Amazing Me OMB_11-9-12_Final_rev

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-0919)

TITLE OF INFORMATION COLLECTION:

Exploration of Distribution and Reach of Educational Children’s Book Amazing Me- It’s Busy Being 3! In Pediatric Office Settings

PURPOSE:

As part of CDC’s “Learn the Signs. Act Early” campaign, CDC has developed a children’s book entitled Amazing Me- It’s Busy Being 3! Though Amazing Me is a children’s book, the primary target audience is parents of 3-year-old children. Throughout the story, “milestone moments,” located at the bottom of the pages, teach parents about the connection between Joey’s actions (e.g., Joey dresses up as a king) and developmental milestones (e.g., Joey plays make-believe). The book’s appendix includes a 3-year-old milestone checklist for parents, parenting tips, and warning signs of potential developmental delay. Amazing Me is intended to be read out loud by the parent to their child.

Through a partnership with Reach out and Read (ROR), this past Spring 250 of ROR’s largest pediatric clinics each received 300 copies of Amazing Me for distribution to parents of 3-year-old children. ROR is a nonprofit organization that promotes early literacy and school readiness in pediatric exam rooms. ROR provides children’s books to families through their network of pediatric practices, including low-income families. In participating ROR practices, parents receive a new book during each well-child visit from 6 months to 5 years of age, and health care providers often couple the book giveaway with advice for parents about reading to young children.

To determine the success of working with ROR to distribute Amazing Me to parents, a brief online survey will be conducted with clinic administrators from each of the 250 ROR pediatric offices. The survey will document the number of books received and distributed and assess the process that clinics used to disseminate these books to parents of 3-year-olds. The survey will also gather feedback from the clinics about their experiences distributing Amazing Me books.

DESCRIPTION OF RESPONDENTS:

Online survey respondents (N=250) will be clinic administrators at each of the ROR clinics who received the Amazing Me books.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [X ] Other: web survey

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Katie Green, [email protected]

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X ] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ X ] Yes [ ] No

We plan to offer survey respondents a chance to win 50 popular children’s board books for their clinic for completing the web survey. Three winners will be selected for the initial survey. The initial web survey will be kept open for a total of 3 weeks. During the second and final weeks of the initial survey, reminder emails (along with a link to the survey) will be sent to administrators who have not completed the survey, encouraging them to do so to be eligible to enter the drawing to receive 50 board books for their clinic.

Follow-up surveys will be conducted with clinics that have 50 or more Amazing Me books that have not yet been distributed to families at the time of the initial survey. Each follow-up survey will be kept open for a total of 2 weeks. Clinic administrators who complete each follow-up survey will be entered in a drawing to receive 50 board books for their clinic.  Our partners at ROR have indicated that most clinics have distributed their full supply of books. Thus, we anticipate having to conduct very few follow-up surveys. Table 1 provides a breakdown of the incentive plan for the initial survey and each follow-up. A total of five drawings will be held.

Table 1: Incentives for each survey administration.

	Initial Survey			Follow-up Survey (clinics with >50 books left)
	Week 1 (N=250)	Reminder, Week 2 (N<250)	Reminder, Week 3 (N<250)	Follow-up 1 (6 weeks after initial survey) (N <250)	Follow-up 2 (6 weeks after follow-up 1) (N <250)
Incentive for survey completion	Drawing for 50 books (3 winners selected)
Incentive for survey completion				Drawing for 50 books (1 winner selected)	Drawing for 50 books (1 winner selected)

We have learned that a drawing for children’s board books is an appropriate and effective incentive for our target respondents for several reasons. First, although Reach Out and Read provides substantial support to participating clinics, many clinics must rely on cash or used book donations to maintain their supply of books to distribute to families. Given the fact that ROR clinics often serve a significant number of low income families, many clinics face challenges obtaining needed books. Thus, according to ROR administrators, board books should draw significant support for the web survey among clinics. Second, according to the literature, prize drawings have been shown to be an effective means to incentivize participation in a web survey. One study that tested various incentive options for response to a web survey among 1,332 members of a professional organization found that prize drawings significantly increased the willingness to participate, as well as the number of individuals initiating the survey. Prize drawings also increased actual participation (completion rates) and tended to reduce the number of incompletes compared to prepaid, promised, or no incentives.¹ In light of these findings, along with the feedback provided by ROR, we plan to offer respondents who complete the web survey an opportunity to enter a drawing to win 50 popular children’s board books from ROR. Clinics can distribute these books to their pediatric patients.

We would also like to point out that when compared to other incentive options for the proposed web survey, we believe using a non-monetary prize drawing is the most cost-effective approach. According to ROR, each board book costs $2 and each shipment of 50 books costs $25. Since we plan to conduct a total of 5 drawings over the course of all surveys (initial and follow-ups) for 50 board books each, the total value of each incentive is $100. The total cost to provide all five incentives is $625, including shipping costs. A cash incentive based on hourly wages and burden, however, would cost much more. The respondents selected for the web survey are ROR clinic administrators. According to the Bureau of Labor statistics, for employees of this type, (i.e., health service managers), the 2012 hourly wage is $40.52.² If we offered a cash incentive (based on the hourly wage for ROR clinic administrators and the 7 minutes required to complete the planned survey) each respondent would receive approximately $5. ³ Without accounting for any follow-up surveys, the total cost for monetary incentives would cost this project at least $1,250 (i.e., $5 x 250 respondents). Thus, we believe that the drawings for children’s board books presents substantial cost savings, without compromising response rates. Additional rationale for the raffle includes not wanting to conflate the impact of consistent incentives with the distribution of books through ROR thereby creating an artificial outcome that can not be replicated in a community clinical practice setting.

BURDEN HOURS

Category of Respondent

Through CDC’s partnership with ROR, the sample of 250 ROR clinics has been pre-selected. Surveys will be emailed directly to clinic administrators at each practice and no personally identifiable information will be collected from these participants. This is a targeted, pre-determined sample therefore there are no burden hours for screening. The respondents will be members of the private sector.

Web Survey Participation

There are two sections to the web survey; both have both been tested to assess how long each section takes to complete⁴. The first section of the survey will ask questions about the distribution and reach of the books (i.e., “tracking”) and will take approximately 2 minutes to complete. Each clinic administrator will complete this section of the survey initially and then at up to two follow-ups or until they indicate that they have less than 50 books remaining. We anticipate that by the time of the survey administration, the majority of clinics (~80%) will have already depleted their supply and therefore will only respond to the tracking questions once. Based on feedback from ROR, we anticipate that the number of clinics taking each follow-up survey will continue to decline.

The second section of the survey focuses on the clinics’ experiences distributing the Amazing Me books and will take approximately 5 minutes to complete. This set of “book experience” questions will only be asked once for each clinic--at the point at which they indicate that they have either depleted their supply of books or have 50 books or less remaining (see Question 4 in the attached Word version of the survey instrument.)

Timings for the book distribution or “tracking” questions as well as the “book experience” questions have been rounded to the nearest hour.

Therefore, for the book distribution or “tracking” questions:

250 clinics x 2 minutes (Initial survey) = 500 minutes /60 minutes = 8 hours

Of the 250 clinics that completed the initial survey, 50 will go on to take the survey again, as a follow-up, because they indicated that they have books remaining.

50 clinics x 2 minutes (Initial survey, follow-up 1) = 100 minutes /60 minutes = 2 hours

Of the 50 clinics that completed Follow-up 1, 25 will go on to take the survey again, as a second follow-up.

25 clinics x 2 minutes (Initial survey, follow-up 2) = 50 minutes /60 minutes = 1 hour

For the “book experience” questions (asked of all respondents):

250 clinics x 5 minutes = 1,250 minutes /60 minutes = 21 hours

Total estimated burden hours for the tracking questions, each follow-up, and the book experience questions = 8 hours + 2 hours + 1 hours + 21 hours = 32 hours total burden for participants.

Table 2: Respondent Burden

Respondent Type	Instrument	Number of Respondents	Number of Responses Per Respondent	Burden per Respondent	Burden
Clinic administrators	Book Tracking Questions (Initial Survey)	250	1	2/60	8
	Follow-up 1	50	1	2/60	2
	Follow-up 2	25	1	2/60	1
	Book Experience Questions	250	1	5/60	21
TOTAL					32

FEDERAL COST: The estimated annual cost to the Federal government is $49,047.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X ] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

The target population for this project has been pre-determined. CDC has partnered with ROR to disseminate books to 250 of the largest ROR clinics in the country. The selected clinics received the shipment of Amazing Me books in April, 2012 and have been disseminating them to parents of 3-year-olds during well child visits ever since. Therefore, our universe of potential participants is limited to these 250 largest ROR clinics. Surveys will be attempted with all 250 clinics and no personally identifiable information will be collected. Surveys will be conducted with each clinic every 6 weeks or until they indicate they have 50 or fewer books remaining (up to two follow-ups). However, based on feedback gathered from ROR administrators, we anticipate that most clinics have depleted their supply of books and will only be asked to complete the survey once. ROR has graciously agreed to introduce the research effort to clinics in the form of an email. This will hopefully increase clinic cooperation with completing the survey.

We do not intend to conduct a rigorous statistical analysis with the results from this survey, as we do not have a representative sample. Since we are only surveying the largest ROR clinics, we will be limited in what we can say about the survey results since the data will not be generalizable. As such, we plan to provide descriptive statistics illustrating survey findings, such as a summary of responses to each survey question (e.g., measures of central tendency, range of data, etc.); this will be provided in a final report. Qualitative analyses will be conducted on all open-ended responses to identify both patterns in responses as well as outlier opinions. Findings will be used to inform future book distribution activities and guide future partnership activities between CDC, ROR, and similar organizations with shared interests.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [X ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

1 Bosnjak, M, Tuten, T. (2003). Prepaid and Promised Incentives in Web Surveys: an experiment. Social Science Computer Review, 21(2), 208-217.

2²Bureau of Labor Statistics, Occupational Outlook Handbook, Medical and Health Services Managers, http://www.bls.gov/ooh/Management/Medical-and-health-services-managers.htm (September 2012)

3 Actual calculation $4.72 rounded up to $5.

4 Please note that due to skip patterns, the question numbers for each survey item in the screenshot document do not match the numbering found in the Word version of the survey.  The question numbers will changed based on how respondents answer each question as they may skip ahead to other questions.

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