#10 Justif Memo HINTS Pilot & Attach A_C_D_F

Office of Management and Budget (OMB)

Page 7

Date: February 2, 2011

To: Office of Management and Budget (OMB)

Through: Seleda Perryman, Report Clearance Officer, HHS

Mikia Currie, Program Analyst, OPERA, NIH

Vivian Horovitch-Kelley, OMB Project Clearance Liaison, OMAA, NCI

From: Bradford Hesse, Project Officer,

Health Information National Trends Survey 4 (HINTS 4),

Division of Cancer Control and Population Sciences,

National Cancer Institute/NIH

Subject: Health Information National Trends Survey 4 (HINTS 4) Pilot Test

Generic Sub-study under “Questionnaire Cognitive Interviewing and

Pretesting,” OMB No. 0925-0589-10, Expiration Date 5/31/2011.

The National Cancer Institute’s (NCI) Division of Cancer Control and Population Sciences (DCCPS), Behavioral Research Program (BRP) proposes conducting formative research for the fourth iteration of the Health Information National Trends Survey (HINTS 4) (OMB No. 0925-0538). The purpose of the proposed project is to conduct a pilot test for the upcoming reinstated OMB submission of HINTS in May, 2011.

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 evidence-based recommendations for reducing the burden of cancer throughout the population. The HINTS program develops and disseminates 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-quality and timely data. Based on experimentally controlled methods research conducted as part of the previous round of HINTS, HINTS 4 will use an entirely mail-based data collection procedure that collects data in 4 cycles with 4 independent samples. In addition to switching to an entirely mail-based data collection, the content of the survey itself will not necessarily reflect the identical content as previously implemented in HINTS data collections. The goals of the pilot test are to: 1) conduct a methodological experiment comparing respondent selection options; 2) conduct a test of questionnaire variations; 3) determine how long respondents take to complete the questionnaire in order to more accurately estimate burden; and 4) test the operational procedures that will be used on HINTS.

Participants and Sampling. The participants in the pilot will be adults age 18+ who are members of the non-institutional population in the U.S.

The sample design for the HINTS 4 pilot test will consist of a single-stage stratified sample of addresses selected from a file of residential addresses based on the United States Postal Service (USPS) Computerized Delivery Sequence File (CDSF). The frame will cover addresses from all zip codes in the 50 states and the District of Columbia. Addresses in the frame will be grouped into three mutually exclusive strata: 1) high linguistically-isolated areas, 2) high-minority areas, and 3) in low-minority areas. A total of 1,000 addresses will be selected. The samples from each stratum will be selected independently and addresses within each stratum will be selected with equal probability.

The sample of 1,000 of addresses will be randomly divided into two or three treatment groups depending on the results of cognitive testing.¹ The treatment groups reflect different household selection procedures (see experimental design section below). In cognitive testing, we will ask respondents to provide their understanding of the instructions printed on the questionnaire indicating who in the household should complete the form. In one set of instructions, all eligible adults in the participating household will be asked to complete a questionnaire, in the other two groups, the instructions will select one adult within the participating household to complete the form using either a probability based procedure (next birthday method), or a quasi-probability based procedure (Hagan-Collier method). If both alternatives to the “all adult” method work equally well in the lab, we will evaluate all three in the pilot test. However, if respondents demonstrate a clearly superior understanding of one of the alternatives to the “all adult” method, we will only include that method plus the “all adult” method in the pilot.

The table below shows the sample sizes for each treatment group by sampling strata, assuming three treatment groups. The sample sizes were determined to yield 100 completed adult interviews for each treatment group as well as provide sufficient number of participating Hispanic households to test the procedures related to the Spanish questionnaires (see data collection procedures below).

In the sample size table, there are two columns of sample sizes for each treatment group. The first column gives the number of addresses to sample, and the second column gives the expected number of completed adult interviews. The number of expected completed interviews is based on the assumption of overall response rate of 30 percent and a vacancy/nonresidential rate of 10 percent. Additionally, in treatment group one, we assume that each participating household in the high linguistically isolated areas and the high minority areas will have 1.3 participating adults, and participating households in the low minority areas will have 1.4 participating adults. These numbers are based on HINTS 3 results. In treatment group two, we assumed only one completed interview per household since we are only selecting one adult in a participating household to participate.

	Treatment Group 1: Take All Adults		Treatment Group 2: Next Birthday Adult		Treatment Group 3: Hagan - Collier		Total from All Treatment Groups
Stratum	sampled addresses	completed interviews	sampled addresses	completed interviews	sampled addresses	completed interviews	sampled addresses	completed interviews
High linguistically isolated areas	40	14	50	14	50	14	140	42
High minority areas	130	46	170	46	170	46	470	138
Low minority areas	100	40	145	40	145	40	390	120
Total	270	100	365	100	365	100	1,000	300

For the telephone follow-up as described in the data collection procedures section, the sample of addresses will be reverse-matched to landline telephone directories; we expect to obtain name and telephone numbers for about 60 percent of addresses through the reverse matching process. (This match rate is based on the Westat’s experience on other projects, including the 2009 National Household Education Surveys Program.)

Additionally, the sample of addresses with names obtained from landline telephone directories will be matched to a Hispanic surname file. Addresses that match to this file along with addresses from the high linguistically isolated areas are eligible for a Spanish questionnaire, as described in the data collection procedures below. We expect about 17.3 percent of the names in the high linguistically isolated and the high minority strata and only about 2.7 percent of names in the low minority strata to match this file. These match rates are based on Westat’s most recent experience using the Hispanic surname file.

Embedded Experiments.

Respondent Selection. Three different respondent selection methods will be tested during the pilot test:

1. All Adult Method. This respondent selection procedure asks all adults in the household to fill out a survey. This is the method that was used on HINTS 3 (OMB No. 0925-0538, Expiry Date 3/30/2009).

2. Next Birthday method. This method asks that the adult in the household that has the next birthday fill out the questionnaire.

3. Hagan-Collier Method. This method randomly allocates the selection of specific age-gender populations. In two of seven households, the youngest male is requested. In two of seven, the youngest female is requested. In two of seven the oldest male is requested and in one of seven, the oldest female is requested. If there is no eligible person of the proscribed gender, the opposite gender is selected in the same age group.

The objective of this experiment is to identify whether response rates differ by the respondent selection method, and more importantly whether one of the methods results in a responding population more accurately representative of the US adult population. Previous research suggests that the “all adult” method yields a more representative respondent population than the next birthday method or a self-selection method, but a slightly lower response rate. In addition, data collection costs are slightly higher with the all adult method. Thus this test will identify if either of the alternative respondent selection methods do equally as well for less cost. Attachment A shows the language proposed for each alternative selection procedure.

Questionnaire alternatives. Two different versions of the questionnaire will be compared. The versions use alternative forms of several questions in the questionnaire. Attachment B shows the instrument and identifies questions which will be different between the two versions². The question alternative experiment will be fully crossed with the respondent selection method experiment, so that each respondent selection treatment group will send one version of the questionnaire to a random half the sampled addresses, and the other version to the remaining addresses. Since one of the main objectives of HINTS is to provide trends for many of their measures across time, the pilot provides the opportunity to evaluate wording changes and the impact on estimates and trends in order to inform the final wording for the production survey.

Data Collection Procedures. Each sampled address will be eligible for at least four contacts:

1. The first contact will be a pre-notification letter that is mailed first class to each sampled address.

2. Approximately one week after the pre-notification letter, the survey request will be mailed to the respondent. This packet will include a cover letter and the paper survey(s). Those households using the all adult method of respondent selection will have two questionnaires. Those using the Birthday and H-C method will have one questionnaire. This mailing will include a $2 incentive. The use of an incentive repeats the methodology used on HINTS 3, which found the $2 incentive to significantly increase the response to the questionnaire.

3. If no response is received from anyone in the household after one week, a thank-you/reminder postcard will be sent.

4. If no response is received two weeks later, Westat will mail a second survey packet using an express mail carrier. As with the incentive, HINTS 3 found that using an express carrier significantly improved the response rate.

All of the mailings in the base methodology use the English versions of the contact letters and questionnaires. These materials include an 800 number that Spanish speakers can call to get a Spanish version of the questionnaire. See Attachment C for the English contact materials³.

Additional contact for All Adult selection group. As the surveys from the all-adult methodology are receipted, the household enumeration will be scanned. If it is found that not all eligible members of the household returned a questionnaire, a follow-up mailing will be done which targets the non-responding member. The targeting will be based on the age-gender information that is collected from the roster from the responding member’s questionnaire. See Attachment D for the cover letter to be included with this mailing.

Additional contact for probably Hispanic households. Non-responding households in the linguistically isolated stratum, and those with a Hispanic surname match in the other stratum will receive a third questionnaire mailing package consisting of all Spanish materials⁴.

Follow-up Debriefings. A small subsample of 20 responding households across treatment groups and for whom we have a phone number will receive a follow-up telephone debriefing contact. Project staff will conduct the interview using a qualitative protocol (see Attachment E) to assess how the contact materials and respondent selection methods worked.

Schedule. The table below provides the timeline of the mailing for the pilot survey. We estimate the entire procedure will take approximately ten weeks. The follow-up mailings for within household non-response in the “all adult” respondent selection treatment group will occur throughout the field period, starting in week 3. This marks the first point that households are followed up based on not receiving a questionnaire. This will continue through the second mailing. For the Spanish material, the procedure will wait until there is no response two weeks after the second mailing (week 7). Processing will continue through week 11.

Because of time constraints, this schedule is abbreviated from what will occur in the main HINTS 4 data collection.

Survey Stage	Begin
Pre-notification Letter	Week 1
Survey Request	Week 2
Thank-you/Reminder Postcard	Week 3
2nd Survey Request	Week 5
Follow-up for Within HH Non-response	Week 3 to Week 7
Follow-up for Spanish Questionnaire	Week 7 to Week 10
Debriefing interviews	Week 5 to Week 11
Close out Study	Week 11

Data Analysis. Data from the Pilot will be analyzed to address operational and survey design questions. The questions and analyses include:

1. How well do survey operations work? There are several new procedures that are being implemented relative to HINTS 3, including within-household non-response follow-up and mailing of Spanish questionnaires. Issues associated with these different follow-up mailings will be reviewed and suggestions for revised procedures will be recommended.

2. How much did the within-household non-response follow-up increase response rates in the all-adult method? Response rates before and after the follow-up will be computed and used to assess whether this procedure significantly increased response rates, especially for under-enumerated groups (e.g., young people; males).

3. What is return rate of completed Spanish questionnaires? We will examine the total number of completed Spanish questionnaires returned, as well as the source of the returns (phone-in requests; linguistically isolated areas; Spanish surname matches).

4. Which respondent selection method works best? This will involve analysis along several different areas including: 1) Comparison of response rates, 2) comparison of demographic distributions (e.g., age, gender, race), 3) review of the accuracy of each method using debriefing data and the household roster, and 4) the cost of each method. We anticipate using the “all-adult” method for cycle 1 because of its success on HINTS 3. However, if one of the other two methods shows promise, we will suggest further experimentation as part of cycle 1 where it will be possible to include larger samples sizes.

5. Comparison of the alternative versions of the questions (or series of questions). The response distributions and missing data rates of the questions will be compared.

6. How long do respondents report that it takes them to fill out the questionnaire?

Other Considerations. The pilot test activities and materials outlined in this memo are under review by by Westat’s IRB and will be submitted to NCI’s IRB. Approval or exemption from both IRBs will be provided to OMB once received and prior to the initiation of any testing.

No personally identifying information (PII) will be retained for this submission, however PII wil be collected in the full HINTS questionnaire. The information collection has been reviewed by the NIH Privacy Act Officer and it was determined that the Privacy Act does apply to the HINTS pilot (see Attachment F).

Respondent Burden. The table below displays the burden estimate for this data collection effort. This effort will account for less than 8.5 percent of the total burden hours (1,800) granted in OMB No. 0925-0589.

Estimates of Hour Burden

Type of Respondents	Instrument	Maximum Number of Respondents	Frequency of Response	Estimated Time per Response	Annual Burden Hours
	Mail Questionnaire	300	1	30/60 (0.50)	150
	Debriefing Questions	20	1	10/60 (0.17)	3
Total		320			153

Thank you for your consideration of this proposed sub-study.

List of Attachments (included below)

A: Respondent selection options

C: Contact letters

D: All Adult Method follow-up letter

F: Privacy Act Letter

List of Attachments (in a separate file)

B: Questionnaire versions

E: Debriefing Protocol

Respondent Selection Version 1: All-Adult Method

STATEMENT OF CONFIDENTIALITY

Collection of this information is authorized by The Public Health Service Act, Sections 411 (42 USC 285 a) and 412 (42 USC 285a-1.a and 285a1.3). Rights of study participants are protected by The Privacy Act of 1974. Participation is voluntary, and there are no penalties for not participating or withdrawing from the study at any time. Refusal to participate will not affect your benefits in any way. The information collected in 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. Identifying information will be destroyed when the project ends.

NOTIFICATION TO RESPONDENT OF ESTIMATED BURDEN

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0589-09). Do not return the completed form to this address.

START HERE:

• How many adults age 18 or older live in this household?

• Each adult (age 18 or older) living in your household should fill out one questionnaire. Please be sure that each adult has an opportunity to fill out a questionnaire. This is very important to the success of the study.

• If more questionnaires are needed, please call 1-888-xxx-xxxx

• If you would like Spanish questionnaires, please call 1-888-xxx-xxxx

• Not all questions will apply to you – sometimes you will see instructions following your answer to a question that direct you to skip to a question farther in the questionnaire.

Respondent Selection Version 2: Next Birthday Method

STATEMENT OF CONFIDENTIALITY

Collection of this information is authorized by The Public Health Service Act, Sections 411 (42 USC 285 a) and 412 (42 USC 285a-1.a and 285a1.3). Rights of study participants are protected by The Privacy Act of 1974. Participation is voluntary, and there are no penalties for not participating or withdrawing from the study at any time. Refusal to participate will not affect your benefits in any way. The information collected in 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. Identifying information will be destroyed when the project ends.

NOTIFICATION TO RESPONDENT OF ESTIMATED BURDEN

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0589-09). Do not return the completed form to this address.

START HERE:

• How many adults age 18 or older live in this household?

WHO SHOULD COMPLETE THIS QUESTIONNAIRE:

• If more than one adult lives here, then the adult with the next birthday should complete this questionnaire. If only one adult lives here, then that adult should complete this questionnaire.

• Please write the first name, nickname or initials of the adult with the next birthday. This is the person who should complete this questionnaire.

First name, nickname or initials

• If more questionnaires are needed, please call 1-888-xxx-xxxx

• If you would like Spanish questionnaires, please call 1-888-xxx-xxxx

• Not all questions will apply to you – sometimes you will see instructions following your answer to a question that direct you to skip to a question farther in the questionnaire.

Respondent Selection Version 3: Hagan-Collier Method

STATEMENT OF CONFIDENTIALITY

Collection of this information is authorized by The Public Health Service Act, Sections 411 (42 USC 285 a) and 412 (42 USC 285a-1.a and 285a1.3). Rights of study participants are protected by The Privacy Act of 1974. Participation is voluntary, and there are no penalties for not participating or withdrawing from the study at any time. Refusal to participate will not affect your benefits in any way. The information collected in 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. Identifying information will be destroyed when the project ends.

NOTIFICATION TO RESPONDENT OF ESTIMATED BURDEN

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0589-09). Do not return the completed form to this address.

START HERE:

• How many adults age 18 or older live in this household?

• In order for the study to accurately represent all adults in America, we are asking households to have the person fitting the rule shown below complete this questionnaire. Following this rule is very important to the success of the study. Thank you for your cooperation.”

WHO SHOULD COMPLETE THIS QUESTIONNAIRE: (only one will display per questionnaire)

• The oldest adult male in the household should complete this questionnaire.  If no males live here, then the oldest adult female in the household should complete this questionnaire.

• The oldest adult female in the household should complete this questionnaire.  If no females live here, then the oldest adult male in the household should complete this questionnaire.

• The youngest adult male in the household should complete this questionnaire.  If no males live here, then the youngest adult female in the household should complete this questionnaire.

• The youngest adult female in the household should complete this questionnaire.  If no females live here, then the youngest adult male in the household should complete this questionnaire.

• Please write the first name, nickname or initials of the (oldest/youngest) adult (male/female) living here. This is the person who should complete this questionnaire. (This language will match the rule used.)

First name, nickname or initials

• If more questionnaires are needed, please call 1-888-xxx-xxxx

• If you would like Spanish questionnaires, please call 1-888-xxx-xxxx

• Not all questions will apply to you – sometimes you will see instructions following your answer to a question that direct you to skip to a question farther in the questionnaire.

Prenotification Letter

(on HHS letterhead)

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.

In the next week, you will receive a package from the Department of Health and Human Services containing the HINTS questionnaire. By completing the 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. The package includes a $2 bill 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 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–xxx-xxxx.

S incerely,

B radford 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

hints.cancer.gov

Si prefiere recibir la encuesta en Español, por favor llame 1-888-xxx-xxxx.

The Health Information National Trends Survey is authorized under 42 USC, Section 285a

Frequently Asked Questions – will be included on the back of each letter

Some Frequently Asked Questions about the

Health Information National Trends Survey

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

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.

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

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.

Q: How did you get my address?

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

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

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.

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

A: Yes, your answers will be kept private under the Privacy Act. 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.

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

A: About 20 to 30 minutes.

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

A: 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 XXXX-XXXX.

Q: 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.

Coverletter (sent with 1^st mailing of questionnaire)

(on HHS letterhead)

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 prescription 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 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 hints.cancer.gov to find out more about HINTS, or call Westat toll-free at 1–888–xxx-xxxx.

Thank you in advance for your cooperation.

S incerely,

B radford 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

hints.cancer.gov

Si prefiere recibir la encuesta en Español, por favor llame 1-888-xxx-xxxx.

The Health Information National Trends Survey is authorized under 42 USC, Section 285a

Reminder/Thank You Postcard

A few days ago you should have received a packet of questionnaires for your household’s

participation in the Health Information National Trends Survey. It was sent to your address as

part of our effort to determine the best ways of communicating important health information to

all Americans.

We requested that each adult in the household complete a questionnaire. If you have already

returned the questionnaire(s) to us, please accept our sincere thanks. If any adult here has not

yet completed and returned a questionnaire, please do so as soon as possible.

Your participation is important to the study’s success.

S incerely,

B radford 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

hints.cancer.gov

Refusal Conversion Letter sent with 2^nd mailing of questionnaire

(on HHS letterhead)

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.

Westat, a research firm under contract with us, is administering the survey. Your answers will be kept private under the Privacy Act.

If you have any questions or would like to request additional questionnaires, please call Westat toll free at 1-888-xxx-xxxx.

S incerely,

B radford 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

hints.cancer.gov

Si prefiere recibir la encuesta en Español, por favor llame 1-888-xxx-xxxx.

The Health Information National Trends Survey is authorized under 42 USC, Section 285a

(on HHS letterhead)

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 received (one/two) completed questionnaires from your household. Thank you for returning those questionnaires.

The success of the survey depends on receiving a completed questionnaire from each adult 18 or older in the household. That is the best way to make sure our survey results reflect all adults in America. Since (two/three/four) adults age 18 or older live in your household, we’re writing to request that the adults who have not yet completed a questionnaire please do so in the next week.

According to the information provided on the completed questionnaires already returned, we still need a response from:

• Male/Female, age (xx)

• (additional as needed)

HINTS has interviewed over 10,000 people since 2003. This year, HINTS needs all the adults in your household to participate. 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. HINTS can then let the government know what people like you do when you need health care information

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 hints.cancer.gov to find out more about HINTS.

There are (one/two/three) questionnaires enclosed. If you or another adult completing one of these questionnaires has any questions, please call Westat toll free at 1-888-XXX-XXXX or go to hints.cancer.gov

S incerely,

B radford 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

hints.cancer.gov

Si prefiere recibir la encuesta en Español, por favor llame 1-888-XXX-XXXX.

The Health Information National Trends Survey is authorized under 42 USC, Section 285a

1 The three respondent selection variations included in Attachment A are being tested under generic OMB clearance #0952-0589-09 (approved February, 2011). For the pilot test, one variation may be eliminated, but no additional variation will be introduced beyond what is presented here. A final decision about respondent selection will be provided to OMB prior to the start of pilot data collection.

2 Some items on this instrument are being cognitively tested under generic clearance OMB No. 0925-0589-09 (approved February, 2011). It is anticipated some items included in Attachment B will be eliminated or slightly altered based on this testing. No additional items will be added. A final version of the pilot test instrument will be provided to OMB prior to the start of data collection.

3 The versions of cover letters in Attachment C are currently undergoing testing in focus groups under generic clearance 0925-0589-6, exp. 5/31/11. Final versions of the coverletters will be provided to OMB prior to data collection.

4 HINTS is using the TRAPD method of translation described in the generic clearance package 0925-0589-06, ex. 5/31/11. Because of the time intensive nature of this translation process, fully translated documents cannot be included in this application. Spanish versions can be provided to OMB prior to the start of data collection.

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