Expedited Review Form

2 Sepsis Assessment R3 HMTS Expedited Review Form HCP ONLY 1 31 2018_FI....pdf

CDC and ATSDR Health Message Testing System

Expedited Review Form

OMB: 0920-0572

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

Sepsis Educational Awareness Message/Materials Assessment

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

Healthcare providers aged 18 and older registered with an online panel provider and living the United
States. Respondents will be recruited using an online panel.

Respondent characteristics:
Number of subject: 786

Number of males:

~50% of sample

Age range: Age 18 and older

Number of females: ~50% of sample

Racial/ethnic composition: Mix of racial and ethnic backgrounds
Special group status: (e.g., risk group, health care providers)
Type of group(s): Healthcare providers (HCPs)
Geographic location(s): The United States (specifically randomly selected states in the
US census regions 1, 2, 3 and 4).
3. Incentives: (State what incentive will be offered and justify proposed incentives to be used in study.)

Sepsis Educational Effort Message and Materials Testing Survey (SEMS) respondents will be individuals
registered with an online panel provider. Respondents will be offered survey choice “points” equal to $30.
Points are commonly provided to survey panel respondents who complete online surveys and can be
redeemed for prizes. Points will be given to respondents directly by the online panel provider. See
attachment for 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.)

The online survey to assess the "Get Ahead of Sepsis" Educational Effort will gather information to
understand target audiences’ knowledge, perceived effectiveness, perceived severity and susceptibility,
self and response efficacy and behavioral intentions related to exposure to sepsis messages/materials.
Survey results will be used to refine and modify sepsis messages/materials. The data collection is not
intended for program evaluation to assess the effectiveness/impact of the educational effort.
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 educational effort provides information to raise
knowledge and awareness about the threat of sepsis. It is critical to rapidly assess the efforts messages and
materials to ensure that they resonate with target audiences for updates and continued implementation.

8. Number of burden hours requested: 295

BURDEN HOURS
Category of Respondent

No. of
Participation
Respondents Time

Burden

Healthcare providers 18 and over unexposed (SEMS)

393

20/60

131

Healthcare providers 18 and over exposed (SEMS)

393

25/60

164

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

786

295

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
Print Form


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