HTMS Review Form

HMTSExpeditedReviewForm_Asthma Control Communication Materials Field Testing.pdf

CDC and ATSDR Health Message Testing System

HTMS 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)

Asthma Control Communication Materials Field Testing

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

Focus groups with adolescents (ages 12 to 18) who suffer from asthma and their caregivers will be
conducted in four locations. Participants will be selected and recruited using screening criteria as outlined
in the screener questionnaire.
Respondent characteristics:
Number of subject: 64

Number of males:

32

Age range: ages 12 and older

Number of females: 32

Racial/ethnic composition: mixed
Special group status: (e.g., risk group, health care providers)
Type of group(s): Adolescents age 12-18 affected by asthma and caregivers if
adolescents with asthma
Geographic location(s): Birmingham, AL; Raleigh, NC; Baltimore, MD; Atlanta, GA

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

Focus groups: $75 for caregivers and $45 for adolescents plus $30 for caregivers to cover transportation of
the adolescent to the focus group facility. Incentives must be high enough to equalize the burden placed
on respondents in respect to their time and cost of participation, as well as provide enough incentive to
participate in the study rather than another activity (Russell, 2000). The target population is unique and
include youth disparately affected by asthma and caregivers of youth disparately affected by asthma.

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 goal of the focus groups is to gauge audience reactions to messages and communication materials
related to adolescents’ asthma self-management. This information will be used to further develop and
refine communication materials for outreach.

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.)
The study looks into how educational approaches and materials can be improved in addressing the practice
of asthma self-management among children. Current practice in this area is inadequate, suggesting
existing materials and approaches bear improvement.

8. Number of burden hours requested: 128

BURDEN HOURS
Category of Respondent

No. of
Participation
Respondents Time

Burden

Adolescents and caregivers screened

384

5/60

32

Adolescents and caregivers focus group participants

64

90/60

96

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

128

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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