Justification for Change

Colorectal Cancer Screening Survey

(OMB no. 0920-1023, approved 06/20/2014, exp. date 06/30/2015)

Justification for Non-Substantive Change

January 7, 2015

Summary

The currently approved information collection Colorectal Cancer Screening Survey consists of a single, online survey to measure preferences for colorectal cancer screening tests and experience with cancer screening. The respondents are part of the GfK Knowledge Networks online panel.

The estimated burden per response was based on limited pre-testing of the survey instrument. After collecting the first 300 responses, the data revealed that respondents required more time to complete the survey than originally estimated. Hence, the Centers for Disease Control and Prevention (CDC) is requesting OMB approval for revisions to our survey instruments to remove selected survey questions and reduce the burden of the survey instrument to the approved burden level. Reducing the burden is expected to improve the response rate and improve data quality.

The specific instrument revisions are outlined in Table 1, which includes details on currently-approved wording and the justification for the specific change. In order to launch our survey in a timely fashion, CDC respectfully requests approval of these revisions as soon as possible.

Justification for Change

During the initial launch of the survey, data indicated that the survey required more time to complete than initially estimated. We propose to eliminate questions 10, 42, 52, 59, 62, and 65 through 72. These questions are not central to the research goals of the survey and were originally included only to provide a more detailed characterization of the sample. Based on the timing data from the initial launch, eliminating these questions will reduce respondent burden to the original estimate.

Effect of Proposed Change on Burden Estimate

None. The changes will bring the survey into line with the originally approved burden estimates.

Effect of Proposed Changes on Currently Approved Instruments and Attachments

The survey instrument will be revised to eliminate questions 10, 42, 52, 59, 62, and 65 through 72. The following files will be replaced:

Information Collection	Delete File	Add/Substitute Revised File
Colorectal Cancer Screening Survey	Attachment 2. Overview of Survey and Screen Shots.docx	Attachment 2. Overview of Survey and Screen Shots REV.docx

Table 1. Changes to Survey Instrument

Item	Currently Approved	Change Type	Justification
Q10	Have you ever had a medical test that required you to follow a special diet or fast (not eat) for several hours before the test?	Delete	Reduce burden of survey to original estimate.
Q42	In the last 12 months, has a doctor or other health professional recommended that you get a test for colorectal cancer?	Delete	Reduce burden of survey to original estimate.
Q52	How did you learn about the screening test you had for colorectal cancer or who recommended it? Check all that apply.	Delete	Reduce burden of survey to original estimate.
Q59	Before today, had you ever heard of a colonoscopy?	Delete	Reduce burden of survey to original estimate.
Q62	Has a family member or close friend ever had a colorectal cancer screening test, such as a stool test like an FOBT, a flexible sigmoidoscopy, or a colonoscopy?	Delete	Reduce burden of survey to original estimate.
Q65	Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?	Delete	Reduce burden of survey to original estimate.
Q66	Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?	Delete	Reduce burden of survey to original estimate.
Q67	During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?	Delete	Reduce burden of survey to original estimate.
Q68	Is there a place that you usually go to when you are sick or need advice about your health?	Delete	Reduce burden of survey to original estimate.
Q69	What kind of place is it - a clinic, doctor's office, emergency room, or some other place?	Delete	Reduce burden of survey to original estimate.
Q70	What kind of place do you go to most often - a clinic, doctor's office, emergency room, or some other place?	Delete	Reduce burden of survey to original estimate.
Q71	Is [IF ANSWERED Q70 ITEMS 1-5, INSERT “that ‘ITEM SELECTED IN Q70’ ”] [IF Q70=7, INSERT, ‘that’][IF ANSWERED Q69 ITEMS 1-5 INSERT ITEM SELECTED IN Q69][ IF ONLY SELECTED Q69=6, INSERT, ‘that’] the same place you usually go when you need routine or preventive care, such as a physical examination or check up?	Delete	Reduce burden of survey to original estimate.
Q72	What kind of place do you usually go to when you need routine or preventive care, such as a physical examination or check-up?	Delete	Reduce burden of survey to original estimate.

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