. De esas entrevistas hemos aprendido
que:
•

El número de estadounidenses que utilizan correo electrónico para hablar con un medico o un
consultorio médico se duplicó entre el 2003 y el 2007.

•

En los últimos años a medida que información sobre salud se vuelve más disponible en la internet,
la confianza que los estadounidenses tienen sobre la información de salud que reciben en la
internet ha disminuido.

•

Durante ese mismo periodo de tiempo, la confianza pública en los médicos como fuente de
información sobre salud ha incrementado.
Al completar este cuestionario, usted ayudará a que los profesionales de (la) salud usen
HINTS para saber como usted y otros estadounidenses reciben y/o obtienen información de salud y
qué se necesita hacer para que la información sea más fácil de encontrar y entender.

Pedimos que cada adulto en este hogar complete un cuestionario y lo envié de regreso en el
sobre con franqueo pagado dentro las próximas dos semanas. Hemos incluído dos dólares como
agradecimiento por su participación. Por supuesto que su participación es voluntaria. (Usted) puede
quedarse con el dinero aún si decide no participar en la encuesta.
Westat, una firma de estudios de investigación, bajo contrato con nosotros, estará administrando
esta encuesta. Sus respuestas se mantendrán de forma segura en la medida provista por la ley. Al otro lado
de esta página encontrará mas información sobre este estudio. Usted también puede visitar la página
www.HINTS.cancer.gov para mayor información sobre HINTS.
Gracias de antemano por su cooperación. Si usted tiene alguna pregunta sobre el estudio o si
usted desea solicitar más cuestionarios, por favor llame a Westat al número gratuito 1–888–
636-6540. .

Algunas preguntas Frecuentes Acerca de la Encuesta HINTSHealth Information National Trends Survey

(Tendencias Nacionales Sobre Información de Salud)

Q: ¿De qué se trata este estudio? ¿Que tipo de preguntas preguntan?
A:

El estudio se trata de la salud y de cómo la gente recibe información sobre salud. Por
ejemplo, nosotros le haremos preguntas sobre cómo usted por lo general recibe
información sobre cómo mantenerse saludable, las fuentes de información en las cuales
usted más confía, y cómo a usted desea recibir ese tipo de información en el futuro.
También le preguntaremos sobre sus creencias sobre lo que contribuye a la buena
salud, de cuales son las mejores formas de prevenir el cáncer, sobre su participación en
varias actividades que tienen que ver con la salud, y temas relacionados.

Donde puedo encontrar más información acerca de HINTS?
A:

Si tiene alguna pregunta acerca del estudio o si quiere pedir más
cuestionarios por favor llame a Westat al número gratuito 1–888–636-6540
o puede visitar la página web www.HINTS.gov

¿Cómo se utilizarán los resultados del estudio? ¿Qué se hará con mi información?
A:

La información que colectemos ayudara al Departamento de Salud y Servicios
Humanos de los Estados Unidos promover la buena salud y prevenir enfermedades
mediante la determinación de formas de mejor comunicar información de salud precisa
a los estadounidenses.

Q: ¿Cómo consiguió mi dirección?
A:

¿Por qué debería participar en este estudio? ¿Tengo que hacer esto?
A:

Su participación es voluntaria y usted puede negarse a contestar cualquier pregunta o
retirarse del estudio en cualquier momento. Sin embargo, sus respuestas son muy
importantes para el éxito de este estudio y se representan a miles de otros. Obtener una
respuesta de todos los hogares seleccionados para el estudio es la mejor manera de
asegurarse que los resultados del estudio reflejan los pensamientos y las opiniones de
todos los estadounidenses.

¿Se mantendrán privadas mis respuestas a la encuesta?
A:

Su dirección fue elegida al azar de todos las direcciones de origen conocido en la
nación. Fue elegida mediante métodos de muestras científicas.

Sí. Sus respuestas no podrán ser conectadas a su nombre o a cualquier otra información
que puede identificarle a usted o su hogar hasta el exento previsto por ley.
¿Cuánto tiempo se tarda en responder a las preguntas?

¿Quien patrocina este estudio? ¿Es este estudio aprobado por el Gobierno
Federal?
A:

Se tarda como 20 a 30 minutos.

El estudio es patrocinado por el departamento de salud y servicios humanos de los
Estados Unidos. El estudio ha sido aprobado por la Oficina de Gerencia y Presupuesto
(OMB), la Oficina que revisa todos los estudios patrocinados por el Gobierno Federal. El
número de aprobación de la OMB asignado a este estudio es 0925-0538.

¿Quien es Westat?
A:

Westat es una compañía de estudios de investigación ubicada en
Rockville, Maryland. Westat está llevando a cabo esta encuesta bajo contrato del
Departamento de Salud y Servicios Humanos de los Estados Unidos.

Attachment 6C – 2: Cover letter 2 and Frequently Asked Questions – English and
Spanish

Dear Sir or Madam:
I’m writing to ask you to take part in a national survey sponsored by the U.S. Department of
Health and Human Services. The Health Information National Trends Survey (HINTS) is how policy
makers and researchers identify the information that Americans need and want to know about health.
For example, by answering the HINTS survey you can help identify:
•

How people find out about food and drug recalls

•

The number of Americans who use the internet as their main source of health information

•

How people order and receive their prescriptions medicines

By completing this questionnaire, you can help to find ways to get you and all Americans the
health information you need, when you need it.
We ask that each adult in this household complete a questionnaire and return it to us
in the postage-paid envelope within the next two weeks. We’ve enclosed $2 as a token of our
appreciation for your participation. Of course, your participation is voluntary. You can keep the
money even if you decide not to take part in the survey.
Westat, a research firm under contract with us, is administering the survey. Your answers will
be kept private under the Privacy Act.
More information about the study is provided on the other side of this letter. You can also go
to www.HINTS.cancer.gov to find out more about HINTS, or call Westat toll-free at 1–888–636-6540.
Thank you in advance for your cooperation.
Sincerely,
Visit the HINTS
website:
www.HINTS.cancer.gov

Bradford W. Hesse, Ph.D.
HINTS Project Officer
Chief, Health Communication and Informatics
Research Branch
National Institutes of Health
U.S. Dept of Health and Human Services

Si prefiere recibir la encuesta en Español, por favor llame 1-888-636-6536.
The Health Information National Trends Survey is authorized under 42 USC, Section 285a

Some Frequently Asked Questions
about the
Health Information National Trends Survey

What is the study about? What kind of questions do you ask?
A:

How will the study results be used? What will be done with my information?
A:

About 20 to 30 minutes.

Who is sponsoring the study? Is this study approved by the Federal Government?
A:

How long will it take to answer the questions?
A:

Your participation is voluntary, and you may refuse to answer any questions or withdraw from the
study at any time. However, your answers represent thousands of others and are very important to
the success of this study. Getting an answer from all the households chosen for the study is the
best way to make sure the study results reflect the thoughts and opinions of all Americans.

Will my answers to the survey be kept private?
A:

Your address was randomly selected from among all of the known home addresses in the nation.
It was selected using scientific sampling methods.

Why should I take part in this study? Do I have to do this?
A:

Findings will help the U.S. Department of Health and Human Services promote good health and
prevent disease by determining ways of better communicating accurate health information to
Americans.

How did you get my address?
A:

Who is Westat?
A:

Westat is a research company located in Rockville, Maryland. Westat is conducting this
survey under contract to the U.S. Department of Health and Human Services.

Estimado Señor o Señora:
Estoy escribiéndole para pedir que participe en un estudio nacional patrocinado por el Departamento
de Salud y Servicios Humanos de los Estados Unidos. La Encuesta Nacional de Tendencias Sobre Salud
(HINTS por sus siglas en Inglés) es como los investigadores y políticos encargados de hacer políticas de
salud identifican la información que los estadounidenses necesitan y quieren saber sobre la salud.
Por ejemplo, respondiendo a la encuesta HINTS usted puede ayudar a identificar:
•

Cómo la gente se entera sobre las retiradas de alimentos y medicinas.

•

El número de estadounidenses que utilizan el internet como su principal fuente de información
sobre la salud.

•

Cómo la gente ordena y recibe sus recetas médicas.

Al completar este cuestionario, usted ayudará a encontrar maneras para que usted y todos los
estadounidenses reciban información sobre la salud que necesitan, cuando la necesitan.
Pedimos que cada adulto en este hogar complete un cuestionario y lo envié de
regreso en el sobre con franqueo pagado dentro de las próximas dos semanas. Hemos incluído dos
dólares como agradecimiento por su participación. Por supuesto que su participación es voluntaria. (Usted)
puede quedarse con el dinero aunque decide no participar en la encuesta.

Westat, una firma de estudios de investigación, bajo contrato con nosotros, estará administrando
esta encuesta. Sus respuestas se mantendrán de forma segura en la medida provista por la ley.
Más información sobre este estudio se encuentra al reverso de esta página. Usted también puede
visitar la página www.HINTS.cancer.gov para más información sobre HINTS, o puede llamar a Westat al
número gratuito 1–888–636-6540.

Gracias de antemano por su cooperación.
Sinceramente,

Bradford W. Hesse, Ph.D.
HINTS Project Officer
Chief, Health Communication and Informatics
Research Branch
National Institutes of Health
U.S. Dept of Health and Human Services
Algunas preguntas Frecuentes Acerca de la Encuesta HINTSHealth Information National Trends Survey
(Tendencias Nacionales Sobre Información de Salud)

¿De qué se trata este estudio? ¿Qué tipo de preguntas preguntan?
A:

El estudio se trata de la salud y de cómo la gente recibe información sobre salud. Por
ejemplo, nosotros le haremos preguntas sobre como usted por lo general recibe
información del cómo mantenerse saludable, las fuentes de información en las cuales
usted mas confía, y como desea recibir ese tipo de información en el futuro. También le
preguntaremos sobre sus creencias sobre lo que contribuye a la buena salud, de cuales
son las mejor formas de prevenir el cáncer, sobre su participación en varias actividades
que tienen que ver con la salud, y temas relacionados.

¿Cómo se utilizarán los resultados del estudio? ¿Qué se hará con mi información?
A:

Q: ¿Cómo consiguió mi dirección?
A:

¿Por qué debería participar en este estudio? ¿Tengo que hacer esto?
A:

Sí. Sus respuestas no podrán ser conectadas a su nombre o a cualquier otra información
que puede identificarle a usted o su hogar hasta el exento previsto por ley.

¿Cuánto tiempo se tarda en responder a las preguntas?
A:

¿Se mantendrán privadas mis respuestas a la encuesta?
A:

Su dirección fue elegida al azar de todas las direcciones de origen conocido
en la nación. Fué elegida mediante métodos de muestras científicas.

Se tarda como 20 a 30 minutos.

¿Quien patrocina este estudio? ¿Es este estudio aprobado por el Gobierno
Federal?
A:

El estudio es patrocinado por el Departamento de Salud y Servicios humanos de los
Estados Unidos. El estudio ha sido aprobado por la Oficina de Gerencia y Presupuesto

(OMB), la Oficina que revisa todos los estudios patrocinados por el Gobierno Federal. El
número de aprobación de la OMB asignado a este estudio es 0925-0538.
Q:

Quien es Westat?
A: Westat es una compañía de estudios de investigación localizada en
Rockville, Maryland. Westat está llevando a cabo esta encuesta bajo contrato del
Departamento de Salud y Servicios Humanos de los Estados Unidos.

Attachment 6C - 3: Refusal Conversion Letter 1- English and Spanish

Dear Resident:
Recently, the U.S. Department of Health and Human Services mailed two
questionnaires to your household for the Health Information National Trends Survey
(HINTS). As of today we have not received any completed questionnaires from your
household.
HINTS has interviewed over 10,000 people since 2003. This year, HINTS is
asking you to participate. As health care in America continues to change, we want
you to tell us what health topics matter the most to you. Will the ways you
communicate with your doctor’s change? Can you get current information about
medical treatments for you or a family member? Do you have concerns about your
ability to take care of your own health needs? HINTS is a way for you to let the
government know what people like you do when you need health care information.
We know your time is valuable, but your participation in the study is important
to its success. To understand the health topics important to people today, HINTS
needs to collect the current views and experiences of all the people we’re trying to
contact.
Whether or not you or anyone in your family has ever had health problems,
your input and opinions are crucial to the success of this study. Your answers,
combined with those of other survey respondents, will help us understand what
health information you and other Americans want and what needs done to make that
information easier to find and understand.
In the event that your questionnaires were misplaced, replacements are
enclosed. If you have any questions, please call Westat toll free at 1-888-314-1133
or go to www.HINTS.cancer.gov.
Sincerely,

Bradford W. Hesse, Ph.D
HINTS Project Officer
Behavioral Research Program
National Cancer Institute
Si prefiere recibir la encuesta en Español, por favor llame 1-888-636-6536.
The Health Information National Trends Survey is authorized under 42 USC, Section 28

Estimado Residente:
Recientemente, el Departamento de Salud y Servicios Humanos de los Estados Unidos
envió por correo a su hogar dos cuestionarios de la encuesta de Tendencias Nacionales de
Información Sobre La Salud (HINTS por sus siglas en Inglés). Hasta el día de hoy no
hemos recibido cuestionarios completados de su hogar.
HINTS ha entrevistado más de 10.000 personas desde 2003. Este año, HINTS le
pide que participe. A medida que el cuidado de salud sigue cambiando en los Estados
Unidos, queremos que usted nos diga que temas de salud son más importantes para
usted. ¿Cambiará la manera de comunicarse con su médico? ¿Puede usted obtener
información actualizada sobre tratamientos médicos para usted o un miembro de la familia?
¿Tiene usted inquietudes acerca de su capacidad para cuidar sus propias necesidades de
salud? HINTS es una manera en que usted puede dejarle saber al gobierno lo que
personas como usted hacen cuando necesitan información sobre cuidado médico.
Sabemos que su tiempo es valioso, pero su participación en el estudio es importante
para su éxito. Para entender los temas de salud importantes para la gente hoy en día,
HINTS necesita colectar opiniones y experiencias actuales de todas las personas que
estamos tratando de contactar.
Ya sea o no que usted o alguien en su familia ha tenido problemas de salud, su
opinión es crucial para el éxito de este estudio. Sus repuestas, combinadas con las de otros
encuestados nos ayudara entender que tipo de información de salud usted y otros
estadounidenses desean y lo que se necesita hacer para que esa información sea más fácil
de encontrar y entender.
En el caso que sus cuestionarios han sido extraviados, los reemplazos están
incluidos con esta información. Si usted tiene alguna pregunta por favor llame a Westat al
número gratuito 1–888–314-1133 o visite la página www.HINTS.cancer.gov.
Sinceramente,

Bradford W. Hesse, Ph.D
HINTS Project Officer
Behavioral Research Program
Instituto Nacional del Cáncer

Attachment 6C – 4: Refusal Conversion Letter 2 – English and Spanish

Dear Sir or Madam:
You’ve been selected to take part in this year’s Health Information National
Trends Survey (HINTS). Policy makers and researchers use HINTS to identify the
information that Americans need and want to know about health. With your help, we
can use HINTS to keep Americans better informed on the health issues important to
them.
We recently mailed two HINTS questionnaires to your home. As of today we
have not received any back from your address. We know your time is valuable.
However, your household is part of a scientific sample representing many other
households and it cannot be replaced.
To make sure HINTS provides accurate information we need you and all the
household’s selected for this year’s HINTS to complete the survey. By taking part in
this survey, you can help us find ways to get you and all Americans the health
information you need, when you need it.
In the event that your questionnaires were misplaced, replacements are
enclosed. We ask that each adult in this household complete a
questionnaire and return it to us in the postage-paid envelope within the
next two weeks.
If you have any questions or would like to request additional
questionnaires, please call Westat toll free at 1-888-636-6540.
Sincerely,
To find out more about
HINTS, go to:
www.HINTS.cancer.gov

Bradford W. Hesse, Ph.D.
HINTS Project Officer
Chief, Health Communication and Informatics
Research Branch
National Institutes of Health
U.S. Dept of Health and Human Services

Si prefiere recibir la encuesta en Español, por favor llame 1-888-636-6536.
The Health Information National Trends Survey is authorized under 42 USC, Section 2

Estimado Señor o Señora:
Usted ha sido seleccionado para participar en La Encuesta de Tendencias Nacionales de
Información Sobre La Salud (HINTS por sus siglas en Ingles) de este año. Políticos y investigadores
usan HINTS para identificar la información que los estadounidenses necesitan y quieren saber acerca
de la salud. Con su ayuda podemos utilizar HINTS para mantener a los estadounidenses mejor
informados sobre los temas de salud importantes para ellos.
Recientemente le enviamos por correo a su hogar dos cuestionarios de HINTS. Hasta el día de
hoy no hemos recibido cuestionarios de regreso de su hogar. Sabemos que su tiempo es valioso. Sin
embargo, su hogar es parte de una muestra científica que representa muchos otros hogares y no puede
ser reemplazado.
Para asegurar que HINTS proporciona información precisa necesitamos que usted y todos
los hogares seleccionados para HINTS de este año completen la encuesta. Al participar en esta
encuesta, usted puede ayudarnos encontrar maneras de que usted y todos los estadounidenses
obtengan la información de salud que necesita, cuando la necesite.
En el caso que sus cuestionarios han sido extraviados, los reemplazos están incluidos con
esta carta. Pedimos que cada adulto en este hogar complete un cuestionario y lo envié de
regreso en el sobre con franqueo pagado dentro de las próximas dos semanas.
Si usted tiene alguna pregunta sobre el estudio o si usted desea solicitar más cuestionarios,
por favor llame a Westat al número gratuito 1–888–636-6540.
Sinceramente,

Bradford W. Hesse, Ph.D.
HINTS Oficial de Proyectos
Jefe, Comunicación de Salud e Informática
Subdivisión de Investigaciones
Institutos Nacionales de Salud
Departamento de Salud y
Servicios Humanos de los Estados Unidos

Attachment 6C – 5: Alternative Facts – English and Spanish
•
•
•
•
•
•

About 4 out of 5 adults believe that there are so many recommendations about nutrition that it
is hard to know which ones to follow
Similarly, more than three‐quarters (78%) of Americans think there are so many cancer
prevention recommendations that it is hard to know which ones to follow.
Nearly 40% of all Americans have looked for cancer information at some point.
About 50% of those people are looking for information about a specific type of cancer, but
nearly 20% are looking for information about cancer symptoms, early detection or diagnosis.
About 45% of English speaking households feel their doctors always explain things to them in a
way they can understand.
However, only a little more than 30% of Spanish‐speaking households feel their doctors explain
things to them in an understandable way.

SET 1.
Usando datos de HINTS, investigadores y oficiales del gobierno pueden identificar los tipos de
información que los estadounidenses necesitan para entender los riesgos a la salud correctamente. En
2005, HINTS encontró que:
•

•

Cerca de 4 de cada 5 adultos creen que hay tantas recomendaciones sobre la nutrición que es
difícil saber cuáles seguir.
Del mismo modo, mas de tres‐cuartos (78%) de los estadounidenses piensan que hay tantas
recomendaciones para prevenir el cáncer que es difícil saber cuáles seguir.

SET 2.
Datos de HINTS pueden decirnos de que tipo de información acerca de la salud están interesados los
estadounidenses. Por ejemplo –
•
•

Casi 40% de todos los estadounidenses han buscado información sobre el cáncer en algún
momento.
Casi 50% de esa gente está buscando información sobre un tipo específico de cáncer, pero casi
20% están buscando información sobre síntomas del cáncer, detección temprana o diagnostico.

SET 3.
Datos de HINTS pueden ayudar a médicos y otros profesionales de cuidado de salud mejorar la
comunicación que tienen con sus pacientes.
•
•

Cerca de 45% hogares de habla Inglesa sienten que sus médicos siempre le explican las cosas a
en una forma que ellos pueden entender.
Sin embargo, solamente un poco mas de 30% de hogares de de habla española
Sienten que sus médicos le explican las cosas en una manera comprensible.

Attachment 6E: ENGLISH AND SPANISH CONSENT FORM
You have volunteered for a focus group discussion being conducted on behalf of the U.S. Dept.
of Health and Human Services (DHHS). The purpose of the study is to improve certain
procedures used for a survey that Westat conducts on behalf of DHHS.
•

The discussion will be videotaped and notes will be taken. Project researchers may also
observe the discussion.

•

The discussion should take up to 1½ hours.

•

Your participation is completely voluntary. You may stop at any time, and you do not
have to answer any questions you do not wish to answer.

•

This research does not involve any foreseeable risks.

•

All information obtained from this study will be kept private under the Privacy Act and will
only be seen by people authorized to work on this project. The report summarizing the
findings will not contain any names or identifying information. We will destroy any
identifying information when the project ends.

•

There are no direct benefits to participants in this research.

•

Participants will receive $50 in cash for participating.

•

If you have questions about this research please contact Brad Hesse, the Principal
Investigator at NCI (301-594-9904; [email protected]). If you have questions about
your role as a research participant, please contact Sharon Zack, the Westat Institutional
Review Board Administrator (800-937-8285; [email protected]).

•

A copy of this consent form has also been provided for your records.

If you agree to participate in this focus group, please read the following statement and sign your
name below:
I have read the above information about this project and my rights as a participant. I
consent to participate in this research and to have this discussion videotaped.
______________________________
Researcher’s Signature

______________________________
Participant’s Signature

______________________________
Printed Name

_____________________________
Date

Usted se ha ofrecido como voluntario para un grupo de discusión conducido de parte del
Departamento de Salud y Servicios Humanos (DHHS por sus siglas en Inglés). El propósito de
este estudio es para mejorar ciertos procedimientos usados para una encuesta que Westat
lleva a cabo de parte del DHHS.
•

La discusión será grabada en video y se tomarán notas. Los investigadores del proyecto
también observaran la discusión.

•

La discusión puede tardar hasta hora y media.

•

Su participación es completamente voluntaria. Usted puede parar en cualquier momento
y no tiene que contestar ninguna pregunta que usted no quiere contestar.

•

Esta investigación no implica ningún riesgo previsible.

•

Toda información de este estudio se mantendrá de manera segura y solo será vista por
personas autorizadas para trabajar en este proyecto. El reporte que resume las
conclusiones no contendrá nombres o datos de identificación. Vamos a destruir
cualquier información que identifique a los participantes cuando termine el proyecto.

•

No hay beneficios directos para los participantes en esta investigación.

•

Cada participante recibirá $50 en efectivo por participar.

•

Si usted tiene alguna pregunta acerca de este estudio de investigación por favor
contacte a Brad Hesse, el Investigador Principal el Investigador Principal en el Instituto
Nacional del Cáncer (NCI por sus siglas en Ingles) al 301-594-9904;
[email protected]). Si usted tiene alguna pregunta acerca de su papel como
participante de la investigación por favor contacte a Sharon Zack, Administradora de la
Junta de Revisión institucional de Westat (800-937-8285; [email protected]).

•

Una copia de este formulario de consentimiento también se ha previsto para sus
archivos.

Si usted acepta participar en este grupo de discusión, por favor lea la siguiente declaración y
firme su nombre abajo:

He leído la información arriba acerca de este proyecto y sobre mis derechos
como participante. Doy mi consentimiento para participar en este estudio de
investigación y para tener esta conversación grabada en vídeo.
______________________________
Firma del Investigador

______________________________
Firma del Participante

______________________________
Nombre en Letra Imprenta

_____________________________
Fecha

Attachment 6F: Westat IRB approval

Date:

November 30, 2010

To:

Terisa Davis, Project Director

From:

Kerry Levin; Chair, Westat IRB

Subject:

Amendment Approval of OMB, Project 8861.01.04
FWA 5551

As Chair of the Westat Institutional Review Board (IRB), I reviewed the materials submitted for the following:
OMB, Project 8861.01.04. The Westat IRB reviews all studies involving research on human subjects. This project
was last approved November 11, 2010.
This request was to approve the following:
1. Focus group research to elicit feedback on alternative message content included in the survey mailing
materials.
2. Revise the informed consent form. Replace “confidential” to “secure.” As in: All information obtained
from this study will be kept secure.
3. Decrease the incentive amount from $75 to $50.
IRB regulations permit expedited review of minor changes to previously approved activities [45 CFR pt. 46.110 (b)].
This study can be considered minimal risk and is approved under expedited authority
As the Project Director you are responsible for the following:
If you received a conditional approval, project activities (e.g., recruiting, enrolling) may not begin until your
responses have been received by the IRB and final approval is granted.
You are required to submit this study for a continuing review on or before November 11, 2011.
In the interim, you are responsible for notifying the IRB Office as soon as possible if there are any injuries
to the subjects, problems with the study, or changes to the study design that relate to human subjects.
cc:

Institutional Review Board
Nancy Weinfield

Attachment 6G: Privacy Act Memo

DATE:

January 11, 2011

TO:

Bradford Hesse, Ph.D., HINTS Project Officer
Chief, Health Communication and Informatics Research Branch, DCCPS, NCI

FROM:

NIH Privacy Act Officer

SUBJECT: Applicability of the Privacy Act: Health Information National Trends Survey 4
(HINTS 4) 2010
I have reviewed the NCI submission to OMB requesting approval for the HINTS 2010 survey to
refine theories of health communication in an effort to reduce the burden of cancer.
I have determined that the Privacy Act will apply to this data collection which involves the
collection of name and address of potential respondents in order to contact them for participation
in a focus group. As part of the recruitment process and survey, additional personally
identifiable information will be collected (e.g., age, gender, race, citizenship, height, weight,
cancer diagnosis and treatment, occupation, military and marital status, and level of schooling).
The mapping and electronic version of recruitment responses and associated ID number will be
stored on a restricted-access drive located behind a firewall in the Westat company and will be
accessible only to those working on the study. Recruitment information will be destroyed within
two weeks of completion of the final report covering the focus group.
The data collection is covered by NIH Privacy Act Systems of Record 09-25-0156, “Records of
Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public
Health Service, HHS/PHS/NIH/OD”.
If you have any questions, please contact my office at (301) 496-2832.

Karen M. Plá
Attachment

File Type	application/pdf
File Title	Microsoft Word - #6_Justif Memo and Attach 6B 6C 6E_6F_HINTS_rev.doc
Author	Marshall_C
File Modified	2011-01-13
File Created	2011-01-12