HMTS Expedited Review Form 120312

Health Message Testing System Expedited Review Form
1. Title of Study: (Please append screener and questionnaire)

Dissemination of Occupational Safety and Health Materials through Mexican Consulates

2. Study Population: (Discuss study population and explain how they will be selected/recruited.)

Adult Latino immigrant workers visiting the Mexican consulate. Individuals will be approached as they
leave the consulate. Please see Attachments A, B and C for additional details.

Respondent characteristics:
Number of subject: 400

Number of males:

200

Age range: 18 and older

Number of females: 200

Racial/ethnic composition: Hispanic or Latino
Special group status: (e.g., risk group, health care providers)
Type of group(s): Immigrants
Geographic location(s): Atlanta and Los Angeles

3. Incentives: (State what incentive will be offered and justify proposed incentives to be used in study.)

No incentive will be offered.

4. Study method: (Please check one below)
Central location intercept interview:
Online Interview:
Telephone interview:
Other (describe):

Focus group:
Individual in-depth interview (cognitive interview):

(CATI used: yes or no):

5. Purpose of the overall communication effort into which this health message(s) will fit:
(Please provide 2-3 sentences below.)

The purpose of this pilot study is to develop, implement, and evaluate occupational safety and health
informational interventions tailored for Mexican immigrant workers and adapted to the mechanisms of
health information dissemination currently used by the Mexican Consular Network in the US.
See Attachments D and E for copies of data collection instrument regarding message, distribution channel
preferences and participant recall of the information materials. See Attachment F for copy of materials.
6. Category of time sensitivity: (Please check one below)
Health emergency:
Time-limited audience access:
Press coverage correction:
Time-limited congressional/administrative mandate:
Trend Tracking
Ineffective existing materials due to historical event/social trends:
7. Describe nature of time sensitivity: (Please provide 2-3 sentences below.)
This project is a collaboration between the NIOSH, the Mexican Foreign Ministry and the Mexican
consulates in Atlanta and Los Angeles. Ensuring the collaboration of the agencies involved has taken
much time and effort. All agencies currently have approval to move forward with the project. Delays
could result in loss of funding, support, and access to subjects if the project is perceived by the partner
agencies as not advancing at an acceptable pace.

8. Number of burden hours requested: 100

BURDEN HOURS
No. of
Participation
Respondents Time

Category of Respondent
Consulate clients

Totals
9. Are you using questions from the approved question bank?

Burden

400

15 minutes

100 hrs.

400

15 minutes

100 hrs.

Yes

If yes, please list the item number(s) for questions used from the question bank separated by a comma.
(e.g., 1a, 3c, 130d)
The following items come from HMTS Question Bank (OMB No. 0920-5072) dated February 2011:
1a, 2a, 10a, 11a, 13a.
*** Items below to be completed by Office of Associate Director for Communication (OADC)***
1. Number of burden hours remaining in current year's allocation: 6,113.5
2. OADC confirmation of time-sensitivity:
Yes:
No:

Sarah Lewis
Project Officer
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