HMTS Form - Sepsus R2 Testing with HCP

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

Sepsis Campaign Development: Round 2 Concept/Materials Testing with Healthcare Providers

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

Healthcare professionals registered with an on-line panel provider and living in the following states or
district: GA, LA, MS, TN, Washington DC, NY, NJ, MO, IL or NV. Respondents will be recruited using
an on-line panel from these states.
Respondent characteristics:
Number of subject: 420

Number of males:

210

Age range: 18 and older

Number of females: 210

Racial/ethnic composition: Mix of ethnic and racial backgrounds
Special group status: (e.g., risk group, health care providers)
Type of group(s): Healthcare Professionals
Geographic location(s): The following locations in the United States: GA, LA, MS, TN,
Washington DC, NY, NJ, MO, IL, NV.
3. Incentives: (State what incentive will be offered and justify proposed incentives to be used in study.)

For the R2 research, we are requesting approval for incentives that will be point equivalent to $55 for all
HCPs. Points will be provided by the online panel provider and will be redeemable online or at a retailer.
These incentives are different from those used in R1 because, unlike R1 which involved conduct of online
in-depth interviews, in R2 we will conduct a 30 minute online survey. Please see the attached incentive
justification.

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

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

(CATI used: yes or no): No

Other (describe): Online (or Web-based) survey

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

CDC requests OMB approval to collect information related to development of the sepsis awareness
building campaign. Information collected will inform revisions to draft campaign materials (developed
based on Round 1 formative research) and help ensure that the national campaign meets the needs of
intended target audiences.

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.)
Each year in the U.S., more than a million people are infected with sepsis and it is estimated that 28-50%
of those infected die each year from sepsis. The sepsis campaign provides information to raise knowledge
and awareness about the threat of sepsis. Because campaign launch is scheduled for fall of 2017, it is
critical to rapidly test initial campaign concepts and materials to ensure that they resonate with target
audiences prior to the campaign launch.

8. Number of burden hours requested: 56

BURDEN HOURS
Category of Respondent

No. of
Participation
Respondents Time

Burden

Healthcare Providers - Screener

420

5/60

35 hours

Healthcare Providers - Online survey

42

30/60

21 hours

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

462

56 hours

No

If yes, please list the item number(s) for questions used from the question bank separated by a comma.
(e.g., 1a, 3c, 130d)

*** Items below to be completed by Office of Associate Director for Communication (OADC)***
1. Number of burden hours remaining in current year's allocation:
2. OADC confirmation of time-sensitivity:
Yes:
No:

Project Officer
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